Clinics warned to get their act together over telehealth, advertising abuses

SINGAPORE’S health authorities jointly reminded medical providers of the need to comply with guidelines on telemedicine services and advertisements, in an industry circular on Friday (Nov 22).

These include ensuring that teleconsultations are appropriate for the patient’s condition and avoiding the prescription of controlled drugs through telemedicine.

The reminder came after the Ministry of Health (MOH) and Health Sciences Authority (HSA) said on Nov 13 that they were reviewing weight-loss drug advertisements flagged by The Business Times. The ads are potentially in breach of a ban on advertising prescription-only medicines.

On Oct 15, MOH also said it would revoke telehealth provider MaNaDr Clinic’s licence, for its failure to deliver outpatient services in a clinically and ethically appropriate manner. Investigations had revealed teleconsultations as brief as one minute, often followed by the issuance of medical certificates (MCs).

Friday’s circular was issued by MOH, HSA and the Singapore Medical Council (SMC). It highlighted various obligations under the Healthcare Services Act (HCSA), the SMC’s Ethical Code and Ethical Guidelines (ECEG), and the Health Products Act.

“For the avoidance of doubt, in addition to the specific requirements emphasised in this circular, HCSA licensees and medical practitioners are required to comply with all applicable legislation, licence conditions, codes of practice, and the ECEG,” stated the circular, which was seen by BT.

Clinical responsibilities

The circular noted that teleconsultations must be offered only when medical care can be provided in a “proper, effective and safe manner”.

Telemedicine providers must establish guidelines to identify cases where telemedicine is unsuitable, such as when conditions require physical examinations, or when prescribing controlled drugs.

Transparency is also required, with providers informing patients of the identity, role, and designation of medical personnel.

For first-time patients, real-time video consultations are mandatory to establish a doctor-patient relationship.

Providers are also responsible for follow-up care, and must ensure that patients are informed of post-consultation options as well as arrange in-person follow-ups when necessary.

They must also conduct regular service reviews to ensure proper patient assessments; appropriate issuance of medications and medical certificates; make sure frequent MC cases are flagged; and take corrective actions to address lapses.

Advertising guidelines

As for advertisements, they must be factual and not be misleading. They should not promote prescription-only medicines or exploit patient vulnerabilities.

“Advertisements of prescription-only medicines and professional-use only medical devices are not allowed,” the circular stated.