How Telemedicine Is Redefining Risk In Medical Practice In India

-By Team Policy Era

TELEMEDICINE AND ITS LEGAL CHALLENGES

The evolution of telemedicine in India has brought about a revolutionary shift in healthcare delivery, enabling patients from the most remote corners of the country to access medical consultations from qualified professionals. However, this transformation has also introduced a new set of legal, ethical, and risk-based challenges. With increasing dependency on virtual consultations, India now faces rising cases of data breaches, diagnostic errors, and medico-legal ambiguity. For Indian healthcare practitioners, it’s vital to understand these risks and ensure proper indemnity coverage and regulatory compliance.

1. Telemedicine Risks: The Digital Shifts And Its Pitfalls

Telemedicine allows doctors to consult patients via phone calls, video conferencing, or apps. However, its widespread adoption, especially post-COVID-19, has uncovered several vulnerabilities.

Telemedicine Risks in the Indian Context:

• Data leaks due to unsecured platforms and weak cybersecurity protocols.
• Misdiagnosis due to a lack of physical examination and limited diagnostic tools.
• Digital illiteracy among patients, leading to communication gaps.
• Technological infrastructure issues, including power cuts and poor internet in rural India.
• Cross-border practice concerns, as doctors consult patients beyond their licensed jurisdictions.

Case Example:

A doctor based in Delhi treats a patient in a remote area of Bihar via a video consultation. Poor connectivity results in a missed diagnosis of appendicitis, which later becomes life-threatening. Such cases raise complex medico-legal issues regarding accountability and standard of care.

2. Medical Malpractice In Telehealth: Legal Grey Areas In India

Medical malpractice claims in India are regulated under:

• The Consumer Protection Act, 2019
• Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002
• Telemedicine Practice Guidelines, 2020

How Malpractice Arises in Telehealth:

• Failure to conduct a proper virtual examination, leading to a wrong diagnosis.
• Inappropriate or delayed referrals to physical hospitals.
• Lack of informed consent, especially for invasive treatment recommendations.
• Prescribing without proper medical history due to limited patient interaction.

Legal Complexity:

In India, while the Telemedicine Practice Guidelines, 2020, provide some clarity, no exhaustive law governs all aspects of virtual care. This creates loopholes that can be exploited or misunderstood, increasing a doctor’s exposure to lawsuits.

3. Indemnity Insurance For Telemedicine In India: An Emerging Necessity

With the medical profession becoming increasingly litigious, Professional Indemnity Insurance is no longer optional, especially in the telemedicine era.

Why Indian Doctors Need Telemedicine-Specific Indemnity:

• Protection against claims of negligence, errors in judgment, or misdiagnosis during virtual consultations.
• Coverage for cyber liability, such as patient data theft or ransomware attacks.
• Legal support and defence costs in case of civil suits under the Consumer Protection Act.
• Security against record-keeping failures or loss of digital data.

What to Look for in a Telemedicine Indemnity Policy:

• Policy must include coverage for online consultations and cybersecurity breaches.
• Should be tailored for multi-platform usage (mobile apps, video platforms, telemedicine portals).
• Must include legal assistance and out-of-court settlement coverage.
• Ideally, the insurer should offer risk assessment services for virtual practices.

4. Telehealth Legal Challenges In India: Navigating Uncertain Terrain

While the Telemedicine Practice Guidelines, 2020 (issued by the Ministry of Health & Family Welfare and NITI Aayog) were a landmark move, several legal and regulatory grey areas remain.

Key Legal Challenges in India:

• Licensing and Jurisdiction:
  • Indian doctors must be registered with the Medical Council of India or the relevant State Medical Council.
  • However, there is no mechanism to restrict or validate cross-state teleconsultations within India.
• Prescription Rules:
  • Schedule X and narcotic drugs cannot be prescribed via teleconsultation.
  • Violation can attract penalties under the NDPS Act, 1985.
• Patient Consent and Documentation:
  • The guidelines mandate explicit patient consent and digital documentation, yet many practitioners skip these due to a lack of awareness or poor systems.
• Data Privacy and Cyber Laws:
  • The Information Technology Act, 2000, and rules under the Digital Personal Data Protection Act, 2023 regulate digital data storage and privacy.
  • Any breach can lead to civil penalties and criminal liability.

5. Risk Management In Virtual Healthcare: Indian Best Practices

Effective risk management in Indian telemedicine practices is the key to mitigating exposure to lawsuits, regulatory penalties, and reputation loss.

Indian Best Practices for Risk Management:

• Use Compliant and Encrypted Platforms:
  • Platforms like eSanjeevani (by the Ministry of Health) are government-approved.
  • Avoid WhatsApp, Facebook Messenger, or Skype for official consultations.
• Documentation is Paramount:
  • Keep records of symptoms, advice given, diagnosis, prescriptions, and consent.
  • Use digital tools for maintaining Electronic Health Records (EHRs).
• Follow Ethical Guidelines:
  • Be transparent about the limitations of telemedicine.
  • Always refer patients to in-person care when the situation demands it.
• Patient Education:
  • Educate patients about how to access teleconsultation, limitations, and when to seek emergency care.
• Annual Policy Review:
  • Reassess your indemnity insurance each year to cover new services like second opinions, home-based diagnostics, or tele-ICU services.
• Legal Awareness Training:
  • Train all staff about basic legal responsibilities, data handling, and emergency management in virtual care settings.

Conclusion: A Balanced Future For Indian Healthcare

Telemedicine in India is here to stay. While it offers incredible benefits—wider access, time efficiency, and affordability—it also brings with it significant legal and clinical responsibilities.

Final Thoughts from PolicyEra:

• Be proactive, not reactive.
• Always ensure legal compliance, platform security, and adequate indemnity cover.
• Embrace telemedicine as a formal mode of care, not as an informal alternative.

Remember: In India, a digitally secure doctor is a legally safe doctor.