Supporting Clinical Governance in Telehealth

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It is evident that COVID-19 has had a profound impact on our health service. One of the biggest changes since the start of the pandemic is the rapid growth of Telehealth. The Medical Council’s research conducted in 2020 identified a five-fold increase in the use of telehealth services, this was mainly associated with the impact of COVID-19 on telehealth.

The ISO/TS 13131:2014 defines telehealth as the use of information and communications technologies to deliver healthcare and transmit health information over both long and short distances. Although Telehealth can be effective across a wide range of health services when used appropriately, it does pose challenges and questions around clinical governance and whether the appropriate Quality and Safety Management Systems are in place to ensure delivery of safe, high-quality care.

In this blog post we consider some of the challenges brought about by the rapid growth in telehealth and provide guidance for Telehealth services to address some of the key areas of concern.

Challenges associated with Telehealth

The principles of care for telehealth are the same as with delivery of care through face-to-face consultation. However, the delivery of care via technology presents additional risks compared with face-to-face healthcare delivery, for example breakdown in communication, inappropriate care or decision making and data protection issues. Unsurprising, the Emergency Care Research Institute (ECRI) included Telehealth Workflow Challenges as no. 6 in their list of Top 10 Patient Safety Concerns for 2021.  They note challenges in relation to poor WIFI, inadequate or inappropriate monitoring, inadequate availability of monitors and rooms with monitoring capability and inadequate language services. They also note that 19% of events included concerns regarding escalation of care.

In the Report of the Medical Council Working Group (2021) on Telemedicine, they highlight issues such as education, framework for telemedicine, the legal landscape in telemedicine, prescribing, doctor work burden and fatigue, lack of physical examination, communication,  regulation and practical challenges such as technology, Wi-Fi connectivity and administration.

So, what does this mean? The rapid increase in use of Telehealth services means that there could be patient safety issues particularly around clinical governance, oversight and ineffective infrastructures. Traditional healthcare services have had time to develop their systems and prepare for the change we experienced during the pandemic, however, many telehealth services have not had this time to prepare due to the unprecedented rapid growth they have experienced since 2020. They now need to consider how they are assuring that care is appropriate, that there is follow up and that the correct processes and systems are in place.

10 Recommendations for Telehealth Services

How can HCI help?

HCI’s Quality and Safety of Care Assurance Programme supports Telehealth Services in implementing and managing an effective Quality and Safety Management System. Our programme is fully comprehensive and will drive effective leadership, oversight and delivery of services whilst also providing a framework to meet all regulatory requirements.

HCI’s Quality and Safety of Care Assurance Programme includes:


The expansion of Telehealth is likely to become permanent. Telehealth services and organisations utilising Telehealth services now need to consider the effectiveness of their clinical governance arrangements to ensure that they are providing a safe, high quality service that can adapt and drive continuous improvement.

HCI is a provider of professional services in relation to patient safety, quality improvement, and regulatory compliance. As such we understand your requirements and have the necessary experience to expertly support you in buildings a robust QSMS, support your clinical governance framework and drive quality improvement across your service.

If you would like more information on Quality and Safety Management Systems contact HCI.

Contact Us

For more information contact or Phone +353 (0)1 6292559.