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Dos and Donts for doctors for practicing Telemedicine
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Dos and Donts for doctors for practicing Telemedicine

A virtual consultation is a process in which the person can seek a medical opinion without visiting the specialist in person.It is the only difference which makes virtual consultation different from a traditional medical consultation. The virtual consultations also allow a physician to start a chat session with the patient. The primary purpose of the virtual consultation is to provide quality healthcare services all over India. It includes facilitating access to healthcare to all the people in India. It will provide faster, cheaper and better communication for treatment, follow-up by experts, and to store medical records. There are some cons of virtual consultation as well. For instance, the virtual consultation will reduce direct interaction of patients with doctors because online interactions are impersonal, and also there is a need for a physical examination to be doneto make a complete diagnosis. Also, there is a lack of a standardized format to the interaction.A consent form is absent for either opting for or refusing the service of virtual consultation.

The doctors should begin the virtual consultation by informing the patient about his name and qualifications.Following are the Do’s and Dont’s for the doctors for video consulting:

No.

Do's

Dont's

1

The doctors can exercise his professional judgment to decide whether a virtual consultation is appropriate in a given situation, or there is a requirement of an in-person consultation. The doctor must gather sufficient medical information about the patient’s condition beforemaking any professional judgment.

The doctors cannot insist on the patient for virtual consultations if patientis willing to travel to a hospital or clinic orrequests an in-person consultation.

2

The doctorsshould verify and confirm the patient’s identity at the time of 1st consultation by name, age, address, email ID, phone number, registered ID or any other identification.

The doctors cannot misuse the patient images and data which are obtained at the time of virtual consultation.

3

Every doctor should display the registration number on prescriptions, website, electronic communication (i.e. through WhatsApp/ emailand receipts, etc.)that are given to his patients at the time of virtual consultation.

The doctors cannot use virtual consultations to prescribe medicines that are mentioned in a restricted list of Telemedicine guideline 2020.

4

The doctors must ascertain the identity of an adult, in the case where the minor is involved in a virtual consultation along with an adult.

The caregiver’s identity and authorization should be checked by the doctor before starting with the virtual consultation.

The doctors should not solicit patients for virtual consultationsthrough any advertisements.

5

The doctors must get the patient’s consent for any virtual consultation.

The doctor must record the explicit consentof the patient’s in his patient records.

The doctors should not do any acts which contravene the provisions that are mentioned under the telemedicine guidelines 2020.

6

The doctorsshould maintain all patient records, including case history, investigation reports, images, etc.

The doctors should not contravene the provisions that are mentioned under the Drugs and Cosmetics Act and Rules.

7

The doctors mustprescribe medicines via virtual consultation at his professional discretion only when he is satisfied that he has gathered all adequate and relevant information relating to the patient’s medical condition and prescribed medicines that are inthe best interest of the patient.

The doctors cannot prescribe the drugs mentioned under the prohibited list of telemedicine guidelines 2020 to a patient via virtual consultations.

8

The doctors must issue a prescription as per the Indian Medical Council Regulations.

The doctors should not continue with virtual consultations if he is not satisfied with the information given by the patient to provide specific treatment.

9

The doctors must retain the Patient records, reports, documents, images, diagnostics, data, etc. (Digital or non-Digital) that are utilized in the virtual consultation.

The doctors should not deny virtual emergencyconsultation. However, it should be limitedto first aid, life-saving measures, counselling and advice on referral.

Note - In case of every virtual emergency consultation, the doctors must advise the patient for in-person interaction with a doctor at the earliest.

10

The doctors are required to maintain the prescription records in the same way as it was required for the in-person consultations.

11

The doctors can charge an appropriate fee for providing the virtual consultation. From a fee perspective, the virtual consultations are treated in thesame way as in-person consultations.

12

The doctors must give a receipt or invoice for the fee that has been charged by him while providing virtual consultation.

13

The doctors must ensure that there is no breach of the patient’s privacy and confidentiality. The personal data of the patients should not be disclosed or transferred without the written consent of the patient.

14

The doctors must uphold and practice all the principles of medical ethics, including the professional norms such as protecting patient privacy and confidentiality as per the Indian Medical Council Regulations 2002 Act.

15

The doctors are required to fully abide by the IT Act, Data protection and privacy laws or any applicable rules that are notified from time to time to protect patient privacy and confidentiality and regarding the handling and transfer of such personal information of the patient.

16

The doctors can prescribe the drugs mentioned under the list O, A and B of telemedicine guidelines 2020 to a patient via virtual consultations.

Note - The List A contains those medications which can be prescribed during the first consult through video consultation and are being re-prescribed for re-fill, in case of follow-up consult.

The List B contains a list of medication which the doctors can prescribe to a patient who is undergoing follow-up consultation in addition to those which have been prescribed during an in-person consult for the same medical condition.

The List O contains those medicines which are safe to be prescribed through any mode of virtual consultation.


Conclusion

The video consultations will reduce the exposure of doctors, patients and medical staff to potential infections through remote screening and consultation. It also reduces the costs on time, expenditure and cuts travel of long distances for consultation and treatment in cases where there is no necessity for physical access, follow-up consultations, etc. With the beginning of the COVID-19 outbreak in India, there is a massive rise in virtual consultations. Hence, one can notice that the virtual consultation has started to grow in India.

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