The aim of the article is to provide an overview of telemedicine, its benefits for different groups in society, its regulation and the different aspects that should be considered when using and practicing it. A better understanding of the concept and of its actual application will make it accepted by patients and health professionals to realize the potential of this service. At a time when Europe’s population is on a steady trend towards ageing and health systems are choking with overcrowding and inefficient use of resources, telemedicine offers undeniable advantages.
Definition and examples
The World Health Organization defines telemedicine as “the provision of health services, at a distance, by all health professionals using information and communication technologies to exchange valid information for the diagnosis, treatment and prevention of disease and injury, research and evaluation, and for the continuing education of health care providers, all in the interest of strengthening the health of individuals and their communities.”
Examples of telemedicine are many and varied and cover a wide variety of services. Perhaps the most commonly used are: teleradiology, telepathology, teledermatology, teleconsultation, telemonitoring, telesurgery and teleophthalmology. Other potential services include online call centres/information centres for patients, remote consultations/visits or videoconferences between health professionals. Emphasis could be placed on telemonitoring and teleradiology. In both cases, the reason is that they have concrete and measurable benefits for patients and health systems, and represent a vast field for innovation and business development. Both telemonitoring and teleradiology enable:
- better organisation and reallocation of health resources, for example by reducing hospital visits, thus contributing to greater efficiency of health systems;
- improve the quality of care for patients, especially the chronically ill and the elderly;
- the most rapid implementation of the results of technological and scientific advances in medicine in combination with information technology.
The benefits in detail
For patients
Disease prevention – easier access to medical tests, for example. The only thing that requires the patient’s personal involvement in one way or another is giving a sample for tests or being present for the insertion of a certain medical device to monitor a condition. The results are obtained on-line, can be read by a doctor on-line and a consultation can be made or treatment prescribed if necessary.
Increased access to specialized health care.
Provision of medical care for the chronically ill and aging. Often one is associated with the other, but not necessarily. Both, however, require increased (more frequent and more comprehensive) health care. Telemedicine makes meeting this requirement significantly more efficient.
The serious lack of health professionals at all levels of the health system in recent years has permanently deprived patients living in remote or small settlements of medical care – telemedicine can solve some of the problems in this regard and give people the medical care they need.
About Health Systems
More efficient use of human and material resources, respectively more efficient health systems;
Reduced queues at doctors’ surgeries, fewer hospital stays;
More people diagnosed in a timely manner, cured or in process, and passed through the system;
More people actually covered by health systems, increased social impact; Increased efficiency leads to increased profits, which stimulates investment in health care in general.
For industry and business
The positive effects of telemedicine for people and society make it an interesting potential field for innovation on the one hand and investment on the other. Telemedicine can also contribute significantly to the EU economy. The sector, in which European industry, including thousands of small and medium-sized enterprises (“SMEs”), is well placed, has developed rapidly over the last decade and is expected to continue growing at a rapid pace. From a business point of view, telemedicine is a technology development due to the need to adequately address technical problems and processes of investment, business development, sourcing timely funding. Participants in the telemedicine sector, in particular SMEs, do not have the financial capacity to independently participate in large-scale telemonitoring trials as pharmaceutical companies. More serious and sustained public sector intervention seems necessary and timely, of course in full compliance with Community legislation on State aid and public procurement. Public-private partnerships can also be a tool for deploying large-scale telemonitoring projects.
Legal aspects in need of regulation
Due to its nature, namely a combination between a health service and an information technology service, telemedicine affects a number of areas of regulation of public life. There are differing opinions as to whether separate legislative regulation is needed or whether changing and introducing certain provisions in legislation may be sufficient, by applying it in combination with existing legislation.
Telemedicine as a health service should be subject to the rules on the provision of these services at national level, but also to those on the free provision of services within the European Union. Consideration should be given to rules on patients’ rights in the country concerned, but also in cross-border healthcare. Other important issues relating to the regulation of telemedicine are: the licensing/registration of healthcare professionals providing telemedicine services, whether separate requirements are needed from existing ones for all healthcare professionals, or whether rules are rather needed for the registration of relevant professionals in information portals providing telemedicine services. The rules on lawful processing of health data, general data protection rules, are certainly applicable. An important issue closely linked to the development of telemedicine is the possibility of the costs of receiving telemedicine care being recognised and reimbursed by health insurance funds. Last but not least, issues that will require legal clarity are those relating to product and physician liability, especially in the case of cross-border provision of services, and in this respect the determination of applicable law and competent jurisdiction. Certainly telemedicine will continue to evolve and raise a range of technological, medical, ethical and legal issues in an interesting way for business.
