In Russia, telemedicine as a publicly available medical practice is just beginning to develop, although telemedicine services are especially important for a country with huge distances and transport underdevelopment.
Telemedicine can be used for remote audio and video consultations, reducing the cost of repeated visits to the doctor, constant monitoring of patients with chronic diseases, remote surgical operations, urgent emergency assistance, assistance to the military and astronauts, as well as for training and advanced training of doctors.
Telemedicine has two types: "doctor-doctor" and "doctor-patient." And if the first has long been actively used in Russia, then the second faces serious challenges. In general, a patient can already consult a doctor remotely - for example, send test results after an in-person primary examination or consult a well-known specialist from another city via Skype.
The problem is that the legal status of such consultations is not fully determined. The patient cannot be sure that the doctor will be held responsible due to incorrect advice, and doctors cannot diagnose or prescribe treatment[1].
Telemedicine: The Future of Healthcare
Main article: Telemedicine: The Future of Healthcare
Global market
Main Article: Telemedicine (Global Market)
Telemedicine projects in Russia
The catalog of projects in the field of telemedicine is presented in the TAdviser section Telemedicine service.
Commercial Telemedicine Services
At the beginning of 2021, the most common commercial telemedicine services in Russia are:
- Yandex.Health, in which pediatricians, therapists, gynecologists, dermatologists, venereologists, gastroenterologists, neurologists, psychologists and children's psychologists, cosmetologists give recommendations via chat or video link. They answer questions, create medical records and decipher test results.
- with SberHealth a website and application for. smartphone The service allows you to receive consultations, appointments, diagnostics or examinations.
The DOC + service is available as a website and mobile application. It allows you to receive doctor's recommendations, call a doctor at a specific address, make an appointment, conduct tests or procedures at home, and order medicines at the pharmacy.
- Medved.Telemed is a remote physician counseling system. In addition to the already described functionality of other services, the system has a convenient doctor interface with the ability to hold consultations and chat tete-a-tete.
- Qapsula is an interactive support system aimed at increasing the effectiveness of prevention and treatment of various conditions. In addition to the possibility of consulting a doctor in any convenient format, the project has a chatbot program for Web, iPhone and Android. In it, you can control physical activity and body parameters, the service recalls a meeting with a doctor, passing tests and taking drugs.
Telemedicine problems in Russia
Main article: Telemedicine problems in Russia
Legislative regulation
Main article: Telemedicine regulation in Russia
2024: Russia is creating ultra-fast backbone networks for telemedicine and industry. The project is supported by the government
On October 7, 2024, it became known about plans to create interregional communication networks in Russia with a signal delay for priority traffic. The project, aimed at the development of telemedicine and remote industrial management, received government support and is included in the Telecommunications Industry Development Strategy until 2035. Read more here
2023
11-fold increase in the number of telemedicine consultations in Russia since 2019
The number of telemedicine consultations in Russia has increased 11 times since 2019, as evidenced by data published by the Russian Ministry of Health. This became known on August 6, 2024.
According to Kommersant, in 2023, specialists from the subordinate clinics of the Ministry of Health held more than 8 million remote appointments, including medical consultations. This figure reflects a steady trend towards an increase in demand for telemedicine services among the population.
The most popular specialties for online consultations were oncology, pediatrics, cardiology, obstetrics and gynecology. In addition, in the first half of 2024, there was an increase in demand for remote consultations of physical therapy doctors, traumatologists and dentists.
Private health services also note an increase in interest in telemedicine. According to SberZdorovye, the demand for online receptions in the first half of 2024 increased by almost 45% compared to the same period in 2023. Most often, patients seek remote consultations with therapists, pediatricians, gynecologists, psychologists and dermatologists.
The development of telemedicine in Russia was facilitated by the introduction of an experimental legal regime from August 1, 2023, expanding the possibilities of remote interaction between a doctor and a patient. As part of a three-year pilot project, doctors received the right to remotely adjust the diagnosis, change the prescribed treatment and write electronic prescriptions for drugs.
The Ministry of Health also announces more than 205 thousand consultations between doctors and medical consultations using telemedicine technologies in subordinate federal centers at the end of 2023. In addition, more than 8 thousand telemedicine consultations were held to provide assistance to patients from new Russian regions.[2]
Growth of the Russian telemedicine market for 3 years by 40% to 6.33 million consultations
In 2023, 6.33 million telemedicine consultations were carried out in Russia. For comparison, in 2020, the indicator was 4.51 million. Thus, in three years, the number of sessions increased by about 40%. One of the drivers of the industry was the COVID-19 pandemic, as stated in the BusinesStat materials published on July 9, 2024.
The review includes various types of services: teleconsilium, telemonitoring, teleconsultations, as well as a remote appointment with a doctor. Consultations cover areas such as gastroenterology, gynecology, dermatology, cardiology, neurology, general therapy, pediatrics, endocrinology, etc. Significant players in the domestic market are "Innovative Medicine," "RT Medical Information Systems," "Digital Medical Operations," "Medrating," "Post Modern Technologies," etc.
In 2019, according to BusinesStat estimates, about 1.07 million telemedicine consultations were held in Russia. In 2020, there was a sharp jump: the number of sessions soared by 320.1%, reaching 4.51 million. Due to quarantine restrictions against the background of a pandemic, patients had to either postpone an appointment with a doctor until the epidemic situation stabilized, or communicate with a specialist online. Many people chose the second option.
In 2021, restrictions on visits to clinics were weakened, and market growth slowed down: the increase was 9.7% with a final result of 4.95 million telemedicine consultations. In 2022, an increase of 5.4% was recorded - up to 5.21 sessions. In 2023, the growth rate rose to 21.5%: the demand for telemedicine services increased from Russians outside the country. In addition, the development of the market is stimulated by the expansion of the range of paid medical services, the active inclusion of telemedicine in VHI policies, as well as the implementation of telemedicine projects within the framework of compulsory medical insurance.[3]
The Ministry of Defense of the Russian Federation allowed to treat the military with telemedicine
On October 5, 2023, the Ministry of Justice of the Russian Federation registered an order of the Russian Ministry of Defense "On establishing the specifics of organizing the provision of medical care to military personnel of the Armed Forces of the Russian Federation and citizens called up for military training held in the Armed Forces of the Russian Federation, including the procedure for their exemption from military service duties due to illness and other reasons." The document, among other things, refers to telemedicine.
According to the order of the defense department, telemedicine technologies can be used to assess the state of health of a serviceman, clarify the diagnosis, determine the forecast and tactics of examination and treatment, the advisability of transferring to a specialized department of a military medical unit (organization) or medical evacuation. The last point is activated in the presence of medical indications, the transportability of the serviceman and the absence of the possibility of providing the necessary medical care in the military medical unit, part or organization in which the serviceman is being examined and treated.
At the same time, earlier in the Russian troops have already begun to introduce telemedicine technologies. So, the Armed Forces of the Russian Federation received hardware and software complexes of remote diagnostics. With their help, doctors on the ground will be able to contact the advisory centers of the country's leading military hospitals. Advice and help from experienced specialists will be indispensable in making the right diagnosis and performing complex surgical operations. The first complexes were sent to units located on the Kuril Islands. According to experts, telemedicine will provide the opportunity to provide qualified assistance to military personnel in remote garrisons, on ships, as well as in emergency situations and during humanitarian operations.
Order of the Minister of Defense of the Russian Federation on August 28, 2023 No. 553
In Russia, created a device for online medical examination. It combines the functions of a heart rate monitor, oximeter, stethoscope, otoscope, tonometer, glucometer and ECG
The Moscow Institute of Physics and Technology (MIPT) has developed a medical device that combines the functions of eight diagnostic devices. Read more here.
