Is telemedicine revolutionising or complicating healthcare?

Source: unsplash.com

The fragility of the Doctor-patient relationship in telemedicine

One of the cornerstone principles of traditional healthcare is the trust established through in-person interactions.

“Doctors who build strong relationships with their patients are significantly less likely to face litigation,” states Meyer.

“However, telemedicine inherently lacks the depth and flow of face-to-face engagements, making it harder to establish this rapport.”

The remote nature of telemedicine limits a practitioner’s ability to fully assess non-verbal cues, contextual factors and subtle clinical signs that are often pivotal for accurate diagnosis.

Without physical examinations, healthcare providers must rely heavily on patient-reported symptoms, which are often subjective and incomplete.

This increases the risk of diagnostic errors, a leading cause of malpractice claims.

Challenges in diagnosis and standards of care

Meyer warns that the absence of physical examinations compromises the ability to meet traditional standards of care.

“A primary examination should always be physical because understanding your patient and obtaining a thorough history cannot be fully achieved virtually. Virtual consultations are better suited for follow-ups,” she explains.

A poignant example involves patients with hereditary conditions like hypercoagulability.

Symptoms such as headaches may be dismissed as minor during a teleconsultation but could signal severe underlying conditions like cerebral thrombosis.

Misdiagnosis or delayed diagnosis in such cases can have devastating consequences and significantly increase liability risks.

From queues to convenience: how technology is making healthcare more efficient

5 Sep 2024

Legal frameworks and duty of care

Healthcare providers assume the same duty of care in telemedicine as in traditional in-person consultations. “When a doctor engages with a patient virtually, they enter into a binding doctor-patient relationship,” says Meyer.

“This means they can be held liable for breach of contract or negligence if they fail to meet expected care standards.”

However, the lack of jurisdictional clarity in cross-border telemedicine complicates liability.

For instance, a psychologist based in one country consulting a patient in another raises questions about regulatory oversight and legal accountability. Without comprehensive guidelines, such cases are fertile ground for legal disputes.

Telemedicine platforms: Partners or liabilities?

Telemedicine platforms play a pivotal role in managing liability risks.

Meyer emphasises that platforms must ensure robust data security measures, provide standardised consultation protocols and facilitate thorough documentation of patient interactions.

“Security breaches or inadequate record-keeping could shift liability to the platform, but doctors must still remain vigilant in maintaining their own documentation and informed consent processes,” she advises.

Telemedicine can expand universal access to care and improve patient experience, by Medshield

Stone  5 Jul 2024

Data privacy and ethical concerns

The digital nature of telemedicine introduces significant risks related to data breaches and patient confidentiality.

South Africa’s Protection of Personal Information Act 4 of 2023 (PoPIA) and similar global data privacy laws mandate stringent safeguards.

Non-compliance could expose practitioners and platforms to severe legal and financial repercussions.

Regulatory landscape and the road ahead The Health Professions Council of South Africa (HPCSA) has issued guidelines that mandate telemedicine consultations adhere to the same standards as in-person care.

However, these regulations are vague, creating ambiguity for practitioners.

Additionally, acts like the Consumer Protection Act 68 of 2008 and PoPIA enhance patient rights but also heighten healthcare provider responsibilities.

Meyer highlights the urgent need for more specific and enforceable regulations.

“Telemedicine is here to stay, and it can revolutionise rural healthcare access if managed correctly. However, without clear guidelines and robust systems, liability risks will continue to escalate.”