18 Apr 2018
TELEMEDICINE AND ISSUANCE OF ONLINE MEDICAL CERTIFICATES
1. There has been an increase in discussions and interest in telemedicine recently, and the Singapore Medical Council (SMC) has received a number of queries and feedback in this regard. Following separate statements issued recently by the Ministry of Health (MOH) and the medical professional bodies, there was also some media attention on this matter.
2. Registered doctors providing telemedicine services are required to comply with the 2016 SMC Ethical Code and Ethical Guidelines (ECEG) and may take reference from the National Telemedicine Guidelines (NTG) issued by the MOH in 2015. Specific ECEG and NTG references and guidance are provided in Annexes A and B respectively. In summary, diagnosis, prescription of medicine and issuance of medical certificates (MCs) via telemedicine (i.e. without a physical medical consultation) are subject to doctors’ professional judgment and the precise circumstances of each presenting case.
3. With Singapore’s ageing population and increasing incidence of chronic diseases, MOH and SMC are aware of the potential benefits of telemedicine for both simple acute and chronic disease management by improving accessibility to care. As such, MOH and SMC support the use of telemedicine in our maturing healthcare system and will be regulating it further under the upcoming Healthcare Services Act (HCSA) in 2020.
4. In the interim, MOH will be reaching out and encouraging selected telemedicine providers to enter into a regulatory sandbox with the MOH. The sandbox will enable telemedicine providers to develop innovative models but within well-defined patient safety and welfare parameters. Depending on the model, MOH will also ask these providers to share key data on their service. This approach will allow MOH to better understand the evolution of the sector, and provide a platform for the co-creation of telemedicine regulations under HCSA. The sandbox will exist up till the point of HCSA licensing after which all telemedicine providers will have to comply with the prevailing legal and regulatory requirements. The public and licensees will be able to identify MOH sandbox partners via a Regulatory Sandbox logo (see Annex C).
5. All doctors currently performing or planning to practise telemedicine should abide by the ECEG, Health Products Act and Regulations (including but not limited to record keeping, labelling, reporting of serious adverse events) and take reference from the NTG. If they are aware of any standalone telemedicine providers, they should refer these providers to MOH. 6. For more information on the regulatory sandbox and the list of telemedicine providers collaborating with MOH, you may refer to the MOH website or contact MOH at HCSA_enquiries@moh.gov.sg.
Yours sincerely,
A/PROF BENJAMIN ONG PROF TAN SER KIAT
DIRECTOR OF MEDICAL SERVICES
MINISTRY OF HEALTH
The full document (together with Annex A, and B) can be downloaded below:
Download [.pdf, 342KB]