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The right to telemedicine

20/ 03/ 2018
  Ukraine has actively created conditions for the introduction of innovative technologies into the healthcare system. Among the laws adopted in the course of health reform, and was the Law of Ukraine On increasing the availability and quality of health services in rural areas, designed to change our view of the manner and forms of medical assistance. One of the main innovations of the Act is the introduction of telemedicine and the creation of this phenomenon for the legal field. Note the legal framework laid down in 2007, when the order of the Ministry of Health of Ukraine was established the State Clinical Research Center of Telemedicine practical. On approval of regulations on the application in the field of health care telemedicine In 2015, the Decree of the Ministry of Health of Ukraine №681 from 19.10.2015 was adopted. But the most resonant proved the Law of Ukraine On increasing the availability and quality of health services in rural areas, which provides for the introduction of modern technologies in the sphere of health care, including the use of telemedicine. Telemedicine Despite the fact that telemedicine for Ukraine phenomenon is fairly new, the other countries of the world already appreciate its advantages. A key factor for the use of telemedicine is the distance between the doctor and the patient. First telemedicine firmly entrenched in countries with remote areas, such as Norway, Finland and Croatia. Later, however, they have been evaluated and other telemedicine. So, telemedicine has been effective for the purposes of Military Medicine (US wounded soldiers often operate a robot that remotely control the doctors who are thousands of kilometers away from the patient). Consequently, the use of IT-technology helps to reduce the costs of health care, medical legalizes online-consultation opens up new opportunities to improve the knowledge and skills of health personnel, simplifies the process of interaction between the patient and the doctor. On the other hand, telemedicine implementation process has the need to review the precautionary measures, allowing to store personal data of patients, as well as the need to make constant training to work in this direction. However, telemedicine significantly reduces medical costs and increases the availability of medicine in general, and is a perfect solution in case the distance between the doctor-patient relationship is critical. The law and the concept of telemedicine Current legislation defines telemedicine as a set of actions, technologies and activities that are used in health care with the use of remote communication means in the form of electronic messaging. The legislator meant by telemedicine is not only a process of consultation between doctor and patient, but also a number of other forms of cooperation. Telemedicine includes home tele, telemedical consultations and telemetry. Thus, the adoption of several laws, legalized communication between doctor and patient in the house, defined requirements for the offices of telemedicine, as well as an opportunity to conduct a survey and transmit the data in real time. In fact, telemedicine is a long time, though illegally, came into our lives - many private clinics offer advice around the clock support to their patients, and the exchange of medical information has long been simplified and transferred to electronic form between doctor and patient. With the adoption of the Law of Ukraine On increasing the availability and quality of health services in rural areas telemedicine attributed to the category of basic services to citizens. Regulation of requirements Legislator does not preclude the application of telemedicine only public sector health facilities, allowing the use of telemedicine is not only private clinics, but also physicians in private practice, who operate in the field of medicine. Today in Ukraine, in contrast to other countries, the using of telemedicine is allowed at all levels of medical care and does not require an additional license. Decree of the Ministry of Health of Ukraine № 681 from 19.01.2015, the regulated requirements for the office of telemedicine, developed requirements for primary documentation, as well as regulates many aspects of the interaction between doctor and patient. Thus, the use of telemedicine is possible only if the signing of the patient or his legal representative informed consent, because the strict regulation document as a preventive measure for the protection, as the patients rights and the rights of the doctor. Forms and requests from Members of the telemedicine consultation are the patient, his doctor, the doctor (or doctors in the event of a consultation), which provides advice and staff telemedicine cabinet. Order of the developed and approved forms of primary accounting documents for health care workers who use telemedicine, and the corresponding filling instructions: Form №001 / tm Request for telemedical consultations; Form №002 / tm Conclusion adviser; Form №003 / tm telemedicine consultations Journal of Accounting. Telemedicine counseling is provided based on the request (form №001 / tm), which is made by the attending physician and the clinician is sent (transmitted in telemedicine cabinet). By request supplied all the information needed to provide counseling, scanned copies of diagnostic and laboratory tests, MRI, ultrasound, etc. After receiving the request the consultant physician registers it in the journal (form 003 / mt), which is stored in the office of telemedicine, and on the same day, prepares advisory opinion (form 002 / mt). If the request has the status of urgent medical consultant should prepare a conclusion as soon as possible. Protection of personal data Should also address the subject of protection of personal data. In order to achieve the maximum level of protection of personal data doctors using telemedicine, are combined into a single network with separate software. Every doctor, attached to the system, has a personal digital key. However, in comparison with the world standards level of protection of personal data is not sufficient. To overcome this barrier was developed by the EU Directive on 09.03.2011, On the rights of patients in cross-border health care. The implementation of this Directive would have opened to patients from Ukraine opportunities for consultation, not only domestically, but also abroad, which is especially important, given the growing health care needs of cancer patients, members of ATU and other categories of patients, for whom the possibility of consultations with doctors from other countries may be decisive in making vital decisions. Cost Telemedicine CMU from 09.22.2016, № 648 of telemedicine services are included in the list of paid services rendered to the state and municipal health care institutions, and created the conditions for telemedicine services to patients. Creating a legal framework for the use of telemedicine in Ukraine provides ample opportunities to get proper medical care. Given the characteristics of medical reform, the patient has a real chance to get on consultation to highly specialized doctor without the expense of time and money. In addition, when the legalization of patients continues treatment opportunities at home, keeping in touch with the doctor using telemedicine, all parties receive the necessary amount of legal protection. Of course, now it is too early to talk about spreading of this phenomenon. After the creation of the legal framework does not address the technical challenges, including procurement of necessary equipment, software cabinets telemedicine internet and many others. However, the incorporation of modern technology in the health care system will inevitably lead to the improvement of its quality and accessibility for patients.

