One of the perplexing questions that have baffled technologists for long is why the regulators have not approved the use of teleconsultation for doctors. In the past, I have felt the need for Tele-Consultation or Telemedicine, tremendously to improve care in India.
Here are my reasons
- As a doctor, I used to see the 8 hours of works heavily imbalanced. I was free for the first 5 hours of the day but loaded towards the evening. The last three hours and especially the weekends would be packed and I would be overworking at that time. If I had to balance that time well, was If I could equally load the patients throughout that 8 window period. But as I would have to meet the patients and they might require someone to bring them to the clinics.
- Our health infrastructure, both in terms of people, beds and devices, is based in the cities. Our rural areas are underserved and they need to make the trip tot he cities for any healthcare service. Sometimes even to take a blood test or an X-Ray. While they might need to make the trip to avail of lab facilities, through Tele Medicine, this problem should be solved.
- India needs cheap access to care. Most consultations are expensive as they take into account the investments in infrastructure, rent, etc. With Telemedicine, one has to only pay rent for platform and bandwidth charges. The overall cost of consultation should come down.
While I have argues for this for long, the regulations until recently did not allow for telemedicine or teleconsultation.
The breakout of Covid19 has changed everything. With social distancing emerging as the best defense against Covid19 it is obvious that the next step was the guidelines for telemedicine from the Medical Council of India.
On 25th March 2020, the Medical Council of India along with Niti Aayog has released the Telemedicine Practice Guidelines. The document can be found here
In summary, these are the key areas covered by the document.
- Guidelines for Telemedicine in India Elements specific to Telemedicine
- Appropriateness of Telemedicine
- Identification of RMP and the patient
- Appropriateness of technology/Mode of Telemedicine
- Patient Consent · Patient Evaluation · Patient Management: Health education, counselling and medication Duties and responsibilities of RMP in general
- Medical Ethics, Data Privacy & Confidentiality
- Documentation and Digital Records of Consultation
- Fee for Telemedicine
2) Framework for Telemedicine
- Patient to Registered Medical Practitioner
- Care Giver to Registered Medical Practitioner
- Patient to RMP through Health Worker at a Sub Center or any peripheral center
- Registered Medical Practitioner to another RMP / Specialist
3) Guidelines for Technology Platforms enabling Telemedicine
I would recommend that everyone should read these guidelines. It’s a great read for startups and technology providers planning to build these platforms and healthcare providers planning to develop their telemedicine services.
As always questions and clarifications are welcome.