Integrated Healthcare Delivery and Telemedicine: Existing Legal Impediments in India

Chhavi Sharma; Reeta Sony; Meera Mathew

doi:10.17323/2713-2749.2021.3.98.125

Chhavi Sharma Indian Institute of Public Administration
Reeta Sony Centre for Studies in Science Policy, School of Social Sciences, Jawaharlal Nehru University
Meera Mathew Symbiosis Law School

DOI: https://doi.org/10.17323/2713-2749.2021.3.98.125

Keywords: virtual healthcare, telemedecine, ethics, legal implications, privacy, patient's rights

Abstract

Technological innovation and development in the healthcare sector have cast the foundations for the growth of telemedicine. Telemedicine uses remote virtual channels to deliver healthcare services to regions in the rural and urban belts. The advantages of telemedicine include timely access to healthcare: in many
cases, it would be difficult to provide timely healthcare services in the absence of telemedicine. In remote healthcare, telemedicine has been especially helpful in areas with scarce healthcare services. Telemedicine is not an autonomous service; rather, it is subject to different regulations of a complex ethical and medico-legal nature. The Constitution of India states that healthcare services are largely the responsibility of state governments as per item 6 “Public health and sanitation; hospitals and dispensaries” of the State List under Schedule 7 of the Constitution. However, the central government provides the framework for health policy and planning. In particular, the Ministry of Health and Family Welfare of India (MoHFW) is responsible for initiating the digitization of healthcare. In January 2020, the NDHB promulgated the comprehensive architectural framework of the “Federated National Health Information System.” This framework is directed towards linking public and private healthcare organizations across all the value chains of primary, secondary and tertiary healthcare. Furthermore, on 25 th March 2020 after the unexpected outbreak of the COVID-19 pandemic, the Medical Council of India and the NITI Aayog released new telemedicine guidelines for registered medical practitioners to facilitate healthcare services during the complete lockdown. These guidelines set down the rules for providing medical consultations to patients using telemedicine
in such areas as diagnosis, treatment and the avoidance of illness and injuries. They also govern research, evaluation and the continuing education of healthcare personnel. These guidelines have led to the empowerment of medical practitioners, yet they have also imposed various restrictions. In India, telemedicine is a nebulous concept that needs to be analyzed in the light of its prospective opportunities. This paper critically examines existing Indian collaborative approaches to digital health, the prevailing legal and ethical frameworks, and the correspondence of clinical practices to current medical guidelines. It further analyzes the steps taken by India to develop telemedical practices while balancing privacy norms, medico-legal responsibility and regulatory standards. To this end, we analyze the timeline of the development of telemedicine as well as examining the role of different policies in facilitating the promotion of telemedicine and the critical impact of technological innovation on the delivery of healthcare in rural and urban India.

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