2022
Telemedicine Market Volume Growth of 15% over 2 Years
In 2022, approximately 5.2 million telemedicine consultations were held in Russia, which is 5.1% more compared to 2021, when an increase of 9.7% was recorded. Thus, in two years, the popularity of this service has risen by about 15%. This is stated in the review of BusinesStat, published on December 29, 2023.
Analysts are considering several segments of the industry. This is a teleconsilium (communication between consultant doctors from different medical institutions and the attending physician), telemonitoring (monitoring patients with chronic diseases), teleconsultations (remote doctor-patient consultations) and a remote appointment with a doctor. Significant market players are "Innovative Medicine" ("SberZdorovye"), "RT Medical Information Systems" ("To the Doctor," ECP.LIS, ECP.MIS), "Digital Medical Operations" ("Doctrine"), "Medical Company" Doctor Nearby "(" Doctor Nearby. Telemed Premium ") and " Medrating "(" MedPoint ").
It is estimated that 0.51 million telemedicine consultations were carried out in 2018. A year later, their number reached 1.07 million, rising by 110.1%. A sharp jump occurred in 2020 in connection with the COVID-19 pandemic, quarantine restrictions and self-isolation of Russians. Patients were forced to postpone an appointment with a doctor until the epidemiological situation stabilized or communicate with the doctor via the Internet. As a result, the volume of the telemedicine market on an annualized basis soared by 320.1% to 4.51 million consultations. In 2021, the number of such sessions reached 4.95 million.
The study says that in 2022, the telemedicine industry continued to show positive dynamics, despite the deterioration of the geopolitical situation and macroeconomic challenges. The demand for remote medical consultations was supported by the development of paid medical services, the active inclusion of telemedicine in VHI policies, as well as in connection with the implementation of telemedicine projects under the compulsory medical insurance.[4]
Telemedicine market growth by 20.4% to RUB 18.19 billion
The volume of the Russian telemedicine services market in 2022 amounted to 18.19 billion rubles, an increase of 20.4% compared to 2021. Analysts of the market research agency GuideMarket published such data in November 2023.
According to experts, the increase in the costs of Russians for remote consultations of doctors is due to a number of factors, including:
- increasing the volume of services provided: with the spread of telemedicine technologies, more and more patients seek online services;
- increasing the availability of the Internet: thanks to the development of broadband access to the Internet, more and more citizens are able to use telemedicine services.
As noted in the study, telemedicine has become one of the fastest developing areas in the field. With the health care advent of new technologies and the improvement of existing ones, telemedicine opens up new opportunities for patients, doctors and medical institutions. The main types of services that are provided in the telemedicine market are:
- remote consultations with doctors. One of the main types of services provided in the telemedicine market is remote consultations with doctors. Patients may receive advice on a variety of health-related issues, such as symptoms, diagnosis, treatments, and disease prevention;
- monitoring the health status of patients. Remote monitoring of patients' health allows doctors to monitor the treatment process and adjust it if necessary. This is particularly important for patients suffering from chronic diseases requiring ongoing follow-up.
- sale of annual subscriptions for consultations. In addition to one-time consultations, some companies offer annual season tickets that include a certain number of consultations with doctors of various specialties. This format is convenient for those who wish to have access to health services on an ongoing basis;
- services for travelers. For people who are often on business trips or travel, the services of doctors specializing in providing medical care in conditions of distance from hospitals are offered.
According to a study of the online service SberHealth"," which is cited by GuideMarket, therapists, pediatricians, psychologists, gynecologists and dermatologists became the most popular specialists for remote consultations of patients in 2022. The top ten also includes a neurologist, gastroenterologist, endocrinologist, ENT and cardiologist. In addition, the frequency of online visits of Russians to dentists and oncologists has increased.
Industry experts note a significant increase in demand for psychologists and psychotherapists as part of online consultations. According to the study, the need for psychologists increased in Russia compared to last year by 62.9%. The authors also noted a significant - by 62% - increase in the number of sessions with specialists in this profile, as well as an increased demand for corporate psychological assistance several times. Experts explained such indicators both by political events and by the natural growth of the market (including the popularization of online psychological assistance services - "Clear," "Sigmund.Online," etc.).
As the head of the Ministry of Health Mikhail Murashko said, in 2022, 4.5 times more telemedicine consultations were held in Russia than a year earlier. However, they do not always want to introduce such consultations in the regions, while 17 million Russians today have a digital profile, the minister noted at the end of April 2023.[5]
Named specialists to whom Russians most often turned on telemedicine
In Russia, in 2022, therapists, pediatricians, psychologists, gynecologists and dermatologists became the most popular doctors for online consultations. On January 24, 2023, the Kommersant newspaper writes about this with reference to the data of the SberZdorovye service.
It is reported that more often residents of the Russian Federation remotely turned to dentists for help: consultations with them in 2022 became 5 times more. Oncologists became the second most popular, the number of online calls to which has tripled. The top three also included psychologists who a year earlier were not included in the list of in-demand specialists. The number of calls to them increased by 67%.
Representatives of the SberZdorovye service explain this not only by the universal value of mental health, but also by the fact that Russian companies began to pay attention to the psychological state of employees. The share of consultations with corporate clients amounted to more than 60% of all sessions with psychologists.
Last year, the top 10 most popular online specialists also included neurologists, gastroenterologists, endocrinologists, otolaryngologists and cardiologists.
 | Russians gradually get used to receiving the first recommendations on general health issues online, and make an appointment with highly specialized doctors with recommendations received from therapists and pediatricians during a remote consultation, the study says, excerpts from which the publication leads. |  |
According to a survey of the SberZdorovye service and the Rambler & Co. media holding, 28% of 280 thousand respondents turned to a therapist for telemedicine advice, and 19% to a psychologist. Almost every fifth Russian was at the online reception (19%) - follows from the survey. A Superjob survey conducted in November 2022 showed a different result: one in ten resorted to telemedicine services. At the same time, the popularity of online consultations doubled during the COVID-19 pandemic.[6]
An experimental legal regime for the regulation of telemedicine is being created in Russia
On July 20, 2022, it became known that the Budu medical tech service submitted an application to the Ministry of Economic Development to create an experimental legal regime (EPR) to regulate telemedicine in Russia. Read more here.
Ministry of Health of the Russian Federation launches a platform for remote monitoring of patients with chronic diseases
In early June 2022, the Ministry of Health of the Russian Federation announced the launch of a project for remote monitoring of patients with chronic diseases - "Personal Medical Assistants." The patient monitoring platform will be integrated with the Unified State Health Information System (Uniform State Health Information System) and the main IT systems in the health sector. In general, it will process information received from personal medical devices. Read more here.
Russia will create a telemedicine platform based on the GIS
On the basis state of the information system ERA-GLONASS , it is planned to create a telemedicine platform. This was GLONASS Care Zdrav.Expert reported on May 16, 2022 in. It is GLONASS JSC assumed that the digital service will increase fivefold, up to 2500 species, the number of laboratory tests available to residents of all regions, including Russia hard-to-reach areas. countries More. here
Putin gave instructions for the development of telemedicine
At the end of April 2022, the president Russia Vladimir Putin gave the Cabinet instructions for the development of telemedicine. These and other instructions were given following a meeting with members.
