Technology has assumed a big role in delivering healthcare services, particularly in the wake of the pandemic. The healthcare infrastructure of the country was brought to its knees due to the caseload during the Covid period.
Historically discouraged due to vast technological, financial, and legal barriers, the medical industry has undergone a massive overhaul now. Lowering data costs, penetration of the internet and improving user confidence have led to the steady adoption of telehealth services, a trend that is on the rise.
However, some long-standing concerns remain in the mind of patients such as the lack of transparency about the credentials of the doctor, improper patient diagnosis, concerns regarding misuse of a patient’s health information etc.
Though the practice of telemedicine has been legal in the country, these issues (including an inherent lack of trust on the part of patients, as well as practitioners) continued to persist. In 2020, the Union government came up with a framework for facilitating health-related services. It drafted legislation for public consultation in 2022 to bring further reforms to the existing law.
The Telemedicine Practice Guidelines, 2020 (TPG), were issued to offer assistance to healthcare professionals towards adopting telemedicine and provide protocols for physician-patient relationships. It focuses on patient evaluations and management, continuity of care, referrals for emergency services, privacy and security of the patient records, correspondence etc among other considerations.
As per the law, medical practitioners are required to adhere to the same professional and ethical norms applicable in traditional in-person care and exercise their professional judgment to determine the efficacy of teleconsultation, in the interests of the patient. Furthermore, the practitioners must be aware of any shortcomings of a particular mode of communication and they should inform patients of the same.
If the treatment cannot be done digitally, it must be “paused” or be “validated” with any required diagnostic reports, laboratory investigations, or a local referral to a physical facility, for examination.
The law enables the practitioner to discontinue and disengage from an ongoing consultation if they feel teleconsultation does not serve the purpose.
During digital consultation, the law prevents practitioners from receiving any information from the users without their explicit consent. The professional is not allowed to assume anything, instead, explicit consent is mandated under data privacy legislation for the usage and processing of health information.
The TPG imposes inherent restrictions on the ability of a healthcare practitioner to prescribe medications drugs should be prescribed when physicians are confident that they have relevant and adequate information. While there is a lot of dissatisfaction among practitioners about the list of drugs that can be prescribed over teleconsultation.
In addition to this, the patient continues to be the focal point, and nothing should be done without documentation. A practitioner I have been working with says “digital consultations premise themselves on ‘documentation” it is to keep both the patient, as well as the practitioner safe and aware at all times.