4 Tips and Tricks in Avoiding The Most Common Telemedicine Malpractice (With Examples)

Today’s healthcare professionals want to do right by their patients. Sometimes that means thinking about how we improve business processes and using the best tools for the job.

Telemedicine, or telehealth, is an emerging practice in healthcare that comes with clear benefits. It allows doctors to deliver healthcare remotely, whether over the phone, through text message, or via sophisticated video conferencing tools. This technology has increased tremendously in popularity over the last few years, especially for patients with limited mobility or those living in remote parts of the country.

However, like all technologies, there are easy ways to misuse it. In the world of healthcare, that can have serious consequences. Medical malpractice occurs when a healthcare professional neglects to provide appropriate treatment, takes inappropriate action, or gives substandard treatment that causes harm, injury, or death to a person. Between 1990 and 2020, there was an average of around 47,000 medical malpractice suits every year.

Just as with standard healthcare, there are circumstances where telemedicine malpractice can occur. The most common malpractice errors in telehealth include misdiagnosis, failure to treat, and prescribing errors (such as prescribing the wrong medication, the wrong dosage, or a drug the patient is allergic to). It is vital for any professional involved in telemedicine to be aware of what issues they may face and to ensure that they provide a reasonable standard of care.

Addressing the Risks of Telemedicine

Keeping patients at a distance from their healthcare providers inspires some concerns. Some relate to whether people can access telemedicine in the first place, but many more are around the standard of care provided during contact. As such, healthcare providers risk opening themselves up to accusations of malpractice. To avoid such a scenario, here are some key concerns to think about when you’re communicating with patients.

#1. Technical challenges

This is one of the most obvious concerns and one of the easier ones to address. While app testing lets us spot problems before a product releases, it’s not always plain sailing. It’s likely that even with a good internet connection, you’ll sometimes have to contend with glitches, dropped video or audio, or even a struggle to connect in the first place.

Healthcare professionals can also encounter issues with other tasks, such as transferring files digitally from one place to another. The files themselves can become corrupted, or the wrong files can be transferred.

More serious issues arise when we have to transcribe medical records. A misinterpreted note can, naturally, have serious medical consequences for a patient. This problem becomes more likely if we outsource the transcription of written messages to people without medical experience. All of these make it more likely a poor level of healthcare is provided, with an increased risk of legal action from your patients.

Another solid strategy here is to, as much as possible, have another professional with you during conversations. The specific person doesn’t matter much, provided they have a baseline of medical expertise (like a nurse or physician assistant). Virtual team communication tools can help you set this up. One thing that may help in this area is AI audio transcription, which may prove to reduce the occurrence of human error.

#2. Diagnosis hurdles

While telemedicine can bridge gaps between doctors and patients, some situations demand in-person contact. Focusing too much on using telemedicine because it’s convenient can mean you miss some signs of illness, something that may leave you open to a charge of malpractice.

A fundamental legal principle governs this area: the telehealth standard of care is legally equivalent to in-person care. Doctors cannot use the limitations of technology as an excuse for providing substandard care that leads to patient harm. If a virtual visit cannot provide the diagnostic accuracy that an in-person visit would, the provider is obligated to recommend an in-person assessment.

For example, doctors may sometimes need to palpate an area of a patient’s body to identify the issue accurately. Lacking these options could compromise a doctor’s ability to diagnose a problem, and virtual meeting best practices (while important) can’t alleviate these issues.

Telemedicine can also present diagnosis problems in branches of medicine where you wouldn’t expect to find them. On the surface, radiology seems like a practice that benefits from telemedicine. This is because much of it revolves around looking at various texts and images, such as X-rays, MRI scans, ultrasounds, etc.

While today’s technology makes accessing these images simple, its ease of use may unwittingly increase the professional’s workload. This may mean they fail to spot crucial signs of illness.

To alleviate this problem, it’s vital to consider if telemedicine is an appropriate choice for each specific situation, especially if a hands-on approach is necessary. When you need to participate in a telemedicine appointment, ensure you keep highly accurate and comprehensive records of what transpired. A voice transcription tool can assist in this kind of task.

EHR-Related Malpractice Risks

Electronic Health Records (EHRs) are essential to telehealth, but they introduce their own malpractice risks. One significant danger is "copy-paste" errors. When clinicians copy notes from previous visits to save time, outdated or incorrect information can propagate through a patient's chart, leading to inappropriate treatment decisions based on stale data.

Alarm fatigue is another hidden hazard. Digital monitoring systems generate countless alerts for everything from minor vital sign fluctuations to potential drug interactions. Over time, providers may become desensitized and ignore critical warnings, leading to dangerous missed interventions. Furthermore, when telemedicine platforms are not properly integrated with a clinic's main EHR system, patient records become fragmented. A doctor making a clinical decision via video may only see part of the patient's medical history, increasing the risk of misdiagnosis and subsequent malpractice claims.

#3. Regulations

Even if you can resolve some of the issues with the distance that telemedicine presents, you should check if there are roadblocks around actually prescribing a treatment. For example, the US state of Arizona doesn’t allow pharmacies to distribute drugs using prescriptions given via telemedicine. In-person checkups are also required in this scenario to avoid legal consequences.

It’s also important that you’re licensed to practice medicine in the right areas. US law typically states that clinicians must be licensed in the state where their patient resides rather than where the clinician practices. While this isn’t often an issue with in-person appointments, the rise of telemedicine presents new issues. This is particularly challenging when patients travel or live across state borders. Geolocation tools can help verify a patient's location at the time of a virtual visit, but providers must remain vigilant about this requirement.