According to information published on the Kremlin's website, by September 15, 2022, the government must report to the head of state on the measures taken to gradually introduce remote technologies to provide doctors with advice to patients, correct previously prescribed treatment, and form prescriptions for drugs in the form of electronic documents within the framework of an experimental legal regime. Prime Minister Mikhail Mishustin has been appointed responsible for this order.
Meanwhile, the head of the Government of the Russian Federation himself instructed the Ministry of Health and Ministry of Digital Development, together with the MHIF, to work out the issue of the advisability of using telemedicine technologies as a separate service in the compulsory medical insurance system, as well as expanding their use. The deadlines for the execution of orders are May 20 and 27, 2022, respectively, Izvestia reports.
Mishustin made a report on April 7, 2022, and then the prime minister's question on the topic of telemedicine was asked by State Duma deputy Rosa Chemeris, who was elected from the Far East. According to her, the introduction of telemedicine would help large regions in length. The deputy called for permission to receive services within the framework of compulsory medical insurance, including making preliminary diagnoses, prescribing treatment, issuing electronic sick leave and prescribing drugs with the electronic signature of a doctor.
According to the Prime Minister, the issue of expanding the use of telemedicine must be discussed carefully with the medical community, although the government supports "everything innovative and technological." He instructed to work out the issue of including telemedicine in the compulsory medical insurance.
The head of the Higher School of Organization and Health Management (VSHUZ), Doctor of Medical Sciences Guzel Ulumbekova notes that the inclusion of telemedicine in the compulsory medical insurance system is logical, because it must be paid, like all other medical services.[7]
CST and SberZdorovye launched a telemedicine service in the Leningrad Region
On March 10, 2022, the CST company announced that in 23 medical organizations of the Leningrad Region, using robotic calling, remote monitoring of patients is carried out using the SberZdorovye platform. The solution allows you to track changes in health indicators and conduct home support for more than 40,000 patients. The voice robot for the platform was developed by the CST group of companies (part of the Sberbank ecosystem). Read more here.
AlfaStrakhovanie and Medsi launched a telemedicine service with remote opening of sick leave within the framework of VHI
On March 2, 2022, AlfaStrakhovanie announced that, together with the federal network of private clinics, Medsi had launched a remote consultation service under the VHI with the possibility of opening and closing an electronic list of disability for symptoms of ARVI and COVID-19. Read more here.
The Ministry of Health of the Russian Federation opposed the diagnosis without a full-time appointment with a doctor
In January 2022, the Ministry of Health of the Russian Federation did not support the program of the Ministry of Economic Development to launch a program of experimental legal regime (EPR) for telemedicine in the country, allowing doctors to make diagnoses without mandatory face-to-face consultation.
| | The Ministry of Health of Russia supports the development of telemedicine technologies... At the same time, the possibilities of remote staging of preliminary and (or) final diagnosis, prescription (adjustment) of treatment, as well as appointment to the patient of remote monitoring of the state of health without previously established on a face-to-face reception (examination, consultation) of the diagnosis, consultation with the use of telemedicine technologies contain high risks for the patient in connection with the failure to conduct a face-to-face examination due to the doctor's lack of complete information about the patient's health status necessary for the diagnosis, TASS the press service of the Ministry of Health said. | |
A source familiar with the Kommersant discussion said that at a meeting in December 2021, the Ministry of Health "informed about the practice of remote provision of medical services in a pandemic in many countries." At the same time, the deputy medical director of the GC "" Medsi Ksenia Shekhovtsova clarified to the publication that the participants in the experiment failed to agree with the ministry on a number of fundamental points of the program.
EPR should lead to the improvement of general regulation and the development of technologies in the health care system, explains Dmitry Ter-Stepanov, director of Regulatory Regulation at ANO Digital Economy. But this, according to the expert, is possible only if positive conclusions are received on the project from the Ministry of Health, the government and business[8]
2021
The Russian telemedicine market grew by 9.7%
In 2021, doctors in Russia conducted about 4.95 million telemedicine consultations, which is 9.7% more than a year earlier. Such data analysts BusinesStat led in mid-August 2022.
According to the study, investment activity in the industry began to grow after the adoption of the law on telemedicine in 2017. So, in the period from 2017 to 2019, the number of medical teleconsultations increased almost 6 times, to 1.07 million appointments.
| | The market grew as a result of the legalization of telemedicine and the explosive development of relevant services. Existing services expanded their functionality and databases of partner clinics, new business models appeared, for example, package offers, the report said. | |
According to analysts, which was announced in August 2022, in the coming years the number of teleconsultations will continue to grow, despite the fact that restrictions on visits to clinics have been lifted. The geopolitical and economic crisis will not stop the market growth. Teleconsultations, as a rule, are cheaper than face-to-face appointments, which will be relevant for patients in the face of a decrease in their real income. Telemedicine compensates for the insufficient availability of narrow specialists in the regions, according to BusinesStat.
The researchers also believe that the number of patients with chronic diseases will continue to grow, for which remote health monitoring and electronic update of prescriptions are important. The market will support state participation: some of the services and projects will be financed from the budget.
According to the World Health Organization (WHO), Russia is one of the five leading countries in terms of the introduction of telemedicine technologies with a penetration rate of such services of 14%. For comparison, the same figure in China is 58%.[9]
Minek has developed a program of experimental legal regime for telemedicine
In mid-October 2021, it became known that the Ministry of Economic Development of the Russian Federation had developed a program of an experimental legal regime (EPR) for telemedicine. It is assumed that doctors will make diagnoses via the Internet.
The EPR program in the field of telemedicine will be launched for three years throughout the Russian Federation. According to the document, Medsi, SberHealth, Doctor Nearby and Niarmedic will take part in the experiment. Other companies will also be able to join the experiment if they meet certain conditions.
According to RBC with reference to the general director of the Doctor Nearby service Denis Shvetsov, and EPR in telemedicine will enable the doctor to diagnose, prescribe or adjust the previously prescribed treatment. At the same time, not only the doctor who received the patient, but also another specialist will be able to provide medical care online, while by October 2021 this is prohibited without face-to-face admission.
Pre-trip and periodic medical examinations of workers will remain outside the framework of the EPR to identify contraindications to certain types of work, as well as to diagnose socially significant diseases and diseases that pose a danger to others.
The initiative of the Ministry of Economic Development provides for targets for assessing the effectiveness of the program: by the end of the third year of the experiment, at least 860 health workers and 75,000 patients should take part in it, at least 120,000 telemedicine consultations should be provided.
The Ministry of Health noted that the initiative of the Ministry of Economic Development raises questions from the professional medical and expert community. The department added that it is important to carefully assess all the risks, since we are talking about the life and health of patients.[10]
Chronic patients in Russia will receive devices for remote health control
In Russia, remote monitoring of the health of people with chronic diseases will be organized, which will be conducted by domestic portable medical devices. The corresponding strategic initiative called "Affordable medical care for all" was approved by the Cabinet of Ministers in October 2021. Read more here.
The Ministry of Digital Development approved telemedicine targets
The Ministry of Digital Development, Communications and Mass Media of the Russian Federation approved targets for the development of telemedicine in the country. This became known in early April 2021.
As Vedomosti writes with reference to the order developed by the department on the approval of methods for calculating the Digital Transformation targets, the share of medical consultations provided via the Internet should increase to 50% of the total by 2030. The corresponding document was signed by Deputy Minister of Digital Development Oleg Pak.
The publication notes that the law "On Telemedicine," which entered into force on January 1, 2018, remotely allowed to provide medical services. However, by April 2021, the possibility of providing such services according to the law is limited by the fact that the doctor must conduct the initial admission and examination of the patient in person.
