Telehealth and Digital Health
Chapter 14 Bedside Questions · 10 questions · about 10 minutes
Organizations run telehealth as a separate product line with its own documentation, quality, safety and governance, with no written indications or contraindications, remote teams without authority to act, and a strategy built on Medicare flexibilities that expire at the end of December 2027.
Telehealth as a route of administration (infusion, injection, pill): the same medicine delivered by a different route, with its own indications, contraindications and discontinuation criteria.
Answer as your executive team would, with the evidence in hand. Each question has a factual answer in a system you already own.
Can you produce written telehealth indications, and are they operationalized in scheduling and intake or only in a policy document?
Add a note: where is the evidence, or who owns it?
Can you produce written contraindications and an escalation pathway from virtual to in-person, or is each clinician deciding privately?
Add a note: where is the evidence, or who owns it?
Are virtual encounters documented, measured and safety-reported to the same standard as in-person, or on a parallel track?
Add a note: where is the evidence, or who owns it?
Does decision support fire in the telehealth interface, and has that been checked rather than assumed?
Add a note: where is the evidence, or who owns it?
In tele-critical care, tele-stroke or virtual nursing, does the remote physician have decision-making authority in writing?
Add a note: where is the evidence, or who owns it?
In each remote monitoring program, who receives the reading, within what window, and with what authority to change therapy?
Add a note: where is the evidence, or who owns it?
Are any clinicians treating your patients virtually outside your clinical governance, and how does their prescribing compare with yours?
Add a note: where is the evidence, or who owns it?
Can you report telehealth utilization by race, ethnicity, language, age and payer, and video share separately from total telehealth share?
Add a note: where is the evidence, or who owns it?
Who in the executive group is accountable for the integrated patient experience across modalities?
Add a note: where is the evidence, or who owns it?
What is your exposure if the Medicare telehealth flexibilities are not extended, and has it been modeled?
Add a note: where is the evidence, or who owns it?
A reflection tool from the book, not a validated diagnostic test or benchmark. Your answers and notes stay in this browser unless you choose to send them. Please don't enter patient information.
The technology is almost never the variable. The variable is whether a physician with authority stood behind it.
The Diagnostician, Chapter 14