Consider other relevant legislation, like the Health Insurance Portability and Accountability Act. HIPAA demands that healthcare providers safeguard protected health information (which varying types of data ingestion can help with) that could influence things like your choice of technology.

While we’ve already touched upon this from a call quality perspective, it’s also crucial to consider it from a regulatory one. It’s unlikely that you would use them, but it’s best to avoid the likes of Facebook Live and Twitch in this context.

Ensure that the platform you choose cannot be hacked (or eavesdropped on) to remain in compliance with HIPAA. Register your domain names in the territory in which you operate — purchase domain name Canada, for example, if that’s where your practice is based.

You should also make sure you don’t overlook the issue of informed consent. It’s easy to neglect this principle as a healthcare provider, thanks to the more informal nature of telemedicine.

Address this problem by thoroughly understanding the legalities of practicing and prescribing medicine in your area. There may be lessons you can learn from other industries in how to manage collection of medicines. You may also benefit from brushing up on the concept of informed consent and how to properly apply it in a telemedicine environment. Be aware that the law in this area of medicine may shift rapidly over a short period.

Establishing the Physician-Patient Relationship Virtually

Proving that a physician-patient relationship exists is the very first step in any malpractice claim. In traditional medicine, this relationship is straightforward: the patient visits the clinic, the doctor examines them, and a formal duty of care is established. In the context of on-demand telehealth, the lines can become legally ambiguous.

Consider asynchronous telemedicine, where a patient fills out an online questionnaire and a doctor reviews it hours later. Or think about a casual inquiry where a physician briefly responds to a message on a health forum. Courts are still actively defining exactly when a formal duty of care begins in these digital interactions. To protect against liability, providers must ensure that the start and end of a virtual consultation are clearly documented. Explicit informed consent should be obtained before the visit begins, establishing a clear framework for the encounter.

Telemedicine Malpractice Insurance Requirements

As the use of telehealth grows, so does the need for specialized risk management. A standard malpractice policy may not automatically cover telemedicine services, especially when provided across state lines. Healthcare providers must verify whether their current professional liability coverage explicitly includes telehealth. If a policy only covers in-person visits, a malpractice claim stemming from a video consultation could be denied entirely.

Providers practicing virtual medicine need dedicated telemedicine malpractice insurance. This specific professional liability coverage for telehealth addresses the unique risks of remote care, such as misdiagnosis due to physical exam limitations and multi-state jurisdictional issues. When securing a policy, clinicians should ensure it covers all the states where their patients reside and that it meets the specific policy limits required by each state's telehealth regulations.

#4. The personal touch

While it’s harder to quantify, it’s important to consider what kind of relationship you’re building with your patients. This is because the better your relationship with them, the lower the chance they will sue you for something you’ve done (or failed to do).

While this might be because you’re offering a better standard of healthcare (and things like online booking) it’s often because things like empathy and compassion are best conveyed when we’re in a face-to-face meeting, and it’s harder to sue someone you care about. This contact allows medical professionals to build a rapport with patients, better understand their problems, and help patients feel that somebody cares about them.

It is possible to have this kind of personal touch during a telemedicine conversation, but it requires a conscious effort and training to carry off properly. As such, this is another reminder that telemedicine is best used as a supplement to conventional patient appointments rather than a replacement for them.

Don’t forget to take care of yourself, either. You need to know how to deal with professional burnout to ensure you provide quality healthcare.

The Takeaway

There is little doubt that telehealth offers many benefits, both to patients and to healthcare professionals. However, it is important to note its limitations and the potential for errors to be made. Some things that may be used to give an accurate diagnosis, such as an MRI scan, are impossible to carry out by phone. But when used properly, telemedicine can help overworked professionals and can also benefit patients living in remote or rural areas.

As some of the potential errors that can lead to malpractice are the same in both standard healthcare and telemedicine, it’s essential that professionals try to maintain the same standard of care in both areas. If there is doubt, then a professional healthcare provider should consult with a colleague or a more senior practitioner. There is nothing wrong in admitting you are unsure about something. In fact, it’s quite the opposite and can reflect positively on your professionalism.

One thing you need to consider strongly if you’re practicing telehealth is confidentiality. You need to ensure that you are complying fully with HIPAA regulations and that any communications equipment you use, and how you store patient data, will not allow accidental information leaks or be susceptible to cybercriminals’ attacks.

Take Your Healthcare to the Next Level

Telemedicine is an invaluable tool for healthcare professionals nowadays, as we increasingly use technology to bridge long distances. It can be the perfect way of providing healthcare to people traditionally deprived of it. From that perspective, telemedicine shouldn’t be overlooked by any healthcare provider.

At the same time, it’s integral to recognize telemedicine’s drawbacks, particularly around security and the overall standard of healthcare. It’s essential to work consciously to alleviate these problems and recognize telemedicine isn’t a silver bullet.

Frequently Asked Questions

1. Can a doctor physically examine me during a telehealth visit?

A doctor cannot perform a traditional hands-on physical exam through a screen. They rely on visual assessments, patient-reported symptoms, and reviewing vital signs from remote monitoring devices. If a physical exam is strictly necessary to make an accurate diagnosis, the provider should instruct the patient to seek immediate in-person care.

2. Does signing a telehealth user agreement waive my right to sue?

Signing a user agreement or an informed consent form for a telehealth platform does not waive your right to sue for medical negligence. These documents acknowledge that you understand the inherent limitations of virtual care, such as technology failures. However, they do not protect a doctor from legal liability if they provide substandard care that causes you harm.