Telemedicine Practice Guidelines 2020: What Hospitals Must Get Right
Identity, consent, records and prescribing rules for teleconsultations in India.
Where the rules come from
The Telemedicine Practice Guidelines were issued on 25 March 2020 by the Board of Governors that then superseded the Medical Council of India, and were added as Appendix 5 to the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. They remain the reference point for how registered medical practitioners consult remotely.
Identity, consent and records
The doctor and patient should know each other's identity. When a caregiver, health worker or another doctor starts the consultation, the patient's explicit consent is needed, and explicit consent is also needed before a prescription is sent directly to a pharmacy. Doctors must keep a digital trail or documentation of each consultation, which your teleconsultation platform should capture automatically.
- Verify identities at the start of each consultation.
- Record explicit consent where the guidelines require it.
- Keep the consultation record and prescription in the patient file.
Prescribing limits
The guidelines sort medicines into lists. List O medicines are considered safe to prescribe by telemedicine, List A can be prescribed at a first video consultation, and List B can be added in follow-ups. Schedule X drugs and drugs under the NDPS Act are prohibited. Prescribing without an appropriate or provisional diagnosis is treated as misconduct. Build these lists into your platform so the system helps doctors stay inside them.
- The guidelines date from 25 March 2020 and sit in the medical ethics regulations.
- Identity, explicit consent and records are basic duties.
- Prescribing lists should be built into the platform.
Review your teleconsultation platform: where is identity confirmed, where is consent recorded, and can it block a prohibited medicine?
Check your understanding
1. When were the Telemedicine Practice Guidelines issued?
2. Which medicines cannot be prescribed by telemedicine?
3. What must a doctor keep for each teleconsultation?
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