By Sudhir Mishra and Mansi Batra
With the advancement of technology, there has been an increase in the number of people in India to take help of the online health portals. Online medical consultations or telemedicine services are an ideal resource for everyone, mainly those who have limited or no health insurance or who are unable to leave the house to go to the doctor’s.
The concept started initially with patients taking second opinion about the medicines online, prescribed to them by their doctors. It soon became a source for prescription, boosting the numbers of over-the-counter medicine. The trend, which is widespread in Western countries, is catching up in India as well.
In a country like India, where there is only one doctor for every 1700 people and where most people need time to travel more than 20 km to reach a hospital, these health portals claim that they seek to bridge the doctor-patient gap.
But some are worried about the increased numbers of self-diagnosis using Internet. These online portals don’t consider the basic facts about a person and prescribe the medicines which may or may not suit the person seeking advice. Due to the vagueness in the queries and the answers to those queries there are various questions that arise like where should a doctor draw the line in prescribing medicine online without an examination? Is it possible for a doctor to know what’s wrong with a patient with so little evidence?
A very important aspect of the medical field is to see and touch the patient. Sometimes the patient is not able to convey what exactly the problem is. It is on the doctor to understand the symptoms and find the correct diagnosis. For example, if a patient comes to the doctor with fever, it could be a symptom of a bigger problem. Unless a proper diagnosis is conducted, this cannot be found out if there is a serious problem.
The doctors also these days are creating websites rather than setting up the traditional clinics due to increasing trend of involvement of consumers in e-commerce and because seeking online medical advice has become cheaper and easier. Each health portal follows a different business model.
Some health portals allow doctors to register for free but take a part from the fees. A few portals charge money from the doctors to join with the promise that it will help them expand their practice. This is especially attractive for upcoming doctors. Doctors have used the digital medium for long but only with patients they know well and where physical examination is not required.
These questions remain unanswered. However, those who firmly believe in the online medical portals think that it is unnecessary to visit a doctor when the problem can be solved with a click of a mouse. However, a virtual consultation cannot replace an in-person visit. Some people look at online consultations with a sense of suspicion.
But the main question arises that who will bear the legal liability if the treatment goes wrong: the technology platform or the doctor? The question of liability seems even more important in the absence of a clear regulatory framework for online medical portals in India.
Indian Medical Association is working on a code of ethics for telemedicine, although to what extent it will cover health portals is not clear. Those who have been in the business of long-distance healthcare before any of the online health portals came up understandably have reservations about the escalating of health websites.
At present, the country lacks a law that singularly deals with online healthcare delivery, let alone online medical advice. The Information Technology Act, 2000; the Drugs and Cosmetics Act, 1940; and the Indian Medical Council Act, 1956 address concerns about medical negligence, cyber security breach, manufacture and sale of drugs but there is no stringent law for online medical advice.
Moreover, certain guidelines pertaining to registration of doctors under the Code of Ethics Regulations, 2002, issued by the Medical Council of India could also apply to online medical consultation. It is important that all the parties involved, right from the service provider to the doctors, must comply with all the regulations that affect them.
Thus, the online health portals are all set to broaden their areas and range of services in the coming years. But, is it going to be a plain sailing journey for them? This question remains unanswerable as even though there is growing IT implementation, a large part of the population of India are slow to adopt technology.
Building their faith in the online healthcare portals would be a huge challenge. Striking a balance between providing securities of data and validating its authenticity along with offering easy access to medical records will be another challenge to tackle.
They will also have to decide on crucial issues like: Medical data should be provided only by their healthcare providers, or should the patients be able to enter their own data? How to ensure that the information received are reliable and authentic? How to avoid information overload for both patients and doctors and make the data useful and usable to both?
Thus, it can be said that the online healthcare service in India is a case of irony. While it is quick and easy to get the medical advice from the online health portals, they are not as reliable and efficient as they seem to be.
So the online medical portals have become convenient for the people in India and also for the doctors as now the doctors are generally available throughout the day eliminating the need to wait in lines, sit with other sick people in waiting rooms, or schedule appointments at the office’s convenience.
Taking into account India’s huge developments in the field of information and communication technology, online medical portals could help to bring specialized healthcare to the remotest corners of the country and if leveraged well, India too can benefit and mitigate some of its healthcare challenges.