With the multitude of developments in digital medicine, a pressing concern which patients have is the legitimacy of telemedicine. In terms of medical care, can a video consultation ever replace a physical consultation? Where lies the accountability?
A video consultation is certainly not the same as a physical consultation. However, they both serve the same ultimate goal, which is to utilise the best available medical resources to help patients in distress. In this regard, understanding the constraints of each medium is useful in helping one decide whether a physical or video consultation is effective in the given circumstances. Physical consultations may allow for a more comprehensive level of assessment, but they are inherently limited in terms of accessibility. While a traditional physical examination may not be achievable with a video consultation, the latter provides its own benefits such as great convenience and timeliness of treatment. The undeniable advantage of video consultations in specific circumstances where spot diagnoses are feasible, as well as in times of crises such as pandemics or haze alerts that limit outdoor travel, makes telemedicine a powerful tool in our battle against disease. This often involves the use of innovative interfaces coupled with self-examination techniques and/or home monitoring devices to overcome the physical constraints of a video consultation. More on that to follow.
On a national healthcare level, digital medicine can ease the burden on physical clinics by redirecting foot traffic in appropriate cases. Both doctors and patients benefit when waiting times are reduced. Several national hospitals, in their recognition of the benefits of telemedicine, have already started adopting the use of telemedicine across various healthcare projects targeting different groups of patients with varying needs, such as bed-bound patients, patients with chronic but stable conditions as well as patients requiring time-dependent treatment.
As for the issue as to how digital health providers are held accountable, acknowledging the emergence of digital self-help options and recognising that telemedicine is set to become a key player in the healthcare landscape, the Ministry of Health of Singapore (MOH) has established a regulatory sandbox for participating service providers to develop and refine emerging telemedicine healthcare models in a controlled and safe environment before the eventual introduction of the slated Healthcare Services Act which shall regulate the digital health space.
If you have decided to seek a doctor via a video consultation, pull up this simple 5-question checklist to evaluate your digital health provider:
1) Is your digital health provider working with a regulatory body?
Check if the digital health provider is participating in the MOH regulatory sandbox for telemedicine service providers. For identification purposes, all MOH sandbox providers will bear a Regulatory Sandbox logo. Sandbox providers work closely with MOH to “set clear boundary conditions, undertake clinical and data governance, and patient risk mitigation strategies”, keeping patient safety and welfare as the paramount consideration. MOH’s stringent requirements mean that sandbox providers are held to the highest levels of accountability and standards.
2) Who are the doctors on the digital health platform? What are their qualifications and years of practice?
Review the doctor profiles on the platform to find out more about their expertise and experience, and check if the doctors are registered with the Singapore Medical Council.
3) Is there a physical clinic you can visit if further medical attention is necessary after the video consultation?
Should you need further medical assistance beyond a video consultation, check to see if the digital health provider has an associated physical clinic which you can visit for continuity of care.
4) How is medication packaged and delivered to you?
Ensure that quality practices are in place, which include but are not limited to:
1. The use of tamper-evident bags and opaque sleeves to safeguard patient privacy
2. Appropriate packaging and delivery of medication which preserves and protects integrity of the products
3. Implementation of appropriate patient-identifiers at the time of delivery to ensure that the correct medication is delivered to the patient
5) How is your data protected?
As with any digital enterprise, check that the digital health provider uses reliable and secure servers to store data.