Risk Management In Tele-health Medicine

Risk Management in Telehealth Medicine

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Risk Management in Telehealth Medicine

Telehealth Medicine

Telehealth medicine is a novel technology that helps patients receive healthcare through means of communication. In this method, the process of assessing the health of the patients is practiced by digital photography, videoconferences, websites, and instant messages. It removes the need for patients to visit hospitals and face-to-face interactions with health professionals. It is a highly efficient practice of connecting health providers and facilities that are located geographically far apart. It comprises of several methods and advanced technologies that range from traditional data applications and diagnostics to innovative robotic surgery, emergency consultations and prescriptions ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"t6vP2UUB","properties":{"formattedCitation":"(Bertoncello, Colucci, Baldovin, Buja, & Baldo, 2018)","plainCitation":"(Bertoncello, Colucci, Baldovin, Buja, & Baldo, 2018)","noteIndex":0},"citationItems":[{"id":259,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/KUC3JBZF"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/KUC3JBZF"],"itemData":{"id":259,"type":"article-journal","title":"How does it work? Factors involved in telemedicine home-interventions effectiveness: A review of reviews","container-title":"PloS one","page":"e0207332-e0207332","volume":"13","issue":"11","archive":"PubMed","archive_location":"30440004","abstract":"INTRODUCTION: Definitive evidence of the effectiveness and cost-effectiveness of telemedicine home-interventions for the management of chronic diseases is still lacking. This study examines whether and how published reviews consider and discuss the influence on outcomes of different factors, including: setting, target, and intensity of intervention; patient engagement; the perspective of patients, caregivers and health professionals; the organizational model; patient education and support. Included reviews were also assessed in terms of economic and ethical issues. METHODS: Two search algorithms were developed to scan PubMed for reviews published between 2000 and 2015, about ICT-based interventions for the management of hypertension, diabetes, heart failure, asthma, chronic obstructive pulmonary disease, or for the care of elderly patients. Based on our inclusion criteria, 25 reviews were selected for analysis. RESULTS: None of the included reviews covered all the above-mentioned factors. They mostly considered target (44%) and intervention intensity (24%). Setting, ethical issues, patient engagement, and caregiver perspective were the most neglected factors (considered in 0-4% of the reviews). Only 4 reviews (16%) considered at least 4 of the 11 factors, the maximum number of factors considered in a review is 5. CONCLUSIONS: Factors that may be involved in ICT-based interventions, affecting their effectiveness or cost-effectiveness, are not enough studied in the literature. This research suggests to consider mostly the role of each one, comparing not only disease-related outcomes, but also patients and healthcare organizations outcomes, and patient engagement, in order to understand how interventions work.","DOI":"10.1371/journal.pone.0207332","ISSN":"1932-6203","journalAbbreviation":"PLoS One","language":"eng","author":[{"family":"Bertoncello","given":"Chiara"},{"family":"Colucci","given":"Massimiliano"},{"family":"Baldovin","given":"Tatjana"},{"family":"Buja","given":"Alessandra"},{"family":"Baldo","given":"Vincenzo"}],"issued":{"date-parts":[["2018",11,15]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Bertoncello, Colucci, Baldovin, Buja, & Baldo, 2018).

Risks associated with telemedicine

Though telemedicine has brought revolution in the health sector and has made access to these services efficient and convenient, the system also poses several risks associated with it. The reliance of the system on continuous and digital data transmission through complex computing networks may cause serious issues. Throughout the process, there are chances for diagnostic, interpretation, and technical issues. It may also have risks for patient security and violations of the privacy codes. The transmission pathway may have glitches in the transmission medium or network site. Secure transmission requires effective checkpoints at differing transmission points. The data can either be sent through internet, satellite, or virtual private network. The risks associated with this system are the authentication of the data accession permit and organization's means of an interface. Privacy of the patients is also a paramount concern during the transmission of data. Issues like hardware tampering, interception, and unauthorized access might violate the privacy policy of HIPPA, federal, and state laws.

