BY: Lisa Esser-Weidenfeller | IN: Medical Malpractice
These dangers can cause harm to patients that may be even more devastating during the coronavirus pandemic. Because many hospitals and emergency response centers are overwhelmed and backlogged as they respond to COVID-19 patients, a medication mistake or misdiagnosis resulting from a telehealth visit may lead to permanent long-term injury or death.
Virtual visits with healthcare providers can be a cost-effective, efficient way to treat patients suffering from common, easily diagnosed illnesses, and evaluate whether a patient should seek in-person care. They are also useful for follow-up care, particularly with patients who have ongoing, effective treatment plans.
These options not only help keep patients safe from contracting illnesses, but they also help expand access to treatment for high-risk patients, those with limited mobility or compromised immune systems, and those in areas with few medical facilities. Patients may also be more willing to discuss uncomfortable or embarrassing symptoms or lifestyle choices than they would during face-to-face visits.
Public and private insurers quickly pivoted to support widespread use of telehealth options as the COVID-19 pandemic closed or overwhelmed hospitals, physician offices, and medical facilities. The move protected patients and, along the way, saved money. A virtual doctor’s visit nearly always costs less than a visit to the emergency room, and, in the face of a deadly pandemic, the benefits of reducing exposure to other sick patients in an office or hospital setting generally outweighed the shortcomings of virtual medicine.
But the shortcomings remain. Remote medical appointments may improve the immediate safety of patients, but in many cases, they may not match the standard of care that’s typical of in-person medical visits. Misdiagnoses or inappropriate treatment plans may result, especially if doctors take less time with virtual patients.
The limitations of the technology itself could be a factor. A doctor examining a patient whose device has a low-quality camera, for example, may not see a rash that that would be noticeable during an in-person visit, indicating a severe condition. Patients who opt for virtual follow-up appointments via telephone or text may not show symptoms that a provider would have observed in person and connect to problems with an ongoing treatment program. This oversight could be the difference between a successful recovery and a deadly relapse.
Remote platforms can also increase the difficulty of maintaining patient confidentiality and could expose private medical data to third parties. Improperly using telehealth technology, either by providers or patients, may cause a data breach or non-secure communication. Similarly, new technology may malfunction, leading to potentially disastrous consequences. Imagine if a patient’s home blood pressure monitor glitched and a physician adjusted his dose of medication in response.
Similar outcomes could occur if a patient or provider incorrectly uses the technology or mistakenly inputs information. Patients self-medicating or performing medical procedures at home could raise their risks of harmful side effects and make it much more difficult for a medical professional to treat them promptly. It may also be impossible for patients to properly perform at-home versions of blood pressure readings or lab tests requiring samples and to maintain a sterile environment. Once a mistake happens, a patient may be unable to reach a medical provider to avert a crisis or repair the damage.
Medical providers face numerous restrictions when prescribing medication. Some providers may write prescriptions to patients without an in-person consultation and full medical history, often relying on a patient’s self-reported online questionnaire. Telemedicine increases the risk that providers may prescribe medication that is incorrect or dangerous to the patient because of interactions, medical history, or allergies. Inappropriate prescribing, particularly to patients outside the scope of a provider’s license, has been the basis for many successful medical malpractice claims.
Virtual patient care must meet the quality standards of in-person care. Ultimately, insurers and legislators may develop guidelines for the kinds of care that can be performed virtually, and that must take place in an office or hospital facility. While convenience, cost savings, and current public health measures favor continuing some telemedicine options, it will be crucial to balance the advantages against the possible dangers.
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Lisa Esser-Weidenfeller focuses her practice on medical malpractice, automobile negligence, and general negligence litigation on behalf injured plaintiffs.