Telemedicine Practice Guidelines 2023

Telemedicine is the delivery of healthcare services from a distance, by use of information and communication technology. There have been no statutory regulations or official guidelines in India specific for telemedicine practice and allied matters till 2020. For the first time, the government of India released telemedicine practice guidelines for Registered Medical Practitioners on March 25, 2020, amid the COVID‐19 outbreak. After three years now the second edition of Telemedicine Practice Guidelines have been released on 2023 under the regulations of NMC Act 2019

The Telemedicine Guidelines 2023 permit Doctors to provide teleconsultation for prescribing medicines, providing counseling, and imparting health education. A doctor may use any digital mode (text/audio/video) for patient consultation, e.g. telephone, mobile or landline phones, chat platforms like WhatsApp, Facebook Messenger, etc., other mobile apps or internet-based digital platforms for telemedicine or data transmission systems like Skype/ email/ fax, etc. Telemedicine Practice Guidelines do not ban social media for consultation. This was a strategic move by the Indian government to reach the last person in a remote village to provide care. The user-friendly ecosystem and widespread use of social media have necessitated this move to reach the public at large.

The guidelines are with a restricted scope for providing medical consultation to patients, excluding other aspects of telemedicine such as research and evaluation and the continuing education of healthcare workers. The guidelines have elaborated on the eligibility for practicing Telemedicine in India, the modes and types of teleconsultations, delved into the doctor‐patient relationship, consent, and management protocols, and touched upon the data security and privacy aspects of Teleconsultation. The decision to manage the specific condition in teleconsultation or otherwise is left to the professional judgment of the RMP. Conversely, if a patient prefers in‐person consultation over teleconsultation, the same cannot be forced upon him. The guidelines take a balanced approach in managing the patient preferences and professional caliber of the RMP. Thus, it provides for shared decision making between the patient and the healthcare provider in terms of utilizing the services. All records of the patient consultation shall be maintained similar to the in‐person consultation similar to previous guidelines of 2020. The concept of informed consent has been included as an essential element in teleconsultation. Implicit or implied consent is taken if the patient initiates the teleconsultation. An explicit consent in words understood by the patient must be obtained if the RMP initiates the consultation, and the same must be mentioned in patient records.

The guideline spells the responsibility of the platforms that facilitate telemedicine to ensure the authenticity and credentials of the RMP enlisted to provide the teleconsultation in their platform. Any violation of the norms by the firms may lead to their blacklisting. The technology platforms are supposed to appoint a grievance officer, as mentioned under the IT Act. Though the present guidelines released in India for telemedicine are comprehensive and facilitator in nature.

There are no major changes between 2020 and 2023 guidelines. There are few changes made in the 2023 guideline, which are discussed in this video.