This article has been written by Khadeeja Zaidi, pursuing the Diploma Programme in Cyber Law, FinTech Regulations and Technology Contracts from LawSikho.

Introduction

The development of communication technologies has a dramatic influence on culture. The internet, cell phones and e-mail are different domains, and if health care professionals want to join this space, they will be careful to do so. Telemedicine has medical-legal implications for aspects of identification, licencing, insurance, protection, privacy and confidentiality, as well as other risks related to online healthcare communication. The International Advisory Group of the World Health Organization (WHO), which met in Geneva in 1997, identified telemedicine as providing healthcare services, where distance is a critical factor, to health care providers, who use the information and communications technologies to exchange relevant information for the diagnosis, treatment and prevention of diseases and injuries, and to continue to do so.

In the context of the COVID-19 Pandemic Lockdown, the Indian Government has authorised telemedicine legal status. The Governing board, established by the Government at a meeting of the Indian Medical Council with the Ministry of Health and Family Welfare’s approval, published a notice dated 25 March 2020 (‘Amendment’) modifying Guidelines of the Indian Medical Council 2002 on telemedicine in India. The amendment introduced ‘Telemedicine consultation’ to the law.

The demand for telemedicine is rising exponentially. With advances in technology, telemedicine devices are more usable and affordable. Telemedicine has been developed to treat people with minimal access to healthcare services in remote areas. However, it is now a comfort device in the area of healthcare. The increasing use of mobile phones is a significant factor responsible for developments in this field. The availability of mobile apps lets patients monitor their health status. This proactive approach enables them to make use of creative means of accessing health services such as telemedicine.

Telemedicine and telehealth

The World Health Organization (WHO) defines telemedicine as ‘the delivery of healthcare services, where distance is a critical factor, to those healthcare professionals using information and communication technologies, the exchange of specific knowledge on detection, treatment and prevention of the disease and injuries, research and analysis, and maintaining health education.’ Telehealth includes distance learning, patient care services, peer review, etc. Telemedicine is a potential healthcare industry that is making use of telecommunications technologies to provide healthcare. Telemedicine seems to be in the beginnings in India. Given that a significant percentage of our population continues to live in rural areas and that health facilities are predominantly concentrated in urban areas, telemedicine has immense potential for growth. It bridges the gap between demand and availability.

Digital consultation is a process of receiving a medical opinion without meeting a doctor in person, which is the only distinction from a conventional medical consultation. Digital consultations often allow a physician to engage in discussion with another physician to consult various electronic medical records. The primary objective of telemedicine and remote consultation is to provide adequate healthcare services in India. It includes promoting access to care for wealthy and underprivileged populations, offering easier, cheaper and effective patient interaction, expert follow-up, and monitoring.

In most cases, telemedicine is beneficial. This provides access to healthcare services in remote areas for persons with mobility issues and people with disabilities. This may also overcome geographic barriers to the delivery of healthcare services. It can provide an incentive for the patient and caregiver to minimise health care costs and save time. With telemedicine’s advent, a medical practitioner or hospital can consult with a range of specialties, irrespective of where they are located. Telemedicine helps patients communicate more often with their health care providers in a relaxed manner, leading to a greater relationship between the doctor and the patient. Patient check-ups are expected to be higher and could improve outcomes. Telemedicine, in general, has the potential to deliver affordable health care to people.

Measures of involvement in telemedicine

For telecommunications, the following steps are taken –

1. Consultation for the first appointment – The patient activates a telemedicine consultation, e.g. the patient may make a video or audio call to an RMP. The patient could write an e-mail or even a message to the RMP Health Consultation. The initial visit suggests that the patient consults with the RMP for the first time, but more than six months down the line since the last appointment or perhaps the patient visited the RMP earlier and a different health issue.
2. Detection and assessment of the patient- The RMP must validate the patient’s identity to the patient’s convenience by requiring the patient’s name, age, address, e-mail ID, telephone number or any other identification that may be necessary.
3. Patient Evaluation – A patient’s condition must be assessed immediately by the RMP based on relevant details. Whether urgent treatment is required, RMP uses its medical experience to decide if emergency care is needed. If the patient’s condition needs emergency intervention, first aid/immediate relief advice is given and, if necessary, reference data is provided.
4. Patient assessment- The RMP may require the patient to request relevant details (complaints, information regarding any other appointments concerning the same issue, possible specifics of the investigation and treatment, if any). The patient is liable for the accuracy of the information shared with the RMP. If the RMP thinks that the information provided is inadequate, it will ask the patient for more details. As far as the nature of such information is concerned, this information can be shared in real-time or shared later via e-mail/text. The appointment can be resumed at a rescheduled time after additional information has been collected (this may include any laboratory or radiological tests).
5. Patient management- If the condition can be handled appropriately through telemedicine, the RMP can take professional judgement either to provide health education as necessary, or to provide advice on specific clinical conditions, including guidance on new investigations to be performed prior to the next appointment, or to provide specific treatment by prescribing medicinal products as outlining.

