Addressing Risks Associated With Telehealth

Advances in telecommunication technologies over the past decades have taken telehealth from a basic concept to a widespread reality. In the current healthcare landscape, telehealth is helping address issues related to healthcare accessibility, quality of care, and costs. Yet, as Oral & Maxillofacial Surgeons (OMS) develop telehealth initiatives, they should be aware of potential risk exposures.

 

Major areas of risk concern for telehealth include licensing, credentialing and privileging, online prescribing, informed consent, health information privacy and security, standards of care, and coordinating care among multiple providers across various sites.

 

Through careful consideration and risk assessment, OMS can identify safety and liability issues associated with their telehealth services and proactively implement safeguards at the originating site, through data transmission channels, and at the distant site. The following list offers key strategies for addressing risks associated with telehealth.

  1. Be knowledgeable about federal and state laws and regulations related to telehealth, such as requirements for licensure, online prescribing, informed consent, clinical decision-making, and quality improvement. Check with your state medical, osteopathic, nursing, or professional board for specific guidance.
     

  2. Identify and implement telehealth best practices, and stay abreast of any changes in telehealth regulations and standards of care. The American Telemedicine Association and other professional associations have published a number of telehealth practice guidelines.
     

  3. Ensure that providers delivering telehealth services are properly credentialed (either by the originating site or the distant site) and qualified for their proposed scopes of service. Any privileges granted should comply with applicable scope of practice laws.
     

  4. Develop and implement patient selection criteria and standardized clinical protocols for telehealth services to ensure consistency, quality, and efficiency of care.
     

  5. When multiple providers are involved in a patient’s care, have a clear understanding of duty of care and clinical responsibilities at both the originating and distant sites, including disclosure of any adverse events. Make sure the specific provisions and accountabilities are documented.
     

  6. Implement protocols to ensure that communication from distant site telehealth providers is promptly reviewed and acted on.
     

  7. Ensure that technology and equipment used for telehealth services are functional and properly maintained and serviced. OMS and staff should be aware of who is responsible for equipment maintenance.
     

  8. Assess the privacy and security risks of your telehealth systems, and implement safeguards at all points of risk exposure. Monitor the systems for possible security breaches.
     

  9. Train telehealth providers and staff on applicable telecommunication technologies, scope of telehealth services offered, equipment maintenance, and privacy/security standards.
     

  10. Ensure that your organization’s mechanism for incident reporting supports telehealth events, and evaluate telehealth activities as part of ongoing quality improvement initiatives. Surveys or questionnaires can help gauge provider and patient satisfaction with telehealth services.

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