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Telemedicine (NMC Telemedicine Practice Guidelines 2020)

Use telemedicine to document NMC-required consent, patient identity, consultation mode and medicine-list restrictions before a remote consultation and prescription.

Who can do this: Practitioners and Doctors with teleconsult.conduct, plus encounter.read and encounter.write. Prescribing during the teleconsult also needs rx.read and rx.write. Where: Patients → patient → Teleconsult or /app/patients/:patientId/teleconsult/new.

Teleconsultation visit banner with mode and allowed medicine lists

Before you start​

  • Enable Telemedicine and Consents.
  • Save the practitioner's registration number in Profile.
  • Have a video or meeting link ready if this is a video consult. Achal stores the link but does not host video.
  • For minors, ensure an adult caregiver is present.

Start a first teleconsultation​

  1. Open the patient details page.
  2. Click Teleconsult. Result: Start teleconsultation opens at /app/patients/:patientId/teleconsult/new.
  3. In Teleconsultation consent, record consent if the page says No valid teleconsultation consent — record it below first.
  4. Under Patient identity, choose Verified by: ID document, Known patient, OTP to registered phone or Caregiver present.
  5. For ID document, choose ID type and enter Last 4 characters of the ID only.
  6. Tick Name confirmed, Age confirmed and I told the patient my name, qualification and registration number.
  7. Under Consultation details, choose Mode: Video, Audio or Text / chat.
  8. Choose First consultation.
  9. Add Video link (https, optional) and Chief complaint if needed.
  10. Click Start. Result: The visit workspace opens and the telemedicine banner shows the mode and allowed medicine lists.

Start a follow-up teleconsultation​

  1. Open Teleconsult for the patient.
  2. Complete consent and identity steps.
  3. Choose Follow-up (seen in person ≤ 6 months). The in-person visit must be yours and on or after the same date six calendar months ago (for example, on 27 September a visit on 27 March or later counts; 26 March does not).
  4. Select Previous in-person visit.
  5. Click Start. Result: The workspace opens only if the previous visit was your own in-person encounter with this patient within 183 days.

Prescribe in a teleconsultation​

  1. Open the visit Prescription tab.
  2. Add medicines as usual.
  3. Watch the visit banner for allowed lists.
  4. Remove medicines marked Not allowed in this teleconsultation or Prohibited in teleconsultation (Schedule X / NDPS).
  5. Finalize only after the prescription passes policy checks.
ConsultationAllowed lists
First consultation by VideoList O and List A
First consultation by Audio or Text / chatList O only
Follow-up (seen in person ≤ 6 months)List O, List A and List B
Any teleconsultationNever Schedule X, narcotic or psychotropic medicines
note

The medicine mapping is conservative: unscheduled medicines are List O, Schedule H is List A unless it belongs in List B, Schedule H1 and higher-risk chronic medicines are List B, and Schedule X, opioids, benzodiazepines, z-drugs, stimulants and phenobarbital are prohibited.

Every medicine in a teleconsultation must be picked from the drug list: typed-in names or brand names without a matching generic are refused. A clinic's own drug entry can never make a medicine "safer" than the master list — for example a custom Alprazolam is still prohibited.

Reopen an active teleconsultation​

  1. Open the patient details page.
  2. Click Teleconsult or Start teleconsultation from the teleconsult visit banner.
  3. If the teleconsultation was already started, continue from the existing visit. Result: Starting twice reuses the same teleconsultation encounter where applicable.

Troubleshooting​

Problem / messageWhat it meansWhat to do
No valid teleconsultation consent — record it below first. or CONSENT_REQUIREDTeleconsult consent is missing or expired.Record Teleconsultation consent and start again.
IDENTITY_NOT_CONFIRMED Confirm the patient's name and age and share your identity and registration numberRequired identity checkboxes are missing.Tick Name confirmed, Age confirmed and practitioner identity disclosure.
CAREGIVER_REQUIRED A minor can be teleconsulted only with an adult caregiver presentMinor patient was started without caregiver identity.Choose Caregiver present and enter caregiver name and relationship.
FOLLOW_UP_NOT_ELIGIBLE A follow-up teleconsultation needs your own in-person visit with this patient in the last 6 monthsFollow-up requirements are not met.Choose First consultation or schedule in-person care.
INVALID_VIDEO_LINK Use a secure https:// meeting linkLink is not HTTPS or contains credentials.Paste a secure meeting link without username or password.
ENCOUNTER_NOT_TELECONSULT This visit is an in-person encounter; open a teleconsultation insteadTrying to attach telemedicine to an OPD visit.Start from Teleconsult.
ENCOUNTER_NOT_OPEN The encounter is not openThe selected encounter is closed.Start a new teleconsultation if needed.
TELECONSULT_NOT_STARTED Start the teleconsultation (identity check and consent) before prescribingRx was attempted before teleconsult start completed.Complete this page first.
TELEMEDICINE_DRUG_PROHIBITED Schedule X and narcotic / psychotropic medicines cannot be prescribed by teleconsultationMedicine is prohibited in telemedicine.Remove it and arrange in-person care if clinically needed.
TELEMEDICINE_DRUG_UNVERIFIED Pick this medicine from the drug listThe medicine was typed in (or brand-only) and has no master generic entry.Search the medicine and select it from the list, or arrange in-person care.
RX_POLICY_UNAVAILABLE Prescribing rules for this visit cannot be checkedThe visit linked to the prescription is no longer available.Reload the visit; if it persists, start a new teleconsultation.
TELEMEDICINE_DRUG_NOT_ALLOWED Some medicines cannot be prescribed in this type of teleconsultationMedicine list is outside the allowed set for mode/kind.Use allowed alternatives or convert to eligible follow-up/in-person care.
Add your medical council registration number to your profile before finalizing.Prescriber profile lacks registration number.Update Profile before finalising Rx.