The devastating coronavirus pandemic has exposed India’s creaky health infrastructure, a sector where things cannot be expected to improve overnight. The task is particularly challenging because of the urban-rural divide and the fact that an overwhelming majority of the doctors live and work in cities and towns. It is here that the advances in telemedicine will come in handy in reducing the stress on the healthcare infrastructure and catering to the health needs in rural areas. Though telemedicine, as a technology option, has been in vogue for nearly two decades, India has not been able to fully tap its potential. The recent expansion of the National Digital Health Mission with the rollout of unified health interface (UHI) gives an indication of the government’s intention to accord priority to telemedicine in the fight against Covid-19. However, while the move is in the right direction, it is essential to safeguard the interests of healthcare professionals as well as patients. The Telemedicine Practice Guidelines, 2020, lay down the basic framework for practising telemedicine in India. Though they help remove the ambiguity surrounding the legitimacy of telemedicine, they still leave several questions unanswered, including those regarding the safety of the entire process and the involvement of technology providers. The guidelines fail to address the issues relating to the data generated in the process of telemedicine. While it is prescribed that the registered medical practitioners are to ensure patient privacy and confidentiality, there are no standards relating to the technology required to ensure the safety of the patient’s electronic records or the explicit liability in case of data leak.
The absence of a clear grievance redressal mechanism regarding telemedicine service providers is another significant omission. As the application of telemedicine grows in India, significant challenges like medico-legal liability of doctors in case of negligent consultations are likely to arise. The rising Covid-19 cases, particularly in rural areas, alarming positivity rate and extended lockdowns have made many healthcare services inaccessible to people. In these troubled times, digitisation of healthcare has offered a reprieve. The challenges arising from the pandemic have provided Central and State governments with a great opportunity to increase the spread of telemedicine and reduce the burden on the overstretched healthcare sector. In fact, the market for teleconsultations in India is expected to grow from $100 million to $700 million over the next five years, marking an annual growth of 48%. There is a need to urgently upgrade the telemedicine regulations and address the issues relating to data safety, privacy as well as demarcating liability of technology providers and healthcare workers. A strong verification process is crucial to prevent quackery. There is also a need to customise digital healthcare and develop more cost-effective, user-friendly and secure telehealth systems.
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