Authored By: Saya Krishnan
Sastra Deemed University
Abstract
Telemedicine has transformed modern healthcare by bridging geographical gaps and makingservices more accessible. The COVID-19 pandemic accelerated its adoption, but regulatorychallenges persist. This article compares India and the United States, focusing on licensure, privacy, patient consent, and liability. Through a comparative lens, it highlights the strengthsand shortcomings of both frameworks and suggests reforms for a robust telemedicine system.
Introduction
Healthcare delivery is rapidly evolving with the integration of telemedicine and digital platforms. Remote consultations, e-prescriptions, and electronic records nowformpart of mainstream healthcare. The pandemic underscored the necessity of telemedicine but alsorevealed legal complexities regarding patient rights, privacy, jurisdiction, and malpractice.
In India, the Telemedicine Practice Guidelines, 2020, recognized digital consultations as legitimate practice. In the U.S., regulation is anchored in HIPAA, the HITECHAct, andstate-specific licensing regimes. This article examines how the two jurisdictions regulate telemedicine, identifies gaps, and proposes ways forward.
Research Methodology
The article uses a doctrinal and comparative method, relying on statutes, guidelines, andcaselaw, supported by secondary sources including scholarly works, government reports, andpolicy papers.
Legal Framework Governing Telemedicine
In India, the Telemedicine Practice Guidelines, 2020, issued under the Indian Medical Council Act, outline permissible modes of teleconsultation, professional duties, and patient consent. The Information Technology Act, 2000, supplements this by addressing cyber liability and data protection. The Drugs and Cosmetics Act, 1940, regulates online prescriptions, while the Digital Personal Data Protection Act, 2023, provides a statutoryprivacy framework.
In the U.S., HIPAA, 1996, ensures confidentiality of patient health information, while theHITECH Act, 2009, incentivized electronic health records. The Centers for Medicare &Medicaid Services (CMS) expanded telehealth reimbursements, particularly during COVID- 19. However, the state-based licensing requirement, obliging doctors to hold licenses inthepatient’s state, creates barriers to nationwide practice.
Judicial Interpretation
Indian courts have linked access to healthcare with Article 21 of the Constitution. In PaschimBanga Khet Mazdoor Samity v. State of West Bengal (1996), the Supreme Court held that denial of timely medical treatment violates the right to life. Though not telemedicine-specific, this principle extends to digital health services.
In the U.S., judicial scrutiny has been sharper. In Doe v. Medlantic Health Care Group(2003), liability was imposed for unauthorized disclosure of medical records, emphasizing strict HIPAA compliance. Telemedicine malpractice suits often hinge on whether the standardof care was upheld in virtual consultations.
Comparative Analysis
India’s 2020 Guidelines gave legitimacy to telemedicine, integrating it with national healthschemes like the Ayushman Bharat Digital Mission. Yet, questions persist about liabilityfor misdiagnosis, limited enforcement in rural areas, and absence of standards for cross-border teleconsultations.
The U.S. system excels in privacy protections and insurance reimbursements but suffers fromregulatory fragmentation. State licensing laws prevent seamless practice across borders, anduncertainty over reimbursement post-pandemic creates instability. High compliance costs alsodiscourage smaller providers.
Recent Developments
India has advanced digital health through the Ayushman Bharat Digital Mission, creatingunique health IDs, and the 2023 Data Protection Act, which fortifies privacy safeguards. Inthe U.S., the CARES Act, 2020, expanded Medicare telehealth services. States are nowdebating permanent reforms on licensing and reimbursement, signaling institutionalizationoftelemedicine beyond emergency measures.
Suggestions and Way Forward
Both systems need reform. In India, liability for digital consultations and rules for cross- border practice require clarity. In the U.S., interstate licensing needs harmonization. Bothcountries must strengthen privacy safeguards: India by enforcing its new data law, andtheU.S. by modernizing HIPAA for emerging technologies such as AI-based diagnostics. International cooperation through bodies like the WHO could set global telemedicine norms. Finally, investment in digital infrastructure and literacy is essential to make telemedicineaccessible across socio-economic divides.
Conclusion
Telemedicine promises to democratize healthcare but requires strong regulatory foundations. India’s 2020 Guidelines laid a much-needed base, yet gaps in liability and enforcement persist. The U.S. leads in privacy but struggles with fragmentation. A balanced approach, combining India’s centralized model with the U.S.’s strong data safeguards, could serve as ablueprint for future reforms. Ultimately, the law must adapt to ensure telemedicine is safe, accessible, and equitable in the digital era.
Reference(S):
Paschim Banga Khet Mazdoor Samity v. State of West Bengal, (1996) 4 SCC 37 (India). Doe v. Medlantic Health Care Group, 814 A.2d 939 (D.C. 2003) (U.S.). Telemedicine Practice Guidelines, 2020 (India).
Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110Stat. 1936 (U.S.).
Digital Personal Data Protection Act, 2023 (India).
CARES Act, Pub. L. No. 116-136, 134 Stat. 281 (2020) (U.S.).