In 2020, more than 5 million people received telemedicine consultations in Russia, and the number of users registered with telemedicine service providers already exceeds 10 million, Anna Meshcheryakova, general director of the Third Opinion company, told the newspaper. During the COVID-19 coronavirus pandemic, the market has shown record growth dynamics and there is every reason to believe that by 2030 half of the consultations will be provided to patients online, she said.
The spread of telemedicine is hindered by the fact that a large volume of visits to doctors falls on the elderly, among whom the smallest share of users, Internet says the head of practice for working with companies in the field health care pharmaceutics KPMG and in. Russia CIS Victoria Samsonova
| | An important role in the popularization of telemedicine is also played by the issue of trust in such services, and given the prevalence of various fraudulent schemes and information about them, it is obvious that some potential customers are still suspicious of such services, she said. | |
According to Samsonova, by 2030 the influence of these factors will no longer be so significant.[11]
2020
Rostelecom launched a telemedicine service integrated with the public services portal
RT-Doctis (a joint venture of Tsifromed (Digital Medical Services) a, Doctis and RDIF) has completed the development of a federal telemedicine platform integrated with a unified state identification system. This was announced on December 15, 2020 by Rostelecom, which has already begun to actively connect regional health systems to the platform free of charge. Read more here.
More than 70% of all requests for telemedicine consultations "Consent" fell on narrow specialists
According to the partner of the insurance company "Consent" on telemedicine, in October 2020, doctors conducted over 2.5 thousand remote consultations every day. About this "Consent" reported on November 16, 2020.
More than 70% of all requests for telemedicine consultations came from narrow specialists. The most popular of them were obstetricians-gynecologists (16.8%), followed by neurologists and gastroenterologists - 13.6% and 12.3%, respectively. Dermatologists had 12.2% of visits, otolaryngologists - 10%.
In 30% of cases, clients wanted to receive online advice from on-duty doctors - therapists and pediatricians, who can be received for an urgent appointment within a few minutes after contacting.
In Consent, the telemedicine service is available from January 1, 2018 and is included in all corporate voluntary health insurance programs. This summer, the company began selling Telemedicine's policy separately. A client insured under a corporate or individual contract can receive advice from a doctor from anywhere in the world in the format of a video, audio chat, by phone.
| | We are witnessing an increased demand for telemedicine consultations with the beginning of the pandemic, - comments Olesya Sabanova, director of underwriting of personal types of insurance "Consent." - And if in the first wave of coronavirus the most popular among patients were therapists and pediatricians who consulted, including on the prevention of COVID-19, now people more often turn to doctors of narrow specialties. | |
Tifromed, Doctis and RDIF create a joint venture to develop a telemedicine platform
Tsifromed (Digital Medical Services) (a subsidiary of RT Labs JSC and the National Center for Informatization of Rostec State Corporation), Doctis and RDIF are creating a joint venture to develop a telemedicine platform using the resources of the Mother and Child network of medical clinics. Roselectronics announced this on October 30, 2020. Read more here.
Putin instructed to stimulate the development of telemedicine
At the end of October 2020, the president Russia Vladimir Putin instructed Government of the Russian Federation to stimulate development. In telemedicine particular, we are talking about the appropriate training of medical workers; by February 1, 2021, this should be reported to the head. states
In accordance with the order, together with the regional authorities, the Cabinet of Ministers should consider the issue of modernizing the infectious diseases service, building, equipping or re-equipping medical centers in the regions. A report on this topic should be prepared by December 2020.
With the working group of the State Council, the government should assess the effectiveness of the work of medical organizations for the prevention of abortion and develop measures to improve its effectiveness. Including the talk of "strengthening the financial interest of medical organizations in the results of work on the prevention of abortion." The corresponding report must be submitted by May 2021.
Earlier in 2020, Putin instructed to expand the use of telemedicine for the prevention of infectious diseases in citizens in the upcoming autumn-winter season.
According to the instruction, the Cabinet of Ministers, together with the regions, should ensure the expansion of "the use of modern electronic technologies in the field of health care for remote interaction between a doctor and a patient," including through the portal of public services, in order to combat the spread of respiratory infections and prevent infectious diseases in citizens in the autumn-winter epidemic season 2020-2021.
In October 2020, a meeting of the Valdai Discussion Club, Putin touched upon the topic of modern digital technologies. He noted that telemedicine, as well as online training during the COVID-19 coronavirus pandemic, have made a "huge gap in previous regulatory systems," forcing politicians, lawyers and administrative officials to accelerate and intensify their movement towards decision-making on a legislative settlement.[12]
Medical consultations will appear on public services
On October 20, 2020, the Russian Ministry of Health announced the upcoming launch of remote medical consultations on the public services portal. The implementation of the pilot project is planned to start from five regions, said Deputy Department Pavel Pugachev.
| | Remote consultation services for medical workers who work in the relevant subject will be available, "Pugachev said (quoted by RIA Novosti). | |
According to him, the technology will be replicated if the project is successful. The Prime Minister Mikhail Mishustin also noted that Russia it is planned to improve the system of providing public services - it will be more "convenient, understandable and simple."
Earlier in October 2020, Pavel Pugachev at a meeting of the Council for Disabled People under the Federation Council said that starting from January 1, 2021, disabled people will be able to receive remote consultations from physical medicine doctors, kinesiotherapists and other specialists.
| | We are talking about the fact that they can already use remote consultations to carry out rehabilitation... This is certainly important, and from January 1, 2022 we plan to expand this list of specialties, where consultations can be received remotely, - said the Deputy Minister of Health. | |
According to Pugachev, the Ministry of Health also made changes to the order on the medical rehabilitation of children. It will enter into force in January 2021. The document also provides for remote rehabilitation, including remote adjustment of the speech process in disabled children.
In October 2020, a pilot project to include telemedicine services in regional territorial compulsory health insurance programs (OMS Campus Management) was launched in the first five regions - Sakhalin, Tatarstan, Nizhny Novgorod, Ulyanovsk and Ivanovo regions.[13]
Lanit-Integration, together with Intel, is introducing a telemedicine service throughout Russia to combat COVID-19
LANIT-Integration (part of the LANIT group of companies), with the support of Intel, has developed and implemented a system for remote coordination of medical actions in 39 clinics in Russia. LANIT announced this on October 5, 2020. The results of the April pilot project in the main coronavirus center of Moscow City Clinical Hospital No. 40 (Kommunarka) made it possible to scale the decision to other medical institutions. Read more here.
Telemedicine became free in 6 regions
On September 23, 2020, Doctor Nearby announced the introduction of telemedicine services into the compulsory health insurance system in six regions. Pilot projects were launched in Tatarstan, Nizhny Novgorod, Ivanovo, Ulyanovsk and Sakhalin regions. Read more here.
Terminals for remote consultations of doctors appeared in the branches of the Russian Post
Terminals for remote consultations of doctors appeared in the offices of the Russian Post in the Sverdlovsk Region. Read more here.
Investments in Russian telemedicine companies for the year reached 1.5 billion rubles
In 2019, 1.5 billion rubles were invested in Russian telemedicine companies, according to VEB Ventures (a subsidiary of ВЭБ.РФ). Read more here.
Insurance.Ru: the demand for online consultations of doctors in the first half of the year increased by 177%
On July 17, 2020, it became known that the experts of Strahovka. Ru, having analyzed the search queries of Russians on the Internet, found out that the demand for telemedicine services - remote consultations of doctors through mobile applications and online services in the first half of 2020 increased by 177% compared to the same period in 2019. Among the popular requests: "doctor online" - an increase of 305%, "consultation of a doctor online" - by 151%.
