This post is Part 7 of a series based on Nursine Jackson’s article, “What about that Device Data?”.
Telemedicine Consults and Monitoring
The use of Telemedicine or Telehealth significantly increased in the past year because Medicare and many other private insurances increased access to telehealth visits. Care rendered by both physicians and non-physicians may be preserved – and discoverable. Remote monitoring of critical care patients is an increasingly common cost cutting method being implemented in many hospitals. Telehealth allows for patients at multiple units to be remotely monitored at a separate site. Data transmitted back and forth and communications regarding patient care is likely stored.
Your minor plaintiff, a newborn baby, was transported with a team administering interventions, directed remotely by a neonatologist – and the communications and assessments were likely done via an iPad. Assessments of stroke patients by teleneurologists, used to make important decisions, such as whether the patient qualifies for thrombolytic therapy, are performed via iPad communications. Recordings of these telemedicine care interactions were likely saved, and this data would have been stored on the cloud or somewhere else, but not on the device itself.
This scenario doesn’t change the defense’s immediate response that the data has been overwritten and is no longer available, but that response is probably untrue. The data files from the assessments and care rendered via iPad communications may be provided in response to a discovery request. Currently, due to the Covid-19 pandemic, HIPAA regulations surrounding the security and data retention of telehealth appointments are not being strictly enforced. This is an evolving situation, though it should not apply to care provided prior to the pandemic.
Typically a motion to compel, or other assistance from the courts, is often required to obtain a proper response to this discovery request.
Stay tuned for Part 8 of this series, “Bed Alarms, Smart Beds, Smart Mattresses & RFID Badges”.
 MLN Booklet: Telehealth Services. Centers for Medicare and Medicaid Services. Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TelehealthSrvcsfctsht.pdf. Page last modified: 01/2019.
 King, C. (2015, May 05)How could remote monitoring serve the intensive care unit. Remote Monitoring News, mHealth Intelligence. Retrieved from https://mhealthintelligence.com/news/how-could-remote-monitoring-serve-the-intensive-care-unit
 https://www.hhs.gov/sites/default/files/telehealth-faqs-508.pdf [MOU1]I VE NEVER HEARD OF REMOTE MONITORING UNITS FOR L&D MONITORING.