TelecomLive April-2020

Telemedicine www.telecomlive.com 13 Telecom LIVE April 2020 of telemedicine. The new guidelines aim to address such concerns and empower regis- tered doctors to reach out to patients safely. Globally, telemedicine has emerged as a front-line weapon against the Covid-19 pandemic. The Centers for Disease Control and Prevention in the US and the National Health Service in the UK have recom- mended its use for identifying high-risk patients and for treating other illnesses during the outbreak. The decision has been lauded by existing digital healthcare platforms who believed that such a framework was the need of the hour especially when the country is grap- pling with the coronavirus pandemic. In India, till now there was no legisla- tion or guidelines on the practice of telemedicine, through video, phone, Internet based platforms (web/chat/apps etc). The existing provisions under the Indian Medical Council Act, 1956; the Indian Medical Council (Professional Con- duct, Etiquette and Ethics Regulation 2002); Drugs & Cosmetics Act, 1940 and Rules 1945; Clinical Establishment (Regis- tration and Regulation) Act, 2010; Infor- mation Technology Act, 2000; and the Information Technology (Reasonable Secu- rity Practices and Procedures and Sensitive Personal Data or Information) Rules 2011, primarily govern the practice of medicine and information technology. Gaps in legis- lation and the uncertainty of rules pose a risk for both the doctors and their patients. support systems etc. could assist and support anRMP on patient evaluation, diagnosis or management, the final prescription or counseling has to be directly delivered by theRMP. 5. Technology platform must ensure that there is a proper me chan i sm i n p l a c e t o addr es s any que r i es or grievances that the end- customermay have. 6. In case any specific technol- ogy platform is found in violation, BoG, MCI may designate the technology platform as blacklisted and no RMP may then use that p l a t f o r m t o p r o v i d e telemedicine. 3. In the event some non- compliance is noted, the technology platform shall be required to report the same to Board of Governors (BoG), in supersession to MCI who may take appropriate action. 4. Technology platforms based on Artificial Intelligence / Machine Learning are not a l l owe d t o c oun s e l t h e patients or prescribe any medicines to a patient. Only an RMP is entitled to counsel or prescr ibe and has to directly communicate with the patient in this regard. While new technologies such as Artificial Intelligence, Internet of Things, advanced data science-based decision 1. T e c h n o l o g y p l a t f o r m s (mobile apps, websites etc.) p r o v i d i ng t e l emed i c i ne services to consumers shall be obligated to ensure that the consumers are consulting with Registered Medical Practitioners (RMP) duly registered with national medical councils or respective state medical council and comply with relevant provi- sions. 2. Technology platforms shall conduct their due diligence before listing any RMP on its online portal. Platform must provide the name, qualifica- tion and registration number, contact details of every RMP listed on the platform. Guidelines for Technology Platforms enabling Telemedicine Medicine Lists List O Common over-the counter medications such as: § Antipyretics: Paracetamol § Cough Supplements: Lozenges § Cough / Common-cold medications (such as combinations of Acetylcysteine, Ammonium Chloride, Guaifensen, Ambroxol, Bromhexene, Dextromethorphan) § ORS Packets § Syrup Zinc § Supplements: Iron & Folic Acid tablets, Vitamin D, Calcium supplements, etc Medications notified by government of India from time to time on an emergency basis such as: § Chloroquine for Malaria control for a specific endemic region, when notified by Government List A First Consult Medications (Diagnosis done on video mode of consultation) such as: § Ointments / Lotion for skin ailments: Ointments Clotrimazole, Mupirocin, Calamine Lotion, Benzyl Benzoate Lotion etc § Local Ophthalmological drops such as: Ciprofloxacillin for Conjunctivitis, etc § Ear Drops such as: Clotrimazole ear drops, ear wax drops etc § Follow-up consults for above medications Follow-up medications for chronic illnesses for ‘re-fill’ such as: § Hypertension: Enalapril, Atenolol etc § Diabetes: Metformin, Glibenclamide etc § Asthma: Salmetrol inhaler etc List B Follow-up medications prescribed as ‘Add-on’ to ongoing chronic medications to optimize management such as: § Hypertension: e.g. add-on of Thiazide diuretic with Atenolol § Diabetes: Addition of Sitagliptin to Metformin