Telemedicine offers healthcare services and information through remote access. Telemedicine uses technology, including video conferencing, telephone, email exchange, or other forms of communication between a patient and healthcare provider.
Some of the benefits of telehealth include greater access to care for people in remote locations, or services on short notice and during off-peak hours. However, there are some drawbacks with telemedicine, including lack of clear communication, overworked healthcare providers making mistakes, or difficulty accessing telemedicine for people who are tech-challenged.
When telehealth is to blame for a medical error, the injury victim may have a claim for medical malpractice. A telemedicine malpractice claim can help the patient recover damages for their injuries and losses.
Telemedicine and COVID-19
Telemedicine has been on the rise over recent years. However, the coronavirus/COVID-19 pandemic has had an immediate impact on the recent growth in teleservices. In one example, LifeBridge Health, one of the largest healthcare systems in Maryland, quickly implemented a tele-triage program to help reduce the pressure on the system's emergency departments with the rapid spread of the virus. LifeBridge Health's Virtual Hospital was established only a year before the pandemic.
When the program opened on March 11, the number of patients screened was 33. After a couple of days, more than 100 patients were using the program each day. After a few weeks, call volume increased to between 500 and 600 patients per day. Telescreening is a way to service many more patients compared to in-person service, reduces the risk of spread between patients and healthcare workers, and patients who meet the criteria can then be referred to a drive-thru test or follow-up care.
According to the Centers for Disease Control and Prevention (CDC), “healthcare systems have had to adjust the way they triage, evaluate, and care for patients using methods that do not rely on in-person services.” This primary purpose is to deliver care while reducing staff exposure, preserving personal protective equipment (PPE), and minimizing the impact of patient surges.
However, many of the telehealth changes are expected to remain in place, to some extent, beyond COVID-19. Telemedicine will likely become more common in many aspects of healthcare, including primary care, triage before hospital visits, and follow-up care.
Telemedicine in Baltimore
Maryland is home to a number of top hospitals, including Johns Hopkins Hospital and the University of Maryland Medical Center. These hospitals and healthcare systems have active telemedicine systems across multiple modalities. Modalities of telemedicine can be categorized as:
- Synchronous: Synchronous telehealth provinces real-time interaction and feedback, generally using a telephone or audio/video application with the computer, tablet, or smartphone. Real-time telemedicine can also involve a healthcare provider interacting in-person with the patient to provide remote feedback to a specialist or medical provider in another location.
- Asynchronous: Asynchronous telemedicine, or “store and forward,” collects, stores, and transmits information, for access at another time. This could include a lab collecting and processing samples, imaging studies, or other tests that are stored and forwarded to a doctor or healthcare provider. The doctor can access the information remotely and use this information to evaluate, diagnose, or monitor a patient.
- Remote patient monitoring: Remote monitoring uses special devices to monitor a patient remotely, allowing the patient to continue with their daily activities and not have to visit a doctor in-person to monitor vitals and status. Remote patient monitoring systems can include:
- Devices sensing falls for dementia patients,
- Blood glucose monitors for diabetics, and
- Cardiac monitors for patients with heart conditions.
Telehealth and Technology
Telehealth takes the place of a lot of one-on-one interactions. Telemedicine can include advanced technology remote robots conducting microsurgeries across the world, or they can involve a simple telephone call. Some of the methods of telemedicine communications include:
- Phone calls
- Live video chats (Skype or FaceTime)
- Emailing images or files
- Text and SMS messages
- Remote or cloud storage of files for later access
- Remote monitoring through take-home medical devices
Other specialized remote technology is used between healthcare professionals. This includes healthcare-specific software programs.
Most Common Telemedicine Services
Many employees and employers are finding that the majority of an employee's tasks can be done remotely. The same is true for many areas of healthcare. As telehealth expands, certain healthcare professions and services are especially suited for remote access. Some of the most common healthcare specialties using telemedicine include:
Teleradiology involves transmitting patient images, such as X-rays, CT scans, and MRIs, for remote access by other radiologists and physicians. Radiology uses specialized imaging devices to capture, store, and transmit high-resolution scans. A radiologist can then access and review radiographic images remotely.
Telepharmacy involves providing pharmaceutical services to patients remotely. Telepharmacy services include drug therapy monitoring, counseling, prescription authorization, and monitoring compliance. In some cases, telepharmacy can also dispense medications remotely. Telepharmacy services can be beneficial for individuals seeking the assistance of a pharmacist during off-hours or while in a remote location.
Telepsychiatry often uses video-counseling to provide patients access to psychiatric services. Telepsychiatry services can include diagnosis, counseling sessions, medication monitoring, and consultations with other medical professionals. Some individuals seeking telepsychiatry services may have difficulty seeking out in-person service, and provide an alternative for getting care.
Pathology is the study of causes and effects of diseases and injuries. Some pathologist work can be conducted remotely, to diagnose, counsel, and treat patients through video, phone calls, or sharing files. Telepathology can be beneficial for getting a diagnosis when a pathologist is otherwise not accessible. Additionally, telepathology is a way to get a second opinion quickly.
Telegenetics can provide genetic testing and counseling services remotely. Geneticists can interact directly with a patient using remote communication, or with other doctors and healthcare professionals to consult on a patient's care. Geneticists may not be available at every clinic or doctor's offices and telegenetics allows greater access to specialized genetic testing and counseling for patients and their families.
Telecardiology has been using remote technology for decades. On the patient's end, a device can read and record electrocardiograms (ECGs), transmit the signal over the internet or through a phone line, and allow a cardiologist to review the results. A simple ECG can be worn like a watch, allowing for regular monitoring without having to go into the doctor's office. Cardiologists can also monitor patients with pacemakers, interpreting issues like arrhythmia remotely.
