Coronavirus has become the booster shot that telemedicine was waiting for in India

Going virtual.
Going virtual.
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India formally recognised the practice of telemedicine recently.

With Covid-19 cases spreading across the country, face-to-face consultations can be risky for both patients and doctors. Under the circumstances, remote consultations over the phone or video calls can help patients access health care while also limiting their and doctors’ exposure to the disease.

The government’s new “telemedicine practice guidelines” (pdf) legitimise the practice of remote consultations. This could pave the way for widespread adoption of telemedicine not only during this crisis but also in the future.

The story so far

The telemedicine space in India has seen some growth in recent times. Platforms like DocsApp, mfine, and Practo allow patients to connect with doctors and schedule virtual consultations.

However, the adoption of telemedicine has been limited. Patients’ comfort with face-to-face interactions and inertia to change were the key obstacles.

The regulatory uncertainty around health technology did not help either. Health tech players have faced some setbacks recently. For instance, e-pharmacies are still waiting for the government to finalise rules that would regulate their platforms. A 2018 Delhi high court order had banned the illegal sale of medicines online.

While e-pharma players maintain that they are only tech platforms and the ban does not hit them, the uncertain regulatory environment is still a cause of worry for investors.

Formal recognition offers much-needed clarity to existing players and potential investors who may have been on the fence about entering the space.

Pragmatic guidelines

The telemedicine guidelines, prepared by the Medical Council of India (MCI) board of governors and the government think tank NITI Aayog, provide doctors with practical guidance on the process of remote consultations.

Doctors can now provide consultations through video, audio, email or text. The guidelines categorise medicines that can be prescribed through different modes.

For instance, paracetamol and other mild drugs can be prescribed through any mode, drugs for hypertension or diabetes can only be prescribed on a follow-up consultation (that follows an initial physical consultation), and serious drugs like narcotics cannot be prescribed remotely at all.

A decision on whether a remote consultation is appropriate or not is left to a doctor’s professional judgement. Going forward, doctors will have to complete an online course administered by the MCI’s board to provide remote consultations.

Since an online course may take a while to develop, doctors can examine patients remotely in the interim but must abide by the guidelines.

The guidelines separately address tech platforms that enable telemedicine services. Such platforms can list a doctor only after due diligence verifying the doctor’s credentials. Importantly, the guidelines allow the use of artificial intelligence (AI) and machine learning tools to assist a medical practitioner in counselling a patient.

However, AI cannot be used to directly counsel patients. A platform cannot use bots to dole out medical advice. The advice must come directly from a doctor.

In sum, the guidelines follow a pragmatic approach in light of a compelling public health need.

Telemedicine: A new way of life

Many of the stop-gap solutions for the next few months could become our new normal. Digital payments in a post-demonetisation India and surveillance in a post-9/11 America are prime examples.

The current push for telemedicine could lead to wide adoption of e-health services in the long-run. This could include not only help in popularising remote consultations but also interoperable solutions that connect patients, doctors, diagnostic clinics, and pharmacies.

Telemedicine could be hugely valuable in India’s smaller towns and rural areas where there is a severe shortfall of doctors.

It could especially benefit women who often face additional barriers in accessing health care, such as being unable to visit healthcare professionals without a male companion. To be sure, there are already several public-private partnerships aimed at e-health in India’s remote towns.

The current environment, the government’s patronage and the rise of startups may provide the push necessary for India to embrace telemedicine.

With inputs from Tanya Sadana, principal associate, Ikigai Law. We welcome your comments at