Telemedicine in 2023: Where we are and where we are going

We are at a time when digital technology is playing an ever-increasing role in all aspects of our lives, and healthcare is no exception. The healthcare industry is currently undergoing significant changes, especially with the digitisation of healthcare. One of the most significant innovations in healthcare is telemedicine. This institute represents a turning point in the provision of healthcare, but its implementation raises a number of issues and challenges that need to be addressed.

Telemedicine is the use of technology to deliver healthcare remotely. This can include everything from online consultations with doctors to monitoring chronic diseases using digital devices. Telemedicine can provide greater access to healthcare for individuals, and can improve the efficiency of healthcare by allowing doctors to monitor patients remotely or provide care immediately when it is most convenient. However, nothing is black and white, and telemedicine comes with a number of risks.

Legal regulation of telemedicine

Current legislation does not regulate the provision of telehealth in any way. However, an amendment to Act No 372/2011 Coll., on Health Services and Conditions of their Provision, is currently under discussion, which should establish a definition of telemedicine as the provision of health services at a distance using telecommunications and information technology or a medical device. The amendment should also stipulate that telemedicine can only be provided under the conditions laid down by law and at the same time only if the technical requirements for the quality and safety of communication are met. The implementing legislation is then to lay down the detailed conditions for the provision of telemedicine, including the technical requirements for the quality and security of communication.

The explanatory memorandum to this forthcoming amendment to the Health Services Act and the implementing decree lists some requirements for the minimum technical characteristics of the telecommunication and information technologies used, in particular that the communication channel used must be encrypted; proof of the identity of both communicating parties must be ensured - visually, by a control question, or in some other way; the recording of the communication may be recorded on the provider's side only with the patient's consent; only certified medical devices may be used for remote monitoring of vital signs and remotely controlled intervention devices.

It is important to emphasise that only a healthcare provider who has been authorised to provide telemedicine health services can still provide telemedicine health services. Telemedicine does not constitute a separate type of health service and therefore only a health service provider can provide telemedicine on the basis of an authorisation, as is the case for conventional health care provision.

Benefits and risks of telemedicine

Telemedicine brings with it significant benefits such as the aforementioned wider accessibility of healthcare, convenience for patients, increased efficiency of care delivery and others, but it also carries certain risks, especially related to limited access of the doctor to the patient, the inability to physically treat the patient or perform diagnostic tests, possible technological barriers or limited access of the doctor to the patient's medical records. However, the expert community agrees that, although the standard of healthcare provision must be maintained, it is always necessary to compare whether the benefits of this institution outweigh the risks. Patients should make a free and informed decision as to whether they wish to undergo this type of care despite the risks involved in providing care at a distance.

Telemedicine has the potential to fundamentally change the way healthcare is delivered. When properly used and regulated, telemedicine has the potential to improve access to healthcare, improve treatment outcomes and reduce healthcare costs. The field continues to evolve over time and it will be important that regulatory, privacy and data security issues are properly addressed.

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