Article

Increasing Trends in Medical Malpractice Claims Due to Telehealth Misdiagnosis

Telehealth services have experienced unprecedented growth, particularly since the COVID-19 pandemic, with utilization increasing by an astounding 7060% nationally from 2019 to 2020. While this expansion has improved healthcare accessibility, it has also introduced new risks and challenges in patient care. Recent evidence suggests a concerning pattern of medical malpractice claims specifically related to misdiagnosis in telehealth settings.

Prevalence of Misdiagnosis in Telehealth Malpractice Claims

Current data clearly indicates that diagnostic errors constitute the most significant category of telehealth-related medical malpractice claims. Multiple studies have highlighted this trend:

Statistical Evidence

A study examining telehealth-related medical malpractice claims revealed that over 70% were directly related to diagnostic errors. This finding is consistent across multiple sources and time periods. Another analysis of telemedicine-related claims between 2014 and 2018 found that 66% were diagnosis-related. For specific conditions like cancer and stroke, misdiagnosis accounted for 45% of telehealth medical malpractice claims in 2021.

When comparing telehealth to traditional care settings, the disparity becomes even more apparent. Misdiagnosis has been estimated to account for approximately 47% of claims associated with in-person consultations, significantly lower than the 66-70% rate observed in telehealth settings. This suggests that diagnostic challenges are disproportionately problematic in virtual care environments.

Human Impact

The consequences of telehealth misdiagnosis can be severe. Twelve million Americans are misdiagnosed annually, and about half of them face severe harm because of these errors. Misdiagnosed patients often experience delays in recovery or receive treatments for conditions they don't actually have, which can lead to additional complications and suffering.

Factors Contributing to Telehealth Misdiagnosis

Several factors unique to the telehealth environment contribute to the increased risk of misdiagnosis:

Limited Physical Examination

The most significant limitation of telehealth is the inability to directly examine patients physically. This constraint can hinder physicians' ability to assess patients' conditions accurately and may lead to overlooking crucial symptoms or signs that would be evident during an in-person examination.

Technology Dependence and Overreliance

Healthcare providers may compensate for the lack of physical examination by over-relying on technology, such as Electronic Health Records or other technological alerts. This dependency can inadvertently increase the possibility of misdiagnosis when the technology fails to capture nuanced clinical information.

Communication Challenges

Telehealth consultations may create barriers to effective communication between providers and patients. The lack of personal connection may lead to misunderstandings and miscommunication, potentially resulting in diagnostic errors and subsequent malpractice claims.

Emerging Trends in Telehealth Malpractice Claims

Recent data suggests a potential upward trend in medical malpractice cases related to telehealth services. This increase appears to correlate with the expansion of telehealth adoption across healthcare systems nationwide.

From 2014 to 2018, nearly two-thirds of all malpractice claims related to telemedicine concerned misdiagnosis. More recent data indicates this pattern continues, with recent studies consistently showing misdiagnosis as the predominant issue in telehealth-related claims.

Interestingly, earlier research from 2019 found no reported cases of medical malpractice in Direct-to-Consumer telemedicine. This stark contrast with current findings highlights how rapidly the landscape has evolved as telehealth has become more mainstream.

High-Risk Clinical Scenarios

Certain clinical scenarios appear to carry higher risks in telehealth settings:

Cancer, Stroke, and Infection Misdiagnosis

Approximately 45% of all telehealth medical malpractice claims are specifically for misdiagnosis of cancer, stroke, and infection. These conditions often require comprehensive physical examinations or immediate intervention, making them particularly vulnerable to diagnostic errors in virtual settings.

Teleradiology Concerns

Teleradiology, a specific subset of telemedicine involving remote interpretation of medical images, has shown concerning patterns in malpractice claims. Cases involving teleradiology more frequently involved patient death and had higher median indemnity payment amounts compared to radiology malpractice cases not involving teleradiology.

Risk Mitigation Strategies

To address the increasing risk of malpractice claims due to telehealth misdiagnosis, several strategies have been proposed:

Enhanced Patient Engagement

The Institute for Healthcare Improvement (IHI) suggests inviting patients to demonstrate health-related behaviors in the context of their home environment and engaging family members or patient advocates during virtual visits to prevent misunderstanding of symptoms.

Provider Training

Training healthcare providers in telehealth best practices is essential to help them conduct limited physical examinations virtually and identify important clinical clues when observing patients in their home environment.

Robust Protocols and Systems

Implementing strong telehealth systems and protocols with necessary support is critical for preventing liability issues. Clear documentation practices and communication standards can help mitigate the increased risks associated with virtual care.

 

The evidence suggests that there is indeed an increase in medical malpractice claims related to misdiagnosis in telehealth settings, both in absolute numbers and as a proportion of overall telehealth claims. The percentage of telehealth malpractice claims related to diagnostic errors (66-70%) exceeds that of traditional in-person care (approximately 47%), indicating that misdiagnosis represents a particularly significant challenge in virtual healthcare delivery.

As telehealth continues to evolve and integrate into mainstream healthcare, addressing these diagnostic challenges will be essential to ensuring patient safety and reducing legal liability. Healthcare systems, providers, and technology developers must work collaboratively to implement solutions that enhance diagnostic accuracy in virtual settings while maintaining the accessibility and convenience that make telehealth valuable.