Medical Mishaps In Telemedicine And Their Prevention

One solution to the dilemmas of geographical separation between the doctor and the patient, and scarce resources would be to consider the feasibility of telephone consultation as an alternative method of consultation, as this may be more convenient for busy patients and may save costs. Telemedicine has been defined as the use of telecommunications to provide medical information and services.

Successful communication is based on congruence of the communicators and of the method of communication. Potential mismatches between the meaning of information for the patients and for the physicians do not disappear when the information is transmitted through technology. Data transmitted by patients to doctors must include the facts that the doctors need to make decisions about diagnosis and management of disease. Technology must be designed so that it is efficient, however if the information that is transmitted is not accurate, then technology becomes an ineffective tool.

A recent study, published in the October issue of Journal of General Internal Medicine, states that errors in telephone communication can result in outcomes ranging from inconvenience and anxiety to serious compromises in patient safety. Although 25% of interactions between physicians and patients take place on the telephone, little has been written about telephone communication and medical mishaps. Increasing familiarity with common telephone challenges with patients may help physicians decrease the likelihood of negative outcomes. The authors use case portraits to highlight communication errors in common telephone scenarios. These scenarios include giving sensitive test results, requests for narcotics, managing ill patients who are not sick enough for the emergency room, dealing with late-night calls, communicating with unintelligible patients, and handling calls from family members. The researchers, at the Yale School of Medicine and the VA Connecticut Healthcare System provide management strategies to minimize the occurrence of these errors.

The study emphasizes that expanded physician and residency training in telephone medicine is needed to prevent medical mishaps with patients caused by telephone communication failures.