Dr Michelow’s call to rigorously audit and assess the safety of telemedicine programs is timely and important. Safe care, one dimension of quality emphasized by the National Academy of Medicine (formerly Institute of Medicine), is defined as “Avoiding harm to patients from the care that is intended to help them.” Dr Michelow describes two cases of diagnostic errors and well-known safety issues that have been the target of multiple improvement efforts long before telemedicine. As the case examples illustrate, these errors are prone to happen for potentially different reasons when care is delivered via telemedicine. Telehealth encounters are not equivalent to in-person encounters. Providers seeing patients remotely have less audio and visual information and lose the benefit of physical findings that can only be elicited from palpation or skilled maneuvers. Such limitations are known as preconditions that raise the risk of diagnostic and other medical error types that...

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