This trend is also confirmed by analysts of the RESO-Garantia insurance company, who reported a 10-fold increase in sales of telemedicine policies in April 2020 compared to the same period in 2019 against the background of general self-isolation of citizens and quarantine measures. Insurers are confident that the popularity of the product will continue after all restrictions are lifted. Insurance companies bring telemedicine into a separate product - promising and relatively inexpensive for customers.
{{quote 'The pandemic has outlined a trend towards lower prices for insurance products. At the same time, we are not talking about dumping, but about reducing coverage, optimizing service packages that customers can buy for less money. Therefore, insurers adapt personal insurance products, VHI, CASCO in such a way as to reduce the average check and maintain buyer demand. Thus, telemedicine in the form of a separate policy has become a budgetary alternative to voluntary health insurance. If before the pandemic, insurers concluded an average of 150-200 telemedicine contracts per month, then already in June 2020 the number of policies sold was about 1000-1500 in different companies, - said Elena Sukhovey, General Director of Insurance. }}
Experts from Strahovka Ru also note the increased demand for TV broadcasting. Users Internet were 74% more likely to seek vet advice online in the first half of 2020 than in 2019. Pet owners remotely seek help from nutritionists, zoopsychologists and veterinarians. Before the pandemic, this service was also included in VHI policies, but, as experts explain, there are requests for the purchase of a separate insurance program for their favorites, since it is more profitable for the consumer.
| | Insurance companies note that interest in television broadcasting is growing systematically. The number of requests for online consultations on pet health increases by 30-40% per month, starting in April 2020, according to our partners, - said Elena Sukhovey. | |
Start providing remote medical advice on compulsory medical insurance
On July 16, 2020, it became known that remote medical consultations for the first time in Russia began to be provided under the compulsory health insurance policy. Telemedicine service "Doctor nearby" has become available to the owners of the compulsory medical insurance policy in the Kaluga region - this is about 1 million people. Read more here.
COVID-19 pandemic stimulates market development in Russia
The COVID-19 coronavirus pandemic has become a powerful incentive for the development of telemedicine both in the world and in Russia. The 1st Sechenov State Medical University became responsible for providing telemedicine services to patients with coronavirus. In a short time, the university conducted more than 2,000 teleconsultations in the "doctor-doctor" mode for regional medical institutions. Increasingly, they resorted to this method of communication in the regions themselves. For example, in the Sverdlovsk region for 4 months of 2020, compared to the same period of the previous year, the number of telemedicine consultations on the infectious profile increased by 16%, on medical rehabilitation - 3.5 times, on pulmonology - 9 times.
At the same time, the number of telemedicine consultations "doctor-patient" was growing. Doctors communicated both with patients infected with COVID-19 and undergoing treatment at home, and with those who, during self-isolation, were deprived of the opportunity to visit a doctor in person. Many telemedicine services have also been offered free consultations with on-duty doctors, therapists and pediatricians. For example, with the help of the Doctor Nearby telemedicine service, it was possible to consult a therapist, pediatrician and doctors of key narrow specialties. The project involved 20 Moscow and regional clinics, more than 500 doctors who conducted more than 2,000 consultations per day.
For June 2020, after the gradual lifting of restrictions, life is gradually returning to its usual course. However, according to experts, the experience gained over the past three months will not remain in the past. Both medical organizations and patients, who had previously only thought about more actively using the possibilities of telemedicine, in extreme conditions were forced to switch to this form of communication. And many of them liked it.
The avalanche-like growth in demand for remote medical consultations during the COVID-19 pandemic in 2020 revealed the weaknesses of the telemedicine system existing in Russia. Firstly, not all those in need had the technical ability to use the remote service. Secondly, not all doctors were ready to provide telemedicine services. And, thirdly, the stress test was unsuccessful for the IT infrastructure of many medical organizations and telemedicine services. Some of them struggled to cope with the influx of telepatients. Moreover, communication with them, especially in those who were under observation as a patient with coronavirus, required quick access to the medical record and the results of examinations, the ability to quickly send those who became worse for inpatient treatment.
| | "Obviously, to provide full-fledged telemedicine services, three conditions must be met. The patient must have stable access Internet to and a device connected to it with a good camera (smartphone, laptop or computer), and at the moment not everyone has this. Doctors are in about the same position, but for them the requirements for the quality of Internet access and equipment are even higher, "says the Dmitry Borodachev technical director. - IBS DataFort The third condition concerns information systems that are used to provide telemedicine services. You need powerful, secure resources that can change almost instantly, which are manageable and guaranteed for authorized users. " | |
A separate topic is information security.
| | "Telemedicine is associated with the processing of so-called special and biometric personal data of patients. To ensure their safety in accordance with the 152-FZ, maximum requirements are imposed both in terms of organizational and technical measures, "says Egor Bigun, information security director of IBS Datafort. - In addition, medical information systems fall under the requirements of the 187-FZ "On the security of critical information infrastructure." | |
Creating a secure information environment is very expensive, and not all medical institutions can afford it financially. And, of course, in order for the protection to be reliable, high-class information security specialists are needed. And there are also not enough of them in medical organizations. And the medical data of patients need the most reliable protection, and the responsibility for non-compliance with the requirements of the legislation is very serious.
Sberbank launches SberHealth service for the development of all types of medical services
On June 17, 2020, Sberbank informed Zdrav.Expert about the launch of the multifunctional service SberZdorovye, which will provide a range of medical services. This will be the next step in developing the direction of health care as one of the strategically important in the bank's ecosystem.
Through the online resource SberHealth, residents of Russia can already make an appointment with a doctor in private clinics in their city, get online advice using telemedicine provided by medical specialists in more than 20 areas; make an appointment with a doctor on the VHI policy, call a doctor at home, make an appointment for diagnostics, order a comprehensive examination, keep your health diary and even take care of your pets using veterinary services online. Read more here.
Cloud Polyclinic service launched in Yakutia
On May 18, 2020, the Cloud Clinic service was launched in Yakutia. He will make it possible to consult with doctors remotely, keep a "Health Diary," open and close a sick leave. In May 2020, it is focused on working with patients in self-isolation and at risk for COVID-19. Read more here.
Named the most popular specialists in telemedicine services in Russia
At the end of April 2020, the most popular specialists in telemedicine services in Russia became known, the demand for which increased greatly in the context of the COVID-19 coronavirus pandemic.
According to Izvestia, citing data from the Online Doctor service, since the introduction of the self-isolation regime in Russia, the most popular remote doctors have been a therapist, pediatrician, obstetrician-gynecologist, endocrinologist and gastroenterologist.
Inna Zlotnikova, medical director of the Doctor Nearby telemedicine service, noted a threefold increase in the number of visits to cardiologists - patients complain of spikes in blood pressure.
Also, users began to call neurologists more often due to panic attacks. In addition, the home regime negatively affected the state of the skin: against the background of stress and dietary errors, the problems of acne and atopic dermatitis worsened. Also in April, the number of patients who needed an allergist's consultation increased: in self-isolation, people constantly contact with "irritants" - dust, animal hair, household chemicals, Zlotnikova said.
In the first half of April 2020, 70% of patients using the capabilities of telemedicine from the Online Doctor turned to on-duty doctors, therapists and pediatricians with complaints of ARVI symptoms and food disorders. 30% sought advice from narrow specialists.
It is also reported that 90% of users of telemedicine services expect to continue to contact the Internet format, according to a study by the Online Doctor service among 7 thousand users.
