Doctors cannot sign lab reports via remote authentication: NMC RTI response

New Delhi: The Telemedicine Practice Guidelines 2020 do not allow registered medical practitioners to sign Pathology and Radiology lab reports via remote authentication without physical presence and supervision, the National Medical Commission (NMC) has said.

Offering clarification regarding the scope of the Telemedicine Practice Guidelines 2020 to remote authentication of RMPs for Pathology and Radiology lab reports, NMC responded to a Right to Information (RTI) application mentioning that the guidelines do not address the use of telemedicine for remotely operated invasive or surgical procedures.

The RTI application in this regard was filed by Dr. Rohit Jain, who referred to the confusion among doctors regarding the physical presence requirement to authenticate lab reports and the usage of cloud-based software to sign/authenticate lab reports called Telepathology & Teleradiology.

In connection with this matter, in the public interest, Dr. Jain questioned NMC, "Does Telemedicine Practice guidelines 2020 allow a Registered Medical Practitioner to sign Pathology and Radiology lab reports via remote authentication without physical presence and supervision."

Also Read: Only Registered Doctors with MD Pathology can Counter-sign Lab Reports: Rajasthan HC

However, in response, NMC stated, "No. This guidelines do not address the use of telemedicine for remotely operated invasive or surgical procedures."

With the advent of technology, the use of digitized/scanned signatures has become a common phenomenon in diagnostic reports particularly laboratory reports. However, such technological advancement, while bringing convenience to doctors, has indeed proven to be risky as patients with the growing practice of lending and/or even signature stealing, where signed lab reports are given to the patient without authentication of the test by the qualified doctor.

Back in 2018, ruling the act of lending signatures as "unethical", the Maharashtra Medical Council (MMC) had barred a pathologist in this connection. The doctor was lending his name and registration number to more than 200 laboratories across the State, where his personal supervision was "physical impossible".

Medical Dialogues had earlier reported that back in 2019, the erstwhile Medical Council of India (MCI), now NMC, had also clarified that physical presence of doctors was necessary for the authentication of Laboratory as well as radiology reports.

Such a clarification by MCI was equivalent to a death knell to the practice followed by many specialists, who verify laboratory reports remotely based on technician's evaluation without going through the investigations themselves.

MCI had offered this clarification in response to an RTI application filed in December 2019 by Dr Rohit Jain back then. However, pointing out that the Telemedicine guidelines had come up in May 2020, Dr. Jain told Medical Dialogues, "Now, people are taking the recourse of the Telemedicine guidelines saying that the Telemedicine guidelines permit."

"Scanned signatures are being misused for authenticating remotely across the country. It has been massively misused by almost everyone. Somebody is sitting in Delhi and blood samples are being processed in Patna and the reports are being authenticated in Delhi," he mentioned, further adding that "Doctors are lending their signatures for some amount and they are not looking at anything."

"Doctors are confused because they say that Telemedicine guidelines permit telepathology and teleradiology. So, I sought a clarification. Also, if you go through Telemedicine Practice Guidelines 2020, they permit the consultation among a registered medical practitioner to another registered medical practitioner. So, I as a doctor can consult another doctor transferring images and get an opinion. But, what is happening is that somebody has opened up a lab 500 kms far off and then they are running the tests (for example a CBC sample) there and the doctor sitting in Delhi does not see anything, physically the sample (if there is a clot or anything). They see nothing but simply authenticating it and delegating it to the Telemedicine guidelines saying that the Telemedicine guidelines permit this. So, that is why I sought this specific query from NMC," he said, adding that the RTI was filed in November 2024 and the RTI thereafter went to the Ethics Board of the NMC, which gave this decision.

"It reiterates the stand that the physical presence is very much necessary," added Dr Jain.

Also Read: Physical Presence of Doctor must to Authenticate Lab, Radiology Report: MCI in RTI response