Many patients with neurological conditions, including stroke, epilepsy, movement disorders, and Parkinson's, can have a specialized consultation with a neurologist remotely. Video conferencing and sending test results allows a doctor to evaluate a patient, monitor the patient, and prescribe medication and treatment remotely.
Benefits and Drawbacks of Telemedicine
There are benefits as well as drawbacks to the increased use of telemedicine. Both patients and doctors are mixed about telemedicine's uses and limitations. Health care administrators often prefer telemedicine because it is cheaper. A doctor can see many more patients remotely compared to in-office visits. Healthcare companies may also be able to use overseas healthcare professionals at a lower expense compared to U.S.-based doctors and specialists. However, these cost-savings for the corporations may come at the expense of patient care.
Benefits of Telemedicine
Increased Access: The primary benefit of telemedicine is increased access to healthcare. People in larger cities, like Baltimore, may have access to some of the best surgeons, specialists, doctors, and health technology in the country. However, people who live only a few hours outside of Baltimore may have very limited access to specialized care.
Round the Clock Care: Even for people who do live in an area with access to quality care, it can be hard to find help at a moment's notice, in the early morning hours, or on the weekends. Medical questions and concerns can pop up at any hour and are not limited to being an issue during the 9 to 5 weekday hours. In an emergency, people can go to the ER. However, a lot of health issues fall somewhere between urgent and waiting 3 weeks for an appointment. Telehealth can help answer a patient's question whether they should seek immediate care or it can wait a few weeks.
Telemedicine Can Be Less Expensive: Not everyone has insurance and healthcare can be expensive, even if you do have insurance. Phone or video consults may be less expensive than in-office visits, which can be a lifeline for people struggling financially to still get access to care.
Cons of Telemedicine
Errors, Leaks, and Glitches: Computers can make mistakes. There may also be a risk of data breaches, putting personal information at risk of discovery. Even doctors can make mistakes when reviewing so many records over a short period of time, making clerical errors, forgetting to input data, or failing to get timely notices of messages.
No In-Person Assessment: A video consult cannot replace a full physical assessment. Most people are using low quality phone cameras for their videoconferencing. Low quality video can create artifacts or hide problems that a doctor would immediately notice on an in-person meeting.
Doctor Burnout: The healthcare companies know that they can save money with telemedicine and they can also go through more patients in less time. Unfortunately, this may mean overburdening doctors with unreal expectations of how many patients, files, and reviews a doctor needs to perform over a workday. Meeting 20 patients in one day may seem like a lot but reviewing 100 X-rays from different patients may be overwhelming. Burnout and overworked professionals can lead to an increase in telemedicine mistakes, which can have serious consequences for patients.
How Do I Know if Telemedicine is Malpractice?
Telemedicine is still relatively novel for patients and even some doctors. Patients may have limited access to knowing what the doctor, nurse, or specialist is entering into their terminal and the exact care they received may be a mystery.
A patient may also have no idea who is providing telehealthcare. A healthcare professional may introduce themself at the beginning of a video call but then the patient forgets and does not know where to turn to get more information. Telemedicine puts a lot of the control in the hands of the healthcare system and puts a burden on the patient to review their own care and treatment.
How can a patient tell if an injury or harm was caused by a medical mistake when it was done remotely? Medical malpractice is a type of personal injury claim where a patient can seek compensation when medical negligence was to blame for an injury, illness, or caused harm. When a doctor or other healthcare professional deviates from the accepted standard of care, causing harm, it may be malpractice.
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 telemedicine, the same general rules apply. 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.
Examples of Telemedicine Medical Malpractice
As with general healthcare, telemedicine medical malpractice can occur anywhere. This includes improper diagnosis, prescription errors, or failure to diagnose. However, some areas of telemedicine may be more likely to involve medical malpractice. This includes:
HIPAA Violations and Data Breach of Personal Information
There have been multiple data breaches reported by the Department of Health and Human Services. Healthcare providers claim their systems are secure, until they aren't. Hackers may not be looking for your blood pressure or list of medications. Most of the time, data breaches are looking for personally identifying information, like your name, address, phone number, date of birth, and Social Security Number.
However, there is a lot of very personal information that most people do not want others to see outside of a professional medical context. This could include sexual history, HIV status, cancer, drug use, and congenital diseases.
Informed Consent May Be Compromised
Informed consent is important for making sure patients are informed of the benefits and risks of a procedure to allow them to make an informed choice about their care. Failure to obtain informed consent can be a basis for medical malpractice. The quality and extent of informed consent may be compromised when a doctor is meeting with so many people through the phone or by video, leaving patients without all the necessary information to make a decision.
Filing a Medical Malpractice Claim After Telemedical Care in Baltimore
There is a limited time to file a medical malpractice claim in Maryland. In general, claims must be filed within five years of the date the injury occurred, or within three years from the date the injury was discovered, whichever is earlier (§ 5-109). The date of discovery includes the day the plaintiff should have reasonably discovered the injury.
The time limit may be different for injury victims under the age of 18 or for claims against government agencies. If you wait too long to file a claim, you may be denied compensation, so do not take any chances and talk to your Baltimore malpractice attorney as soon as possible after a telemedicine mistake.
Telemedicine Malpractice Lawyers in Baltimore
If you or a loved one suffered an injury after receiving telehealth care over the phone or through video chat, the injury may have been caused by a medical error. Contact the experienced Baltimore medical malpractice lawyers at Gilman & Bedigian. 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.