Pre-requisite

  • This Advisory is guided by the Medical Act 1971 (Amended 2012) which regulates the registration and practice of medicine in Malaysia and the Malaysian Medical Council’s Code of Professional Conduct. 

  • Malaysian Medical Council’s jurisdiction is within this country only and physicians must ensure appropriate liability protection is in place to provide indemnity for malpractice.

  • The Council reminds physicians that the use of technology does not alter the ethical, professional and legal requirements in the provision of care.

Definitions

  • A virtual consultation is a form of Telemedicine. 

  • Telemedicine: a medical service provided remotely via information and communication technology.

  • Remotely: without physical contact and does not necessarily involve long distances. 

  • In-person: Physical attendance with the Physician.

Before you start:

In providing medical care using telecommunications technologies, physicians are advised that they must:

  • Possess adequate training and competency to manage patients through telemedicine.

  • Follow all ethical and legal requirements such as to obtain valid informed consent from the patient.

  • Ensure that the physician’s identity, place of practice and registration status are made known to the patient, and the identity of the patient is confirmed at each consultation.

  • Ensure that the identities of all other participants involved in the telemedicine encounter are disclosed to and approved by the patient and documented in the patient record.

  • Ensure that both the physician-site and the patient‐site are using appropriate technology that complies with legal requirements regarding privacy and security and accreditation standards where required.

Always remember:

Due considerations must be given to the safety and maintaining a high standard of patient care:                

  • Consider whether the telemedicine medium affords adequate assessment of the presenting problem and if it does not, arrange for a timely in-­person assessment.​

  • Explain the appropriateness, limitations, and privacy issues related to telemedicine to the patient. ​

  • Provide an appropriate medical assessment based on the current symptoms or condition, past history, medications and limited examination possible.​

  • Create and maintain medical records of the consultation, in accordance with professional and legal requirements. ​

  • Ensure patients have enduring access to their medical records and that medical records are available to other health care professionals for the provision of ongoing patient care.

If you’re not sure, what can you do?

  • Ensuring follow­‐up and referring to other facilities and colleagues if care is not adequate:

  • Communicate with the referring and other treating physicians and provide follow‐up and after-­hours care as medically appropriate.

  • Ensure patients referred to specialists are adequately investigated and treated before referral and are advised about accessing primary care following specialist assessment and treatment. 

  • Ensure adherence to the same obligations for patient follow-up in telemedicine as is expected with an in‐person consultation. 

Stop, think and act

Limitations of Telemedicine Virtual Consultation:

  • Exercise caution when providing prescriptions or other treatment recommendations to patients whom they have not personally examined.

  • Ensure that patients with cognitive disorders, intoxication or language barriers be seen at a physical facility.

Download reference document, here (Malaysia Medical Council)