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.

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
- Open the patient details page.
- Click Teleconsult.
Result: Start teleconsultation opens at
/app/patients/:patientId/teleconsult/new. - In Teleconsultation consent, record consent if the page says No valid teleconsultation consent — record it below first.
- Under Patient identity, choose Verified by: ID document, Known patient, OTP to registered phone or Caregiver present.
- For ID document, choose ID type and enter Last 4 characters of the ID only.
- Tick Name confirmed, Age confirmed and I told the patient my name, qualification and registration number.
- Under Consultation details, choose Mode: Video, Audio or Text / chat.
- Choose First consultation.
- Add Video link (https, optional) and Chief complaint if needed.
- Click Start. Result: The visit workspace opens and the telemedicine banner shows the mode and allowed medicine lists.
Start a follow-up teleconsultation
- Open Teleconsult for the patient.
- Complete consent and identity steps.
- 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).
- Select Previous in-person visit.
- 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
- Open the visit Prescription tab.
- Add medicines as usual.
- Watch the visit banner for allowed lists.
- Remove medicines marked Not allowed in this teleconsultation or Prohibited in teleconsultation (Schedule X / NDPS).
- Finalize only after the prescription passes policy checks.
| Consultation | Allowed lists |
|---|---|
| First consultation by Video | List O and List A |
| First consultation by Audio or Text / chat | List O only |
| Follow-up (seen in person ≤ 6 months) | List O, List A and List B |
| Any teleconsultation | Never Schedule X, narcotic or psychotropic medicines |
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
- Open the patient details page.
- Click Teleconsult or Start teleconsultation from the teleconsult visit banner.
- If the teleconsultation was already started, continue from the existing visit. Result: Starting twice reuses the same teleconsultation encounter where applicable.
Troubleshooting
| Problem / message | What it means | What to do |
|---|---|---|
No valid teleconsultation consent — record it below first. or CONSENT_REQUIRED | Teleconsult 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 number | Required 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 present | Minor 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 months | Follow-up requirements are not met. | Choose First consultation or schedule in-person care. |
INVALID_VIDEO_LINK Use a secure https:// meeting link | Link 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 instead | Trying to attach telemedicine to an OPD visit. | Start from Teleconsult. |
ENCOUNTER_NOT_OPEN The encounter is not open | The selected encounter is closed. | Start a new teleconsultation if needed. |
TELECONSULT_NOT_STARTED Start the teleconsultation (identity check and consent) before prescribing | Rx was attempted before teleconsult start completed. | Complete this page first. |
TELEMEDICINE_DRUG_PROHIBITED Schedule X and narcotic / psychotropic medicines cannot be prescribed by teleconsultation | Medicine is prohibited in telemedicine. | Remove it and arrange in-person care if clinically needed. |
TELEMEDICINE_DRUG_UNVERIFIED Pick this medicine from the drug list | The 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 checked | The 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 teleconsultation | Medicine 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. |