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Digital health companies have urged the Union ministry of health and family welfare (MoHFW) to revise Telemedicine Practice Guidelines to address ethical concerns about privacy, use of patient data and its storage.
Telemedicine Practice Guidelines was released by the health ministry on March 25, 2020, a day after Prime Minister Narendra Modi announced a country-wide lockdown to curb the spread of the novel coronavirus. This led to closure of out-patient departments in most government and private hospitals.
The guidelines, prepared by the Board of Governors of the Medical Council of India (MCI) in partnership with NITI Aayog, enabled registered medical practitioners to provide healthcare using telemedicine. The guidelines list video, audio, and texting as three modes of communication and outline the provisions for their use by practitioners, including limitations.
Before Covid-19 pandemic, India had not introduced telemedicine practice in a big way. The telemedicine practice was not legal before issuance of the March 25, 2020 guidelines.
“With the emergence of the pandemic, there is an absolute rise in the use of teleconsultation. While slowly stepping into the healthcare industry, telehealth is yet to determine its full potential. To realize the full potential of telehealth, providers need to secure patients' crucial information. Without adequate privacy protection policies for the underlying telehealth data, patients will lack trust in the use of telehealth solutions. There is a need for secure connections which will protect the users' information as they use telehealth,” said Ramya Subramanian, co-founder, Docty, an AI-integrated global digital healthcare platform designed to eliminate care fragmentation in the health industry.
“The Telemedicine Practice Guidelines do not have clarity about privacy and data usage for patients and medical practitioners. They expect doctors to maintain records of all exchanges of communication between themselves and patients. The guidelines do not mention duration for storing data nor limits to further use of that data. The guidelines simply require the medical practitioner to be aware of the data protection and privacy laws and follow them. Privacy concerns arise as details, including a patient’s address and other reasonable identification is required to be recorded by the medical practitioner,” said Docty co-founder.
The guidelines specified the concepts of implicit and explicit consent but a mere start of a telemedicine consultation by an individual is considered as implicit consent. The guidelines need to elaborate more on consent in a teleconsultation and ways to obtain and record it. The guidelines also lack any mechanism for resolving grievances of patients or medical practitioners, said Subramanian.
Acknowledging this concern and bridging the Data Privacy gap, Docty has come up with its end-to-end data encryption. With this technology, the data stays completely secured, easing down the privacy concerns of the patients. Docty also abides by the HL7 security standards to ensure the security of critical information shared by its users, she added.
The startup aims to provide safe and reliable healthcare for patients anytime, anywhere. At present, Docty has marked its presence in India, Colombia, and South Africa and is further exploring and expanding its services in the African countries alongside the 'LATAM' region.
Echoing Subramanian’s concern, Amol Naikawadi, joint managing director and preventive healthcare specialist, Indus Health Plus said “With the opportunities of digital health (or telehealth) also come some fundamental security risks. In absence of data protection regulations, it is imperative for healthcare providers to take data privacy and security seriously to ensure that digital health platforms like telehealth remain an essential part of the future of patient care.”
“In order to safeguard the whole process, the first step is to assess how the data is encrypted and who is authorized to access this data. From there, IT teams should work closely with leadership to fill in the security gaps on telehealth solutions that protect patients while also providing convenience,” he said.
“The segment experienced a great surge after health ministry issued the guidelines on telehealth in March 2020. Telehealth allowed patients to interact to healthcare professionals even during the strict lockdown period. Delay in certain consultations due to restriction in physical movements could have otherwise led to many health complications. Online medical advice along with the use of technology, which would help provide vital information to the doctors to judge and understand the actual condition of the patient, could simulate an actual physical consultation in many cases. In this pandemic, where ensuring the safety of both the patients and healthcare professionals became the topmost priority, telemedicine came across as the ideal option especially for non-emergency cases,” said Naikawadi.
This platform also has the potential to enable health services to reach out to the rural and remote areas which presently do not have very updated healthcare facilities and has a financial advantage in terms of minimizing the costs of travel or establishing high end healthcare set ups in such areas, he stated.
Indus is planning to expand its resources to boost and enhance telehealth and genetic testing services pan India in coming months.
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