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White Paper Telemedicine
White Paper Telemedicine
White Paper Telemedicine
TELEMEDICINE RISK
MANAGEMENT
A PRACTICAL GUIDE FOR
UNDERSTANDING AND
MITIGATING PATIENT
SAFETY RISK AND
MALPRACTICE EXPOSURE
Paul Hildebrand, MD
Associate Director
TeamHealth Patient Safety Organization
Tele-ICU
Telepsychiatry
The number of patients presenting to emergency
departments with mental health issues is
growing. These patients can place a great burden
on already busy emergency departments because
they are often difficult to manage and observe,
and the shortage of available psychiatric consults
or psychiatric beds may cause long waits for
appropriate treatment.xiii Telepsychiatry offers a
solution to expedite the treatment process for
these patients and improve patient flow in
emergency departments.
According to the American Psychiatric
Association, telepsychiatry allows for diagnosis
and assessment, medication management, and
individual and group therapy. It also provides an
opportunity for consultative services between
psychiatrists, primary care physicians and other
healthcare providers; and it is also being used to
Annals of Emergency
Medicine,xx the vast
majority of strokerelated lawsuits
involved a patient suing
telepsychiatry providers
an emergency
Photo Courtesy of Specialists on Call
must be held to the
physician who failed to
same standards as psychiatrists treating at the
make, or delayed, a stroke diagnosis with the
bedside.xv,xvi
patient not receiving tPA (drugs to break up or
dissolve blood clots). Teleneurology mitigates this
Teleneurology
risk.
Teleneurology is especially useful in consultation
Tele-emergency medicine
for stroke care and other emergency neurological
consultations for hospitals and emergency
Tele-emergency medicine involves providing
departments not staffed by American Board of
emergency service consultation to outlying
Emergency Medicine (ABEM)-certified specialists
hospitals. (The previously discussed applications
in emergency medicine. The challenge for these
of telemedicine are often used in emergency
hospitals is that they need specialists with
departments as well.) Academia began to
expertise and training in stroke care, and roundembrace tele-emergency medicine by the late
the-clock availability historically has not been a
-affiliated medical school
major area of interest for neurologists.
programs in states across the country. Looking
Teleneurology by stroke care specialists fills the
forward, there is opportunity for tele-emergency
need by preventing disruption of office hours with
emergency calls, relieving the on-call burden, and
ABEM-certified physicians in an academic
physicia
home state.
CONCLUSION
Telemedicine is emerging as an increasingly sought-after tool for addressing some of the challenges and
changes within the healthcare industry, including poor physician access in remote areas and high demand for
specialists in both rural and urban areas. This relatively new healthcare delivery mode comes with new risks
that hospitals and physicians must consider when entering into a telemedicine agreement, designing their
telemedicine programs, and providing care via telemedicine. However, adhering to strategies that can
mitigate those risks can help hospitals lower their exposure to negative events while providing quality care to
their patients.
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