Telemedicine usage spiked early in the COVID-19 Pandemic as consumers and providers sought safe ways to access and deliver healthcare. The healthcare profession had to react swiftly to deal with the social distancing measures put in place to assist flatten the curve of COVID-19 infections. At the peak of the epidemic, hospitals, clinics, and physicians looked to telemedicine for a method to deliver the same level of care while limiting the spread of the coronavirus. Key trends in the utilisation of technology have evolved, which will continue to impact the future of telemedicine services.
This necessary step change was made possible by the following factors: (1) increased consumer desire to utilise telemedicine; (2) increased provider willingness to use telemedicine; and (3) regulatory improvements that allow for more access and payment. During the pandemic’s tragedy, telemedicine provided a bridge to care, and it now provides an opportunity to rethink virtual and hybrid virtual/in-person care models, with the objective of improving healthcare access, results, and cost.
By bringing AI to the edge, telemedicine has evolved patient care and experience through accessibility, which was invaluable for treating COVID-19 as well as curbing its spread. In FY 2021, the Indian Telemedicine Market was valued at USD 1314.83 million and is predicted to develop at a healthy Compound Annual Growth Rate (CAGR) of roughly 22.31 per cent.
This is attributed to the country’s strengthening healthcare IT infrastructure, as well as India’s expanding digitalisation. Furthermore, the rising incidence of chronic and infectious illnesses in the nation, along with a dearth of healthcare workers and doctors, is predicted to drive market expansion through FY 2027.
Through remote patient monitoring, for example, physicians were able to use internet connected, at home devices to track the health of high-risk individuals, like the elderly and post-op patients, while minimising their exposure.
Telemedicine connects healthcare professionals with patients using new technology such as kiosks, online monitoring programmes, mobile phone applications, wearable devices, and videoconferencing. This article will investigate different telemedicine rules in several worldwide jurisdictions, as well as offer a more in-depth look at the Indian situation.
What is Telemedicine?
Telemedicine/telehealth can be understood as the delivery of healthcare services by healthcare professionals using information and communication technologies for the exchange of valid information for the diagnosis, treatment, and prevention of disease and injuries, as well as continuing education of healthcare providers and research and evaluation, all in the interests of advancing health.
According to the Centers for Disease Control and Prevention (CDC), telemedicine use increased by more than 154% in late March 2020 when compared to the same time in 2019. Furthermore, according to current Fortune Business Insights forecasts, the industry will be worth more than $397 billion USD by 2027. To demonstrate the effect of the epidemic, the market was only worth $42 billion USD in 2019. While utilisation has declined since the pandemic’s height, it is obvious that telemedicine is now an important component of the future of healthcare delivery.
Telemedicine use has stabilised at 38 times pre-pandemic levels as of July 2021. Even before to the epidemic, research suggested increasing usage of telemedicine. In a McKinsey poll, 76 per cent of patients stated they would be interested in adopting telemedicine in the future. Furthermore, in research published in the Journal of Telemedicine and Telecare, more than half of respondents stated they would use telemedicine to refill prescriptions, prepare for an impending visit, check test findings, or obtain instruction.
A number of nations have established telemedicine practice guidelines. Telemedicine practice standards, not to be confused with the standard of care or scope of practice, are regulations and restrictions that clinicians must follow while practising medicine through telemedicine and often do not apply to in-person treatment. Patient informed consent to telemedicine services, specific disclosures on the provider’s website, mandatory forwarding of the patient’s medical records to the patient’s other caregivers, restrictions on the type of telemedicine technology/modality that can be used, and requirements for in-person examinations are examples of practice standards. Thus, providers must comprehend and follow nation-specific practice requirements, or risk being sanctioned by the Board of Medicine.
Many nations passed new telemedicine laws and guidelines in 2020, altering previous practice standards, permitted modalities, and prescription criteria. Changes included removing face-to-face assessments, practising primarily over the phone, and lifting telemedicine mode prescription limits. Some of these modifications were implemented by legislation, while others were made through executive order or regulation. During the pandemic, many of the alterations were just transient (with expiration dates that, confoundingly, often did not match the federally declared public health emergency date).
These exemptions produced a telemedicine regulatory environment that was more concerned with achieving the standard of medical care for a specific patient than of the technological modalities of care delivery (e.g., audio-video versus asynchronous). The American Telemedicine Association (ATA) aided in this endeavour by publishing sample policy wording for State telemedicine laws to serve as a reference source for best practices. This trend toward technology neutral telemedicine legislation is expected to continue in 2022, with stakeholders stressing the relevance of medical standard of care and clinical quality of services above proscriptive modality restrictions.
