MOH investigates 8 telehealth providers for lapses
Eight telemedicine providers have been or are currently being investigated for lapses in clinical care or inappropriate advertisements of services, said Senior Minister of State for Health Janil Puthucheary in Parliament on Jan 7.
Enforcement action has been taken against three of the providers, including MaNaDr Clinic, Mr Puthucheary added.
One of them, MaNaDr Clinic was found to have more than 100,000 teleconsultations that lasted one minute or less in a sampled month, amongst other lapses. The Ministry of Health revoked the clinic’s licence on Dec 20, barring it from providing outpatient medical services.
Responding to parliamentary questions on whether there are similar trends of unethical telehealth providers following the MaNaDr Clinic case, Dr Puthucheary said that the eight telemedicine providers have been or are being investigated for non-compliances in two categories.
The first is in clinical care, such as doctors issuing prescriptions and medical certificates without proper clinical assessment or not conducting video consultations for first time patients.
The second is for inappropriate advertisements, such as those promoting the unnecessary use of telemedicine services.
Other than MaNaDr Clinic, two other operators have had enforcement actions taken against them. Actions taken include a short suspension and a stern warning, commensurate with the severity of the breaches, said Mr Puthucheary.
In addition, medical practitioners have also been referred to the Singapore Medical Council (SMC) for potential lapses in professional standards. SMC’s review is currently underway.
He did not name the other operators that have been or are being investigated as investigations are still ongoing.
In 2024, the ministry received 59 complaints regarding telemedicine involving 20 operators.
There are a number of licencees involved, and there were “some very short teleconsultations”, and the ministry is trying to establish what the exact numbers are, said Dr Puthucheary.
He pointed out that a short teleconsultation isn’t automatically incorrect if it is with a regular patient, or a follow-up, or if the necessary information has been obtained.
“We have to look at the entire clinical care that has been provided and make sure it’s appropriate. It’s not the fact of telemedicine that is necessarily wrong, it’s whether correct clinical care has been provided through this modality, and that sometimes requires inpatient consultation.”
“Sometimes it requires the appropriate breadth and time for the interactions so that correct information is provided. And in some cases, it is an issue of whether or not the correct documentation of the process has been carried out. So all of these things are part of the investigation process,” said Dr Puthucheary.
Responding to a question on how telemedicince may be abused to get easy access to medical certificates, Dr Puthucheary pointed out that such inappropriate behaviour can happen in an in-person setting as well.
When it comes to telemedicine abuse, there are a variety of things that MOH looks at, which includes metrics in terms of the numbers, the patient mix and the justifications for the medical certificate or any other therapeutic intervention.
“Ultimately, has a correct assessment been provided? And is the treatment - whether it is medication, investigation or medical certificate appropriate to the medical condition that has been detected and appropriately documented?”
Mr Puthucheary said it is important to recognise that telemedicine can bring tremendous benefits to patients, especially those who are immobile, or doing regular follow-ups. It makes healthcare much more accessible and convenient to patients.
“However, as in any new service delivery model, there will be abuse and misuse, especially in the initial period of implementation. MOH will take the necessary enforcement action, that over time, best practices become normalised.”
The public can raise concerns on the provision of telemedicine via the public feedback channels on the Health Ministry’s website.
Get The New Paper on your phone with the free TNP app. Download from the Apple App Store or Google Play Store now