PETALING JAYA: The Malaysian Society for Quality in Health has urged patients to verify that it is safe to consult telemedicine practitioners to prevent misdiagnoses.
Its CEO Prof Datuk Dr Abdul Rahim Abdullah said while the number of patients accessing telemedicine in the country is unknown, verifying the credentials of practitioners is critical although the country has no recorded judgments or cases of misdiagnosis in telemedicine thus far.
Telemedicine is a remote clinical service that offers contact, care, advice, reminders, education, intervention and monitoring of healthcare. It came to the forefront after the Covid-19 outbreak in the country when physical visits to hospitals and clinics were discouraged.
The innovation enhances virtual access to healthcare services, especially for long-distance patient and clinician contact, where medical facilities are scarce.
Abdul Rahim said: “Continuing advances in telemedicine technologies are useful to patients. However, telemedicine presents new challenges for diagnoses. Errors are one of the most prevalent safety issues in outpatient care and this risk can be made worse if negligence occurs through access to telemedicine.
“I suggest in-person visits that allow medical practitioners to observe a more complete presentation of the individual before them, including health issues that can be assessed more thoroughly through touch and smell.
“During virtual visits, doctors would rely on patient history and digital records, ensure they review information with patients thoroughly, and decide when in-person visits are necessary.
“In case a patient is dissatisfied or uncertain about the accuracy of a diagnosis, he has the option to schedule an in-person appointment with his primary care doctor to address any additional concerns or seek a second opinion from another healthcare provider. The patient needs to take prompt action in this regard.”
In supporting Abdul Rahim’s opinion, lawyer Jeremy Balang said: “Since the lifting of the various movement control orders, the general practice of medicine has returned to the usual in-person appointments and consultations, although advancements in remote technology have allowed for greater remote communication between patients and their healthcare providers.
“No matter how, a healthcare provider will be held liable for misdiagnosis in telemedicine in the tort of negligence. The Telemedicine Act 1997 provides for the regulation and control of the practice of telemedicine and matters connected therewith.
“Telemedicine provides various advantages for patients who are in long-distance care. However, this also comes with disadvantages. A physical examination by a doctor may provide him with relevant and sometimes crucial information about the patient’s condition, which may not be so easily obtained via telemedicine.”
Balang said the Malaysian Medical Council had, in an advisory on virtual consultations, advised medical practitioners to exercise caution when recommending prescriptions or other treatment to patients whom they have not personally examined and ensure that patients with cognitive disorders, intoxication or language barriers are seen at a physical facility.
“Whether a misdiagnosis was made physically or via telemedicine, the law would apply the usual principles in tort when determining the quantum of damages due to the negligence of misdiagnosis.
“The patient would need to prove that the healthcare provider had been negligent, and he or she would also have to show that such negligence had caused or materially contributed to the harm or injury suffered by that patient, which in law is known as causation,” he told theSun.