Leveraging AI and Telemedicine
According to MIT research, 75% of healthcare facilities that used AI recognised an enhanced capacity to manage ailments, and 4/5 claimed it proactively helped reduce worker fatigue. With COVID-19 placing a burden on both sectors (amount of clinical information and related patients, as well as increased clinician workload), AI in telemedicine is a strong strategy for the future of medical delivery. Years ago, advances in computers and artificial intelligence made cutting-edge telemedicine applications viable. Policy has been a major impediment to complete implementation until recently. Telemedicine has enhanced patient care and experience via accessibility by bringing AI to the edge, which has been helpful for treating COVID-19 as well as controlling its spread.
Physicians, for example, were able to employ internet connected, at home equipment to follow the health of high-risk populations, such as the elderly and post-op patients, while reducing their exposure via remote patient monitoring. This is a game changer, not just because it provides doctors with unprecedented levels of insight into their patients, but also because the more these technologies are employed, the more innovation they enable. For example, Intel is collaborating with Medical Informatics Corporation (MIC) to assist hospitals in centralising and analysing data from devices that monitor patients’ vital signs, reducing the frequency with which care teams must round on patients and reducing “alarm fatigue” by triaging the patients to whom they must respond.
AI and edge powered telemedicine has also enabled physicians and hospitals to interact in novel ways, pooling resources during crucial periods. Telemedicine, will have an influence on every aspect of healthcare. In the not too distant future, for example, psychiatric care teams may utilise AI enhanced, high definition videoconferencing to evaluate patients’ facial clues to get a deeper grasp of their emotional states in the present.
The most common AI applications in telemedicine include data analysis and cooperation, remote patient monitoring, and intelligent diagnosis and help. The potential of AI may be used to complement doctors’ skills to diagnose and treat patients, reduce physician burnout, and improve the overall patient experience. Due to the continuing public health issue, the emphasis on AI and telemedicine remains a significant push for healthcare executives looking to stay competitive by improving clinician processes and uncovering predictive potential via patient data analysis.
Global perspectives on Telemedicine
The constraints on travel imposed by COVID-19 in many areas of the globe have prompted Governments to see the promise of telemedicine and, overnight, alter laws and regulations to allow healthcare practitioners to install telemedicine systems. Many Governments have implemented telemedicine measures in a matter of weeks that would have normally taken years to evaluate and implement. There are several possibilities in the telemedicine arena for existing organisations, firms contemplating expanding into telemedicine, and startups.
Healthcare providers are increasingly reaching across borders to give medical services directly to overseas patients and doctors via the use of technology. While hospitals, colleges, research institutes, and healthcare firms have always been involved in global health activities, current communications technology has permanently transformed the delivery paradigm. Today, offering services to patients and doctors situated halfway across the world requires synchronous and asynchronous communication technologies such as e-mail, interactive video, and smartphone applications that aid in diagnosis, consultation, treatment, monitoring, and even medical research. Remote second opinions, in which a healthcare practitioner is requested to confirm a diagnosis or treatment from a distance by either a physician or a patient, have also increased in the worldwide medical industry.
International telemedicine is rapidly expanding. Even with a basic internet connection, telemedicine services offer convenience, increased access to experts, cost savings, and collaborations among healthcare providers from other nations. All of this has the potential to improve health outcomes. And, as the globe prepares for public health events like the COVID-19 Epidemic, harnessing telemedicine to battle illness is critical.
Although the practice of medicine is regulated globally, telemedicine does not necessarily fall under the conventional realms of legislation and regulation relevant to the medical profession and thus it requires more stringent regulations and monitoring.
Regulations for Telemedicine in the United States of America
While telemedicine is typically permitted in the United States, it is exceedingly complicated and heavily regulated, both in terms of general practice and coverage. There is no federal legislation that controls telemedicine practice. Telemedicine is governed at the State level, and the definition of acceptable telemedicine activities varies widely. States often define telemedicine differently, with some allowing asynchronous connections and others requiring only real-time interactive voice and video chats. In addition to the rules governing telemedicine practice, there are significant differences in telemedicine coverage and payment at both the State and Federal levels.
