Telemedicine involves the delivery of healthcare to patients in remote locations and to underserved patient populations through audio-visual, online, and wireless applications. This leads to improved access to medical care and consultation, more efficient treatment plan implementation, cost savings for patients, and increased patient satisfaction.
The use of telemedicine is growing, and the Centers for Medicare and Medicaid Services recently announced that in the 2015 physician fee schedule, Medicare payments to telehealth originating sites will increase by 0.8 percent.1 However, numerous federal and state statutes have created significant liability risks for medical practitioners who engage in any form of telemedicine.
The Health Insurance Portability and Accountability Act (HIPAA) established national standards for the use and disclosure of personal health information (PHI) and the prevention of healthcare fraud and abuse. The Health Information Technology for Economic and Clinical Health (HITECH) Act implemented government-mandated requirements for breach notification, authorized random audits, substantially enhanced penalties for statutory violations, and specified that all transmissions of PHI must be “secure” (encrypted). Practices that engage in telemedicine must strictly comply with the various statutory requirements of HIPAA and HITECH or risk an investigation and potential fines.
Physicians who engage in telemedicine across state lines face serious considerations. The scope of practice is generally determined by the location of the patient. Providing care to a patient located in a different jurisdiction requires the practitioner to satisfy the licensing requirements of the state in which the patient is located. Without proper licensure, adverse consequences might include criminal prosecution for the unlicensed practice of medicine or disciplinary action by a medical board. Physicians should also be aware that their professional liability policy may not cover a claim that is filed outside a specific territory or jurisdiction.
To reduce these liability risks and enhance patient safety:
- Comply with HIPAA, HITECH, and state-specific laws when transmitting all PHI.• Ask your system vendor to provide training to you and your staff on how to protect and secure your data.
- Ensure robust and reliable high-speed broadband connectivity to support clinical functions.
- Check practice requirements and legal limitations in states where you anticipate providing care to patients. Understand reimbursement practices for telemedicine services.
- Use telemedicine carefully—and understand any limitations on the reliability and accuracy of the information.
- Communicate directly with your professional liability insurer to make certain that your policy extends coverage to all jurisdictions where you provide services.
- Wicklund E. CMS boosts telehealth in 2015 physician pay schedule. mHealthNews. http://www.mhealthnews.com/news/cms-boosts-telehealth-2015-physician-pay-schedule. Accessed November 25, 2014.
Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety.