World Health Organization defines telemedicine as:
“The delivery of health-care services, where distance is a critical factor, by all health-care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and the continuing education of health-care workers, with the aim of advancing the health of individuals and communities.”
India's digital health policy advocates use of digital tools for improving the efficiency and outcome of Healthcare system and lays significant focus on the use of telemedicine services especially in the Health and Wellness centres at the grass root level wherein a mid-level health care provider / health worker can connect the patient to the doctor through Technology platforms for providing timely and the best possible care.
Siddha E-Clinic is founded based on the above theme to deliver Siddha System of health care services through tele-medicine to the needy people by leveraging the digital technologies. Practice of Telemedicine can prevent transmission of infectious diseases, reducing the risk to both doctors and patients by avoiding social contact. Telemedicine will not only encourage social distancing in special situations of epidemics and pandemics but talking to doctors will also allay their anxiety in the situation of complete lockdown.
Siddha E-Clinic – Approach to Telemedicine:
We, at Siddha E-Clinic follow the framework as depicted below for the best delivery of the Siddha system of medicine.
Complexity of Patient’s health condition varies patient to patient. Doctor exercises her professional judgment to decide whether a telemedicine consultation is appropriate in a given situation or an in-person consultation is needed in the interest of the patient. She considers all necessary diagnosis before choosing to proceed with any counselling or medication. Doctor shall uphold the same standard of care as in an in-person consultation but within the intrinsic limits of telemedicine.
Telemedicine consultation is not anonymous: both patient and the Doctor need to know each other’s identity. Doctor verifies and confirms patient’s identity by name, age, address, email ID, phone number, registered ID or any other identification as may be deemed to be appropriate.
Likewise, patient can check all the credentials of the Doctor who shall display the registration number given by the State Register of Siddha council, on prescriptions, website, electronic communication (WhatsApp/email etc.) and receipts etc. given to patients.
Patient consent is necessary for any telemedicine consultation. The consent can be Implied or explicit depending on the situations. If the patient initiates the telemedicine consultation, then the consent is implied. An Explicit patient consent is needed if the Doctor invites a Telemedicine consultation.
An Explicit consent is recorded in patient records. Patient can send an email, text or audio/video message. Patient can state his/her intent on phone/video to the Doctor.
Doctor uses primarily 3 modes of communications: Video, Audio or Text (chat, images, messaging, email, fax etc.) depending on merits and situation. Considering the situation, using her best judgment, the Doctor may decide the best technology to use to diagnose and treat.
Mode of Tele Medicine
Doctor makes all efforts to gather sufficient medical information about the patient’s condition before making any professional judgment. If a physical examination is critical for consultation, Doctor shall not proceed until a physical examination can be arranged through an in-person consult.
Doctor shall maintain all patient records including case history, investigation reports, images, etc. as appropriate
First Consult means:
· The patient is consulting with the Doctor for the first time; or · The patient has consulted with the Doctor earlier, but more than 6 months have lapsed since the previous consultation; or · The patient has consulted with the Doctor earlier, but for a different health condition.
Follow-Up Consult(s) means:
· The patient is consulting with the same Doctor within 6 months of his/her previous in- person consultation and this is for continuation of care of the same health condition.
Doctor preserves Log or record of Telemedicine interaction (e.g. Phone logs, email records, chat/ text record, video interaction logs etc.). Also stores patient records, reports, documents, images, diagnostics, data etc. (Digital or non-Digital) utilized in the telemedicine consultation.
Specifically, in case a prescription is shared with the patient, Doctor maintains the prescription records as required for in-person consultations.
Doctor may prescribe medicines via telemedicine ONLY when the Doctor is satisfied with the gathered adequate and relevant information about the patient’s medical condition and the prescribed medicines are in the best interest of the patient.
Prescribing medications via telemedicine consultation is at the professional discretion of the Doctor
First or follow-up
In any emergency, the goal and objective should be to provide in-person care at the earliest. However critical steps could be life-saving and guidance and counselling could be critical. The Doctor, based on her professional discretionary
• Advises first aid • Counselling • Facilitate referral to other Doctors
In all cases of emergency, the patient is advised for an in-person interaction with suitable Registered Medical Practitioner at the earliest.
Technology infrastructure used for Siddha E-Clinic:
Telemedicine platform built on robust IT infrastructure on a high availability mode to support 24*7 basis
Network connectivity established using high speed broadband
Video consultation using high quality application
On-line appointment scheduling through user-friendly scheduler application
Telemedicine services delivery available on both browser based and Mobile ( Android only )
Online payment facilitated through completely secured payment gateway