Elena Shershneva, head of MedTech at Lurie, Chumakov & Partners law firm, told the publication that several factors hinder the development of the Russian telemedicine market by the end of April 2020, including the need for a doctor to be in the clinic's premises and the law remotely so far it is impossible to diagnose (even beforehand) and prescribe treatment.[14]
Telemedicine service for child psychiatry launched in Russia
On April 10, 2020, it became known that at the site of the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva, with the assistance of the Center for Diagnostics and Telemedicine of the Moscow Department of Health (DZM) and Mobile Medical Technologies, a project was launched to use telemedicine technologies in the field of mental health of children and adolescents. Read more here.
Rostec has developed a telemedicine service for remote admission of patients
On April 9, 2020, the Vega concern (part of the Roselectronics holding of Rostec State Corporation) announced the development of a telemedicine service designed for remote admission of patients. Read more here.
ВЭБ.РФ launched a project to provide free telemedicine assistance to Russians
On March 30, 2020, ВЭБ.РФ announced the launch of a federal project to provide free telemedicine assistance to residents of Russia. He earned on the basis of the infrastructure of the Doctor Nearby company. Read more here.
"Invitro" launched a service of remote consultations of doctors
On March 4, 2020, it became known about the launch of a remote consultation service for doctors based on outpatient clinics. " Invitro By contacting the holding clinic, patients will be able to remotely receive recommendations from leading medical specialists. here More.
2019
MTS: The Russian telemedicine market grew by 8% to 20 billion rubles
The volume of the Russian telemedicine market in 2019 reached 20 billion rubles, an increase of 8% compared to 2018. This is evidenced by MTS data.
Other cellular operators confirm soaring demand for remote consultations of doctors. So, according to MegaFon estimates, this market is growing by about 40-50% per year.
VimpelCom In "" they did not give such assessments and only reported that according to the results of their own survey in 2019, only 2% of their subscribers used telemedicine, 27% would like to try this service, and 46% heard about her for the first time.
| | The ability to receive consultations without a visit to a doctor, a second opinion or decoding of analyzes can reduce the number of patient visits to clinics, "but the effect will depend on the penetration of the service and the functionality of the services, - said Anna Aibasheva, a representative of VimpelCom. | |
According to the investment manager of the Fund for the Development of Internet Initiatives Alexei Grinenko, while the telemedicine market is at the stage of formation, key leaders have not yet been determined on it and "in fact, there is no acute struggle for the patient."
The potential of the Russian telemedicine market, according to the company's estimates "Mobile medical technologies" (develops the services "Pediatrician 24/7" and "Online Doctor"), amounts to 18 billion rubles. The company analyzed the reasons for remote visits of patients to doctors. In Moscow, this is a requirement of a high level of qualification of specialists and dissatisfaction with the attention of doctors to a specific patient at a face-to-face reception. In the regions, the main problem is that about 40% of patients do not have physical access to the necessary specialists.
However, in Russia, by August 2020, a ban on staging remains diagnoses and prescribing treatment to patients remotely, which holds back development of the telemedicine market.[15]
Rosstat: Sales of telemedicine services increased by 17% to 4.3 billion rubles
According to Rosstat and Mobile Medical Technologies LLC, as well as on the basis of expert assessments in this area, the market for telemedicine services in 2019 in Russia amounted to 4,399,10 million rubles, having increased by 2018 compared to 17.8%.
In 2018, the market for telemedicine services amounted to 3,735 million rubles, which is 39.5% higher than the value of 2017 (2,677,17 million rubles). Throughout the analyzed period, there is a significant increase in the volume of the telemedicine market in monetary terms at current prices. Every year, the growth driver is the factor of an increase in the volume of services provided, while price increases have a slight impact on the market volume.
The structure of telemedicine services in Russia includes two main areas - remote diagnostics and remote control. The remoteness of medical institutions from settlements has a positive impact on the demand for telemedicine services in Russia.
Telemedicine in Russia is at the stage of development, but many patients express their readiness to actively use it (82% of patients in paid clinics are ready for online consultations with doctors).
The demand for telemedicine has tripled
The largest number of requests for remote medical consultations in 2019 came from residents of Moscow - more than a third of the total number of requests. Ufa is in second place in terms of popularity of the service - about 10% of calls. The five cities where telemedicine services were the most in demand also included St. Petersburg, Yekaterinburg and Krasnodar. This was announced on February 18, 2020 by Sberbank Life Insurance. Read more here.
Yandex: Telemedicine in Russia does not make a profit
Telemedicine, as one of the directions of the digital health care market, is not a profitable business in Russia. This opinion is held today by Yandex, which has ceased to invest in this technological direction.
Recall that before that, the company for three years acted as an investor in the online medical platform Doc +, which develops telemedicine services in the country. The latter was able to raise almost $20 million, including from Baring Vostok Capital Partners. The company also launched its own service of telemedicine consultations "Yandex.Health[16].
| | "Yandex has a call to telemedicine, we made it as an experiment and market research. We went there, quickly became the No. 1 player, felt the ground and realized that this was not a business, "said Grigory Bakunov, director of technology distribution at Yandex, at a meeting on technologies in the healthcare sector (DigitalHealth) in the Digital Business Space. | |
As Bakunov specified, the company now has no emphasis on telemedicine service, although it continues to work, providing about 20-25 thousand consultations per month.
| | "The economy is converging there, for Yandex this is not income, not profit, these are some funny things," said Grigory Bakunov. | |
He also clarified that the company launched a telemedicine project with an eye to the fact that the data collected within the project and anonymized data can be used to improve medicine in general. It turned out to be impossible to use them, including because of the still too small big data arrays.
| | "To change medicine through the analytics of the reception of patients, and telemedicine lies in communication between the doctor and the patient, you need not even millions, but tens of millions of appointments, this is a very distant prospect," said Grigory Bakunov. | |
Telemedicine is not the only niche in digital healthcare, the prospects for which in Russia are still quite ghostly. As Grigory Bakunov noted, most of the digital Russian health care is damned.
| | "Most of the companies and businesses that are trying to build on the basis of the digitalization of medicine will die of natural causes, having exhausted their monetary resources," said Grigory Bakunov. | |
The reason remains the deep confidence of the Russian population that medicine in the country is free, that is, digital solutions in the industry simply cannot be monetized. This applies to almost most of the technologies that are highlighted today, speaking of the digitalization of medicine, from artificial intelligence and big data to blockchain and wearable devices.
| | "Every area sounds great. But if you look deeper, there is by and large no business there. It's very small, pocket-sized, maybe it can feed your family, but it's not going to be able to feed the company and it's definitely not going to be able to feed the big corporation. This is one of the reasons why Yandex is now by and large not invested in the healthcare sector. There's very little money there.' | |
Sechenov University and Protek agree to create a joint venture for the development of telemedicine
On November 26, 2019, Sechenov Medical University informed TAdviser about the signing of an agreement on the creation of a joint venture on the basis of the university with the Protek Implementation Center. The document was signed by the rector of Sechenov University, academician of the Russian Academy of Sciences Pyotr Glybochko and general director of the PROTEK CV Dmitry Pogrebinsky. Read more here.
