Regulating Remote Care: A Legal Overview Of Telemedicine

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The integration of technology into healthcare has improved drastically in recent years. As consultations, diagnoses, medical records and even prescriptions move online, the legal framework government telemedicine, or lack of it, is being tested in real time. The traditional in-person or face-to- face consultation with a practitioner is no longer the sole method of accessing general practice services in Malaysia.

Once considered a supplementary tool for rural outreach, telemedicine has become an essential mode of care, accelerated significantly by the COVID-19 pandemic and the widespread adoption of digital health platforms.

While telemedicine offers substantial benefits in terms of accessibility, efficiency, and continuity of care, it also presents a unique set of challenges, particularly around professional accountability, patient consent, data protection, and clinical standards.

1.       What is telemedicine?

At a practical level, telemedicine refers to the provision of healthcare and health-related services using telecommunications, information and multimedia technologies.

2.       Regulatory Environment

The Telemedicine Act 1997, which was legislated to provide for the regulation and control of the practice of telemedicine, never came into force. During the Covid-19 pandemic and its movement control orders, the Malaysian Medical Council (MMC) issued an Advisory on Virtual Consultations (during the Covid-19 pandemic) in April 2020. The advisory was then revoked and replaced with the MMC’s Guideline on Telemedicine.

Despite this, there remains no dedicated legislation or regulation specifically governing telemedicine services in Malaysia. In the absence, medical practitioners are left to self-regulate. This regulatory gap gives rise to several unanswered questions. For instance:

• Is a doctor permitted to record a video consultation, and under what conditions?

  
  

• In the event of a technical disruption during a consultation, what are the clinician’s obligations in managing patient care and documentation?

These uncertainties underscore the pressing need for a clearer and more robust legal framework to govern the landscape of digital healthcare in Malaysia.

3.       When are virtual consultations suitable?

As a general rule, virtual consultations should only be conducted after a doctor-patient relationship has been established through a prior physical consultation, typically as part of follow-up care.

However, the MMC recognises that there may be limited circumstances in which a virtual consultation may be permissible as a first consultation, particularly in primary care settings.

It is important to emphasise that teleconsultations may not be appropriate across all medical specialities. For example, in disciplines such as obstetrics and gynaecology or orthopaedics, a physical examination and diagnostic testing are often essential for accurate assessment and safe clinical decision-making.

Conversely, telemedicine may be more suitable in general practice for minor or self-limiting complaints such as flu-like symptoms, headaches, or migraines.

4.       What if a patient refuses a physical examination that is clinically necessary?

The MMC advises that practitioners must carefully assess whether the medium of telemedicine permits an adequate evaluation of the patient’s presenting complaint. Where it does not, arrangements should be made for the patient to undergo a timely in-person consultation.

Where a patient declines a physical consultation, the reasons for their decision should be explored. In light of the patient’s decision, the practitioner’s management plan and safety-netting advice is crucial. This may include scheduling a subsequent remote review to reassess the clinical situation.

Effective safety-netting typically involves:

• Highlighting specific red-flag symptoms to watch for; and

  
  

• Explaining how and when to seek further medical attention if symptoms persist or worsen.

Crucially, all advice given, including safety-netting advice, should be clearly communicated and documented in the medical records.

5.       What should be documented in the medical records?

Medical records arising from teleconsultations must comply with all professional and legal documentation requirements. All ethical guidelines issued by the MMC, including those related to consent and confidentiality also apply to teleconsultations.

When conducting a remote consultation, the following must be documented:

• the mode of consultation (e.g. telephone, video);

  
  

• the identities of all individuals present during the consultation; and

  
  

• discussions regarding the necessity for an in-person assessment, if applicable.

Commentary

Telemedicine is a powerful tool in modern medical practice, but it must be approached with the same rigour and professionalism as conventional face-to-face consultations. While technology has transformed the way care is delivered, it does not alter the ethical, professional, or legal responsibilities of medical practitioners in providing care to patients.

As technology continues to evolve, so too must the safeguards that protect both patients and practitioners.

2 July 2025