Telemedicine and its importance during the COVID-19 pandemic

Due to the outbreak of the COVID-19 pandemic, access to health care has been significantly restricted. Overcrowded hospitals, closed private practices, and restricted access to doctors.
This is our reality now and there is no doubt that telemedicine can help us through these difficult times. Although the number of remote healthcare services has been growing in Poland systematically for several years, the boom for telemedicine has not occurred yet. Paradoxically, the current pandemic crisis can become a true game-changer for the industry. Especially given the fact that the Ministry of Health and the National Health Fund (NFZ) have recently called for increased use of telecommunication technologies while seeking medical advice, considering it as an important tool to reduce the risk of coronavirus spread.

What is telemedicine?

Telemedicine (medicine at a distance) is a collective term used to describe health-related services provided “remotely”, using distance communication tools such as telephone or Internet. These services can take a variety of forms – from a telephone consultation or online chat, through the exchange of messages and documents by email, to remote diagnostics and monitoring of parameters such as sugar levels, blood pressure or heart rate. This allows the patient to tell the doctor about his or her health problems and expresses his or her needs without leaving home, whereas the doctor can interview the patient and make a diagnosis, and, if necessary, issue a prescription, referral, or sick note, while staying kilometers away.

What constitutes a legal basis for providing telemedicine services in Poland?

The provision which serves as a legal basis for providing telemedicine services in Poland is Article 3 sec. 1 of the Act of 15 April 2011 on Medical Activity (as amended in 2015), according to which medical activity involving health-related services which may be provided via electronic information and telecommunication technologies.

Rules allowing to provide remote/online medical services and health care can also be found in some profession-specific laws and regulations, an example of which is provided by an Act of 5 December 1996 on the Profession of Doctor and Dentist. Pursuant to Article 2 sec. 4 of this Act (also as amended in 2015), the health services provided by a doctor or a dentist (including, if applicable, examining the state of health, recognizing and preventing disease, treating and rehabilitating patients, providing medical advice, and also issuing opinions and medical certificates) may be carried out “through information and communication systems”. Another important provision is Article 42 sec. 1, under which a doctor shall rule on the state of health of a person after examining that patient “in person or by means of information and communication systems”.

What is also worth noting here is the recent amendment of the Polish Pharmaceutical Law of 6 September 2001, according to which, since 1 January 2020, all prescriptions – with some minor exceptions listed in Article 85b therein – can be issued in electronic form. E-prescriptions are given to patients by email, SMS, or as a printout.

What are the conditions for providing telemedicine services?

The basic conditions for providing health-related services “at a distance” (“remotely”) are identical to those set for health-treated services provided “on site” (“stationary”), as confirmed in the Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions on telemedicine for the benefit of patients, healthcare systems and society, according to which “the classification of specific telemedicine services as medical acts should ensure that these meet the same level of requirements as equivalent non-telemedicine services”.

For a person providing health-related services “at a distance” (e.g., for a doctor) this means that he or she must act according to all applicable professional rules (i.e. assess the extent to which he or she is actually able to perform given action remotely, based on current medical knowledge, as well as to observe the principle of medical ethics and medical confidentiality) for which it bears civil, criminal, and professional responsibility on the same basis as in the case of health-related services provided “on site”.
The patient, on the other hand, has all the rights that he would have if he had been using the “stationary” services. It means that he or she has the right to medical information, as well as the right to ask additional questions and to request access to medical records produced as part of the service provided.

How telemedicine services are being financed?

There are two basic sources of funds for the telemedicine services: patients’ own resources and public resources coming from the National Health Fund (NFZ). Until now, NFZ has only paid for cardiac and geriatric teleconsultations and teleconsultations provided as part of basic health care (POZ). This has changed with the outbreak of the COVID-19 pandemic, which has affected appropriate changes to the existing legislation, including an extension of the scope of telemedicine services financed by NFZ, to which the Ambulatory Specialised Care (AOS) has been added.

The article is for information purposes only and under no circumstances constitutes a legal opinion or advice. For more detailed information or legal assistance, contact DT’s lawyer.

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2020-05-08 11:07

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