Govt Notifies Guidelines For Practising Telemedicine

Govt Notifies Guidelines For Practising Telemedicine

New Delhi, 16 May 2020:


The government has gazette notified guidelines to practice telemedicine in India, a significant step as telemedicine consultation was a grey area in India.


The experts in the centre had been working on drafting standard guidelines that doctors could refer to because of the challenges posed for in-person consultation owing to the country’s large size and varied topography.


Telemedicine is referred to the delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communication technologies, a practice that has gained significance globally over the past few years with advances in technology.


In India it had been a somewhat grey area because there was no central guideline regulating the practice even though some states had come out with individual guidelines. The centre had been in the process of drafting these guidelines for sometime that got expedited because of the restrictions imposed by the sudden lockdown.


The Board of Governors in supersession of the Medical Council of India (MCI), has been working on the guidelines amended the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, to include telemedicine consultation. However, the guidelines prohibit use of digital technology to conduct surgical or invasive procedures remotely.


“We had already put in six months of work into the guidelines and, when the coronavirus pandemic happened, we expedited it. Technology platforms were something available and being used, but were not regulated, which exposed both patients and providers to challenges…” Dr Nikhil Tandon, head, department of endocrinology and metabolism, All India Institute of Medical Sciences, had explained earlier when the draft was out during March end. Dr Tandon is a member of the Board of Governors, MCI.


The release of guidelines that aim at protecting both patients and practitioners got expedited because of the restrictions on movement imposed during the national lockdown to contain the pandemic, as the practice provides patient’s safety, as well as health workers’ safety, especially in situations where there is risk of contagious infections.


“Disasters and pandemics pose unique challenges to providing health care. Though telemedicine will not solve them all, it is well suited for scenarios in which medical practitioners can evaluate and manage patients. A telemedicine visit can be conducted without exposing staff to viruses/infections in the times of such outbreaks. Telemedicine practice can prevent the transmission of infectious diseases reducing the risks to both health care workers and patients,” the guidelines say.


“…It can provide rapid access to medical practitioners who may not be immediately available in person. In addition, it makes available extra working hands to provide physical care at the respective health institutions. Thus, health systems that are invested in telemedicine are well positioned to ensure that patients with Covid-19 kind of issues receive the care they need.”


In the long run, there is a special focus on Health and Wellness Centres that provide preventive and primary healthcare within a 5 km radius at the grassroots level, especially in remote and largely inaccessible areas.


There are a number of benefits of telemedicine. It increases timely access to appropriate interventions, including faster access to services that may not otherwise be available.


One of the major advantages of telemedicine, say experts, can be saving cost and effort, especially of rural patients, as they need not travel long distances for obtaining consultation and treatment.


The practice can be particularly helpful for patients who need a follow up consultation but do not have to be physically present for a check-up, which will, in turn, reduce the burden on the secondary hospitals.


“There are a number of technologies that can be used in telemedicine, which can help patients adhere better to their medication regimens and manage their diseases better. Telemedicine can also enable the availability of vital parameters of the patient to the physician with the help of medical devices such as for blood pressure, blood glucose, etc management,”the guidelines further mention.


The results from the home montiring devices can be directly uploaded online for a physician to access, and advise accordingly.


The expert document has also provided a list of medicines that can be prescribed by doctors to treat patients.


Telemedicine includes all channels of communication with the patient that leverage information technology platforms, including voice, audio, text and digital data exchange.


However, telemedicine services cannot be used for providing emergency care when alternative in-person care is available. Also, it should largely be limited to first aid, life-saving measure, counselling and advice on referral.


Health care providers say it is a welcome move, not just the under current circumstances but also in the long run, when physical examination is not required.


“It will help to have a standard operating guidelines in place as earlier different guidelines were emerging from different states. Apollo has a telemedicine programme running for long, and through our network we cater to states such as Andhra Pradesh, Jharkhand, and higher reaches of Himachal Pradesh such as Kaza and Keylong. The formal notification will help us scale up and reach out to a larger population base. It anyway doesn’t make sense for a patient to come all the way to a health facility just to show, say, blood reports,” says Dr Anupam Sibal, group medical director, Apollo Hospitals.


“Also, telehealth is definitely going to be a key component of the new normal that we are going to see in the post-pandemic world,” he added. Hindustan Times