Homoeopathic Practitioners (Professional Conduct, Etiquette and Code of Ethics) Amendment, Regulations, 2020
BOARD OF GOVERNERS IN SUPER SESSION OF CENTRAL COUNCIL OF HOMOEOPATHY
New Delhi, the 23rd November, 2020
F. No. 7-3/2003-CCH (Pt.-I).—In exercise of the powers conferred by sub-section (I) of section 33 read with section 24 of the Homoeopathy Central Council Act, 1973 (59 of 1973), the Board of Governors in Supersession of the Central Council of Homoeopathy, with the previous sanction of the Central Government, hereby makes the following Regulations to amend the Homoeopathic Practitioners (Professional Conduct, Etiquette and Code of Ethics) Regulations 1982, namely:—
1. (1) These regulations may be called the Homoeopathic Practitioners (Professional Conduct, Etiquette and Code of Ethics) Amendment, Regulations, 2020.
(2) These regulations shall come into force on the date of their publication in the Official Gazette.
2. In the “Homoeopathic Practitioners (Professional Conduct, Etiquette and Code of Ethics) Regulations 1982, after regulation 29, the following regulation shall be inserted, namely:—
“29A Consultation by Telemedicine.— (1) The Consultation through Telemedicine to the registered Homoeopathic Practitioners shall be permissible in accordance with the Telemedicine Practice Guidelines contained in Appendix 3.
(2) Telemedicine Practice Guidelines shall be followed by the registered Homoeopathic Practitioners to enhance health services to the public at large.”
Dr. KUMAR VIVEKANAND,
Note: The principal regulations were published in the Gazette of India, Extraordinary part III- Section-4 vide Number 7-1/82-CCH dated the 16th March, 1982 and subsequently amended vide No. 7-3/2003-CCH (Pt.) dated 12th – 18th July, 2014; and No.7-3/2003-CCH (Pt.1) dated 8th June, 2018.
Telemedicine Practice Guidelines
(see regulation 29A)
‘The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.’
‘The delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communication technologies.’
REGISTERED HOMOEOPATHY PRACTITIONER
‘A Registered Homoeopathy Practitioner [RHP] is a person who is enrolled in the State Register of Homoeopathy or the Central Register of Homoeopathy under the Homoeopathy Central Council Act 1973.’ [HCC Act, 1973] S.O. No. 76 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 1] dated 28th December, 1973.
Homoeopathy being a wholistic system of medicine has been benefiting people for their health problems. Telemedicine can help to increase the availability of homoeopathy to the level where health care is difficult to reach. Telemedicine can play a particularly important role in cases where there is no need for the patient to physically see the RHP (or other medical professional), e.g. for regular, routine check-ups or continuous monitoring. Homoeopathy Telemedicine / Teleconsultation will enhance primary health care immensely.
India’s digital health policy advocates use of digital tools for improving the efficiency and outcome of Healthcare system and lays significant focus on the use of telemedicine services especially in the Health and Wellness centres at the grass root level wherein a mid-level health care provider / health worker can connect the patient to the doctor through Technology platforms for providing timely and best possible care.
In spite of this policy till now there is no legislation or guidelines for Homoeopathic practitioners on the practice of telemedicine through video, phone and internet based platforms (webchat, apps etc). Lack of clear guidelines has created significant ambiguity for registered medical professionals of the Homoeopathic systems raising doubts on the practice of telemedicine. The 2018 judgment of the Honourable High Court of Bombay has created uncertainty about the place and legitimacy of telemedicine as an appropriate Framework does not exist.
In India the practice of Homoeopathic medicine is mainly governed by concerned State Acts along with The Homoeopathy Central Council Act 1973, the Homoeopathic Practitioners (Professional Conduct, Etiquette and Code of Ethics) Regulations 1982; Drugs & Cosmetics Act 1940 & rules 1945; and Clinical Establishment (Registration and Regulation) Act, 2010. Information technology is governed by IT Act 2000, and the information technology (reasonable security practices and procedure and sensitive personal data or information) rules 2011. Gaps in legislation and the uncertainty of rules force a risk for both the doctors and their patients.
It is the need of the hour to bridge the gaps in legislation and the uncertainty of rules. These guidelines will serve as a step forward to be treated as professional norms that need to be followed by RHPs to enable them to regulate the practice of telemedicine.
• The purpose of these guidelines is to enable Homoeopathic practitioners to use telemedicine tools. This will be done by providing information as well as training which will be updated from time to time in the coming years. Telemedicine will continue to grow and be adopted by more health care practitioners and patients in a wide variety of forms.
• These guidelines will give practical advice to registered homoeopathic practitioners regarding telemedicine to encourage them to consider the use of telemedicine as a part of their normal practice as well as in disasters and pandemics which pose unique challenges to provide Healthcare.
• Practice of Telemedicine can prevent transmission of infectious diseases reducing the risk to both doctors and patients by avoiding social contact. These guidelines will provide norms and protocols relating to doctor patient relationship issues of liability and negligence, evaluation, management and treatment, informed consent, continuity of care, referral for emergency services, medical records, privacy and security of patient records and exchange of information, describing and reimbursement, health education and counseling.
• Telemedicine will not only encourage social distancing in special situations of epidemics and pandemics but talking to doctors will also allay their anxiety in the situation of complete lockdown
ADVANTAGE OF TELEMEDICINE
• Telemedicine provides patient’s safety as well as doctor’s & health worker’s safety, especially in situations where there is a risk of contagious infections. A telemedicine visit can be conducted without exposing staff to viruses/infections at the time of such outbreaks.
• Telemedicine provides rapid access to medical practitioners who may not be available in person.
• Telemedicine will not only encourage social distancing in special situations of epidemics and pandemics but talking to doctors will also allay their anxiety in the situation of complete lockdown.
• With telemedicine there is higher likelihood of maintenance of records and documentation. Written documentation increases legal protection of doctors as well as patients.
• Telemedicine, when effectively used, reduces the burden on secondary health care system.
• Telemedicine is useful for regular routine checkup on continuous monitoring and minimizes gaps in timely follow ups.
It is to be noted that unlike other technologies, the technology used for telemedicine has some risks, drawbacks & limitations, which can be mitigated through appropriate training, enforcement of standards, protocols & Guidelines from time to time. These guidelines should be used in conjunction with the other national clinical standards, protocols, policies and procedures.
1. TELEMEDICINE: DEFINITIONS AND APPLICATIONS
1.1.1 Definition of Telemedicine
World Health Organization defines telemedicine as “The delivery of health-care services, where distance is a critical factor, by all health-care professionals using information and communications technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and the continuing education of health-care workers, with the aim of advancing the health of individuals and communities.”