Even as firms promote remote authentication of lab reports as if it is permissible in law, doctor says his RTI plea shows NMC bars it.
Published Feb 14, 2025 | 7:00 AM ⚊ Updated Feb 14, 2025 | 7:00 AM
Synopsis: A diagnosis cannot be made without correlating the lab results with clinical checking by the doctor – even so, the RTI response pertains not specifically to laboratory tests, but invasive procedures and surgeries.
Prime Minister Narendra Modi, speaking at the AI Action Summit in France, said, “If you upload your medical report to an AI app, it can explain in simple language, free of any jargon, what it means for your health.” India’s National Medical Commission (NMC), however, in response to a Right to Information application, appeared to clarify that registered medical practitioners cannot authenticate pathology and radiology reports remotely.
The trend of remote authentication of laboratory reports by pathologists, microbiologists, and radiologists has been growing, but NMC appeared to assert that signing a lab report without physical presence is not allowed, under the law.
The National Medical Commission (NMC) clarified that the Telemedicine Practice Guidelines 2020 do not allow registered medical practitioners to authenticate pathology and radiology reports remotely.
It also stated that telemedicine does not extend to remote-operated invasive or surgical procedures, reinforcing the requirement for direct supervision.
Remote signing of pathology and radiology reports has become increasingly common, especially with advancements in digital infrastructure and the widespread adoption of telemedicine.
Many laboratories and diagnostic centers now use cloud-based software that allows doctors to review and authenticate reports from remote locations. However, this practice raises significant ethical and legal concerns.
NMC has clarified that telemedicine guidelines do not permit remote authentication of lab reports without a doctor’s physical presence and supervision.
This is particularly crucial in cases where clinical correlation is required, as automated readings from machines cannot replace a doctor’s judgment.
Dr. Rohit Jain an RTI Activist and Pathologist based out of Jaipur, who filed the RTI application, pointed out that many doctors rely on cloud-based software for Telepathology and Teleradiology, often unaware of the regulatory constraints.
Seeking clarity, he filed an RTI with NMC, asking “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?”
NMC stated in response dated 3 January : “No. The guidelines do not address the use of telemedicine for remotely operated invasive or surgical procedures,” leaving no room for any other interpretation.
Dr Jain had filed a similar query in 2019 with the erstwhile Medical Council of India (MCI).
At that time, he had asked whether a doctor’s physical presence was necessary to sign pathology and radiology lab reports. The then head of the MCI confirmed that physical presence was indeed required.
In May 2020, the Telemedicine Practice Guidelines were introduced as part of the Indian Medical Council’s Professional Conduct Regulations. These guidelines were incorporated as addition of clause 3.8 by Gazette notification of Indian Medical Council (Professional Conduct, Etiquette and Ethics) (Amendment) Regulations 2020, amending IMC Regulations 2002.
“Large corporate laboratory chains across cities like Delhi and Bangalore are increasingly employing pathologists to sign reports remotely,” Dr. Rohit Jain told South First, “For instance, a sample processed in Hyderabad is authenticated by a doctor 1,500 km away in Delhi using only a scanned signature.”
He pointed out a widespread misconception that the Telemedicine Practice Guidelines 2020 permit telepathology and teleradiology.
“Many doctors don’t read the guidelines thoroughly, leading to this misunderstanding,” he said.
A similar issue exists in radiology, where MRI and CT scans conducted in one city are reviewed remotely by radiologists elsewhere.
“This practice has become routine, but using scanned signatures for authentication is illegal — it’s a clear case of malpractice,” Dr. Jain emphasised.
He clarified that the guidelines only allow telemedicine consultations between two registered medical practitioners (RMPs), not for remote authentication of lab reports.
“For example, I can seek a second opinion from another pathologist, but I cannot sign off on reports remotely. Section 4.4 of the guidelines makes this explicit,” he explained.
“Registered Medical Practitioners might use telemedicine services to consult with another RMP or a specialist for a patient under his/her care. Such consultations can be initiated by a RMP on his/her professional judgement,” states section 4.4.
(Edited by Rosamma Thomas)
