Navigating telemedicine technology
A Digital Health Malaysia (DHM) webinar about virtual consultations drew a flurry of questions, especially by healthcare practitioners who are concerned about how to provide medical services to first-time patients, over teleconference technologies.
Now that face-to-face consultations are slowly but surely being replaced by virtual versions, it extends the potential of consultations conducted across country borders, for example. This was one of the many subjects that drew the most questions as the medical fraternity tried to understand how far they can extend their services, how wide their scope may expand if at all, and under what circumstances it would be still legal for them to do both.
Valiantly fielding all these questions were the president of the Medico-legal Society of Malaysia (MLSM), Raja Eileen Soraya, General Secretary of the Malaysian Medical Association (MMA), Dr. Thirunavukarasu Rajoo, and Director of Ethics and the Legal Division at the Malaysian Medical Council (MMC), Dr. Faizi Rosli. Moderating this panel was Dr. Wong Chee Piau, President of the DHM Pro Tem Committee.
Navigating the virtual consultation landscape
In light of how COVID-19 has upended the healthcare landscape and created a deluge of demand for disease information and informed decision-making in its wake, DHM has prepared COVID-19 resources at https://www.digitalhealthmalaysia.org/covid-initiative. This initiative includes a way to chat with a a healthcare professional.
But virtual consultation has a critical role to play as well, especially during this public health situation. How shall the medical fraternity navigate use of this technology?
Dr Wong shared, “Face-to-face consultations will not be replaced for a very simple reason that physical examination will be required in many instances. Virtual consultation can complement this with many benefits.”
The Code of Professional Conduct clearly says a physical examination is ethically mandatory, and that “a non-physical contact virtual consultation makes a physical examination incomplete other than the visual and auditory observation.”
Due to guidelines to practice safe distancing at the moment, MMC’s advisory regarding virtual consultations here, does say it is often possible to make an accurate diagnosis from just the (patient) history, and limited visual and auditory observation.
“If a registered medical practitioner under current circumstances conducting such telemedicine virtual consultation feels this is so in good faith, then appropriate treatment can be initiated based on such, without the need for a physical examination in person.”
Virtual consultation is just one in a line up of digital technologies at the disposal of the medical fraternity to offer their services and expertise.
MMC’s advisory rightly points out that virtual consultation is a form of telemedicine, or a medical service provided remotely via ICT.
There are many other parties out there, not necessarily from a medical background, who can and may offer medical or healthcare-related services, via the use of technologies. What rules and regulations shall govern them, then? The advisory also states that the Council regulates physicians, but not the technology.
Before the coronavirus pandemic, there was already cognisance that digitalisation is coming in a big way, and something had to be done to regulate the digital tsunami.
A representation of that cognisance, came in the form of Digital Health Malaysia which has recently refined their focus and efforts to be industry-led and to inform policy-making.
Also in the pipeline, is ongoing research into a framework for regulation of online healthcare providers in Malaysia, and who knows, maybe even outside our borders.