New Delhi, the 12th May, 2020

No. MCI-211(2)/2019(Ethics)/100659.— In exercise of the powers conferred by Section 33 of the Indian
Medical Council Act, 1956 (102 of 1956), the Board of Governors in Supersession of the Medical Council of India with
the previous sanction of the Central Government, hereby makes the following Regulations to amend the “Indian
Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002:-
1. (i) These Regulations may be called the “Indian Medical Council (Professional Conduct, Etiquette and Ethics)
(Amendment) Regulations, 2020.”
(ii) These regulations shall deemed to have been effective from 25 th March 2020 which is the date on which the Central
Government has accorded approval to these Regulations.
2. In the “Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002”, the following
addition shall be made:-
3.8 Consultation by Telemedicine
3.8.1 Consultation through Telemedicine by the Registered Medical Practitioner under the Indian Medical Council Act,
1956 shall be permissible in accordance with the Telemedicine Practice Guidelines contained in Appendix 5.
3.8.2 Telemedicine Practice Guidelines are designed to serve as an aid and tool to enable Registered Medical
Practitioners to effectively leverage telemedicine to enhance health services and access to all in India.
3.8.3 Telemedicine Practice Guidelines are not applicable to the use of digital technology to conduct surgical or
invasive procedure remotely.
3.8.4 Any of the drugs lists contained in Telemedicine Practice Guidelines can be modified by the Board of Governors
in super-session of the Medical Council of India/Medical Council of India from time to time, as required.
3.8.5 The Board of Governors in super-session of the Medical Council of India may issue necessary directions or
advisories or clarifications in regard to these Guidelines, as required.
3.8.6 The Telemedicine Practice Guidelines can be amended from time to time in larger public interest with the prior
approval of Central Government [Ministry of Health and Family Welfare, Government of India].

Dr. RAKESH KUMAR VATS, Secy.-General
Footnote: The Principal Regulations namely, “Indian Medical Council (Professional Conduct, Etiquette and Ethics)
Regulations, 2002” were published in Part – III, Section (4) of the Gazette of India on the 6th April, 2002, and amended
vide MCI notification dated 22/02/2003, 26/05/2004, 10/12/2009, 28/01/2016, 21/09/2016 & 01/03/2019.

Appendix – 5

In supersession of the Medical Council of India

Telemedicine Practice Guidelines

Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine

These Guidelines have been prepared
in partnership with NITI Aayog

[This constitutes Appendix 5 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics Regulation,

25 March 2020

[PartIII—section 4] Gazette of India: Extraordinary31 TELEMEDICINE

‘The delivery of health care services, where distance is a critical factor, by all health care professionals
using information and communication technologies for the exchange of valid information for diagnosis,
treatment and prevention of disease and injuries, research and evaluation, and for the continuing
education of health care providers, all in the interests of advancing the health of individuals and their


‘The delivery and facilitation of health and health-related services including medical care, provider and
patient education, health information services, and self-care via telecommunications and digital
communication technologies.’


‘A Registered Medical Practitioner [RMP] is a person who is enrolled in the State Medical Register or
the Indian Medical Register under the Indian Medical Council Act 1956.’ [IMC Act, 1956]


Telemedicine: An Enabler of Healthcare Access and Affordability
There are a number of benefits of telemedicine. It increases timely access to appropriate interventions including faster
access and access to services that may not otherwise be available.
In India, providing In-person healthcare is challenging, particularly given the large geographical distances and limited
resources. One of the major advantages of telemedicine can be for saving of cost and effort especially of rural patients,
as they need not travel long distances for obtaining consultation and treatment. In this type of scenario, telemedicine can
provide an optimal solution for not just providing timely and faster access. It would also reduce financial costs
associated with travel. It also reduces the inconvenience/impact to family and caregivers and social factors.
Telemedicine can play a particularly important role in cases where there is no need for the patient to physically see the
RMP (or other medical professional), e.g. for regular, routine check-ups or continuous monitoring. Telemedicine can

