Medical Council cautions patients about telemedicine

Media statement

For immediate release 11 February 2015

Medical Council cautions patients about telemedicine

The Medical Council today cautioned patients about some of the potential pitfalls of telemedicine and at the same time highlighted the need for doctors practising telemedicine to be aware of Council’s expectations when using technology to diagnose and treat patients.

Council chairman, Mr Andrew Connolly says the reality is that telemedicine will increasingly become mainstream, but the challenge is how to manage it and ensure that there are appropriate standards to protect patients and to ensure the competency of doctors practising telemedicine.

’We are working closely with the New Zealand Telehealth Forum to develop safe and effective telemedicine systems and processes’.

The Council has a number of Statements on Telehealth, the Use of the internet and electronic communication and Good prescribing practice that Mr Connolly is encouraging doctors to become familiar with.

‘Doctors practising telemedicine have a responsibility to both their patients and themselves to know what Council’s expectations are in this new area of medicine.’

‘The concept of telemedicine is a fantastic one that potentially offers benefits to both patients and doctors alike.

‘But it is important that both patients and doctors are aware of the pitfalls of undertaking consultations on the internet, for example, a diagnosis made purely online, without a physical examination has the very real potential to be wrong.’

Telemedicine is very much still in its infancy and not the quick fix many think it is says Mr Connolly.

‘The reality is that telemedicine at the current time has difficulty in reaching some diagnoses and it is simply unable to treat patients who may have life threatening illnesses such as cardiac chest pain, difficulty in breathing or poisoning.

‘This means patients with these symptoms will physically need to consult another doctor.

‘Some doctors practising telemedicine are unlikely to have an adequate knowledge of the patient’s usual health especially if they are meeting the patient for the first time online, and if they don’t have access to the patient’s clinical records that are maintained by another doctor.’

Mr Connolly says there are also issues around the continuity of care of patients using telemedicine.

‘In these type of situations, the Council has a concern that telemedicine providers may not liaise with a patient’s GP and there may be a very real threat of harm as a result of the treating doctor not being totally aware of the patient’s medical history.’

In addition, the usual GP must also be made aware of any new diagnoses or changes to medications as these issues have real potential for risk if not professionally addressed. Furthermore, doctors must be aware of their responsibilities under Council standards and legislation regarding prescribing.

The Council’s Statement on telehealth, is explicit (paragraph 7) in stating a doctor is ‘… responsible for the evaluation of information used to form a diagnosis, irrespective of its source. …’

‘It is unlikely a telemedicine doctor would have full or complete information about a patient especially if the patient is consulting them for the first time and they do not have access to the patient’s full clinical records.’

Another issue for the Council, is whether doctors practising telemedicine are based in New Zealand and registered with the Council.

‘It can be difficult to verify on some websites whether a doctor or the service being offered is New Zealand based. A major down side of an overseas based telemedicine service is that if something goes wrong, the patient is unable to make a complaint to the Health and Disability Commissioner,’ says Mr Connolly.

In addition, the Medical Council is unable to verify the qualifications and experience of overseas trained and overseas-based doctors offering services via the internet unless those doctors seek registration in New Zealand.

‘If a doctor is not registered with it, the Council is unable to ensure that they are competent and meet New Zealand standards of practice.’

The Council’s free online medical register lets anyone check on any New Zealand registered doctor. Patients can see details such as a doctor’s qualifications, speciality and any conditions they may have on their practice.

ENDS

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