Financial/Legal

Understand the legal implications of telehealth medicine


 

Telehealth has been steadily gaining mainstream use throughout the last decade, but the practice was recently shoved, almost overnight, into the forefront of the health care profession. Telehealth is now used more frequently by medical groups and physicians than ever before. General reports before the COVID-19 pandemic approximated 90% of health care organizations used or planned to use telehealth in the future. This future may already be a reality, with a McKinsey & Company report estimating that physicians saw 50-175 times more patients over telehealth platforms since the pandemic’s start.1

In general, telehealth includes use of electronic communication and information technologies to deliver long-distance or remote health care. A physician’s use of telemedicine (clinical services) is one of the most common uses, but the industry also includes other professionals, such as pharmacists and nurses.

Ashton J. Hyde, Younker Hyde Macfarlane, Salt Lake City, Utah

Ashton J. Hyde

Telehealth platforms can be used to monitor, diagnose, treat, and counsel patients successfully. It works best for reading images, follow-up care, outpatient care, and long-term care. However, telemedicine is inappropriate for urgent issues, diagnosing underlying health conditions, or any practice where the standard of care would require a physical exam. There is potential liability for decision making without a proper physical exam. Health care providers must use their medical training and good judgment when deciding if telehealth is appropriate for their patients’ needs.

Grace C. Johnson, Younker Hyde Macfarlane, Salt Lake City, Utah

Grace C. Johnson

There are many advantages to telehealth over more traditional health care options. Some of these advantages include:

  • Increased access to health care.
  • Increased access to medical specialists in small and rural communities.
  • Improved long-term care from the comfort of patients’ homes.
  • Improved platforms to document patient care outside regular business hours.

But along with these benefits, telehealth carries the disadvantage of potential increased liability. This increased liability could stem from:

  • Breached standards of care.
  • Inadequate or improper licensing.
  • Limited care options.
  • Decision making without a proper physical exam.
  • Increased informed consent requirements.
  • Restricted prescription access.

Before expanding any practice into telemedicine, awareness of potential legal issues is crucial.

Standard of care

Currently, telehealth laws and regulations vary significantly from state to state. But one rule is consistent across the board – that the standard of care for practicing medicine through telemedicine is identical to the standard of care required for practicing medicine during physical practice. It still requires the appropriate examination, testing, labs, imaging, and consultations that any in-person diagnosis needs. For physicians, it also includes supervising nonphysician clinicians, where state law requires supervision.

The American Telemedicine Association currently determines the primary governing standards and guidelines for telemedicine. These can help physicians understand best practices in meeting the standard of care through telemedicine. The American Gastroenterological Association provides coding guidelines and other resources to help physicians with telehealth and e-visits. Other professional societies, such as the American College of Radiology and the American Academy of Dermatology, offer guidelines specific to their medical specialties’ standards of care. These standards still vary from state to state, so medical professionals must be aware of any differences before treating patients in multiple states.

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