The Union Health Ministry’s recent directive to all states and Union Territories to implement a time-bound action plan in regulating online health service aggregators can go a long way to provide safe health care to every individual who utilises such facilities.
 
As far as the healthcare segment is concerned, the Internet has undoubtedly transformed our societies in many ways. As a vital resource in providing information and support, online information sources are increasingly used by citizens for their own and their families’ needs.
 
Some estimates suggest that over 60 per cent patients in emerging markets make use of mobile health services, while more than a hundred countries are engaged in e-health. According to a FICCI white paper on e-pharmacies published last August, before the COVID-19 pandemic there were 3.5 million households using e-pharmacy services. This grew nearly three times to 9 million in May, and is projected to increase further to 70 million households by 2025.
 
A cause for concern is that the Internet is also many a criminal’s dream come true.
 
Yes, online scams, a large industry by itself are notoriously difficult to catch. The countless number of junk emails and online requests that scammers seem to target unsuspecting individuals is rather mind boggling.
 
That using technology, they often use fake identities, reach a large number of people across cities at a very low cost and simply vanish without trace shows it is a more organised network, with syndicates using sophisticated ways to cheat people.
 
Then there are those who seem to set up dummy websites that look like genuine ones with similar logos and domain names with a product line-up that only exists online with the sole purpose of extracting money from vulnerable buyers and disappearing.
 
There have been instances of some online shopping sites requiring buyers to log in through Facebook or email that serve as an easy entry point for fraudsters, to misuse an individual’s bank details, phone numbers or mail login and password to clean out one’s account.
 
Not long ago, a medical practitioner working in a private hospital in Telangana lost Rs 4 lakh to online fraudsters after he tried to buy some cancer medicines online.

The cheats who made the doctor believe they were sellers of Opdivo injections used for treatment for cancer patients asked him to transfer the 30 per cent advance amounting to Rs 4 lakh and asked him to proceed to a designated place to collect the medicines. On reaching the place the doctor found he had been cheated as there was no body with the medicines and the person with whom he had transacted had switched off his phone.
 
In November, cyber crooks posing as army officials duped a 25-year-old Pune dealer of health-related products worth Re 1 lakh under the pretext of ordering 300 vaporisers for the Army’s medical college. When the complainant sought payment for the goods, the fraudsters sent him a QR code and asked him to scan. The dealer scanned it and some amount was debited from his bank account. He contacted the suspects and they promised to return the amount and sent one more QR code. He scanned the code again to find that money was debited from his account. Totally, Re 1 Lakh got siphoned away from his bank account.
 
In 2019, police in Gujarat’s Vadodara unearthed a fake medical pathology laboratory run by a quack after an audio clip surfaced. In the telephonic conversation, the lab owner was found promising a doctor that he could prepare concocted reports showing malaria, typhoid or whichever disease and also offer 40 per cent commission to him.
 
Why some unscrupulous online health aggregators seem to aggressively market health check-ups is because it can be quite profitable. By trying to drive home the point that “prevention is better than cure”, a close friend  who was lured into such a health check-up, learnt it the hard way that it was a great way of converting healthy people into patients and for creating a constant stream of customers for the online health aggregator. She underwent a sufficient number of tests and got worried to find abnormalities. The online health aggregator negotiated with the “so called patient” in providing expert medical consultation and remedy with a 50 per cent discount. However, before the vicious cycle could start, the friend sought for a clear copy of the lab reports which never was received despite reminders.
 
Now with regard to regulation of online health aggregators, the case has its roots in Gujarat where medical pathologists had moved the judiciary nearly two decades back that laboratory technicians being not pathologists, cannot run any laboratory independently. The Pathologists argued that a large number of unauthorized private laboratories which are virtually in the name of pathological type laboratories are being run by persons who are unqualified having no degree in medicine. They are unscrupulous practitioners who are carrying out various tests of pathology and are giving unauthorized diagnosis on the basis of which the persons are treated. Their test reports are not certified by the registered qualified Pathologist and any person approaching them is in great danger of treatment on the basis of such unauthorized reports. A Division bench of Gujarat High Court in 2010 also held that no medical report can be issued without the signature or counter signature of the practicing pathologist recognised by the Medical Council of India. The Medical Council of India had also clarified that any qualification other than MBBS or MD pathology/biochemistry/microbiology is not eligible to sign a lab report. The Supreme Court had upheld the Gujarat High Court decision.
 
The Central Government enacted the Clinical Establishments (Registration and Regulations) Act, 2010 under which labs and other  Clinical  Establishments, providing any type of medical  services, are required to be registered  either under the (in those States/UTs where it is applicable) or under the State Laws, as applicable. The Ministry of Health and Family Welfare, Government of India too notified the minimum standards for Laboratory Services on 21 May 2018 and an amendment Notification dated on 14 February 2020.
 
Dr Rohit Jain a doctor and pathologist filed a PIL before the Delhi High Court last year for banning  the illegal online health service aggregators which are not registered under Clinical  Establishment (Registration & Regulation) Act 2010 or under any other regulations and without any medico legal liability for collecting and testing the patient samples for diagnosis. He also sought for issuance of guidelines for registration & minimum standards for sample collection centres operated by online aggregators including the minimum qualification for taking samples by representative of aggregators. Dr Jain wanted the aggregators to comply and register with the state pollution control board or state pollution committee for the disposal of biomedical waste. Above all the petitioner stressed for ensuring that the Covid-19 test reports are duly signed by a Registered Medical practitioner with a postgraduate qualification in Pathology / Microbiology / Biochemistry / Laboratory medicine in terms of extant directions of the Apex Court. The Delhi High Court directed the concerned  authorities'  to  initiate  action  against any  illegal  online  health  service aggregators  operating  in  Delhi  in violation  of  the 'applicable  laws',  including  the Clinical Establishments (Registration and Regulations) Act, 2010, 'if applicable. Aggrieved that the Delhi Court’s directive was not translated into action Dr Jain had moved a contempt petition before the Delhi High Court in December last year which is being heard.
 
In the meanwhile the Union Health Ministry has swung into action directing States and UTs to initiate a time-bound action plan and its implementation as per the applicable laws, for regulating such online health service aggregators, and the related service providers besides submission of an action taken report.