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New Delhi: Any registered medical practitioner in India can now offer consultation and treatment from remote locations through the use of technology.

The central government had last week released the ‘Telemedicine Practice Guidelines‘ allowing registered professionals to use technologies for exchange of information to diagnose and treat ailments.

ThePrint explains what this process means, the mode of consultation and kinds of medication that can be prescribed by a professional remotely.

Who can provide consultation

Only registered medical practitioners, enrolled in the State Medical Register or the Indian Medical Register can provide consultation through telemedicine.

The guidelines state that consultation cannot be anonymous, and both the patient and the practitioner need to know each other’s identity. The medical professional is required to verify and confirm a patient’s identity by her or his name, age, address, email ID, phone number, a registered ID or any other form of identification.

Practitioners are also required to begin consultation by informing patients about their name and qualification. They should display their registration number on prescriptions, websites, WhatsApp numbers, emails and receipts.


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Mode of consultation

The guidelines list three modes of practicing telemedicine — video, audio and text messages.

A practitioner needs to choose the “best technology” for every patient. While a voice interaction may be preferred to an email or text message for diagnoses of certain patients, in other situations the professional may need to visually examine a patient.

Noting the strengths and limitations of all these modes of communication, the guidelines also acknowledge that telemedicine provides safety to patients as well as health workers, especially in situations where there is risk of contagious infections.

“It is therefore important to understand the strengths, benefits as well as limitations of different technologies. Broadly, though telemedicine consultation provides safety to the RMP (registered medical practitioner) from contagious conditions, it cannot replace physical examination that may require palpation, percussion or auscultation; that requires physical touch and feel,” states the guidelines.

Getting patient’s consent

The guidelines state that a patient’s consent is “necessary” for any telemedicine consultation. This consent can be implicit or explicit.

If a patient initiates consultation, the consent is implied. But when it is initiated by somebody else or the practitioner herself, then the patient needs to give an explicit consent.

“An explicit consent can be recorded in any form. Patient can send an email, text or audio/video message. Patient can state his/her intent on phone/video to the RMP (e.g., ‘yes, I consent to avail consultation via telemedicine’ or any such communication in simple words),” according to the guidelines.


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Kinds of medication to be prescribed

The guidelines place certain restrictions on prescribing medicines via teleconsultation.

Medicines must be advised “ONLY when a RMP is satisfied that he/she has gathered adequate and relevant information about the patient’s medical condition and prescribed medicines are in the best interest of the patient,” state the guidelines.

“Prescribing medicines without an appropriate diagnosis/provisional diagnosis will amount to a professional misconduct,” it adds.

The guidelines also list certain medicines such as paracetamol, lozenges etc., which can be prescribed through any mode of teleconsultation. But those listed under Schedule X of the Drugs and Cosmetics Act and rules or any narcotic and psychotropic substance listed in the Narcotic Drugs and Psychotropic Substances Act, 1985, cannot be prescribed over teleconsultation.

The guidelines also allow practitioners to provide health education as well as impart advice on immunisation, exercises, hygiene practices and mosquito control etc. They may provide counselling to patients too, especially on subjects such as food restrictions, dos and don’ts for those on anti-cancer drugs, proper use of hearing aids, home physiotherapy, etc to mitigate any underlying condition.


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Teleconsultation hub for Covid-19

Last week, Union Minister for Health & Family Welfare Dr Harsh Vardhan launched the ‘COVID-19 National Teleconsultation Centre’ (CoNTeC).

It was conceptualised by the Ministry of Health & Family Welfare and implemented by the All India Institute of Medical Sciences (AIIMS), New Delhi.

This centre has been made operational at AIIMS and doctors are available in the facility 24×7 on the number +91 91154 44155.

“It is a multi-modal telecommunications hub through which 2 way audio-video and text communications can be undertaken from any part of the country as well as the world…The modes of communication will include simple mobile telephony as well as two-way video communications, using WhatsApp, Skype and Google Duo,” a PIB release said.

According to Vardhan, the Centre will also act as a hub for sharing information regarding coronavirus among doctors across the country.


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