Ukraine has actively created conditions for the introduction of innovative technologies into the healthcare system. Among the laws adopted in the course of health reform, and was the Law of Ukraine “On increasing the availability and quality of health services in rural areas”, designed to change our view of the manner and forms of medical assistance.

One of the main innovations of the Act is the introduction of telemedicine and the creation of this phenomenon for the legal field. Note the legal framework laid down in 2007, when the order of the Ministry of Health of Ukraine was established the State Clinical Research Center of Telemedicine practical. “On approval of regulations on the application in the field of health care telemedicine” In 2015, the Decree of the Ministry of Health of Ukraine №681 from 19.10.2015 was adopted. But the most resonant proved the Law of Ukraine “On increasing the availability and quality of health services in rural areas”, which provides for the introduction of modern technologies in the sphere of health care, including the use of telemedicine.

Telemedicine

Despite the fact that telemedicine for Ukraine phenomenon is fairly new, the other countries of the world already appreciate its advantages. A key factor for the use of telemedicine is the distance between the doctor and the patient.

First telemedicine firmly entrenched in countries with remote areas, such as Norway, Finland and Croatia. Later, however, they have been evaluated and other telemedicine.

So, telemedicine has been effective for the purposes of Military Medicine (US wounded soldiers often operate a robot that remotely control the doctors who are thousands of kilometers away from the patient).

Consequently, the use of IT-technology helps to reduce the costs of health care, medical legalizes online-consultation opens up new opportunities to improve the knowledge and skills of health personnel, simplifies the process of interaction between the patient and the doctor.

On the other hand, telemedicine implementation process has the need to review the precautionary measures, allowing to store personal data of patients, as well as the need to make constant training to work in this direction.

However, telemedicine significantly reduces medical costs and increases the availability of medicine in general, and is a perfect solution in case the distance between the doctor-patient relationship is critical.

The law and the concept of telemedicine

Current legislation defines telemedicine as a set of actions, technologies and activities that are used in health care with the use of remote communication means in the form of electronic messaging.

