Physician Teleconsultation in India Today

Telemedicine, a practice that involves patient consultations and delivery of healthcare from a remote location, has not been a universally accepted practice until recent times, when the COVID-19 virus pandemic has made face-to-face consultations challenging. The benefits of telemedicine were always well known. It bridges the physical distance between the patient and the physician, especially in the rural areas that do not have specialist physicians. It reduces the travel costs and loss-of-time from work for the patients. It also allows the exchange of knowledge between healthcare professionals. There is a school of thought that there is nothing that can replace a face-to-face interaction between a patient and a physician. Several physicians vouch for the fact that they can make an initial diagnosis as the patient walks into the clinic. A doctor has been traditionally taught that both history and physical examination are vital to come to a diagnosis. Telemedicine eliminates the touch-and-feel aspect of the clinical examination and makes the stethoscope redundant. Thus, this valuable information may be lost with the patient on a computer screen, especially when the internet connectivity may not be at its best. Also, in case of email or any other form of asynchronous mode of consultation, the response from the doctor may be delayed, resulting in a delay in treatment. The legalization of telemedicine in India does not mean that doctors will be able to treat any patient remotely. Keeping in mind its benefits and limitations, the Ministry of Health and Family Welfare has set out certain guidelines for the practice of telemedicine in India. An online course has been planned, which registered medical practitioners interested in telemedicine practice will have to complete within 3 years of its notification. Till it is developed, the temporary guidelines should be followed by healthcare practitioners while consulting over video, audio or text-based platforms including email to ensure the best outcomes for the patient, and at the same time protect the physician from any legal complications. According to the new guidelines, telemedicine consultation can be used to treat patients who had met the same physician within the last six months for the same health issue for which they seek the online consultation. In every other case, the physician can prescribe only from a limited list of medications, and only if the physician is confident of the diagnosis. Over-the-counter medications or emergency medications that are relatively safe are included in the list, which is likely to be updated from time to time. Emergency consultations may be done only of alternate care is not available, though the patient should be advised face-to-face consultation at the earliest. As expected, medications with abuse potential cannot be prescribed. During an online consultation, attention should be paid to the verification of the identity of both, the physician and the patient. Though the doctor should introduce herself/himself and confirm the patient’s identity at the beginning of the consultation, the platform should also ensure that steps are taken to establish the identity of both the parties. The doctor’s registration and qualifications should be available for the patient to view. The patient’s mobile number can be verified through a one-time password. Consultation can be given through an authorized caregiver or a healthcare provider or healthcare worker. Minors should be seen only in the presence of an adult. The consultation may have interruptions due to technical glitches, or latency in the calls, and may thus not be as smooth as a face-to-face consultation. The platform should ensure adequate security and privacy of the patient information and should update the security features on a regular basis. It should preferably be HIPPA compliant. The information should follow all the norms of security as in a face-to-face interaction. Since some healthcare providers may not be technology oriented, it should provide end-to-end support, with a helpdesk available 24×7. It should support various electronic devices like mobile phones, laptops and tablets. The physician must take a decision about the treatment for the patient only if adequate information is available. Laboratory or radiological tests should be asked for, in case deemed necessary. If the physician cannot come to a conclusion, he/she could talk with a healthcare worker in contact with the patient or ask the patient to consult a local physician. The physician should maintain all documentation in case of any legal implications that may arise. India has taken a major step in allowing teleconsultation by physicians, and hopefully several patients with benefit from this novel approach to treatment. References: Telemedicine Practice Guidelines Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine. 25 March 2020 This article is for informational purposes only and not intended to replace the relationship between the doctor and the patient. It should not be used for self-treatment by patients or by doctors to treat patients. Consult your doctor before using any of the above information. Last updated on: 25-8-2020 Copyright: InsiWi Solutions