The Medicare Program insures US seniors aged 65 and over, as well as some persons with qualifying impairments. Despite exceptions to Medicare’s Telemedicine Payment Policy, present laws discourage broad adoption and usage of e-health and create a precedent for other big commercial insurers. The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act was proposed in the United States Senate in 2017, however it has yet to move. This legislation proposes removing Medicaid’s geographical constraints and, if approved, would increase coverage of telemedicine services. As a consequence, telemedicine services would be afforded the same Medicaid validity as in-person appointments, perhaps inspiring other insurers to adjust their private policies.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a piece of US law that establishes data privacy and security safeguards for medical information. Its goal is to eliminate healthcare fraud and abuse by establishing industry-wide standards for healthcare data on electronic billing and other operations. It also necessitates the safeguarding and secure processing of sensitive patient health information. This is addressed by the privacy rule and the security rule, and it is very important in telemedicine.
Several commercial insurers have followed suit and are either paying healthcare providers for telemedicine services or directly offering telemedicine access to their members as part of their benefits. Previous rules are also being relaxed, including the expansion of covered telemedicine services and the ability for new patients to be treated through telemedicine rather than just those with a prior connection. Penalties for HIPAA breaches in telemedicine are now waived when Healthcare Personnel (HCP) behave in good faith in the face of the COVID-19 Pandemic.
Furthermore, in order to assist telemedicine, practitioners who are licensed out of State and in good standing are permitted to practice beyond State boundaries. The Federal Communications Commission has just established a $200 million coronavirus telemedicine initiative. Variations in acceptance and disparities in legislative frameworks among States have been one of the barriers to telemedicine adoption. These differences call for a government telemedicine policy push to standardise and expedite an overall framework that might increase telemedicine’s penetration throughout the United States.
Virtual visits increased dramatically as a result of these legislative changes. Now that virtual care has gained broad acceptance and adoption, regulators, politicians, and industry executives are advocating for permanent reforms that will allow for the ongoing widespread use of telemedicine post-pandemic. We are witnessing new legislation initiatives at both the Federal and State levels, and we anticipate substantial changes in the coming years. While most of this reform will take time, there is a strong desire and motivation at both the Federal and State levels to advance rules that would allow for sustained telemedicine access.
Telemedicine Regulations in the United Kingdom
There are no explicit laws that govern telemedicine in general. Instead, healthcare practitioners will be subject to the same regulations, licensing and registration requirements, and professional standards of conduct that apply to their specific area as they would if the service was performed in-person. At the moment, no legislation or regulations in the United Kingdom directly cover telemedicine.
The Care Quality Commission (CQC) is England’s healthcare provider regulator (with Northern Ireland, Scotland, and Wales each having its own regulator). To offer remote medical advice, the CQC requires all service providers to register. Providers must demonstrate to the CQC that the care and treatment they provide will fulfil the criteria of the Health and Social Care Act, 2008 and its accompanying regulations. This implies that digital suppliers of medical advice are subject to the same regulatory framework as non-digital providers.
Telecommunications corporations such as BT, Virgin Media, and Sky in the United Kingdom (UK) have committed to help the National Health Service (NHS) carry out telemedicine for healthcare practitioners. Primary care, clinical trials, counselling, and chronic illness evaluations are all being delivered through telemedicine. The Government had previously declared a centrally sponsored “long term plan” to minimise the number of outpatient presentations prior to COVID-19. This has to be implemented considerably quicker than planned due to the rising demand for telemedicine to replace outpatient appointments. Regulators have recognised that providing healthcare through telemedicine may provide an extra degree of risk to patients, which must be addressed by the healthcare practitioner. As a result, a number of UK authorities and trade organisations have attempted to provide guidelines to the professions they supervise.
As an example, in April 2019, the General Pharmaceutical Council provided guidelines on delivering online pharmacy services, outlining the actions pharmacists may take to ensure they continue to satisfy the standards required of them.
In response to the COVID-19 Pandemic, the General Medical Council released recommendations to help physicians in giving remote consultations and actions they may take to maintain patient safety.
The British Medical Association, a trade union and professional association for physicians in the United Kingdom, has recently produced guidelines on how to conduct patient consultations via videoconference. Any healthcare practitioner interested in using telemedicine in the UK should verify that they have the proper licensing and registration for the healthcare services they offer, as well as evaluate any accessible and relevant guidelines published on best practice for remote service provision.
Given the recent surge in telemedicine usage, it is expected that regulators will continue to react with any applicable recommendations or rules of behaviour, unique to the healthcare service that they supervise. This is likely to be the case if any regulatory loopholes are discovered, as indicated by the CQC on its website. Legislation may often fall behind technology changes, and as a result, it is probable that this sector will be subject to more examination and legal modifications in the future.
