Healthcare Management
Chapter 14: Telemedicine
Telemedicine
The collection and communication of healthcare information over a distance via telecommunication and/or information systems from one site to another.
Telemedicine is not the same as the following terms and should not be used interchangeably:
telehealth
m-health
e-health
Telemedicine Services
Patient Consultation
Specialist Referral Service
Remote Patient Monitoring
Consumer Medical and Health Information and Social Media
Telenursing
Telepharmacy
Telerehabilitation
Emergency Telemedicine
Risk Management and Telemedicine
Many risks remain the same whether the patient is in the same room as the provider or at a distance
Adding to the risks are
Lack of study data on telemedicine
Variability of state regulations
Lack of significant case law
Lack of significant claims studies
Clinical Care Risks
Risks inherent to clinical specialty remain the same when utilizing telemedicine with the addition of
Patient non-compliance without the knowledge of the provider
Patient misinterpretation or inability to relate his condition to the provider
Inability of patient to recall or understand directions
Clinician misinterpretation of the data
Medication errors
Administrative Risks
Administration must evaluate the effectiveness and safety of telemedicine.
Is it adding to or detracting from the quality of care?
Is it increasing or decreasing morbidity and mortality?
Examples of Administrative Risks
Lack of appropriate operational policies
Lack of quality improvement, patient safety and risk management programs
Inconsistent or incomplete understanding of the patient-provider relationship
Integration of the telemedicine into the workflow
Appropriate communication and chain of command
Appropriate documentation
Adverse event notification
Technological Risks
Equipment and function do not meet the need
If equipment and function meet the need, performance does not
Derived data are or become corrupt or unlawfully shared
Consumer Medical and Health Information Services and Social Media Risks
Use of social media has increased the risk to health facilities:
Lack of case law for guidance
Potential HIPAA violations
Healthcare facility should develop a consumer health education and social media plan
Summary
Telemedicine is an expanding service with increased risk for the healthcare organization
As there are few evidence-based studies regarding effectiveness and no case law, risk managers must be vigilant and monitor their telemedicine services for potential risk to the organization