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AVOIDING REGULATORY NON-COMPLIANCE

Risks of Non-Compliant Telemedicine Practice

As the fastest-growing segment of the healthcare industry, telemedicine is well poised to be the ‘new normal’. Particularly suited in providing value-based care, telemedicine has proven its worth by utilising a wide range of technology options instead of clogging up emergency rooms and already-crowded private clinical spaces. Patients experiencing relatively small health issues can now consult with and receive treatment from their personal physicians or medical experts. With the onset of the coronavirus pandemic in 2020, the rules of patient care have changed. Still, it has also opened up new doors of adaptability for doctors and patients who are looking for a more effective healthcare delivery experience.


Telemedicine Guidelines 


Having found a new home in numerous use cases, telemedicine has proven its worth through remote patient monitoring and peer-specialist collaboration to interactive patient-physician consultations and enhanced medical access in remote areas with fewer medical experts. As a result, telemedicine is delivering a host of benefits across all members in the healthcare ecosystem. For instance, as a doctor, it can allow you to interact with and treat patients with less-severe problems quickly, providing additional in-person time concerning more challenging patient scenarios. Within the hospital and private practice setting, telemedicine offers a steady flow of revenue, especially given how it can be a reimbursable solution for insurers. But most importantly, for patients, telemedicine allows them to stay away from congested and potentially unhealthy spaces such as waiting rooms for the right diagnosis and treatment.


Nevertheless, while telemedicine can ensure effective healthcare delivery, the risks of noncompliance can raise potentially significant challenges. According to the latest telemedicine practice guidelines, announced by the Ministry of Health and Family Welfare in association with NITI Aayog, the revised guidelines were issued to meet the crisis faced by the country and do away with patients crowding clinics and hospitals in the era of Covid-19.


From laying down relevant provisions, telemedicine and telehealth were defined with specific exclusions for registered medical practitioners to follow. The guidelines also lay down particular prerequisites that RMPs would need to adhere to. These include:


  • Undergo an online programme that is currently under development by the Board of Governors in accordance with the Medical Council of India.
  • Provide online consultation only after completing the mandatory online course within three years of the notification.
  • Follow the principles mentioned in the guideline during the interim.
  • Undergo and qualify for the course prior to practising telemedicine.


The guidelines also lay down specific tools that RMPs need to use for telemedicine such as technologically-based advancements to carry out consultations over telephone, video, internet, mobile or landline phones. The guidelines also classify telemedicine applications based on the mode of communication, the timing of the data to be transmitted, the purpose of consultation and interaction between doctors and patients.


Further, the guidelines also state how RMPs are required to use their professional judgment in deciding whether the patient needs telemedicine consultation or an in-person meeting depending on the health of the patient. Additional compliance rules indicate that the identity of the patient and the doctor must be disclosed to one-another while seeking the patient’s consent for consultation as a prerequisite. The guidelines also list the kind of discussion that doctors need to provide and specific restrictions on prescribing drugs during the treatment. From laying down the duties and responsibilities of the doctor, the guidelines also include what could constitute misconduct and penalties in the event of noncompliance.


In the event of a breach of contractual obligations between the doctor and the patient, civil suits could arise, or if the breach of duty has been caused by omission, it could result in negligence.


Mitigating Compliance Risk


Regulatory mandates can be an increasingly challenging issue, especially in telemedicine. Since the process of providing patient care is through electronic forms, rather than human interaction, telemedicine activities are likely to fall under the purview of several compliance rules and governing bodies. If the doctor is consulting with patients outside the country, he or she would also need to adhere to growing numbers of state and local regulatory bodies participating in regulations outside India. Besides, additional mandates that also address a wide range of requirements for healthcare data such as Personally Identifiable Information (PII) and Electronic Protected Health Information (EPHI) must be adhered to.


As a healthcare provider, in order to mitigate compliance risk in telemedicine, it is critical to look for a telehealth solution that not only incorporates the entire rainbow of today's compliance issues but is also flexible enough in its technology and design to account for the evolving nature of compliance mandates in the future. The telehealth solution or platform you choose must not only be technology-agnostic to protect the information that you collect across sources and devices but also from equipment such as sensors and medical instruments.


Given that healthcare security is a grave risk adding telemedicine to this hotbed of activity could add to the mix. The telehealth solution that you choose must be in accordance with the Critical Security Controls standard that is an important benchmark for hardware devices, software inventory, application-layer security, malware defences, vulnerability evaluations, system configurations etc.


Choose the right telehealth platform that is designed with security as a core requirement across the solution. Since Internet of Things (IoT) components are increasingly becoming a vital part of the healthcare delivery ecosystem, choosing the appropriate telemedicine solution that can account for the unique and still-evolving requirements of IoT devices is also crucial.


Choosing the Right Telemedicine Solution


Despite numerous telemedicine solutions providers, selecting the right one designed for your specialised needs of consulting with your patients through video and accessing their records is a primary prerogative. Here are some factors to consider when deciding a telehealth solution:


  • Widely deployed as a HIPAA-compliant platform
  • Designed by experts in healthcare practices and IT requirements and compliance, security and governance
  • A fully-compliant telemedicine solution that identifies, blocks and re-mediates regulatory and cyber risks
  • An online clinic that enhances patient engagement
  • Streamlines clinical caregiving and improves your revenue
  • Ensures consistency with enterprise-wide data governance policies
  • Enables data transfer to the right EMR software
  • Ability to help increase patient flow
  • Help patients experience high-quality medical care without the time, expense and hassle of travelling to your clinic
  • A simple and easy-to-understand solution that can improve your workflow and enhance productivity


Rethinking Healthcare


Every healthcare system across the world has been thoroughly tested in the last few months. Unfortunately, while most of them were grossly underprepared for the situation, it also revealed gaping holes in the physical infrastructure of India's healthcare system. Today, we need to wake up to the call to modernise our thinking and reimagine healthcare infrastructure while driving robustness in our healthcare systems in the post-Covid-19 world. Adopting telemedicine is one aspect that could indicate our strength in resolving and rebooting our healthcare sector. And while the current pandemic reveals how healthcare has to be given the topmost priority in the New World, adopting telemedicine practice as a viable solution could be the answer to becoming proactive, well-equipped and watchful in tackling health challenges of tomorrow.


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