Telemedicine Not Tied to Increased Skin Cancer Malpractice Risk

By Lisa Rapaport

June 04, 2021

(Reuters Health) - There hasn't been a single publicly reported medical malpractice case in state or federal court related to telemedicine for the treatment of skin cancer, a review of seven decades of U.S. legal records suggests.

Researchers examined data from the LexisNexis legal case database for all publicly reported cases in federal or state courts from January 1, 1950 to January 1, 2021 that involved 36 terms related to telemedicine, skin cancer, and malpractice. Their search only identified six cases related to skin cancer, none of which were related to medical malpractice or the use of telemedicine to treat skin malignancies.

"Telemedicine in various forms has been around for decades, and about one quarter of malpractice claims are thought to result in court reports, so if there have been substantial numbers of claims, this study would have picked them up," said lead study author Dr. Alexander Fogel, of the department of dermatology at Yale University School of Medicine in New Haven, Connecticut.

There are several possible explanations for this, Dr. Fogel said by email.

"One is that telemedicine may be associated with lower malpractice risk, for example by allowing earlier diagnosis and triage," Dr. Fogel said. "Another possibility is that doctors are very cautious with telemedicine, for example using it for rashes rather than lesions, or for established medical issues rather than new diagnoses."

When researchers tried various combinations of search terms related to telemedicine, skin cancer, and malpractice, they identified 125 cases that warranted review. Out of this total, only 55 cases involved telemedicine, the authors report in JAMA Dermatology.

It's possible that plaintiff lawyers bring fewer cases related to malpractice involving skin cancer treated via telemedicine due to explicit disclaimers used during the consent process for these visits that warm about the limited ability to assess skin lesions during virtual visits, the study team writes.

One limitation of the study is that researchers lacked data on malpractice claims that weren't publicly reported, which might include cases settled out of court or resolved via arbitration, the study team notes.

Still, the study results should reassure clinicians who offer telemedicine services, particularly if they started doing more telehealth visits during the COVID-19 pandemic, said Dr. Sailesh Konda, an associate clinical professor of dermatology and director of mohs surgery and surgical dermatology at the University of Florida in Gainesville.

During the COVID-19 pandemic, the U.S. Department of Health and Human Services made it easier to provide telehealth services, Dr. Konda, who wasn't involved in the study, said by email.

"This flexibility has already encouraged many dermatologists to start or increase telemedicine visits," Dr. Konda said. "As the pandemic subsides, the preliminary findings of this study may reassure some dermatologists to use telemedicine for straightforward skin cancer management."

SOURCE: https://bit.ly/34JOXCP JAMA Dermatology, online May 19, 2021.

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