The Ministry of Health (MOH) has directed MaNaDr Clinic at Beach Road to stop providing outpatient medical services via teleconsultation from Aug. 16 until further notice, the ministry announced in a press release.

This comes after MOH launched an investigation into the clinic located at City Gate and found "a large number of patients who had undergone very short teleconsultations" and "cases of multiple medical certificates (MCs) issued over a short period to the same patients".

Before the suspension, the starting price for MaNaDr Clinic's teleconsultation was S$8.20, and the service was available 24/7, according to the clinic's website.

Complaints filed against MaNaDr Clinic

According to MOH, MaNaDr Clinic is currently licensed under the Healthcare Services Act 2020 (HCSA) to provide outpatient medical services via three modes: At its permanent premises, at any temporary premises, and remotely.

The ministry launched an investigation after receiving "several complaints" against the clinic regarding their provision of outpatient medical services via teleconsultation in the last few months.

"MOH has investigated and assessed that MaNaDr Clinic is likely to have routinely engaged in clinically and ethically inappropriate practices for its outpatient medical services, without due concern for the safety and quality of care of their patients," MOH said.

Findings from MOH's preliminary investigations

During its preliminary investigations, MOH said it found "a very large number of cases seen by MaNaDr Clinic involved very short teleconsultations".

The ministry revealed that in a sampled month, more than 100,000 teleconsultations at the clinic involved video calls with patients that lasted one minute or less, with the shortest one lasting one second only.

"Such short consultations raise concerns about the safety and quality of clinic care provided to patients," said MOH.

In addition to undergoing these "very short teleconsultations", some patients were also issued with "multiple MCs over a short period of time", typically within a month.

"For example, in a 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," MOH added.

Finally, the ministry also found the clinic's documentation "questionable and poor", as some of the case notes from the teleconsultations "contained detailed information that did not appear to be commensurate with the duration of teleconsultation".

"At the same time, in other instances, the case notes were extremely sparse or brief, potentially compromising the continuity of patient care," said MOH.

MOH reviewing consultations of medical practitioners engaged by MaNaDr

MOH added that it will be carrying on its investigations against MaNaDr Clinic and "will not hesitate to take any further enforcement actions against the clinic and its key appointment holders".

Concurrently, the ministry said it is also reviewing the clinical consultations of the medical practitioners engaged by the clinic to assess if there is "any potential breach of Singapore Medical Council (SMC)'s Ethical Code and Ethical Guidelines (ECEG)".

Abiding by ethical guidelines

According to MOH, the ECGC sets out guidelines for medical practitioners pertaining to the provision of telemedicine and issuance of MCs, amongst others.

"MOH will refer any medical practitioners with potential breaches of the ECEG to the SMC for disciplinary actions," added the ministry.

MOH auditing, monitoring other licensed teleconsultation service providers

Besides MaNaDr clinic, MOH 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.

This is to ensure that teleconsultations are properly conducted in compliance with relevant regulatory requirements, stated the ministry.

MOH reminded all healthcare providers approved under the HCSA to provide outpatient medical services via teleconsultations to comply with their statutory obligations under the act, as well as the applicable regulations and relevant licensing conditions issued.

The ministry also emphasised that medical practitioners who practice telemedicine are required to abide by SMC's ECEG at all times when doing so.

"MOH will take decisive enforcement action against errant practices by healthcare service providers, to protect patients and also uphold the reputation of and trust for healthcare professions," added MOH.

Related stories

Top images via Google Maps