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Telemedicine Today and Physician Malpractice Insurance

April 13, 2011

Finally, telemedicine is catching up to our world of technology and with it telemedicine medical malpractice insurance companies.  Telemedicine has grown significantly in a wide variety of settings:  hospitals and clinics, medical laboratories, doctors’ offices, nursing homes, assisted-living facilities, correctional institutions and most commonly physician’s homes.  Telemedicine offers geographical outreach; its services extend into rural areas across the United States and other healthcare stations around the globe. Telemedicine is also used in disaster relief efforts or threats of nuclear and chemical hazards. Telemedicine offers healthcare anywhere, as long as high speed internet is available, which is a much needed change in the health care industry. A study done in 2003 showed that approximately 350,000 patients used telemedicine services, which shows a rapid increase.

Telemedicine today, is defined as the use of medical information sent from one site to another through electronic communications to improve patients’ health care. Telemedicine is a rapidly developing approach of delivering medicine where medical information is transferred through interactive hardware and/or software media for the purpose of consulting, and sometimes remote medical procedures or examinations. Telemedicine includes a variety of programs and service types provided for the patient.

Teleradiology is the Largest Use of Telemedicine

Teleradiology became popular as a result of hospitals seeking ways to lower their costs for over night radiology coverage. Emergency rooms at hospitals are available for patients 24 hours per day, 7 days per week. As radiology images improved (including CT, MRI and ultrasound images), the amount of images captured over the last decade has skyrocketed. Radiology has seemingly improved health care tremendously.

Hospitals and emergency rooms utilize radiology imaging machines all day and all hours of the night requiring radiologists to be on staff 24 hours per day. As internet bandwidth speeds increased, along with the internet explosion of the 1990’s and 2000’s, images were able to be transferred digitally over the internet to radiologists at locations outside of the hospital. Teleradiology groups began to offer hospitals discounted costs and pay per read models offering the hospitals significant revenue savings, while still being able to deliver stat reads for hospitals and emergency rooms.

Telemedicine medical malpractice insurance is complicated and requires an expert in the medical liability insurance field. Telemedicine groups have the unusual risk of facing liability in numerous different states. These physicians require a medical malpractice insurance company that can offer coverage nationwide and a policy that can be crafted to specifically cover the group’s risk. Other common issues that telemedicine groups face when purchasing telemedicine medical malpractice insurance are; tail coverage, premiums per read, policy audits.

Five Main Types of Telemedicine Services

1)      Specialist Referral Services: typically involves of a physician or medical specialist assisting a general or family practitioner with a diagnosis. This allows the patient to see a specialist over a live, remote consult or the transmission of diagnostic images and/or video over the internet. Radiology is the most popular use of telemedicine because radiology physicians can read thousands of images over the internet each year. Other accepted specialty areas include dermatology, ophthalmology, mental health, cardiology, pathology and neurology.

2)      Patient Consultations: involves using telecommunications to provide patient health and medical data, which may include audio, still or live images, between a patient and a physician, surgeon, nurse practitioner or healthcare professional for use in diagnosing a patient.

3)      Remote Patient Monitoring: EKGs, heart, lung, and breathing monitoring systems are used in telemedicine to provide live updated results to doctor at remote locations.

4)      Medical Education: physicians and medical students in training do not have to travel around to classrooms to receive continuing education seminars; instead they can have live feeds from telemedicine providers.

5)      Consumer Medical and Health Information: on-line discussion groups, forums and websites are becoming more and more popular as well as the Internet as patients seek to obtain specialized health care information.

Source: American Telemedicine Association

Concerns of a Telemedicine Practitioner

With the growing popularity of telemedicine, there are concerns and questions associated with this practice. Medical licensing of telemedicine practitioners is one concern. The requirements for telemedicine practitioners vary from state to state, but generally, physicians that provide this service must be properly medically licensed in the state where they make their medical diagnosis. All physicians must have proper medical malpractice insurance to operate as well.

Most medical malpractice insurance companies are now catching up to the growing popularity of telemedicine, but as mentioned above, providing medical liability insurance for telemedicine can be complicated. Usually, telemedicine covers a wide geographic region. Medical malpractice insurance companies do not necessarily like this aspect, which can make it difficult for physicians to get the proper coverage.

Privacy is another issue with telemedicine. Obviously, there are laws currently in place, such as HIPAA, however the whole point of telemedicine is to consult via technology. This makes securing patient doctor confidentiality harder. Technical systems must be installed to protect the patient’s privacy. Telemedicine operations must be regulated and secured electronically to ensure patient’s safety and privacy.

While both the practice of telemedicine and telemedicine medical malpractice insurance have their challenges, they are extremely beneficial for physicians and patients as telemedicine allows for quicker, more efficient medical care.

For more information regarding teleradiology, visit the Radiological Society of North America.

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