Telemedicine - 2 Day Series: Day 2

08 February, 2018

LAW:   There is no existing law on the issues raised by the telemedicine in India, however, the following rules should to be kept in mind:
  • Only Medical Practitioners registered in India are allowed to provide medical consultation, prescriptions and treatment.
  • Prescription in an electronic format may be validated as a legal prescription if it is a secure electronic record affixed with a secure digital signature as prescribed under the IT Act, 2000.
  • Automated Prescriptions using Algorithms are tenable as long as the Doctor takes full responsibility for the prescription and accepts to be identified as the originator of the prescription
  • Before a doctor or an institution does anything with a patient’s data such as medical history and physiological conditions, which are considered Sensitive Personal Information, they are required by law to obtain the recipient’s consent in writing.
  • Service providers who render “Application Services” - which includes telemedicine services – using telecom resources provided by telecom service providers, are required to be registered as an ‘Other Service Provider’ (“OSP”) under the New Telecom Policy 1999 (“OSP Regulations”).

DO’s
  • While adopting telemedicine methods of medical practice, you must ensure that medical consultation, prescriptions, treatment and drugs are dispensed only in accordance with legal provisions and guidelines regulating the medical and healthcare sector in India.
  • Doctor should be courteous, have good communication and rapport with their patients;
  • Standard of treatment, proper records and confidentiality shall be maintained;
  • The patient should be fully explained about the disease, treatment and its side-effects, potential risks and benefits and alternative lines of treatment and should give patient sufficient time to decide.
  • Informed consent in telemedicine is as important as in routine practice.
  • Password security should be maintained so that no person can have unauthorized access to the information at the receiving end or at the sending end.
  • Medicines can be prescribed by doctors online only if he is a regular patient and doctor is aware of his medical history. It  must be in writing, signed and dated by the doctor as per the Drugs and Cosmetics Rules, 1945
  • While providing patient information, remove patient identifying information
  • Preservation of medical records assume significant importance and shall be kept confidential.
  • Upon the demise of the patient where there are no court cases pending, the records can be removed from active status and turned to inactive status. HSPs are free to decide when to make a record inactive, however, it is preferable to follow the “three year rule” where all records of a deceased are made inactive three years after death.

THE STEPS THAT CAN BE TAKEN BY THE DOCTOR’S GIVING CONSULTATION ONLINE
  • First step should be to ask the patient to provide their medical history via the Internet, describe their illness and reason for consulting a doctor, and provide a credit card number.
  • They can then log on to the site and discuss the problem online with a physician, who provides treatment advice.
  • The website can provide medical advice and care to its users. The users can access the site and pick one of two options: either an "immediate medical consultation" or simply an "appointment." After registering, the user may eventually be directed to an online "doctor's office" where he or she may chat over the Internet with the physician.
  • After entering the chat room, the doctor may ask additional questions and, if warranted, prescribe medication.
  • It is better to provide a disclaimer, requiring that all its patients get an in-person follow-up visit to their Internet consultation.
  • Mention on the website that patients must seek "appropriate Medical follow-up" face-to-face with a physician. 


Read Day 1 here