Telemedicine Regulations in China
China has a significant urban-rural health disparity, which large telemedicine networks such as the International MedioNet of China Network, Golden Health Network, and People’s Liberation Army Telemedicine Network have been unable to bridge. The National Health Commission and the National Administration of Traditional Chinese Medicine issued new e-healthcare rules in September 2018 in order to expand telemedicine capabilities and develop the telemedicine industry. This includes advice on commercial company hospital cooperation, telemedicine diagnostics, patient permission, and third-party collaborations. This expanded telemedicine definitions beyond physician-to-physician consultations to include physician to patient contacts, although implementation and regulation remain unclear.
In China, remote medical care delivery utilises both proprietary systems and the use of generic remote messaging applications such as WeChat. According to the good administrative practice for remote medical services (for trial implementation), the inviter institute for remote medical services may directly invite the invitee institute to provide technical support for the inviter institute’s medical treatment activities via telecommunications, computer and network technology, and so on. On the other hand, the inviter institution or a third-party organisation may also build a proprietary platform for remote medical care supply.
Online healthcare platforms, like those in other Asian countries, are expected to see significant increases in market share in the coming years, particularly following COVID-19, with companies offering direct-to-patient telemedicine subscriptions such as Good Doctor, Alibaba, and Tencent experiencing growth. China is also pioneering contactless technologies, such as a Smart Field Hospital experiment in Wuhan at COVID-19, in which patient care is given by robots and digital gadgets.
Telemedicine Regulations in Australia
In Australia, there are presently no rules or regulations governing telemedicine. Existing rules and regulations governing healthcare delivery apply to telemedicine. Various regulatory and industry organisations in the healthcare profession, however, have issued guidance notes on the delivery of services through telemedicine. For example, the Australian Health Practitioner Regulation Agency (AHPRA), the federal organisation in charge of regulating healthcare professionals in Australia, has released telemedicine information for practitioners on its website (AHPRA guidance). According to the AHPRA guidance, all registered health practitioners may utilise telemedicine as long as it is safe, clinically acceptable for the healthcare being delivered, and appropriate for the patient. The AHPRA guidance further points out that no special equipment is necessary to offer telemedicine services, and that services may be delivered using phone and publicly accessible video chatting applications and software.
However, the AHPRA guidance notes that free versions of applications (i.e. non-commercial versions) may not comply with applicable security and privacy laws, and practitioners must ensure that their chosen telecommunications solution meets their clinical requirements, their patient’s or client’s needs, and satisfies privacy laws. In addition to the current “Good Medical Practice: A Code of Conduct for Doctors in Australia,” the Medical Board of Australia has issued online “guidelines for technology-based patient consultations”. The Royal Australian College of General Practitioners (RACGP) has also issued a “guide to conducting telephone and video consultations in general practise”.
Telemedicine Regulations in Europe
The danger of COVID-19 in Europe has required the necessity for patient-accessible telemedicine services. Telemedicine firms such as France’s Doctolib and Qare, Sweden’s LIVI, the United Kingdom’s Push Doctor, and Germany’s CompuGroup Medical SE have all witnessed significant gains in European acceptance. Telemedicine is regarded as both a health service (Directive 2011/24/EU) and an information service (Directives 95/46/EU, 2000/31/EC, and 2002/58/EC) in Europe. A Europe-wide framework is far from being implemented due to the absence of Pan-European common medical responsibility and medical legal rules.
Throughout the epidemic, Germany has persistently stayed at the forefront of the digital health change by constantly developing and adjusting laws. DiGA Fast Track was established in 2019 as a result of the Digital Healthcare Act (DVG) and other legal reforms, which meant that applications could be prescribed by physicians and expenses could be paid via German health insurance. Two health applications were legally accessible for prescription on October 5, eleven months after the German Federal Government enacted the DVG.
France passed a new healthcare legislation in 2019, based on the Government’s “My Health 2022” strategy, which aims to broaden the country’s e-health emphasis. France intends to improve interoperability; roll out nationwide electronic health records (EHR) to become the cornerstone of e-health platforms; leverage the use of AI in health; establish a data hub for healthcare data sets; and invest further in the public health system’s recent introduction of telemedicine.
