TelecomLive April-2020

Telemedicine Telecom LIVE April 2020 12 www.telecomlive.com According to guidelines, there are three primary modes: video, audio or text (chat, messaging, email, fax etc.) Each one of these technology systems has their respective strengths, weaknesses and contexts, in which, they may be appropriate or inadequate to deliver a proper diagnosis. It is, therefore, important to understand the strengths, benefits as well as limitations of different technologies. Broadly, though telemedicine consultation pro- vides safety to the registered medi- cal practitioners from contagious conditions, it cannot replace phys- ical examination that may require palpation, percussion or auscultation; that requires physi- cal touch and feel. Newer technol- ogies may improve this drawback, said the guidelines. Patient consent is necessary for any telemedicine consultation. If the patient initiates the telemedicine consultation, then the consent is implied while an explicit patient consent is needed if a health worker, RMP or a caregiver initiates a telemedicine consulta- tion. "There may be situa- tions where in order to reach a diagnosis and to understand the context better, a real-time consul- tation may be preferable over an asynchronous exchange of information, said the MCI-Niti Aayog report. According to the guidelines, “All registered medical practitio- ners intending to provide online consultation need to complete a mandatory online course within three years of its notification. In the interim period, the principles mentioned in these guidelines need to be followed. Thereafter, undergoing and qualifying such a course, as prescribed, will be essential prior to practice of telemedicine.” The guidelines have also imposed certain restrictions on the type of medications that can be prescribed based on the type of consultations. For instance, over-the- counter drugs and medicines used for common conditions come under “List O” and can be prescribed through any mode of consultation, including texts. There are also certain medi- cines listed in “List B” that can only be prescribed after a follow- up or in-person consultation. Meanwhile, “List A” has relatively safe medicine with low potential for abuse. These can be prescribed over video-consultations only and in a follow-up consultation for a refill. List of medicines under “List A”, “List B” and “List O” is given in table on . next page The government has also listed out certain drugs that cannot be prescribed through telemedicine. This includes drugs listed under “Schedule X” of Drugs and Cosme- tics Act and Rules and any Narcot- ics and psychotropic substance listed in the Narcotics Drugs and Psychotropic Substances Act of 1985. There has been a concern on the practice of telemedicine in the country and lack of clear guide- lines created significant ambiguity for registered medical profession- als, raising doubts on the practice T he health ministry released the guidelines on telemedicine so that medical practitioners can treat patients, including peo- ple suspecting Covid-19 symp- toms, remotely by using telemedicine tools. The board of governors of the Medical Council of India along with Niti Aayog framed the guidelines. Guidelines came out after almost a decade post its initial proposal in 2010. These guidelines, to be pub- lished under the IMC Act, are designed to serve as an aid and tool to enable all registered medi- cal practitioners (RMPs) to effec- tively leverage telemedicine to enhance healthcare service and access to all. The document provides infor- mation on various aspects of telemedicine, including on tech- nology platforms and tools avail- able to medical practitioners and how to integrate these technolo- gies to provide healthcare deliv- ery. It also spells out how technol- ogy and transmission of voice, data, images and information should be used in conjunction with other clinical standards, protocols, policies and procedures to provide care. “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 medi- cal practitioners can evaluate and manage patients”, read the guide- lines. Telemedicine Govt to notify guidelines What is Telemedicine The delivery of health-care services, where distance is a critical factor, by all health-care professionals using informa- tion and communications technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evalu- ation and the continuing education of health-care workers, with the aim of advancing the health of individuals and communities, is defined as telemedicine.