Technology and Professional Exposure for Health Care Providers - Capstone Brokerage

By: Mary Thompson, Capstone Brokerage President, August 24, 2017

With a shift in Healthcare laws it is no wonder that Professional Liability “Medical Mal-Practice” insurance is changing as well. Over the past several years subtle changes in the healthcare industry have begun to relate to physician’s Professional Liability needs. With the increase in “E-visits”, a decrease in hospital stays, and of course the ever-evolving idea of healthcare reform, it is interesting that little is talked about when it comes to Professional Liability insurance needs for physicians.

As a physician or nurse, the need for Professional Liability insurance is accepted and understood as a necessity to protect those providing healthcare services. Is there a need to increase or decrease coverage limits due to the evolving healthcare system? In short, the answer is no but there are some things to think about, particularly when it comes to the e-visit, telemedicine.

E-Visits or virtual visits are when a physician interacts with a patient over technology. An e-Visit is the new age idea of a house call. The patient can “see” their care provider on the computer, tablet and even by smart phone. Some physicians are concerned that while this is a convenient way to see and treat patients, it may also leave room for more malpractice lawsuits. Can the loss of face-to-face interaction and a physical exam leave a doctor at higher risk for a lawsuit or improper diagnosis? In short, the answer is yes, but the likelihood of a lawsuit arising hasn’t been proven to be correlated to an e-visit over an in-person exam. The idea of e-visits is not as new as you may think; Telemedicine has been practiced for over 50 years even before computers were around. Patients would call their doctor and describe their symptoms and be treated over the phone with a simple call to the pharmacy for a prescription. What makes today’s Telemedicine or the e-visit different? For starters, the insurance coverage now can have a special rate for an e-visit.

Now there is something that every physician needs to know about their Professional policy prior to starting e-visits, they must be sure the policy wasn’t issued when the physician was exclusively doing office visits. If it was it is imperative to inform the insurance carrier that the coverage will need to include Telemedicine. A Physician will want to make sure to share that they are joining a virtual physician network or adding videoconferencing functionality to the practice. Depending on the insurer and policy limits, online interactions with patients may or may not be covered, or may be covered for an extra fee. It’s especially important to keep the insurer in the loop if a physician is planning to practice Telemedicine in multiple states and licensing requirements may be needed.

Other liability concerns are likely to surface soon regarding Telemedicine. The changes in healthcare are bound to bring change to the Medical Profession. Technology is also advancing, for example remote monitoring of patients with chronic conditions in their homes using biometric devices. These types of devices will wirelessly transmit real-time to physicians. An increasing number of hospitals are now doing this with their cardiac patients to reduce the number who require readmission within 30 days of discharge.

Over the past 20 years a shift patient recovery has drastically changed as well. What was once a week’s hospital stay is now considered outpatient. One may argue that the advances in medical knowledge and care have changed the way we recover from procedures others may blame the quick release on insurance companies trying to keep costs down. One thing we know for sure is that the length of hospital stay for procedures today verses 20 years in nearly cut in half. Today with shorter hospital stays there is less room for error in care, thus decreasing the exposure for Professional Mal Practice lawsuits.

It is best to have your Professional Liability policy looked at by a knowledgeable insurance professional on a regular basis. Be sure to make the insurance company aware of any changes in practice and of course when adding the telemedicine option to your scope of care.