by Sergio Pillon and Ombretta Papa
The doctor who writes an electronic prescription after a televisit, as is already possible, risks being accused of false certification. An absolute anachronism that needs to be remedied
On Wednesday 28 February 2024 in the prestigious Sala Zuccari Palazzo Giustiniani, seat of the Presidency of the Senate of the Republic, a conference was held promoted by the Digital Health Commission of the OMCEO Rome (Dr. Ombretta Papa) and the Medical and Health Responsibility Commission of the Order of the Lawyers of Rome in the figure of the lawyer Giorgio Muccio, promoted by the senator Daniela Sbrollini.
At the center of the conference is a “hot” topic of the digital evolution of the National Health Service: doctor certification as it evolves with the introduction of telemedicine.
The conference highlighted how telemedicine is changing the landscape of medical certification. Industry professionals have examined the new challenges that arise when doctors provide diagnoses and certifications without a physical encounter with the patient.
The legal value
The legal value of televisiting is a key issue and the discussion highlighted the complexity of the legal value of certifications issued following televisiting. Despite the convenience and efficiency of telemedicine, doubts remain about its legal validity, especially in the absence of clear regulation. Among the proposals that have emerged, there is the idea of creating a legal framework that allows remote certification in specific circumstances, while ensuring the safety and reliability of the process.
Anachronism
Digitalization is influencing daily medical practice, pushing for an evolution of standard procedures and raising important questions about accessibility and equity in healthcare and telemedicine represents a revolutionary innovation in the field of health, but requires careful consideration of the legal, ethical and operational implications to be effectively integrated into the existing healthcare system.
All clinicians and lawyers agree in stating how anachronistic it is to exclude telematic illness certification from the televisit, especially for pathologies that cannot be “objectified” with a “physical” visit, for example a migraine, gastroenteritis, dizziness, fever and more.
The proposals
Some proposals have emerged: the evaluation of whether to certify the illness electronically after a televisit should be, as indicated in the indications for the use of telemedicine published in the Official Journalaccording to the doctor’s opinion. Furthermore, it should be possible to draw up an electronic illness certification for all doctors regularly registered in professional orders and authorized to practice the profession, not only those of the NHS, in order to avoid unnecessary overloading of family doctors and unnecessary bureaucratization for the citizen.
INPS forms
The INPS and dematerialized prescription forms must be modified, today they only provide for visits in person or at home, excluding televisits, exposing the doctor who writes an electronic prescription after a televisit, which is already possible today, to the accusation of false certification. Furthermore, from today, the forms should be made easier to fill out, in the opinion of family doctors it is clear that a bureaucratic logic and not a clinical logic was followed in drafting the digital forms to be filled out on the INPS portal.
Telematic certification “by documents” should be made possible, certification following a certificate from another professional produced by the patient and finally a clarification on the code of ethics by the FNOMCEO on this “hot” topic is necessary.
The success or failure of digitalization passes through what seem, only apparently, small things. A constructive dialogue between professionals, institutions and legislators is necessary, and a common commitment to define clear guidelines and safe protocols, essential to navigate these uncertain waters and ensure that telemedicine is not only possible but becomes an added value for public health.
Sergio Pillon is vice-president and head of institutional relations AiSDeT, Italian Association of digital health and telemedicine
Ombretta Papa is a member of the Digital Health Commission
of the Order of Doctors of Rome
March 12, 2024 (modified March 12, 2024 | 7:09 pm)
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