MaNaDr Clinic’s telemedicine suspended after MOH finds 1sec consultations, numerous MCs issued

SINGAPORE – MaNaDr Clinic has been ordered to suspend its outpatient telemedicine services from Aug 16, over concerns about care quality and stemming from excessively brief consultations.

This comes after preliminary investigations by the Ministry of Health (MOH) found possible wrongdoing, including the issuing of multiple medical certificates (MCs) after a large number of cases seen by the clinic involved teleconsultations that lasted one minute or less.

Citing a sampled month, MOH said it found more than 100,000 teleconsultations involving video calls with patients of one minute or less in duration, with the shortest being only one second.

Such short consultations, the ministry said, raised concerns about the safety and quality of clinical care provided to patients.

MOH also found that following the very short teleconsultations, some patients were issued multiple MCs over a short period of time, typically within a month.

In a sampled month, more than 1,500 patients were given MCs on five or more occasions, with 19 being the highest number issued to a single patient in that month.

While these teleconsultations were short, related case notes contained detailed information that did not appear to correspond with the duration of the teleconsultation carried out.

In other instances, case notes were extremely sparse or brief, potentially compromising the continuity of patient care.

MaNaDr, which has a clinic at City Gate in Beach Road, is operated by Mobile-health Network Solutions, the first Asia-Pacific telehealth company listed on the Nasdaq stock exchange.

Its website promotes 24/7 access to doctors for online consultations from $8.20. The company claims to have more than 1,500 Singapore doctors and over a million platform users, with over 100,000 monthly teleconsultations and 1.5 million completed.

The website now carries a statement in its footer: “MaNaDr Clinic @ CityGate has been ordered by MOH to stop its teleconsultation service with immediate notice from Aug 16, 2024, until further notice.”

The clinic is currently licensed to provide outpatient medical services through three modes: on its permanent premises, any temporary premises, as well as remotely.

MaNaDr came under MOH’s scrutiny after the ministry received several complaints involving clinically and ethically inappropriate practices, especially those related to its outpatient teleconsultations in the past few months.

MOH is reviewing the clinical consultations of the medical practitioners engaged by MaNaDr Clinic, to assess if there is any potential breach of the Singapore Medical Council’s (SMC) ethical code and guidelines. It said further enforcement action against the clinic and its key appointment holders may be taken.

MaNaDr co-founder Siaw Tung Yeng told The Straits Times that “it would not be appropriate for us to make any comments save to say that we are cooperating with MOH on its ongoing investigations”.

The investigation into MaNaDr comes in the wake of MOH tightening rules over the issuance of MCs by telemedicine platforms.

In an April 22 joint circular to doctors, MOH and SMC said feedback had been received from various employers and government agencies

about the “excessive issuance” of MCs

following outpatient medical service consultations, particularly teleconsultations. 

Among the allegations then were what MOH called “malingering and abusing medical leave privileges”, where MCs were given for non-medical reasons, such as when patients mentioned that they just wanted a certification to skip work or school, and were not sick.

MCs were also repeatedly issued to the same patients, without referring them for physical consultations for further assessment, or following up to check if they were indeed unwell.

MOH said it will also be auditing and monitoring other licensed telemedicine providers, to ensure that teleconsultations are properly conducted in compliance with relevant regulatory requirements.