Telemedicine use has been smashing records in the nation, leading Health Minister Olivier Véran to issue a directive to make it easier to practise telemedicine. Furthermore, the nation has just begun trials for a digital vaccine passport and is making good progress in using health technology to return the country to normalcy. Now, the International Chamber of Commerce (ICC) AOKpass app will be trialled for travellers travelling to the French Caribbean Territory of Martinique and Guadeloupe.
Telemedicine Regulations in India
The Board of Governors (BoG) of the Medical Council of India (MCI), the erstwhile medical education regulator in India that prepared the guidelines in consultation with the premier planning body, the NITI Aayog (National Institution for Transforming India), has attempted to fill an important gap: a lack of legislation and a framework for ethical telemedicine practise. The recommendations identify video, audio, and texting as three means of communication and specify the conditions for practitioners to utilise them, including constraints.
As stated in the background of the aforementioned guidelines, the purpose of these guidelines is to provide practical advice to doctors in order for them to begin using telemedicine as part of their normal practice, as well as to provide them with a sound course of action to provide effective and safe medical care based on current information, available resources, and patient needs to ensure patient and provider safety, to be used in conjunction with national clinical standards.
The guidelines comprehensively set out the standards, norms, and procedures to be followed by any person who has enrolled in the State Medical Register or the Indian Medical Register under the Indian Medical Council Act (Registered Medical Practitioner/RMP) while practising telemedicine in India through any mode of communication viz. video, audio, or text-based communication, either for exchange of information in real time or in synchronous modes for first consults or follow up patients. The guidelines require RMPs to complete an online training session offered by BoG within three years of the guidelines’ announcement.
Individuals That Are Certified To Provide Telemedicine
Under the guidelines, any individual who is registered in the State Medical Register or the Indian Medical Register (RMP) under the Medical Council Act, 1956 is competent to perform telemedicine.
RMPs who intend to practise telemedicine must finish an obligatory online course made accessible by the BoG within three years after notification. Until then, the principles outlined in the guidelines must be observed. The same ethical principles and standards that apply to in-person medical consultations apply to telemedicine.
Telemedicine Consultation Procedure
The guidelines recommend the following procedure, which must be followed by RMP providers.
Consultation using telemedicine
Commencement of consultation and consent – The patient initiates the telemedicine consultation by phone call, video, or text. Following that, the RMP may agree to conduct the consultation. The permission is inferred when the patient initiates the telemedicine session.
Identification – RMP should authenticate the patient’s identity to his satisfaction by asking for the patient’s name, age, address, e-mail ID, phone number, or any other suitable identification.
Brief evaluation – Before providing the telemedicine consultation, a quick examination of the patient should be performed to identify the state of the patient’s health. If the patient’s condition necessitates emergency treatment, the RMP should advise on first aid or other urgent relief, as well as provide assistance.
Information exchange – The RMP must exercise his professional judgment and ask the patient to supply the necessary information (complaints, other consults, medication details, documentation, etc.). The RMP may continue with the consultation after he is satisfied with the information. If the RMP considers that the information supplied is insufficient, he should terminate future telemedicine consultation and recommend in-person consultation. The RMP should keep an accurate record of the whole information exchange with the patient.
Patient management – If the RMP is satisfied with the foregoing information, the RMP may elect to give the patient with particular medications, counselling, or advice/information. The RMP must also keep a complete record of the patient.
Important Telemedicine Consultation Rules and Principles
- Initial consultation
The necessity for patient identification is not required for follow-up appointments (those consultations which are given within six months of in-person consultation). If a new symptom appears, it should be treated as the initial consultation.
The RMP must determine whether to employ text, audio, or video communication.
When offering telemedicine consultation, the RMP should exercise professional judgment and should recommend in-person consultation if it seems essential. Emergency treatment or consultation should normally be done in person, however the RMP may continue with telemedicine consultation if it is urgent and suitable in his professional opinion.
RMP has the option to cancel the consultation at any moment and refer the patient for an in-person appointment, and the patient has the same option.
(a) From time to time, the Central Government may announce drugs (other than those previously specified in Annexure 1 to the guidelines) that may be prescribed through teleconsultation, as well as any limits that may apply, in the following categories:
(i) List O: Medicines that are safe to prescribe through any means of teleconsultation, such as those used for common diseases (paracetamol, ORS solutions, and so on) or those judged required during public health crises.
(ii) List A: Medicines that may be given during the initial video consult and are re-prescribed for refill in the event of a follow-up. This would be a list of medications that are reasonably safe and have a low risk for misuse.
