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SINGAPORE: A clinic at Beach Road has been directed to suspend its outpatient telemedicine services from Friday (Aug 16) following a Ministry of Health (MOH) investigation that uncovered possible wrongdoing, including the issuing of multiple medical certificates (MC) over a short period of time.
MaNaDr Clinic, located at City Gate along Beach Road, is “likely to have routinely engaged in clinically and ethically inappropriate practices for its outpatient medical services”, MOH said in a press release on Friday.
The clinic is currently licensed to provide outpatient medical services via three modes – at its permanent premises, any temporary premises as well as remotely.
MOH said its preliminary findings revealed that there was “a large number of patients who had undergone very short teleconsultations, and cases of multiple medical certificates issued over a short period to the same patients”.
After receiving several complaints in the past months, MOH is investigating MaNaDr Clinic for its telemedicine services via its website and mobile app, the ministry said.
“To safeguard the health, safety and welfare of patients, MaNaDr Clinic has been directed to stop the provision of outpatient medical services via teleconsultation from Aug 16, until further notice.”
A “very large number of cases seen by MaNaDr Clinic involved very short teleconsultations”, said MOH on Friday.
“For example, in a sampled month, more than 100,000 teleconsultations involved video calls with patients of one minute or less in duration, with the shortest being one second.”
“Such short consultations raise concerns about the safety and quality of clinical care provided to patients.”
Some patients were also issued multiple MCs over a short period of time, typically within a month.
MOH said that in one sampled month, more than 1,500 patients were issued with MCs on five or more occasions, with the highest number of MCs issued to a single patient in a month being 19.
While the duration of these teleconsultations was short, some of the corresponding case notes also contained detailed information that did not appear to be “commensurate with the duration of teleconsultation”.
“In other instances, the case notes were extremely sparse or brief, potentially compromising the continuity of patient care,” it added.
Last year, CNA reported concerns about certain telemedicine apps allegedly issuing MCs after extremely brief consultations. In one instance, a CNA reporter obtained an MC from MaNaDr after a remote consultation that lasted only 43 seconds.
MOH said it will continue with its investigations against MaNaDr Clinic and will not hesitate to take any further enforcement actions against the clinic and its key appointment holders.
It also said it is reviewing the clinical consultations of the medical practitioners engaged by MaNaDr Clinic, to assess if there is any potential breach of the Singapore Medical Council’s (SMC) ethical code and ethical guidelines.
MOH will refer any medical practitioners with potential breaches of the ethical code and guidelines to the SMC for disciplinary actions.
The ministry also said it will be auditing and monitoring other licensed providers of outpatient medical services via teleconsultation, particularly those doing so via platforms such as the MaNaDr platform.
“All healthcare providers approved under the Healthcare Services Act to provide outpatient medical services remotely via teleconsultations are reminded to comply with their statutory obligations under the Healthcare Services Act as well as the applicable regulations and relevant licensing conditions issued thereunder (including the Licence Conditions for Remote Provision of Outpatient Medical Service),” said MOH.
“Medical practitioners who practice telemedicine are reminded that they are at all times to abide by the SMC’s ethical code and ethical guidelines when doing so.”
CNA has contacted MaNaDr Clinic for comment.
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