Safety Signals in Telehealth Primary Care and Outpatient Settings: Incident and Reporting Analysis Using World Health...

Area of Science:

• Health Services Research
• Patient Safety
• Primary Health Care

Background:

• Patient safety in primary care is less studied than in hospitals.
• Comparative data on incident profiles across outpatient and telehealth services are scarce.

Purpose of the Study:

• To characterize safety signals and reporting dynamics in primary care settings.
• To compare incident profiles between outpatient and telehealth modalities.

Main Methods:

• Retrospective analysis of 3,287 incident notifications (January 2019 - October 2024).
• Classification of incidents using the WHO International Classification for Patient Safety.
• Comparison of incident types, harm severity, and reporter categories between settings using statistical tests and logistic regression.

Main Results:

• Telehealth incidents: 46.0% infrastructure, 36.0% behavioral. Outpatient incidents: 25.7% clinical processes, 17.8% medication events (P<0.001).
• Telehealth reports were more concentrated in risk circumstances and less often classified as near misses or incidents without harm.
• Nurses submitted significantly more telehealth reports (85.1%) than outpatient reports (38.3%; P<0.001).

Conclusions:

• Telehealth and outpatient primary care exhibit distinct safety profiles.
• A uniform approach to patient safety is insufficient; modality-specific strategies are needed.
• Tailored safety frameworks for virtual and outpatient care are essential for harm reduction.