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Digital IMA: IMA White Paper on Telemedicine

1. IMA supports the expanded role of telemedicine as a method of health care delivery that may enhance patient–doctor collaborations, improve health outcomes, increase access to care and reduce medical costs when used as a component of a patient's longitudinal care.

2. Telemedicine can be most efficient and beneficial between a patient and doctor with an established, ongoing relationship.

3. Telemedicine is a reasonable alternative for patients who lack regular access to relevant medical expertise in their geographic area.

4. Episodic, direct-to-patient telemedicine services should be used only as an intermittent alternative to a patient's primary care physician when necessary to meet the patient's immediate acute care needs.

5. A valid patient–doctor relationship must be established for a professionally responsible telemedicine service to take place. A telemedicine encounter itself can establish a patient–physician relationship through real-time audio-visual technology.

6. A doctor using telemedicine who has no direct previous contact or existing relationship with a patient must take appropriate steps to establish a relationship based on the standards of care required for an in-person visit, or consult with another doctor who does have a relationship with the patient and oversees his or her care. For establishment of such relationship, video conferencing can play a vital role.

7. Doctors should use their professional judgment about whether the use of telemedicine is appropriate for a patient.

8. Doctors should not compromise their ethical obligations to deliver clinically appropriate care for the sake of new technology adoption. If an in-person physical examination or other direct face-to-face encounter is essential, telemedicine may not be appropriate.

9. Doctors should ensure that their use of telemedicine is secure and compliant with security and privacy regulations. Telemedicine should be held to the same standards of practice as if the doctors were seeing the patient in person.

10. Doctors who use telemedicine should be proactive in protecting themselves against liabilities and ensure that their medical liability coverage includes provision of telemedicine services.

Hoping, you all will find the initial note on telemedicine extremely beneficial. Going forward, myriad aspects of telemedicine will be discussed under the IMA Lybrate initiative to help you all gain valuable insights on the topic.

Yours sincerely,

Dr A Marthanda Pillai                                                                                                     Dr K K Aggarwal

National President                                                                                                         Honorary Secretary General
Indian Medical Association                                                                                             Indian Medical Association