A recent study sought to evaluate direct-to-consumer (DTC) telemedicine, a continually emerging form of remote healthcare. They want to see how likely it is that this form of care could lead to medical malpractice liability. They suggest that those engaged in DTC telemedicine are conscious of the risk and are conducting lower-risk treatment using this method. DTC allows for remote medical treatment over the phone, computer, or smartphone. This form of practice has grown in recent years and now several million “visits” are conducted annually.
The leaders of this research were Alexander L. Fogel, MD, MBA, of the Yale University School of Medicine and Dr. Joseph Kvedar, of the Massachusetts General Hospital's Department of Dermatology. Telemedicine providers typically purchase malpractice insurance coverage separately for this form of treatment or have it added to their existing policy based on their circumstances. Some of the liability concerns have involved properly verifying the patient's identity, potentially substandard treatment, having limited access to prior medical history, and others.
Potential Criteria Evaluated
None of the 551 reported cases that the researchers looked at involved DTC treatment. They were unable to find any judgments, dismissals of cases, or any related legal activity. As this form of treatment becomes more common it is likely that incidents of malpractice will begin to emerge.
Less Risky Treatment
Limitations in the form of treatment provided seem to be the reason for the absence of malpractice claims. For example, a dermatologist is likely to treat a patient over the phone for acne; however, will not prescribe any medications that they view are potentially risky. The practitioners they studied did not prescribe controlled substances remotely. The question then is whether the scope and quality of care available through telemedicine is too limited.
Rise in Telemedicine
According to Hub International, an insurance broker, roughly 75% of patient visits can successfully be conducted via telemedicine. Through consultations, via telephone, the practitioner is generally able to make an assessment and prescribe medications when needed. It is largely a convenience that reduces barriers to care associated with transportation and may allow for more timely care. It is estimated that up to 7 million patients will have a visit via telemedicine in the coming year. It seems to be an option best suited for treating relatively minor conditions.
The American Telemedicine Association is a group that represents the industry. They have identified some clear federal legislative goals as follows:
- To gain full acceptance among managed care and reduce geographic problems that act as barriers
- Ensure that the standards and expectations for telehealth are consistent with care provided in-person
- That telehealth be encouraged as a potential solution to shortages of medical providers
- Establish an efficient means of handling payment for services rendered
- To provide patients with more options in the telehealth market and achieve mainstream acceptance and satisfaction
Telemedicine seems like a viable option for non-critical types of medical treatment. With the technology in the U.S. today there are minimal limitations. High-speed internet connectivity makes this option extremely feasible. These medical “visits” can allow for both voice and now visual interaction between the provider and the patient that should lead to increased acceptance.