[SINGAPORE] The Ministry of Health (MOH) has responded to claims made by MaNaDr chief executive Siaw Tung Yeng about the firm’s corporate structure.
Siaw had told the media on Apr 2 that MaNaDr Clinic operates independently as a subsidiary of its holding company Mobile-health Network Solutions and manages its own clinic operations.
MaNaDr Clinic’s licence was revoked on Dec 20, 2024, after MOH’s investigations discovered lapses in its operations, including numerous cases of very short teleconsultations lasting one minute or less, which still resulted in prescriptions and medical certificates.
MOH said that under the Healthcare Services Act (HCSA) 2020, all licensees and their key office holders are ultimately responsible for ensuring compliance with regulatory requirements, regardless of the licensee’s corporate structure.
“Licensees are also fully accountable for the safety and quality of the healthcare services provided by the clinic, including telemedicine services, and must ensure that the services comply with the applicable ethical and professional standards,” it said in the statement released on Apr 9.
During the media briefing on Apr 2, Siaw said that MaNaDr’s clinic operations and its telemedicine platform MaNaDr are separate businesses that run independently of each other under the company Mobile-health Network Solutions. He was responding to queries about why the lapses were not detected earlier.
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MOH noted that as the principal officer and clinical governance officer of MaNaDr Clinic, Siaw would have been responsible for the day-to-day management of the clinic and provision of clinical governance and technical oversight over the clinic’s services.
“Any doctor who practises under the auspices of a licence under HCSA, whether as a locum practitioner or an employee, does not operate independently, but must be under the supervision and oversight of the licensee and their key officeholders,” the MOH statement added.
Siaw also said on Apr 2 that MaNaDr has introduced several safeguards to its telehealth services, including a one-minute minimum for consultations before issuing medical certificates, artificial intelligence (AI) tools to transcribe doctor-patient conversations, and enhanced training and audits for doctors and clinics using the platform.
On the length of teleconsultations, MOH said it is not necessarily the case that so long as a teleconsultation exceeds a minute, it would pass muster.
“The duration of the teleconsultation should be commensurate with the patient profile and presenting medical conditions, as reflected in the Singapore Medical Council’s Ethical Code and Ethical Guidelines,” it noted in the statement.
“Licensees providing teleconsultations are required to put in place quality assurance measures such as implementing and regularly reviewing protocols and processes to ensure that doctors are conducting proper clinical assessments and prescribing and issuing medical certificates on proper medical grounds.”
The ministry also pointed out that while the use of AI in clinical settings can enhance efficiency and has the potential to improve patient outcomes, it also brings about “inherent risks and ethical concerns”.
It reminded licensees that, even with the use of MaNaDr’s AI tools, they remain responsible for complying with HCSA requirements, including ensuring patient safety and welfare for all services provided. For example, where AI-powered tools are used for transcribing interactions between doctors and patients or consolidating prescribed treatment plans, licensees must ensure the accuracy, confidentiality and security of the patient health records.
“Licensees must also check if the AI tools need to be registered with the Health Sciences Authority as a medical device, and ensure that fair and non-biased data was used to train the AI tool,” it said.
Checks by The Straits Times on Apr 2 found that teleconsultations were still being conducted on the MaNaDr app through other clinics and service providers with their own remote licence.
The MaNaDr telehealth platform provides healthcare services via its network of 700 clinics and more than 1,500 medical professionals in Singapore.
It was the largest telehealth solutions mobile application in Singapore, based on the number of user consultations per day in the six months ending May 2023. THE STRAITS TIMES