The quality care through telehealth programs can be compromised as the system depends on the ongoing monitoring and improvement plans that should change according to the needs of the patients. In some cases, there might be certain issues related to diagnosis, data compilation, following clinical protocols, patient satisfaction, delayed consultations, and patient over satisfaction. Individual incident reporting is very crucial in this system; however, sometimes there are some encounters where the proper checklists and documentation is not well perceived. The matter of cost accountability and keeping the economic vitality while providing better services can also pose a threat to the telehealth system. Other risks include training, communication, malfunctioning of the equipment and communication issues ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"F7TAx3bF","properties":{"formattedCitation":"(Di Cerbo, Morales-Medina, Palmieri, & Iannitti, 2015)","plainCitation":"(Di Cerbo, Morales-Medina, Palmieri, & Iannitti, 2015)","noteIndex":0},"citationItems":[{"id":263,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/HKWPCKGB"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/HKWPCKGB"],"itemData":{"id":263,"type":"article-journal","title":"Narrative review of telemedicine consultation in medical practice","container-title":"Patient preference and adherence","page":"65","volume":"9","author":[{"family":"Di Cerbo","given":"Alessandro"},{"family":"Morales-Medina","given":"Julio Cesar"},{"family":"Palmieri","given":"Beniamino"},{"family":"Iannitti","given":"Tommaso"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Di Cerbo, Morales-Medina, Palmieri, & Iannitti, 2015).

Telehealth organizations should also convey the detailed operations procedure and the risk associated with them in order to avoid any legal violations. Telemedicine also encounters malpractice complexities as the communication between patients and the physicians may not be effective, and there might be coverage gaps. The standards of care that are appropriate for the physician might not be adequate for the patient ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jlekyDO0","properties":{"formattedCitation":"(Hong, 2016)","plainCitation":"(Hong, 2016)","noteIndex":0},"citationItems":[{"id":262,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/5IZEW6EJ"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/5IZEW6EJ"],"itemData":{"id":262,"type":"article-journal","title":"Medical tourism and telemedicine: A new frontier of an old business","container-title":"Journal of medical internet research","page":"e115","volume":"18","issue":"5","author":[{"family":"Hong","given":"Yan Alicia"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hong, 2016). The standard of care varies state to state, and thus, due to geographical distances, it cannot be established that laws and regulations of which state will be followed. Such practices have not been yet tested in the legal system. Only a few states have set a standard of care such as Hawaii, Texas, and Colorado, yet their system is flawed.

Risk Management

The implementation of telehealth risk management has a conventional focus on providing patient safety and reducing medical errors. It also focuses on protecting the financial liability of organization. Telehealth technology can be improved by properly utilizing the medical care facilities, improving the communication pattern among these organizations, physicians, and patients. Risk management strategies also include the proper verification and authentication of the data about medical conditions and patients' preferences ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"pCVequat","properties":{"formattedCitation":"(NEJM Catalyst, 2018)","plainCitation":"(NEJM Catalyst, 2018)","noteIndex":0},"citationItems":[{"id":261,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/YSPV733U"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/YSPV733U"],"itemData":{"id":261,"type":"webpage","title":"What is Risk Management in Healthcare?","URL":"https://catalyst.nejm.org/what-is-risk-management-in-healthcare/","author":[{"family":"NEJM Catalyst","given":""}],"issued":{"date-parts":[["2018"]]},"accessed":{"date-parts":[["2019",10,16]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (NEJM Catalyst, 2018). The individuals associated with this technology should comply with the guidelines and regulations identified by legal authorities and health insurance and accountability organizations.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Bertoncello, C., Colucci, M., Baldovin, T., Buja, A., & Baldo, V. (2018). How does it work? Factors involved in telemedicine home-interventions effectiveness: A review of reviews. PloS One, 13(11), e0207332–e0207332. https://doi.org/10.1371/journal.pone.0207332

Di Cerbo, A., Morales-Medina, J. C., Palmieri, B., & Iannitti, T. (2015). Narrative review of telemedicine consultation in medical practice. Patient Preference and Adherence, 9, 65.

Hong, Y. A. (2016). Medical tourism and telemedicine: A new frontier of an old business. Journal of Medical Internet Research, 18(5), e115.

NEJM Catalyst. (2018). What is Risk Management in Healthcare? Retrieved October 16, 2019, from https://catalyst.nejm.org/what-is-risk-management-in-healthcare/