Telemedicine and Telehealth are undoubtedly gaining quick support in the United States, and internationally, due to the incredible
medical benefits of diagnosing patients without needing the doctor to be
physically present. On April 15, 2015
Congress passed the “dox fix” bill, originally titled Medicare
Access and CHIP Reauthorization Act (H.R. 2). The question we are left wondering is: does
this bill actually help progress telemedicine in the United States? The short answer is yes. The Act is a glaring indication to medical
providers that adopting innovative procedures, such as telemedicine, can
increase their organizations likelihood of obtaining new payment prospects. Beginning on July 1, 2015, third party payors
will be required to reimburse medical providers on the same basis for telemedicine
and telehealth programs as they would for face-to-face consultations. Indiana
is just one of twenty-nine
states that have passed Parity Laws for private insurance coverage of
telemedicine. An additional ten states
have proposed legislation that should be voted on shortly.
Benefits of Telemedicine
It is without question that some cities in the United States
provide their residents with greater access to medical care than other cities. However, what happens for small towns across
the globe that lack access to medical professionals capable to make the correct
judgment in life or death situations? The answer, unfortunately, is that without
proper medical attention, some individuals do not survive; although, with the
rise of telemedicine, doctors can more easily make qualified
decisions over a computer monitor. For
instance, a drug called Tissue Plasminogen Activator (“TPA”)—administered a few
hours after a stroke—can break up blood clots and reduce damage to the brain.
However if administered incorrectly, the drug can cause fatal hemorrhages. Only a stroke specialist would have the
medical expertise to decide when to administer TPA with fewer complications. By implementing telemedicine programs in
smaller towns, a stroke specialist in New York City can diagnose symptoms of a
patient in rural Alabama, effectively administering TPA.
Legal Implications and Pitfalls
While the benefits of telemedicine far outweigh the
negatives, they cannot be ignored. With Congress’ explicit approval of
telemedicine through “the Act,” the judicial system will be left with the
inevitable task of determining who is accountable if there is a problem. Without a doubt, technology has limitations. Computer malfunctions, Internet connection issues,
poor video quality, or lack of face-to-face consultation all attribute to a
long list of potential lawsuits. Using
the TPA example above, if the doctor in New York City was to misdiagnose the
patient via video messaging because of poor Internet connection, who would be
at fault? Potentially the doctor,
hospital, insurance company, the telemedicine program, the internet provider
would all carry some blame in this situation, but who would be liable? With the rise in technology, accountability is
blurred. In coming years, the judicial system may see a staggering rise in
telemedicine cases, especially because of the incentives to implement Parity
Laws for private insurance coverage of telemedicine. The potential “flood of litigation” may
overwhelm courts in the coming years.
Technology has limitations. Computer malfunctions, Internet
connection issues, or poor video quality all can lead to potentially incorrect
However, when presented with
the option of getting a qualified opinion or not, it may be worth the time and
money to invest in a video monitor.
with complicated diagnoses, telemedicine also allows for long-term monitoring,
outside of the hospital, which can decrease or prevent complications.
The benefits of telemedicine far outweigh any
potential issues that may arise and can eventually save countless lives in the
Anthony Lopez is a currently 2L at DePaul University College
of Law and is the Wolthers Kluwer Staff Member for the E-Pulse. Mr. Lopez would
like to practice in the area of Health Law after graduation.