Telemedicine involves providing health-related services and information through remote access, using technology like phone calls and video conferencing. Also called telehealth, it allows patients and clinicians to have remote contact, monitoring, and care. The use of telemedicine has been increasing and the COVID-19 outbreak will continue to increase the use of remote healthcare
Telehealth can provide needed services to people in remote areas, individuals with limited transportation options, or restricted access to care. Telemedicine can also be more convenient for busy patients who can get an appointment faster and without having to take a trip to the doctor's office.
Unfortunately, telemedicine that involves mistakes or improper treatment can result in serious injury or death to the patient. When telemedicine involves a medical mistake, the injury victim may have a claim for medical malpractice.
Telemedicine in Philadelphia
Telemedicine and telehealth are often used interchangeably. The U.S. Department of Health and Human Services describes telehealth as, “the use of electronic information and telecommunication technologies to extend care when you and the doctor aren't in the same place at the same time.”
How Telehealth Treatment is Communicated
There are a number of ways doctors, patients, hospitals, and nurses can communicate remotely to interact or monitor care. Some methods of telehealth include:
- Phone call
- Live video
- Emailing images or files
- Storing files for later access
- Remote monitoring through take-home medical devices
Some of the communication is done over standard lines like a phone call. Others use general communication like email. For internal use, healthcare-specific software programs are often used. A number of common programs and applications also enable real-time interactive communication, including:
- Facebook Messenger
- Google Hangouts
Types of Telemedicine Services
Telehealth can also involve a doctor or healthcare specialist reviewing records, images, or labs remotely. For example, a radiologist may be able to review a patient's X-ray on their home computer without having to be at the hospital. Some of the most common healthcare professionals who engage in telemedicine include:
- Emergency Physicians
Teleradiology is one of the most common uses of remote medical services and accounts for almost half of telemedicine use. Radiographic images, like X-rays, CT scans, and MRIs are accessible in another location. Using high-resolution scans, a radiologist is able to review multiple radiographic images from their office, home computer, or even from a hotel room while on vacation. There is also an increased use of using radiologists overseas in other countries, to help facilitate 24-hour care.
Telepharmacy delivers pharmaceutical care to patients remotely. Telepharmacy services include drug therapy monitoring, counseling, authorization for prescriptions, refills, and monitoring compliance. In some cases, telepharmacy can also dispense medications remotely.
Teleneurology involves the use of technology to provide neurologic care and treatment, including for stroke, Parkinson's disease, and epilepsy. Doctors can conduct virtual house calls, monitor the patient, do follow-up visits, review test results, and prescribe medications without having to see the patient one-on-one.
Telecardiology is one of the oldest forms of telemedicine. The inventor of the electrocardiograph (ECG) developed a way to transmit data from the hospital directly to the lab back in 1906. Transmitting ECGs and other heart test results allows doctors to review heart measurements and readings remotely to assess the patient. Cardiologists can also monitor patients with pacemakers, interpreting issues like arrhythmia remotely.
Telepsychiatry can use phone and video to help patients get access to psychiatric services. This includes diagnosis, counseling sessions, medication monitoring, and consultations with other medical professionals. Telepsychiatry is also able to help some patients who find it challenging to go to in-person meetings.
Telepathology allows pathologists to diagnose, counsel, and treat patients remotely. With video, images, or other electronic communication, a pathologist can provide a primary diagnosis when a local pathologist is not available. Telepathology also allows a pathologist to get a rapid second opinion remotely.
Teledermatology, like other remote medical care, allows dermatologists to diagnose skin diseases, provide consultations, and provide treatment options without contacting the patient. This can be a benefit for people suffering from skin conditions who cannot easily access a dermatologist.
Telegenetics can provide remote cancer services for patients, screening the individual's genes for the risk of cancer and counseling patients. Patients who may otherwise be unable to visit genetic specialists can have a counselor help determine if the patient or their family meets the criteria for genetic testing. Genetic specialists can also counsel families on Alzheimer's disease and treatment options.
Increased Use of Telemedicine
There has been an increased use of telemedicine for everything from routine counseling sessions to complex surgeries. As technology improves, more services may continue to be implemented through remote contact. There are a number of reasons for the increased use of Telemedicine in Pennsylvania and across the country, including:
- Increased access for patients
- Expanding treatment for limited specialists
- Reduced healthcare costs
- More regular preventative care
- Reduce spread of infection
However, telemedicine still has a number of problems. The most significant problem may be that the doctor cannot actually examine the patient. A phone or video call may not be able to convey the full picture of a physical examination. Technological problems can also impair the quality of the health services.
Telemedicine allows some doctors to “see” more patients but more patients may lead to more burnout and fatigue which can cause doctors to make a mistake. A telemedicine mistake can have real-world consequences for the patient.
Telemedicine During Coronavirus/COVID-19 and Beyond
The COVID-19/coronavirus has greatly impacted the use of telemedicine. With the virus spread through contact and through respiratory droplets, anyone in close proximity could be at risk of contracting the disease. Symptoms can take a couple of weeks to appear and many carriers are asymptomatic, leaving more vulnerable individuals at risk of contracting the disease from someone who appears to be fine.
A lot of the healthcare industry was mobilized to treat outbreaks of the illness. This left hospital staff short-handed to treat other issues. Individuals with routine medical needs were often kept away from the hospital. Stay-at-home orders in Pennsylvania and across the country also urged people not to go out unless necessary. Patients with COVID-19 symptoms could also have initial screenings done remotely before being directed to come in for a test.
