The Electronic Doctor: Advances in Telemedicine

Steven E. North, Esq.
Shari James, Paralegal

With advances in science and medicine, it is now much easier for a doctor to communicate with patients about their care and treatment without the need for an in-person consultation.

"Telemedicine" electronically melds the interaction between patient and physician, even when they are far. These communications takes place via email, two-way video, smart phones and other forms of technology which are sometimes housed at small remote clinics or implanted in the patient's personal devices.

A May 13, 2014 article in The Wall Street Journal, "The Specialist Will See You Now, on Video", discusses the technological changes in patient care, where one healthcare provider, Mercy Hospital in Chesterfield, Missouri, created a $50 million virtual care center which spans across four states, 42 specialty hospitals, 700 clinics and outpatient facilities with more than 2,100 doctors.

The rationale for the expansion of telemedicine includes the need to "improve patient access and outcomes, and reduce readmission and costs..." with one physician noting that a "telemedicine encounter is better than no consultation capability at all." It allows for necessary consultations without the hassle of getting to and from a doctor's office. Patients can speak with a doctor from their own homes or even from a facility located close to their homes that have telemedical capabilities. And they can have several family members present.

While striking the balance between patient outreach and convenience, physicians should ensure that they are practicing medicine within the boundaries of their licenses. New York state law prohibits physicians from providing medical care and advice across state lines unless they are licensed in the other state. Although there are a few exceptions, for example, where the physician's regular patient lives across state lines, these exceptions should not be taken lightly as an infraction may carry serious consequences or sanctions or be the basis for medical malpractice claims.

Physicians should also remember that the same standard of care that applies to in-person consultations also applies to a telemedicine consultation, including physician-patient confidentiality; accurate record keeping, failure to properly diagnose, informed consent and exercising good medical judgment. By strictly adhering to these principles, physicians will limit the likelihood of a potential medical malpractice claim.

Although nothing can take the place of a good "hands on" physical examination by an experienced clinician, these "virtual examinations" can serve a legitimate but limited purpose. Physicians must be mindful that there is a good likelihood that their communications will be recorded and preserved by the patient and may potentially be used in court if there is litigation.