Discussion of the creation of the Center of Competence for Telemedicine on the basis of Sechenov University
The competence center for to telemedicine may appear on the base. Sechenov University The university announced this on October 28, 2019. More. here
Philips "Health Index of the Future 2019": Russians have access to medical services, but there is no desire to go to the doctor
According to the 2019 Philips Health Index of the Future study, 66% of Russians believe that Russian health care provides them with access to medical care, and 50% of respondents believe that they will be provided with specialist services when necessary. 42% of citizens also noted that the availability of modern equipment in clinics plays a role in their choice of a medical institution. At the same time, the vast majority have no desire to go to the doctor (many Russians experience difficulties or cannot make an appointment with a doctor at all), even if there is a good reason for this. This was the answer of 89% of respondents (the average for 15 countries is 71%).
| | "To motivate Russians to see a doctor regularly, it is necessary not only to improve the quality of diagnostics through innovation, but also to increase patients' access to their personal medical information. The study "Health Index of the Future" allows you to assess the development of the global health care system and offer recommendations for improving the services of medical institutions, "said Dmitry Lisogor, Director of Digital Medicine, Medical Monitoring and Analytics at Philips in Russia and the CIS. - This year, Philips specialists continued to study the impact of digital integrated technologies on medicine and found out what solutions can help monitor health and undergo preventive examinations on time. We hope that the findings of the study will allow us to take a fresh look at the development of digital health care in Russia. " | |
Telemedicine may stimulate people to see a doctor more often
There are several reasons why Russians have no desire to visit doctors. 33% of respondents noted that they experience difficulties or cannot make an appointment with a doctor at all (the average for 15 countries is 22%). 29% of respondents said that to visit a certain specialist, they need to get a referral from a therapist (19% on average in 15 countries). 25% of Russians do not go to doctors, since they do not have time for this (19% on average in 15 countries).
Digital medical technology will help people be more responsible about health
According to the Future Health Index study, only a fifth of Russians surveyed often or always use digital medical technologies or mobile applications to monitor basic health indicators. For example, 20% of Russians use them to measure their heart rate, another 20% - pressure, and 18% of citizens use them to assess physical activity. In addition, 16% of respondents use digital technologies or mobile applications to monitor weight, and 13% of respondents - for timely medication.
Most Russians have never shared health data with medical professionals
52% of Russians who use such devices have never transmitted health data to medical workers. 31% only transmit data when there is a serious problem. 11% of respondents almost always or always share data when they visit the attending physician, and only 5% do it on an ongoing basis, including between visits to a specialist.
Modern solutions can really help people monitor their health. According to the study, respondents from China (80%), Saudi Arabia (74%) and India (70%), who use digital medical technology or mobile applications, often noted that the information they received prompted them to contact a doctor. In Russia, only 37% of respondents answered this way. At the same time, in terms of the number of people who monitor their health using technology, Russia exceeds the average for 15 countries.
Russians believe in medical bracelets, but are afraid to be treated by doctors via video link
Russians have become more interested in innovations in. According to a to medicine joint study by the Analytical Center and the NAFI organization "," ANO Digital Economy Russians are growing interest in innovations in the field of medicine.
The level of digital literacy of the population in 2018 increased by 8 points and reached 60 on a 100-point scale. Citizens are actively interested in technologies that allow them to monitor their health. However, not all areas are ready to trust.
For example, more than half of the respondents expressed interest in using medical bracelets that can continuously measure a person's vital signs and transmit this data to a doctor, and the possibility of identifying a genetic predisposition to various diseases.
At the same time, the respondents were incredulous about the purchase of genetically modified products, as well as the ability to consult with a doctor via video link.
The press service of the Ministry of Health of the Russian Federation noted that telemedicine technologies are most actively used in the regions of the Far East and the Arctic zone, where, due to climatic features and low population density, doctors have to communicate with patients more often via video link.
According to doctors, the interest of patients in the possibility of telemedicine can become a good tool for prevention along with traditional medical examination.
Telemedicine lacks people, freedom and demand
On July 11, 2019, it became known that telemedicine services are successful in Russia only within the framework of individual projects. At the same time, the most important elements of telemedicine services - such as electronic consultations, electronic hospital and prescriptions - are scattered and often incompatible with each other.
As the head of the digital medicine department of Invitro LLC Boris Zingerman noted, one of the important tasks in the field of telemedicine is to determine those cases in which it is possible to provide telemedicine primary inspection. At the same time, according to Boris Singerman, telemedicine is a service that patients and, most likely, medical organizations definitely need.
In turn, the chief physician of the Federal State Budgetary Institution "National Medical Research Center of Endocrinology" Ministry of Health Russia Natalya Mokrysheva said that the main problem of telemedicine is personnel. She also drew attention to the fact that the center raised the issue of payment for state those telemedicine consultations that have a doctor-doctor model.
| | In the compulsory medical insurance system, the billing of teleconsultations is absent. There are only separate regional programs, VHI programs and agreements beneficial for companies. Consultation on the "doctor-patient" model is still outlawed. As a result, the doctors do not have legal grounds and opportunities within the framework of telemedicine services to advise the patient, diagnose him, write a prescription, and prescribe, | |
As other problems of telemedicine, she named the need to confirm the identity of the patient and doctor through the portal of public services and an electronic digital signature; lack of infrastructure for telemedicine care organizations in many regions; lack of compulsory health insurance rates for telemedicine consultations in many regions.
At the same time, Natalya Mokrysheva noted that, despite the funding allocated to the regions for equipment, in general, they have the opportunity to equip and communicate with the main regional specialists, they are not enthusiastic about the development of telemedicine.
| | There is no message from the doctors of the regions themselves to contact those specialists who could, for example, give them this or that advice | |
Denis Shvetsov, General Director of Doctor Nearby LLC, drew attention to the following: what is declared as part of telemedicine and what is being done are completely different things.
| | We declare that telemedicine should provide access and increase access to primary care and increase the availability of narrow professionals. At the same time, in practice, we prohibit doctors in telemedicine from conducting primary consultations, prohibit them from diagnosing and prescribing treatment, | |
At the same time, he noted that for medical clinics telemedicine is primarily an increase in the cost of information technology, additional training of doctors and the inability to attract clients.
| | After all, primary consultations are prohibited, and it is possible, in fact, to conduct only repeated consultations, which are done without telemedicine in clinics. At the same time, the average bill of telemedicine services is significantly lower than that of face-to-face appointments. Patients are quite inert in their behavior, and in particular in the consumption of medical services, | |
In addition, Denis Shvetsov stated that such basic elements of telemedicine services as electronic consultations, electronic hospital and prescriptions are incompatible with each other, being disparate.
| | A doctor advising online cannot close an electronic sick leave. And when prescribing treatment, he cannot give an electronic prescription, | |
The CEO of Doctor Nearby also cited some data on the demand for the company's telemedicine services:
| | There are cases when our telemedicine services are not used by partners at all. At the same time, within the framework of cooperation with a number of other partners, their use reaches 100%, and in the case of one partner - even 150%. At the same time, the number of repeated consultations is also indicative. If a person turned once, then later he will apply constantly. | |
As a tool that can increase interest in telemedicine in Russia, he suggested that the Ministry of Health be bolder in the changes that are being carried out (related to telemedicine) and enable private players to access a large audience thanks to the pilots of the ministry of certain telemedicine services in order to assess their usefulness[17].
How telemedicine develops in Russia after its legalization
On January 25, 2019, the results of a survey of the Ondoc service were released, which showed weak interest of health care institutions in telemedicine services. 72% of the surveyed clinics reported the introduction of remote consultations in 2018 (then the law on the legalization of telemedicine began to operate), but only 67% are ready to continue the development of projects in 2019.
The study was attended by 112 representatives of medical institutions in Moscow, St. Petersburg, Central, Siberian, Volga, North-West, Far Eastern and Ural federal districts, as well as Crimea. Of these, 95% were representatives of private clinics.
