November 30, 2020
Standard of Care for Telehealth Visits In the recent months, telehealth has been an integral part of delivering health care services. Because this avenue of service has increased throughout the pandemic, patients need to trust that their care is competent; their privacy is protected; and there is continuity of care. To ensure patients receive high-quality treatment, state laws and medical board regulations require the standard of care in telemedicine reflect that of an in-person physician-patient encounter. Physicians who participate in telehealth/telemedicine must have appropriate protocols to prevent unauthorized access and to protect the security and integrity of patient information at the patient end of the electronic encounter; during transmission; and among all health care professionals and personnel who participate in the telehealth/telemedicine service, consistent with their individual roles. The key rule is that the standard of care in telemedicine is identical to the standard of care in an in-person office visit.
Practitioners who provide medical care electronically should:
• place the welfare of patients first;
• maintain acceptable and appropriate standards of practice;
• adhere to recognized ethical codes governing the applicable profession;
• adhere to applicable laws and regulations;
• in the case of physicians, properly supervise non-physician clinicians when required to do so by statute; and
• protect patient confidentiality
It is crucial to adhere to the standard of care when discussing evaluation and treatment of the patient through telemedicine, according to many states and the Virginia Board of Health: “A documented medical evaluation and collection of relevant clinical history commensurate with the presentation of the patient to establish diagnoses and identify underlying conditions and/or contra-indications to the treatment recommended/provided must be obtained prior to providing treatment, which treatment includes the issuance of prescriptions, electronically or otherwise. Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional, in-person encounters. Treatment, including issuing a prescription based solely on an online questionnaire, does not constitute an acceptable standard of care.”
Obstacles to safeguard that the standard of care is met are:
• Informed consent to risks and benefits of treatment
• Meeting medical record keeping requirements
• Evaluating and prescribing medications in concordance with the clinical evaluation
• Transparency in insurance coverage and reimbursement
• Accurate diagnosis and treatment
According to a recent analysis conducted by CRICO, a leader in medical professional liability, 66% of telemedicine-related claims received from 2014 through 2018, were diagnosis related.
Telemedicine is no longer viewed as a secondary option for care—it is a new standard of care that is both expected by patients and popular with providers. Consumers expect to see health care adapt—like many other industries already have—to fit within their daily lives and schedules. Whether it is electronic check-in procedures or better automated systems, health care providers are beginning to treat their patients a little bit more like customers, and see telemedicine and patient engagement tools as a means of improving customer loyalty and engagement, while reducing costs.
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