Patient Safety and Telemedicine

In an AHRQ Perspective piece published this week, Stephen Agboola and Joseph Kvedar of Partners Health make the case for enhancing patient safety measures in telemedicine and conducting more research on the impact of telemedicine on patient safety.

They say that “telemedicine” (telemedicine, telehealth, connected health, eHealth and mHealth) on the whole is improving the health of patients and has the promise to revolutionize health care delivery. At the same time, known and emerging threats to patient safety are real, the overall impact of telemedicine on patient safety is less well studied, and some studies have raised concerns.

Agboola and Kvedar write that the answer is not to halt telemedicine operations until all these issues are addressed. “New technologies and care models come with attendant risks. Telemedicine has demonstrated many positive effects on care. Rather than stop the forward progress, we argue for a more thoughtful, continuous safety improvement process that could start from the moment of project conception.

They suggest a number of measures to increase patient safety in telemedicine. Patient safety awareness should permeate all phases of the telemedicine project life cycle. Patient safety testing should be integrated into usability and efficacy trials, and such evaluations should not be limited to academic medical settings. Full disclosure of possible risks should precede engaging patients in telemedicine interventions. Telemedicine should incorporate the latest data security and encryption systems to protect patient privacy.

In addition, regulatory, professional, and health care organizations should work together to create regularly-updated, consensus-driven guidelines, operational protocols, and standards. Systems should be created for clinicians to document telemedicine services and integrate them as part of regular workflow.  And finally, more solutions should be created for patients with low health literacy, along with solutions for non–English speakers.

Agboola and Kvedar write, “Ultimately, we need to balance our commitment to the ethical principle of nonmaleficence (do no harm) with the need to adopt technology-driven innovations in health care to enhance quality and efficiency.” In their view, increasing research efforts aimed at evaluating the impact of telemedicine on patient safety should help to strike that balance.

 

Click here to read the AHRQ Perspective on Telemedicine and Patient Safety.

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One Comment

  1. I would very much like to see all of the professions be recognized in this struggle. It is not just physicians who are being caught in the middle of the legal and reimbursement nightmare, but Dietitians, Counselors and other ancillary licensed health professionals. It would be nice if we could address these legal issues as a team so we can start opening internet “clinics” across the US and provide and entire spectrum of educational and therapeutic care – many times in conjunction with reduced brick and mortar visits as we coordinate with other health providers.

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