Problems encountered

Telemedicine is presently not part of medical education in India. There are concerns about safety, confidentiality, the security of medical information and treatment. The interface includes a formal framework and the absence of an agreement to request or deny service. No health care scheme has some telemedicine considerations in India, says Dr Ravi Agrawal, a field expert. He says there is confusion about responsibility in the case of negligence.

The tremendous reward has been widely promoted in the consolidation and preservation of electronic health records (EHRs). Apart from improving the quality of care and having convenient access to patient medical records, EHRs may also be used for research studies. The growing concerns surrounding the protection of sensitive patient information need to be addressed as rapidly as possible to efficiently implement technical solutions that will allow the storage, evaluation and recovery of medical information.

Telemedicine generally includes medical professionals who administer medications exclusively based on electronic communications (or discussions with the patient about any other audiovisual means). Consequently, the uncertainty surrounding the legality of e-pharmacies and tell pharmacies in India continues to be the biggest challenge for the distribution of telemedicine services in India.

The Prospect of Telemedicine

Telemedicine accounts for just three-thousandths of one percent of all patient appointments. Although in the coming days, this expects rapid growth. This would improve communication and teamwork and satisfy patients. Telemedicine is being used in various situations, e.g. telehealth, telecare, teleradiology, telepathology, telediagnosis, telemonitoring, telepsychiatry, teledermatology, telemonitoring, telemonitoring, telepharmacy, telecardiology, tele endoscopy, teledentistry, teledialysis, telemedicine, telesurgery, robotic surgery as well as automated check.

There seems to be a lot of optimism for the future of telemedicine. Telemedicine would become more comfortable and more widely adopted over the coming years, with growing technological advances. We need to develop plans and guidelines for the successful integration of telemedicine into the existing health care system. Regulations are urgently required to resolve medical issues related to the use of telemedicine so that patients can have access to such services without any reservation. There is also a requirement for an open network for the benefit of telemedicine for consultation, which guarantees that the telemedicine services are readily available in a secure way, in order to preserve the integrity and privacy of the relationship between the doctor and the patient. The use of smartphone-based applications would be implemented to make healthcare services available so that a patient can contact a doctor without having to travel directly for a consultation.

Conclusion

Looking at the numbers, India’s telemedicine sector’s size seems very promising, and with an upward trajectory, one with enormous potential. A recent study by the McKinsey Global Institute estimated that implementing telemedicine technology could save around $4-5 billion annually and replace half of India’s in-person emergency consultations. The Global Market Insight report estimates that the global telemedicine industry will cross a value of $130.5 billion by 2025, with India’s market expected to rise to 2.4 per cent CAGR. Telemedicine services can prove to be an effective way to bridge the gap between urban and access to quality care facilities in rural areas. The current Government’s strong focus on digitisation has served as a catalyst to boost business expansion.

Even so, this industry’s fate and future remain uncertain in the absence of consistent rules and regulations on telemedicine services in India. In order to eliminate any possible danger, manufacturing companies can ensure that they comply with all applicable regulations in place and are contractually covered.

References

• https://www.mohfw.gov.in/pdf/Telemedicine.pdf  
• https://www.goodrx.com/blog/what-is-telemedicine/  
• https://www.expresshealthcare.in/blogs/guest-blogs-healthcare/telemedicine-in-india-is-the-time-ripe/412528/   
• https://www.indialegallive.com/special-story/analysis-of-telemedicine-guidelines-96711  
• http://www.technewsandtrends.com/category/e-commerce/  

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