On 25th March, 2020, there was a big change in Indian Health Care System, when the Board of Governors in supersession of Medical Council of India published Telemedicine Practice Guidelines, thus enabling Registered Medical Practitioners to officially provide health care/ advice/ prescribe medicines to patients in India using telemedicine in any format: text/ audio/ video. These guidelines were notified (published in the Gazette of India) on May 14, 2020. This is going to bring change in the Health Services Delivery in a big way.
In addition to the convenience for patients and caregivers (saving travel and waiting time), it would also help in social distancing that is essential in weeks to come to fight the pandemic of Covid19 that is affecting all of us in multiple ways. In addition, it will give more weight and validity to any advice that the doctors give remotely to patients/ care-givers. The e-prescription issued by the doctors by teleconsultation will be as valid as a traditional prescription for all purposes.
However, it must be understood that teleconsultation has a limited scope as compared to in-Clinic consultation since the patient cannot be completely examined in tele-consultation. For example, in a child with significant cough, it is essential to examine his chest with a stethoscope, but it is not possible to do that in tele-consultation (It may be possible in future as technology is being developed for that also, but as on date it is not possible in India). If a child has severe pain abdomen, his abdomen may have to be examined (palpated) by the doctor and that is not possible with teleconsultation. However, it may be possible to diagnose certain skin or mild eye conditions on video-call. It may also be possible sometimes to follow up a patient with tele-consultation who has been seen in the clinic once. Giving detailed advice on vaccination, diet, physical activity, parenting tips, prevention of injuries, some behavioural issues are very much possible in tele-consultation. It may also be possible to advise some first aid in emergency situations. The scope of tele-consultation can be broadened if a patient who cannot come to the clinic but can be examined by another health worker at his/ her place.
As of now, the guidelines/law allow teleconsultation by registered doctors in India to patients in India only.
Considering all these practicalities and the Govt. Guidelines/law, this Clinic has now initiated formal teleconsultations with prior appointment/ mutual consent and online pre-payment of the fee. The fee would remain the same as that of in-clinic consultation and displayed in the Clinic.
Please understand that in any case, in-Clinic consultation is superior to a tele-consultation and must be preferred wherever feasible. Secondly, the feasibility of tele-consultation is to be decided by the doctor based on professional judgment and cannot be insisted on by the patient/ caregiver in any given case. Both the Doctor and the patient/ caregiver have the right to discontinue tele-consultation at any step, as per the Govt. guidelines/law.
The following process would be followed by the Clinic as of now. The process would be updated/ improved as we gain experience, get your feedback and the technology advances. As of now, we would prefer to use the WhatsApp platform (Whatsapp Video call), as it is most widely available platform and does not require any special app or link or infrastructure to start the process:
1. Patient/ caregiver need to call/ text (Whatsapp no. 011-45535647) to request for a teleconsultation, detailing the need.
2. If teleconsultation is not possible, then the caregiver would be suitably advised for in-Clinic consultation either in this Clinic or anywhere else. If it is acceptable to go for the teleconsultation in the condition, the caregiver would be asked to transfer the required fee. The fee can be transferred by UPI (BHIM or Google Pay or Phone Pe or SBI Buddy or Whatsapp or any other UPI platform)/NEFT/ IMPS/ USSD. The account details will be shared on Whatsapp to facilitate this. Sharing screenshot or transaction ID on WhatsApp is the next step.
3. A mutually acceptable time would be given for the tele-consultation. At that time, the patient/ caregiver would need to make a Whatsapp Video call on 011-45535647 to initiate the process. This would be the most acceptable method. In very selected situations it might be possible to give tele-consultation by phone call/ Whatsapp text or even e-mail.
4. The e-prescription would be sent by Whatsapp or e-mail. E-receipt can also be sent if required.
5. In case anyone needs a hard copy of the prescription/ receipt, he/ she can collect it from the Clinic reception during working hours within 7 days of the tele-consultation, free of cost. After 7 days, it will be issued only on receipt of a small, additional fee as displayed in the Clinic.
HYBRID CONSULTATION: In addition to "pure tele-consultation", we are trying to use this technology to help to reduce the time by parents/ patients inside the Clinic for in-Clinic consultations also, which can be a useful step in these COVID times. So, parents taking appointment for in-clinic consultation also can request for initiating the consultation virtually. The details of the child's ailment can be discussed on video-call before you come to the clinic. In addition general additional queries on the diet, parenting/behavioural issues, choice of vaccine variant etc. can be handled before you come to the clinic via a video-call. This will reduce the time spent by parents/ child in the Clinic. This service is available at no extra cost, but a pre-payment of consultation is essential. We would require a Whatsapp message from your side on 011-44535647, requesting for this service every time you require this.
We welcome your feedback on any aspect of this new service. Please feel free tocontact us.