Page 15 - Part 2 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

must be present for telemedicine visits with individuals under the
age of 18.

A Closer Look at Liability

Malpractice is generally defined as the failure to exercise the
degree of reasonable care, skill and diligence as would ordinarily

be exercised by a similarly situated healthcare provider for a
similar patient under the same or similar circumstances. The

defense generally depends on showing that the provider’s actions

fell within the range of an acceptable standard of care.

So far, there are relatively few reports of medical malpractice cases

related to telemedicine. This is somewhat a matter of volume, but
is also the case because the early adopters of telemedicine have

been, for the most part, conservative regarding the kinds of cases

they consider appropriate for remote management. Careful
fallback and backup options have been built into most published

trials. Screening out high-risk patients tends to limit the severity of
injuries that might result from e-misadventures. Lower severity

claims may skew obtainable data by excluding unreported

settlements. Moreover, higher risk patients tend to be managed by
high capability systems, with detailed guidelines and

documentation. These and other factors bias the outcome data
from telemedical practices in a positive direction and may limit the

visibility of adverse occurrences.

Misdiagnosis and treatment failures in telemedicine are currently
thought to be comparable to rates for traditional office visits. One

study found a higher rate of antibiotic prescribing (for sinusitis) in
e-visits than office visits and a lower rate of urinalysis (for UTI).
7

7 Mehrotra A, Paone S and Martich D. 2013. A comparison of care at e-visits and physician office visits for sinusitis
and urinary tract infection. JAMA Intern Med 173:72-74.

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