Introduction

Demand for healthcare services around the world is increasing exponentially. Healthcare consumption also has grown year after year and this has led to an increase consumption. As the 4th Industrial revolution continues to gain strength, healthcare delivery also rides on the technology wave. Telemedicine will be the backbone of and reshape healthcare delivery. [i]

Telemedicine is rapidly growing in the field of medicine as technology has become a huge part of our daily lives. 88% of our population owns a smartphone while 7% of Malaysians uses their smartphone to track heath.

Telemedicine service with Doc2Us

Doc2Us is a mobile telemedicine platform allowing the general public and corporate partners to connect with their professional healthcare providers (HCP) like doctors and pharmacists. Doc2Us provides online tele-consult, electronic prescription (e-prescription) and online health promotion information by posting daily health articles.

Doc2Us strive to provide an excellent patient centric, safe and value added telemedicine services. Hence all medical professionals including doctors, who are listed in the Doc2Us platform are screened through by the Medical Board in ensuring the doctors are fully qualified to practice in their own respective field.

Telemedicine has a role to provide quick and accessible healthcare services to the general public. However it ​shall not replace the need for a patient to see a doctor face to face if they are ill. Telemedicine is not meant to provide acute management to patients. The human touch cannot be provided via telemedicine. It is strictly ​NOT meant for medical emergency.

Patient’s safety is our priority.

Practice of Telemedicine

Doctors

Only Qualified Healthcare Professionals (HCP) are allowed on the platform. HCP includes doctors, nurses, pharmacist, nutritionists, psychologist and any other qualified medical related personnel.

Doctors or Registered medical practitioners (RMP) shall have a recognize medical degree as per the second schedule of the Medical Act 1971 (Amendment 2012) and are to be fully registered under the same act. Specialists on the platform shall be fully gazetted or registered with the National Specialist Registrar (NSR) as per amended of the Medical Regulations 2017. All RMP shall have their own active medical indemnity insurance.

RMP shall have a valid practicing certificate.

Pharmacists

Pharmacists shall be fully registered with the pharmacist board as per Registration of Pharmacist Act 1951. Registered pharmacist shall have a valid practicing certificate.

Allied Health Staffs

Nurses shall be fully registered with the Malaysian Nursing Board, and process a valid practicing certificate.

Telemedicine Users

Patients or clients that use Telemedicine services on Doc2Us Platform shall agree to the terms and privacy policy stipulated on the platform. Users are required to sign up on the platform either with their email address or Facebook account and shall verify their account before proceed to use. One user account is to be used by one client or patient only. Multiple users on one account is strictly prohibited unless authorised by primary user. Users shall update their biography and personal data from time to time to ensure better healthcare delivery.

Ethics of Telemedicine Practice

Electronic Prescription

Electronic prescription (e-prescription) encompass prescriptions for medications and laboratory testing. Prescriptions shall be valid only when it is prescribed by any RMP. Validity of the prescription shall include an electronic signature or digital signature (whichever is applicable) of the RMP.

Medication Prescriptions

RMP shall adhere to safe and ethical prescribing of medicine. RMP shall adhere to the following “3C” approach when prescribing.

  1. Control. Patients shall provide information that their chronic conditions are in good control. RMP shall ensure that all personal details of the patients, including drug allergies are detailed out before prescribing.
  2. Compliance. RMP shall ensure that patients are compliant to their medication and shall stress the importance of it during each consultations.
  3. Cautious side effects. RMP shall be cautious of any potential side effects of the medicines. Patient’s education is key to safe prescriptions.

RMP shall not provide prescriptions to any patients if any of the “3C”s are not complied.

Corporate Clients

In ensuring safe practice of medicine, the following shall be followed when managing patients with chronic diseases:

  1. The RMP shall gather and assess the general condition of the patient via Doc2Us platform to determine if the patient is fit for continuation of chronic medication (LTM).
  2. Before prescribing medications to patients, RMP shall ensure the same type of medication, the same dose and the same frequency is given.
  3. Changes of types of medicines, dosages or frequency of medicines shall not be allowed.
  4. Patients shall be referred back to their panel doctors if:
    • There are any changes in types, dosage or duration of medicine.
    • A further review of patient’s clinical condition is needed
    • A further review of patient’s medications is needed
    • Failed to satisfy ‘3C’
    • Patients have acute clinical problems
    • Patient developed side effects or do not tolerate LTM previously prescribed
    • “Red Flags” raised in patient’s clinical condition
    • Doubts or uncertainty of patient’s problem.
  5. RMP shall not prescribe acute medication for the treatment of acute clinical condition.
  6. RMP shall ensure that the duration of LTM prescriptions do not exceed 3 months or less (as required by individual corporate clients)
  7. RMP shall not prescribe medications to patients that have not seen their respective general practitioners (GP) for duration longer than 6 months.

Telemedicine Etiquette

HCP shall ensure good etiquette online. As conversations using chat platform has excessively high risk of miscommunication, HCP shall take proactive measures to ensure good online etiquette by not having unnecessary usage of strong languages, capital letters, emojis, jargons or excessive templates.

HCP shall embark on the “3E” approach in handling patients online.

  1. Education. HCPs shall educate patients on their health conditions. Patients shall be well educated health promotion and preventive measures.
  2. Empowerment. HCPs shall empower their patients to take charge of their own health. Patients can monitor their chronic disease on their own and are taught on identifying red flags.
  3. Encouragement. HCPs are to encourage patient to be compliant to medication and lifestyle advice. HCPs shall set health goals to motivate patients to stay well and healthy.

Limitation of Telemedicine

Telemedicine has its limitations and do not replace conventional face to face consultation. The practice of medicine requires human touch, something which telemedicine cannot provide.

Clinical Governance

  1. Governance of clinical practice shall be overseen by the medical board, headed by the medical director.
  2. Practice of medicine shall be evidence based and follow with the current Clinical Practice Guideline (CPG) or international guideline.
  3. Clinical audits shall be done regularly to ensure safe practice of telemedicine.

“Together for a better healthcare tomorrow”

Updated 31 December 2018
Medical Director
Doc2Us