Telemedicine will likely continue to be popular and increase in growth after COVID-19. State and federal laws have changed as a result of the pandemic to accommodate more remote treatment and the healthcare industry will likely want to see the expanded access continue.
Standard of Care for Telemedicine Medical Malpractice
Medical malpractice occurs when a doctor or other healthcare professional deviates from the accepted standard of care. The standard of care is based on whether the doctor used the skill, knowledge, experience, and care that another reasonable doctor would do in the same or similar conditions.
For example, an anesthesiologist is busy on his phone and not monitoring the patient. The patient suffers an injury because the doctor was not monitoring the vital signs. The anesthesiologist may have committed medical malpractice if another reasonable anesthesiologist, with similar experience and training would not have failed to monitor the vital signs under those conditions.
Telemedicine Standard of Care
There is not a specific standard of care for telemedicine. Healthcare professionals using telemedicine must provide the same type and level of care that any other reasonable healthcare professional with the same training and experience would provide under similar circumstances.
When Telemedicine Medical Malpractice May Occur
Telemedicine medical malpractice can occur in many of the same ways as standard health care. For example, a doctor who prescribes the wrong drug on the phone could also prescribe the wrong drug in an office visit. However, some areas of telemedicine medical malpractice may have special considerations.
Security Concerns and Data Breach of Personal Information
Medical care involves a lot of very personal and private information. Insurance companies and doctors generally need a lot of personally identifying information, like your name, address, phone number, date of birth, and Social Security Number. Your medical records may record a lot of personal information, including:
- Medical history,
- Sexual history,
- HIV status,
- Drug use, and
With more information exchanged online, there is a risk of data breaches or someone illegally accessing your medical information. The Department of Health & Human Services has reported multiple data breaches affecting healthcare offices.
A lot of the data breaches may involve identity thieves using your information for financial gain. However, others could access a patient's information in an attempt to extort or blackmail the victim. A stalker or domestic abuser may try and use the information to track someone down. Security problems and data breaches can create a serious risk to patients for harm.
Doctors prescribe medication for patients over the phone or through a video chat. However, there may be identity or privacy concerns about who is requesting the medication and what the medication is being used for. People seeking controlled substances like opioids could be able to request a prescription in someone else's name. Other doctors who are more interested in money could turn into online “pill mills,” diagnosing patients over the phone or online and prescribing dangerous medications.
Telemedicine prescriptions can also involve the same mistakes as in-person doctors involving prescription errors. Telehealth prescription errors could involve prescribing the wrong medication, wrong dose, wrong frequency, or wrong route. A telehealth doctor could also fail to document the prescription or changes in the prescription, repeat prescribing, fail to monitor progress, or prescribe a contraindicated drug.
When treating multiple patients over the phone or through video, doctors may not provide the same level of disclosure they would in an in-office visit. Patients need the information available in order to make an informed decision about their care. This includes the risks and benefits associated with the procedure. If a patient does not understand the risks then the patient cannot give informed consent for treatment. Lack of informed consent that results in injury or harm may be medical malpractice.
Filing a Medical Malpractice Claim After Telemedical Care in Philadelphia
There is a limited time to file a medical malpractice claim in Pennsylvania. For medical malpractice that occurred after March 2002, you may have up to 7 years from the date of the medical negligence to file a claim. If you wait too long to file a medical malpractice lawsuit in Pennsylvania, your claim may be denied.
Damages After Telemedicine Injury or Accident in Philadelphia
Damages in a medical malpractice lawsuit in Philadelphia are intended to compensate the victim for their losses. This includes both economic and non-economic losses. In some cases, punitive damages may be awarded to punish the wrongdoer. Damages in a medical malpractice claim can include:
- Medical expenses,
- Lost wages,
- Loss of income capacity,
- Continuing medical treatment,
- Medications and medical supplies,
- Pain and suffering,
- Loss of consortium,
- Loss of a limb,
- Permanent scarring, and
- Loss of enjoyment in life.
Fatal Telemedicine Accidents
When a medical mistake is made involving telemedicine, the surviving family members may be able to file a wrongful death claim to hold the doctors and hospitals responsible. A wrongful death lawsuit provides compensation for the decedent's beneficiaries. A wrongful death lawsuit may also help prevent similar accidents from happening in the future. Damages in a wrongful death claim can include:
- Funeral and burial expenses;
- Medical bills after the accident;
- Income the deceased would have provided; and
- Loss of support.
Like medical malpractice claims, there is a limited time to file a wrongful death lawsuit in the Commonwealth of Pennsylvania. Most wrongful death lawsuits must be filed within two years of death, or the claim may be denied. Talk to your Philadelphia medical accident attorney as soon as you can so you do not lose out on your claim.
Telemedicine Malpractice Lawyers in Philadelphia
If you suspect an error in the care you received over the phone, online, or through a video conference, you may be a victim of telemedicine medical malpractice. By contacting experienced Philadelphia medical malpractice lawyers Gilman & Bedigian, you will have someone on your side to investigate your case, identify any errors, and fight to get you compensation for your injuries.
At Gilman & Bedigian, we will use our experience, knowledge, and dedication to fight for you to receive the compensation you and your family deserve. Contact us online or call our law office at (800) 529-6162 for a free consultation.