Managing the Risks of Practicing Telemedicine

Introduction

By Eric T. Berkman

Telemedicine – the practice of physicians using technology to consult remotely with patients or other doctors – is a growing field that has the potential to reduce health care costs while making it more convenient to treat patients who cannot easily access the right doctor in person. But legal and medical experts say that any physician or medical group that considers adapting telemedicine in a practice must be aware of possible liability traps and know how to manage the risks. Telemedicine comes in a variety of forms, ranging from videoconferencing and communication over customized Internet channels to good old-fashioned telephone and e-mail contact.

And it offers plenty of benefits. “It has a lot of potential for managing chronic diseases,” such as diabetes or hypertension, said Kevin M. Pho, a Nashua, N.H., internist and publisher of KevinMD.com, one of the most widely read medical-affairs blogs. “These aren’t conditions where you necessarily have to see a patient face-to-face all the time, and you can do a lot of patient management via videoconference, the phone or e-mail.”
It’s also useful for patients who are homebound because of health issues or live in remote locations hundreds of miles from a specialist or even a doctor, said Roy Schoenberg, chief executive officer of American Well Systems in Boston, which produces customized Internet platforms that enable patients (and doctors) to connect with a physician on demand. “This is a completely new way of doing health care,” said Schoenberg, who is a physician himself. “It really doesn’t matter whether you’re in downtown Boston or in rural Maine surrounded by snow and ice. You have immediate access to the same health care professionals.”

Observers expect the field to explode once Medicare and more insurers begin reimbursing for services that aren’t conducted in person. Even if reimbursement doesn’t happen, anyone who delves into telemedicine needs to be sure to address areas of potential risk, said Anne Huben-Kearney, vice president of risk management at ProMutual Group, the commonwealth’s biggest medical liability insurer. Here are six areas that physicians engaging in telemedicine should address (next page):

Next: Privacy, Security and Patient Confidentiality