Page 20 - Part 2 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

Confidentiality

The extensive thought that covered entities are required to put into
protecting health information needs to be applied to real-time and

stored data from telemedical encounters. Privacy and security

policies should address these in some detail, and patients should
be provided with them. There are no special HIPAA concerns

about telemedicine beyond those that apply to in-person care. The

exceptions for “treatment, payment and healthcare operations”
apply. It is important to comply with special provisions that apply

to behavioral health information.

Scope of Practice

Another allegation that can arise in any patient encounter is

practicing outside the scope of one’s training, experience or
authority. Practitioners (including physicians, mid-levels, nurses

and assistants) need to stay aware of the boundaries of their skills

in the telemedicine setting, just as they do in the in-person setting.
There is something about electronic communication that loosens

inhibitions. It is important to know when to fold up the encounter

and move to another venue, even when the impulse on both sides
might be to press on with the wrong plan.

Failure to Use the Necessary Technology

This allegation could arise: if some piece of equipment was not
functioning quite right, if a superior diagnostic or treatment

modality was potentially available but not employed or (as in the
case of failure to examine) if a proper decision process required

another venue or more help. Ironically, this allegation might apply

to a case where a practice had telemedicine technology available,
but used a less robust medium to manage a clinical problem that

would have turned out differently if broadband communication
had been used.

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