Telemedicine in India has long been touted as a tool to overcome the scarcity and skewness in distribution of medical doctors and provide specialist beyond urban centers. It has also been increasingly explored as a tool to increase timely and convenient access to appropriate interventions.
The journey started many years back along with India’s satellite program with VSAT based telemedicine systems. These systems suffered from poor bandwidths and technologies that were not developed enough to deliver a consultation experience that could instill confidence in both doctors and patients. Given the cost of technologies involved and justified commercial interests of all stakeholders (specialist doctors, network provider, local medical practitioners, others), cost per consultation became too high to be commercially attractive. All this while the expectation was that someone will pay these high charges – government did not, and of course the common man could not.
Over the years, technologies evolved, costs came down, communication networks capable of carrying heavy data loads became faster, cheaper, and importantly available across India. While technological acceptance increased, costs were still high but depending on the use case, there was a market willing to pay the price.
Still, there was one key challenge – Tele-medicine was still not strictly legal! There were so many dos and don’ts and grey areas, that many who were interested, were confused.
Industry tried for many years to nudge the government to legalize it through appropriate guidelines. But the discussions dragged on for years.
Then on 29 March 2020, Government of India, finally issued the guidelines legalizing telemedicine in India. And this time, the nudge was not given by any new argument, but by a virus – Covid-19. In context of the unprecedented lockdown, government got the right opportunity to issue guidelines for telemedicine so that citizens could avail medical care during lockdown, and this time, everybody agreed.
The notified guidelines provides norms and protocols relating to physician-patient relationship; issues of liability and negligence; evaluation, management and treatment; informed consent; continuity of care; referrals for emergency services; medical records; privacy and security of the patient records and exchange of information; prescribing; and reimbursement; health education and counseling.
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