Date : 03-05-2020

Telehealth or telepractice is the remote provision of healthcare using technology such as telephone, email, internet connection and/or video conferencing. SNDA has developed some guidance for members who are currently providing or planning to move to telepractice in particular during the extended "circuit breaker" period. The same professional obligations that exist for consent, confidentiality, and security of information in face-to-face services also apply to telepractice.


Standard of Care

As an SNDA member you are bound by the professional code of conduct outlined in the Constitution and other institutional guidelines when applicable. If you are engaging in telepractice you should only provide the level of service you are qualified for with the necessary knowledge and skills, as you would in the provision of standard care. Dietitians may also refer to the “Code of Professional Conduct” developed by the Allied Health Professions Council to ensure safe practice.


Informed Consent

Before initiating tele-consultation, you must obtain informed consent (which may be implied or expressed) for your service and document clearly the consent process in your records. Some considerations during consent taking are outlined below:

  1. Ensure that you provide information about the service, its objectives, risks and benefits and expected outcomes.
  2. Seek consent for any taping of the session and inform the client how this information will be used and stored.
  3. If your client is unable to give consent, informed consent should be obtained from an authorized caregiver.
  4. You must respect your client’s wish for a second opinion, and/or decision to consult with another healthcare professional.


Record Keeping

It is important to maintain comprehensive clinical records and document all professional encounters that take place through telehealth services. As such, the information recorded should include findings from the assessment, diagnosis, intervention and follow-up plan. It is advisable that the records include information about the type of communication (e.g. telephone, email, video conference) and the format of assessment information (e.g. in written or electronic image format, or directly measured). Forms may be developed for more efficient data collection as appropriate.


Confidentiality and Security

Services delivered through telepractice are subject to the same principles of client confidentiality as are all other types of care. Therefore, telepractitioners should understand the security risks of all the information technologies they use and do what is necessary to manage all risks related to potential breach of confidentiality. You must have confidentiality procedures in place and comply with the applicable existing regulations to ensure no unauthorized access, use or disclosure of your client's information. The Personal Data Protection Council (PDPC) provides comprehensive information and support to help organisations and individuals align to the PDPA requirements. One good resource is their PDPA Starter Kit.


Selecting Clients

As dietetic services are based on the needs of the individual client, telehealth may not be suitable for all clients. Appropriateness of service delivery through telepractice must be decided on a case-by-case basis. If telepractice is not appropriate for your client, and you are not able to provide face-to-face consultation you should refer them to another service provider in a timely manner. Please note that the operations of some of the services may also be affected by the current COVID-19 situation


Useful resources:

1. Ministry of Health, Singapore (2015). National Telemedicine Guidelines

2. Allied Health Professions Council, Singapore (2013). Code of Professional Conduct

3. Personal Data Protection Commission, Singapore (2020). Personal Data Protection Act.