(iii) List B: Medicines that may be provided to a patient receiving a follow-up consultation in addition to those recommended during the in-person consultation for the same medical condition.
(iv) Prohibited list: Prescription only medications.
(b) RMP must provide the patient a picture, scan, or digital copy of the signed prescription by e-mail or any messaging platform.
(c) The prescription should be in accordance with the code of conduct and should not violate the Drugs and Cosmetics Act, 1940 or the regulations enacted under them.
(d) When a prescription is sent directly to a pharmacy, the patient’s express agreement is required. Such a prescription should only be issued to the patient’s preferred pharmacy.
- Maintaining Confidentiality
The code of conduct, as well as the IT Act and other data protection requirements, will apply to RMPs who provide teleconsultation.
All information supplied by the patient must be kept secret, and the RMP must take appropriate precautions while using platforms to ensure such confidentiality.
RMP is expected to capture all facts and keep a complete record of the patient, including any documents or information utilised for the consultation and prescriptions.
RMP may charge a reasonable fee, and telemedicine consultations are to be regarded in the same manner as in-person consultations.
RMP is required to provide a receipt/invoice for the price charged for telemedicine consultation.
Impact of the Guidelines
Telemedicine practice in India has now been given legal standing, thanks to the processes and norms outlined in the guidelines and the code of conduct. These guidelines are extensive and cover every element and the Board of Governors has been assigned the task to:
- Amend the guidelines if necessary.
- Issue the medications list under the guidelines.
- As needed, provide instructions, recommendations, or explanations about these guidelines.
Any infraction committed while using telemedicine would be deemed misconduct at the hands of the responsible RMP under the code of conduct. As a result, if the misbehaviour is proven, the RMP may be punished, or their registration may be suspended or terminated.
These guidelines herald the beginning of a new era for India’s pharmaceutical business. Patients no longer have to drive to hospitals and wait in large lines to see a doctor for minor issues. The guidelines have cleared the path for consultations to be conducted through any kind of communication medium while still preserving the patient’s interests. This is particularly important given the situation in India as a result of COVID-19, which has made many people unable to obtain healthcare adequately.
Future Modifications and Reforms
The advancement of information technology has had a profound effect on society. Telemedicine refers to the transmission of medical information and knowledge through telecommunications and computer technologies in order to enhance patient diagnosis, treatment, and management. Telemedicine includes distant learning, medical peer review, patient education efforts, and other related activities.
The internet, mobile phones, and e-mail are all new areas for healthcare practitioners to explore, and they should proceed with caution. Telemedicine has medicolegal consequences for registration, licensure, insurance, quality, privacy, and secrecy, as well as other dangers involved with electronic healthcare communication. Another critical factor is the physician-patient connection, as well as the quality of care and informed consent. These complex concerns are further compounded by the lack of any legislation or laws, particularly concerning matters such as professional negligence, obligations, liabilities, and fines in such instances. Additional concerns in telemedicine, telemedicine, teleconsultation, telemonitoring, tele-treatment, and patient information records must be addressed.
Telemedicine’s reach is expanding, as is the quality assurance of its services. Telemedicine, like the standardisation of information technology, is a growing sector for effective care delivery with standardised information exchange.
Despite differences in telemedicine adoption throughout the globe, it is understood by various jurisdictions that telemedicine helps improve health system performance and needs further regulation. Telemedicine has taken a springboard trajectory in the COVID-19 era, as governments and partnerships formed have forged a way to support and accelerate its rollout, particularly in developed countries. During COVID-19, telemedicine proved companies’ capacity to provide excellent care remotely (at home) while simultaneously lowering expenses. This is expected to continue beyond the COVID-19 time-frame, as telemedicine services are strengthened and expanded. Moving on, one area that deserves special emphasis is increasing the use of telemedicine among sub-specialties to supplement primary care. Building relationships among many stakeholders and encouraging open innovations are developing roles that will enable the advantages of telemedicine to reach disadvantaged geographies.
Once the COVID-19 phase is finished, regional efforts such as Pan-European initiatives may be considered in terms of acceptable regulatory and governance structures. International initiatives to build a public health preparation framework with telemedicine at the centre of public health response during epidemics like COVID-19 are necessary and countries such as India have taken calls to action in this regard which has spearheaded a new wave of e-health regulations.
† Shantanu Mukherjee, Founder, Ronin Legal.
†† Vatsala Sood, Intern, Symbiosis Law School, Pune.