reduce the burden on the secondary hospitals.
With telemedicine, there is higher likelihood of maintenance of records and documentation hence minimalizes the
likelihood of missing out advice from the doctor other health care staff. Conversely, the doctor has an exact document of
the advice provided via tele-consultation. Written documentation increases the legal protection of both parties.
Telemedicine provides patient’s safety, as well as health workers safety especially in situations where there is risk of
contagious infections. There are a number of technologies that can be used in telemedicine, which can help patients
adhere better to their medication regimens and manage their diseases better. Telemedicine can also enable the
availability of vital parameters of the patient available to the physician with the help of medical devices such as blood
pressure, blood glucose, etc management.
Disasters and pandemics pose unique challenges to providing health care. Though telemedicine will not solve them all,
it is well suited for scenarios in which medical practitioners can evaluate and manage patients. A telemedicine visit can
be conducted without exposing staff to viruses/infections in the times of such outbreaks. Telemedicine practice can
prevent the transmission of infectious diseases reducing the risks to both health care workers and patients. Unnecessary
and avoidable exposure of the people involved in delivery of healthcare can to be avoided using telemedicine and
patients can be screened remotely. It can provide rapid access to medical practitioners who may not be immediately
available in person. In addition, it makes available extra working hands to provide physical care at the respective health
institutions. Thus, health systems that are invested in telemedicine are well positioned to ensure that patients with
Covid-19 kind of issues receive the care they need.
The government is committed to providing equal access to quality care to all and digital health is a critical enabler for
the overall transformation of the health system. Hence, mainstreaming telemedicine in health systems will minimize
inequity and barriers to access. India’s digital health policy advocates use of digital tools for improving the efficiency
and outcome of the healthcare system and lays significant focus on the use of telemedicine services, especially in the
Health and Wellness Centers at the grassroots level wherein a mid-level provider/health worker can connect the patients
to the doctors through technology platforms in providing timely and best possible care.
However, there has been concern on the practice of telemedicine. Lack of clear guidelines has created significant
ambiguity for registered medical professionals, raising doubts on the practice of telemedicine. The 2018 judgement of
the Hon’ble High Court of Bombay had created uncertainty about the place and legitimacy of telemedicine because an
appropriate framework does not exist.
In India, till now there was no legislation or guidelines on the practice of telemedicine, through video, phone, Internet
based platforms (web/chat/apps etc). The existing provisions under the Indian Medical Council Act, 1956, the Indian
Medical Council (Professional Conduct, Etiquette and Ethics Regulation 2002), Drugs &Cosmetics Act, 1940 and Rules
1945, Clinical Establishment (Registration and Regulation) Act, 2010, Information Technology Act, 2000 and the
Information Technology (Reasonable Security Practices and Procedures and Sensitive Personal Data or Information)
Rules 2011 primarily govern the practice of medicine and information technology. Gaps in legislation and the
uncertainty of rules pose a risk for both the doctors and their patients.
There are some countries that have put in legislative measures and some countries, which follow non-legislative
measures such as guidelines to practice telemedicine. In some countries guidelines are treated as professional norms that
need to be followed by medical practitioners. We reviewed these other guidelines and consulted to put together these
guidelines to enable medical practitioners to practice telemedicine.
Telemedicine will continue to grow and be adopted by more healthcare practitioners and patients in a wide variety of
forms, and these practice guidelines will be a key enabler in fostering its growth.
The purpose of these guidelines is to give practical advice to doctors so that all services and models of care used by
doctors and health workers are encouraged to consider the use of telemedicine as a part of normal practice. These
guidelines will assist the medical practitioner in pursuing a sound course of action to provide effective and safe medical
[PartIII—section 4] Gazette of India: Extraordinary33
care founded on current information, available resources, and patient needs to ensure patient and provider safety.
These telemedicine guidelines will help realize the full potential of these advancements in technology for health care
delivery. It provides norms and protocols relating to physician-patient relationship; issues of liability and negligence;
evaluation, management and treatment; informed consent; continuity of care; referrals for emergency services; medical
records; privacy and security of the patient records and exchange of information; prescribing; and reimbursement; health
education and counseling.
These guidelines will provide information on various aspects of telemedicine including information on technology
platforms and tools available to medical practitioners and how to integrate these technologies to provide health care
delivery. It also spells out how technology and transmission of voice, data, images and information should be used in
conjunction with other clinical standards, protocols, policies and procedures for the provision of care. Where clinically
appropriate, telemedicine is a safe, effective and a valuable modality to support patient care.
Like any other technology, the technology used for telemedicine services can be abused. It has some risks, drawbacks
and limitations, which can be mitigated through appropriate training, enforcement of standards, protocols and