New telemedicine guidelines released: Urgent need of the
hour
Dr KK Aggarwal
The
government has released new telemedicine guidelines. These guidelines were much
needed and have come at an opportune time.
A
doctor at a mohalla clinic in Delhi has tested positive for Covid-19. His wife
and daughter of the doctor have also tested positive for the virus. Following
this, over 800 people who recently visited the clinic have been put under home
quarantine and asked to contact the control room if they develop any symptoms.
The clinic has been closed and sanitized (Business Today). It has been reported
that the doctor developed the infection after contact with an infected woman
who returned from Saudi Arabia (TOI).
Modalities
like telemedicine are now absolutely essential if we are to prevent many more
such scenarios. The number of positive Covid-19 cases is increasing every day
in India. The entire country is under a lockdown with the intent to break the
chain of transmission.
Teleconsultations
will help to prevent cross infection of flu or corona-like illnesses among the
large number of patients waiting to see the doctor.
We
have been asking the government to permit teleconsultations, especially for
cases of respiratory infections, for precisely this reason. We had written to
the PMO in this regard as early as on 7th February (PMOPG/E/2020/0066034, dated Feb 7,
2020), when the PMO has cancelled Holi celebration events.
Teleconsultations
are useful for routine checkups and follow-up. In cases of flu it is easy to
identify patients who need hospitalization as they will be breathless.
The
guidelines have been developed by the Board of Governors in partnership with
Niti Aayog.
All
Registered Medical Practitioners can provide telemedicine consultation to
patients from any part of the country. But they are bound by the same
professional standards and ethical regulations as they apply to the regular
consultations in the clinic.
Four
types of telemedicine consults have been identified according to:
·
Mode of communication (video, audio,
text-based
·
Timing of the information transmitted (real
time or asynchronous – accessed as per need or convenience)
·
Purpose of the consultation (Non-Emergency or
emergency) and
·
Interaction between the individuals involved
(RMP-to-patient / caregiver, or RMP to RMP).
Five scenarios have been defined:
1. Patient to
Registered Medical Practitioner
2. Caregiver
to Registered Medical Practitioner
3. Health
Worker to Registered Medical Practitioner
4. Registered
Medical Practitioner to Registered Medical Practitioner
5. Emergency
Situations
Both
the patient and the doctor need to know each other’s identity. Patient consent
is necessary for telemedicine. If the patient initiates the telemedicine
consultation, then the consent is implied.
The
complete guidelines are available at the Health Ministry’s website.
Here
are some safe practice guidelines for doctors:
·
Provide as many paid tele consultations as
possible at least for the duration of the lockdown.
·
Doctors aged more than 65 years with
uncontrolled diabetes, immunocompromised, who have six minutes’ walk
distance< 200 meters, are unvaccinated for flu and pneumonia (with common
secondary or co-infections) should completely stop OPDs and only give tele
consultations.
·
Inform all patients that if they or any close
contact has and fever they should call first and not visit the clinic/hospital
without tele consultation.
·
Always wear surgical masks; if doing any
procedure where aerosols may be produced, use N95 masks.
·
Doctor with cough and fever should go for
self-quarantine and Covid-19 assessment, In a WHO study from Italy, it has been
shown that 90% of doctors attending patients were asymptomatic when they were
tested COVID-19 positive.
·
Install air purifiers with 10 air exchanges
per hour rate at the clinic
·
When you come back home from you clinic, wash
feet first, then hands, face, change cloths (keep them in separate box for
washing), decontaminate all surfaces you have touched including your car, wash
hands again with soap and water.
·
Stay away from elderly people in your home if
possible.
No comments:
Post a Comment