The doctor will not arrive: why Russia telemedicine

Last week on the official portal for discussion of legislative initiatives regulation.gov.ru there was a draft law on telemedicine prepared by the Ministry of health. The advent of “telemedicine technologies” in the text of the law is significant progress for the Russian health and medical startups. However, the law restricts the use of telemedicine within just the simplest of preliminary consultations between doctor and patient. In fact, it closes the possibility for further development and services, and telemedical technologies in Russia. To get more information, read the Best Treatment Reviews Singapore Website articles.

There is another vision. An alternative version of the bill, which are ORGANIZED together with the Institute for the development of the Internet, “by Yandex” and the Duma Committee on information technologies, it is proposed to define the concept of telemedicine technologies in the framework to subsequently as the study of various technologies, the Ministry of health can gradually allow certain technologies and services for the treatment of diseases. Why is it so important for our country and its people?

The evolution of medicine

In the twentieth century the main driver of medicine was the development of the pharmaceutical industry, in particular, the emergence of biomedical drugs and therapy of oncological diseases, and the improvement of high-tech methods of diagnostics and surgical tactics. Today an increasingly important contribution to improving the quality of medical care and the increased life expectancy of patients makes telemedicine, which is located at the intersection of health and consumer technologies.

Telemedicine solutions enable you to gather information for clinical trials, analyze patient data and share them for more exact diagnosis, as well as to establish operational processes in the health system. For example, in the USA the opportunity to collect medical online consultation and rapid exchange of information about the patient cancels the need to transport seriously ill patients from one ICU to another or other Department. This saves about half a billion dollars annually — implementation of telemedicine technologies has reduced the number of trips patients in the USA from 2.2 million to 1.4 million.

But the main purpose of telemedicine is to create comfortable and safe living conditions: to track changes in the body, to prevent the occurrence of complications or critical situations. The patient not only gets access to very qualified specialists of the Central clinics and doctors, but also saves on transportation costs and reduces time on the road.

Some of the disease treated without a visit to the doctor is simply dangerous, while others after a careful diagnosis can be treated remotely. The person with diabetes does not require systematic visits to the doctor, but, on the other hand, needs constant supervision. With the help of various portable diagnostic devices that monitor blood sugar, diet and exercise, the doctor can remotely obtained data to adjust therapy. Similar mechanics apply to most chronic diseases. It is the ability to monitor the progress of treatment of patients with chronic and serious diseases — one of the main advantages of telemedicine along with online consultations, which allocates to the international medical community.

Savings and control

The European health market today in General, telemedicine is booming. At the beginning of 2000-ies in Europe was virtually completed the process of establishing systems to ensure each person’s health services at home. Now the penetration rate of this technology on the market is about 30%, and by 2020, experts predict, will reach 50%. While remote health services are being introduced in different areas of health care: radiology, General pathology, dermatology, laboratory examination, psychiatry, gastroenterology, cardiology and many other vital nosology. Remote health care has helped to solve the issue of access to health services in rural regions with limited access to health services, and significantly reduce the time of treatment and hospital stay.

For example, in the Netherlands, the introduction of technologies for telemonitoring of patients suffering from chronic heart disease, has reduced the number of hospitalizations by 64%, outpatient visits by 39%, during hospitalization by 87%. In 2015 in the United States, according to statistics of the American telemedicine Association, conducting remote consultation, monitoring and adjustments of treatment reduces the number of bed-days by 25%, the number of hospital admissions 19%, the number of hits for face-to-face consultation by 70%. That is, the patient not only gets faster and better medical care, saving time (and money) on the road and consultations, but misses to the hospital bed developed to severe forms of the disease.

All this greatly improves the patient’s quality of life while reducing health care costs, it is also important in the spread of non-communicable diseases and population ageing. In Europe to combat chronic age-related diseases consumes 70% of all costs in the States, this figure reaches 80%.

Telemedicine is, there is no legislation

At the moment Russia is only halfway to the introduction of telemedicine technologies: developing medical information system (MIS), promoted remote councils. So, the total number of medical organizations connected to integrated electronic medical record (IAMC) as at the end of 2015 already close to 6 thousand out of 20 thousand medical organizations.

Today in the Russian market there are developments that could allow to provide telemedicine services and the citizens. According to the results of the last set of IIDF accelerator in about half of all “medical” applications filed start-up developing solutions in telemedicine — 76 teams from 154. In the international market for telemedicine solutions also appear more and more often, by 2020, this market could triple and exceed half a billion dollars.

However, distance counseling patients via the Internet is still not fixed in the Russian legislation: the patient, according to the law, can receive medical care remotely only to call ambulances, equipment and medical evacuation. Therefore in the bill we decided to make also an emphasis on the legitimization of medical care to the patient (so-called telemedicine services in the direction of “doctor-patient”).

The bill also sets out important provisions relating to the possibility for remote consulting local physician assistant. Now, for example, between doctor and nurse consultations within the legal framework impossible. Although in Russia a large number of settlements, which is only first-aid obstetric point (FAP). And people living in such settlements to receive prompt quality medical care becomes very difficult.

The paramedic provides pre-hospital assistance, carries out the same manipulations as the emergency doctor, for example, cardiopulmonary resuscitation, automated defibrillation and intrebati of the trachea. It can also diagnose and prescribe drug therapy. But the paramedic does not have the necessary skills to diagnose and treat all diseases, in complicated cases, he sends the patient to a specialist at the regional center or national hospital. This requires a sometimes significant cost on the street, and most importantly — entails the loss of time that could adversely affect the health of the patient. It is therefore important that the nurse could consult with doctors remotely and, as a result, each patient in the village as part of the FAP was the possibility of online appointment with the necessary doctors, cardiologists, therapists, larami and other specialists.

Telemedicine is not a panacea for all problems of the Russian healthcare, but its implementation will benefit the patient who will have access to skilled and quality care. In addition, technology in the field of remote medical services will significantly reduce the expenditures of budgets of all levels, to solve the problem of uneven distribution of high-tech equipment and the distribution of skills.

The point of view of the authors, whose article published in the “Opinions” section, may not coincide with editorial opinion.