To accompany clients, telemedicine is used by 55% of clinics, for mass consultations through aggregators - 45%, as part of insurance policies - 9%, for another - another 9%. 55% of respondents reported that they monitor the level of customer satisfaction with telemedicine consultations. 67% of top clinic managers believe that telemedicine consultations are in demand.
Ondoc noted that representatives of the clinics expected more demand for telemedicine services. According to the representative of Ondoc Yana Kubrick, by the beginning of 2019 it remains not fully regulated, since the law on telemedicine, which entered into force a year earlier, is still being finalized with the help of by-laws. 5% of survey participants said that in 2018 they were disappointed in telemedicine.
Representatives of private clinics interviewed by Kommersant also believe that a number of legislative barriers prevent the development of telemedicine. If the authorities regulate the possibility of remote diagnosis, telemedicine services will be in great demand, according to Medsi. According to Maxim Chernin, managing partner of Doctor Nearby, joint efforts of market participants are needed to develop the legislative framework.[18]
2018
For 9 months, only 81 thousand services with the use of telemedicine were provided in Russia. Everything is in doctor-doctor mode
At the beginning of 2019, the Accounts Chamber presented a report on the state of the Russian telemedicine technology market. According to auditors, in the first 9 months since the entry into force of the law on telemedicine, the volume of medical services (January 1, 2018) provided using telemedicine technologies in the country amounted to less than 81 thousand. Almost all these services were provided in the "doctor-doctor" mode. "Of the 10 medical services provided for by the nomenclature, only seven were provided. At the same time, the main part of them falls on only two services: decoding descriptions and interpretation of data from electrocardiographic studies (80.4%) and decoding X-ray studies (16%). Most services using telemedicine technologies are provided in the Siberian and Ural federal districts, "said the auditor of the Accounts Chamber Mikhail Men.
Rating of districts by telemedicine demand
From March to October 2018, the largest number of requests for telemedicine consultations came from the Central Federal District - 25% of the total. This was reported on December 5, 2018 in. Sberbank The absolute leader in the number of appeals to the Central Federal District was the Moscow region (and), Moscow Moscow region which accounted for 54% of the total number of appeals in the district. The five areas where telemedicine was the most in demand included (6% Lipetsk region of calls), as well as, and Bryansk areas Voronezh(Tula 4% of Yaroslavskaya calls each). More. here
Rostec and the Ministry of Health plan to connect 700 medical institutions of the country to a single telemedicine system
National Center for Informatization (NCI) of the State Corporation Rostec All-Russian Center for Disaster Medicine "Defense" Ministry of Health Russia and on November 20, 2018 announced the signing of a cooperation agreement. The first joint project of the parties will be the completion of the formation of the Russian telemedicine infrastructure. By the end of 2018, it is planned to connect more than 700 medical institutions in all regions of the country to the telemedicine system. More. here
2017
Putin signed a law on telemedicine
"Law on Telemedicine" (No. 242-FZ of 29.07.2017)
Definition of telemedicine technologies
Information technologies that ensure remote interaction of medical workers with each other, with patients and (or) their legal representatives, identification and authentication of these persons, documentation of actions taken by them during consultations, consultations, remote medical monitoring of the patient's health.
At the end of July 2017, the president Russia Vladimir Putin signed a law on telemedicine, providing for the issuance of electronic prescriptions and the possibility of providing remote medical care.
According to the text of the document published on the official portal of legal information, doctors will be able to provide assistance using modern technologies by conducting remote consultations and consultations and monitor the patient's health, including online.
Also, doctors will be able to issue prescriptions (including for drugs containing psychotropic substances and narcotic drugs) in the form of electronic documents. During remote work, medical institutions will use patient information from a unified identification and authentication system.
The law provides for the possibility of issuing prescriptions for drugs, including those containing narcotic drugs or psychotropic substances, certificates and prescriptions for medical devices in the form of an electronic document. The right to choose the form of prescription remains with the patient.
The Law on Telemedicine was developed as part of the implementation of the priority project "Improving the processes of organizing medical care based on the introduction of information technologies" ("Electronic Health") and ensures the creation of the legal framework for the use of information and telecommunication technologies in the field of health protection of citizens.
The law comes into force on January 1, 2018.[19]"
Prime Minister Dmitry Medvedev approved the bill in May 2017. According to the head of government, thanks to the unified system, "access to the information necessary for treatment will be possible from any medical institution," and citizens will no longer need to carry a "pile of papers" with them.
Opening of the first telemedicine mini-office in Moscow
On April 5, 2017, it became known about the opening of the first mini-office in Moscow to provide telemedicine services. It will open in Moscow in the second quarter of 2017 and will be located in one of the shopping centers, according to the city news agency "Moscow" with reference to the head of the department of information and Internet technologies of the First Moscow State Medical University named after I. Sechenov Georgy Lebedev.
| | In late April and early May, only one office will be launched so far, and we will see how effective and useful it is. It will be an experiment, today there have not yet been such precedents, - said Lebedev. | |
According to him, the first telemedicine office will be based in one of the major shopping centers in Moscow. In which particular building this office will appear, Lebedev did not specify and only added that we are talking about a shopping center, which "will definitely be in the very center of Moscow, where there are a large number of visitors."
It is planned that one general practitioner will advise patients in the "mini-office." He will also decide which specialist should be invited for consultation and what other procedures to carry out in order to obtain confirmation of the diagnosis. Each consultation will last about an hour.
According to Georgy Lebedev, the university will monitor the work of the employees of the mini-office of telemedicine, namely how they will advise patients.
| | We will ensure monitoring of this process so that it is useful for performing medical functions and so that it is possible to connect to the process, advise the patient qualitatively and competently, "he explained. | |
In the future, it is planned to open more telemedicine offices in the capital if the mini-office is effective and useful.
By the beginning of April 2017, the law on telemedicine has not yet been adopted. Two different bills on this topic are being discussed - one of them was prepared by the Ministry of Health, the second by the Institute for Internet Development, the Internet Initiatives Development Fund and Yandex.
NCI, 1C and specialized research institutes form a consortium
Main article: Network of telemedicine express mini-polyclinics (STAMP)
In early 2017, a consortium of organizations was created as part of the project to create a Network of Telemedicine Express Mini-Polyclinics (STAMP), which should be equipped with modern telemedicine equipment and specialized domestic software.
Notes
- ↑ for the Russian telemedicine market and its problems
- ↑ The doctor was called
- ↑ In 2023, 6.33 million telemedicine consultations were held in Russia, which is 40% more than in 2020.
- ↑ For 2020-2022, the telemedicine market in Russia increased by 15%: from 4.51 to 5.20 million consultations.
- ↑ Russian telemedicine market shows impressive growth
- ↑ Telemedicine to Russians in the teeth
- ↑ List of instructions following a meeting with members of the All-Russian public organization "Business Russia"
- ↑ Verified diagnosis
- ↑ Doctors established a connection
- ↑ The Ministry of Economic Development has developed a program of an experimental legal regime for telemedicine
- ↑ Half of medical consultations will go online
- ↑ Putin instructed to prepare doctors for telemedicine
- ↑ Medical consultations may appear on the portal of public services
- ↑ Doctors without hospitals: the number of visits to online cardiologists has tripled
- ↑ The government was asked to allow doctors to diagnose via the Internet
- ↑ " Telemedicine in Russia does not make a profit
- ↑ Telemedicine lacks people, freedom and demand
- ↑ Clinics turn away from telemedicine
- ↑ Federal Law of 29.07.2017 No. 242-FZ "On Amendments to Certain Legislative Acts of the Russian Federation on the Use of Information Technologies in the Field of Health Protection
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