The legislator meant by telemedicine is not only a process of consultation between doctor and patient, but also a number of other forms of cooperation. Telemedicine includes home tele, telemedical consultations and telemetry.

Thus, the adoption of several laws, legalized communication between doctor and patient in the house, defined requirements for the offices of telemedicine, as well as an opportunity to conduct a survey and transmit the data in real time.

In fact, telemedicine is a long time, though illegally, came into our lives – many private clinics offer advice around the clock support to their patients, and the exchange of medical information has long been simplified and transferred to electronic form between doctor and patient.

With the adoption of the Law of Ukraine “On increasing the availability and quality of health services in rural areas” telemedicine attributed to the category of basic services to citizens.

Regulation of requirements

Legislator does not preclude the application of telemedicine only public sector health facilities, allowing the use of telemedicine is not only private clinics, but also physicians in private practice, who operate in the field of medicine.

Today in Ukraine, in contrast to other countries, the using of telemedicine is allowed at all levels of medical care and does not require an additional license.

Decree of the Ministry of Health of Ukraine № 681 from 19.01.2015, the regulated requirements for the office of telemedicine, developed requirements for primary documentation, as well as regulates many aspects of the interaction between doctor and patient.

Thus, the use of telemedicine is possible only if the signing of the patient or his legal representative informed consent, because the strict regulation document as a preventive measure for the protection, as the patient’s rights and the rights of the doctor.

Forms and requests from

Members of the telemedicine consultation are the patient, his doctor, the doctor (or doctors in the event of a consultation), which provides advice and staff telemedicine cabinet.

Order of the developed and approved forms of primary accounting documents for health care workers who use telemedicine, and the corresponding filling instructions:

  • Form №001 / tm “Request for telemedical consultations”;
  • Form №002 / tm “Conclusion adviser”;
  • Form №003 / tm “telemedicine consultations Journal of Accounting”.

Telemedicine counseling is provided based on the request (form №001 / tm), which is made by the attending physician and the clinician is sent (transmitted in telemedicine cabinet). By request supplied all the information needed to provide counseling, scanned copies of diagnostic and laboratory tests, MRI, ultrasound, etc.

After receiving the request the consultant physician registers it in the journal (form 003 / mt), which is stored in the office of telemedicine, and on the same day, prepares advisory opinion (form 002 / mt). If the request has the status of “urgent” medical consultant should prepare a conclusion as soon as possible.

Protection of personal data

Should also address the subject of protection of personal data. In order to achieve the maximum level of protection of personal data doctors using telemedicine, are combined into a single network with separate software.

Every doctor, attached to the system, has a personal digital key. However, in comparison with the world standards level of protection of personal data is not sufficient. To overcome this barrier was developed by the EU Directive on 09.03.2011, “On the rights of patients in cross-border health care.”

The implementation of this Directive would have opened to patients from Ukraine opportunities for consultation, not only domestically, but also abroad, which is especially important, given the growing health care needs of cancer patients, members of ATU and other categories of patients, for whom the possibility of consultations with doctors from other countries may be decisive in making vital decisions.

Cost Telemedicine

CMU from 09.22.2016, № 648 of telemedicine services are included in the list of paid services rendered to the state and municipal health care institutions, and created the conditions for telemedicine services to patients.

Creating a legal framework for the use of telemedicine in Ukraine provides ample opportunities to get proper medical care. Given the characteristics of medical reform, the patient has a real chance to get on consultation to highly specialized doctor without the expense of time and money. In addition, when the legalization of patients continues treatment opportunities at home, keeping in touch with the doctor using telemedicine, all parties receive the necessary amount of legal protection.

Of course, now it is too early to talk about spreading of this phenomenon. After the creation of the legal framework does not address the technical challenges, including procurement of necessary equipment, software cabinets telemedicine internet and many others. However, the incorporation of modern technology in the health care system will inevitably lead to the improvement of its quality and accessibility for patients.

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