New rules of teleport advice. Experts sound the alarm: these regulations will make access to doctors difficult

From October 1, new rules for teleporting will apply. The author of the regulation is the Ministry of Health, but medical and patient communities and employers’ associations have many objections to it. The telepaths providers are alarming that the new regulations will make it very difficult for patients to contact doctors. What changes await patients?

1. The government wants to introduce new rules on telemedicine from October
2. The changes will adversely affect patients, especially those living in small towns, working until the evening, and parents of young children
3. The planned changes will worsen the already difficult access to specialist doctors – specialists are alarming
4. The obligation to consult each new health problem in a stationary manner means returning to queues and overcrowded clinics – emphasizes the Polish Employers’ Union
5. More information can be found on the TvoiLokony home page

New rules of teleporting – doctors and patients protest

From October, new rules for teleporting are to enter into force. In a few cases, the regulations limit or even exclude the possibility of remote consultation with a doctor, only direct contact during a visit to the facility will be allowed. Both the medical and patient communities are protesting against the changes, employers’ unions have expressed negative opinions, and companies that mediate in online consultations also raise objections.

The new regulations will make access to specialists difficult, limit the possibility of contacting a doctor for people from small towns, make queues in clinics longer, and the waiting time for an appointment will significantly increase. We cannot forget about the prevailing pandemic, so the necessity to make a stationary visit may still pose an epidemiological threat.

Parents of young children, in turn, pay attention to the provision according to which a patient under the age of 6 will have to appear at the clinic for treatment, remote consultation will not be possible. And this is the age group most exposed to coronavirus infection, vaccinations in Poland still include children aged 12 and over.

Telemedicine – what exactly will change?

The draft ordinance of the Minister of Health on the standard for the provision of teleports appeared on July 2. It specifies situations in which teleconsultation will be impossible, the only way will be direct contact with a doctor.

Medical service only through a personal meeting with the patient will take place:

1. during the first consultation in the case of patients starting treatment in a given entity or covered by care in a given entity, but reporting a new health problem,
2. in connection with a chronic disease in the course of which there was a deterioration or change in symptoms,
3. in connection with the suspicion, diagnosis and treatment of neoplastic disease,
4. in the case of children up to 6 years of age, apart from follow-up consultations during treatment determined as a result of a personal examination of the patient, which can be provided without physical examination,
5. in the event that the patient or his legal guardian did not consent to the provision of the service in the form of teleportation.

The regulation comes into force on October 1, 2021.

«New rules will make access to doctors difficult»

– The planned changes will worsen the already difficult access to specialist doctors. The inhabitants of small towns located far from the agglomeration will be excluded from the scope of possible quick access to consult their research results, which is already a considerable problem. Modern solutions that are needed by the health service include the inclusion of telemedicine as the first form of contact with a doctor, and not its exclusion at this stage – said Rafał Piszczek, CEO of MedFile and the halodoctor.pl platform.

1. COVID-19 Will Become a Childhood Disease? Dr. Grzesiowski: There are such hypotheses

– Moreover, it seems that the legislator puts every telemedical visit on an equal footing with teleportation (i.e. contact only by phone) – adds Piszczek.

– Most developed medical facilities use telemedicine solutions that allow the patient to make an appointment for a specific time for an e-visit, send the results of their previous tests before the e-visit or share their medical history. The consultation takes place via a video chat, where the doctor sees the patient, reviews his test results and at this stage decides whether a physical visit to the medical facility is needed. During the first e-visit, the doctor often refers the patient to specialist tests, which are essential in the diagnosis process. Thanks to the e-visit, this process is quick (24-48h), and we know that in the case of many diseases, delay in diagnosis is key factors in therapy failure – highlights Rafał Piszczek.

“Restriction on access to telepathics will hit patients”

The changes will have a negative impact not only on patients from small towns, but also on professionally active people from larger cities, as the Association of Entrepreneurs and Employers reminds of.

1. Expert of the Polish Academy of Sciences: the epidemic will continue for 3-5 years

“The obligation to consult each new health problem in a stationary manner means returning to queues and overcrowded clinics, where sick patients will mix with healthy people, for example waiting for a referral. In the context of a possible fourth wave of COVID-19 cases, it seems that it would be a highly undesirable state, ”we read in the ZPP release.

“The aforementioned provisions will also lead to a drastic decrease in the clinic’s capacity, a lower number of visits and, as a result, poorer access to medical care for all patients.

The limitation in access to telepaths will hit two groups of patients the hardest, i.e. people living in smaller towns where access to a doctor is difficult, and professionally active people who make visits only after 18»- emphasizes the Association in the commentary on the new regulation.

Telemedicine – when is it better than a classic visit to the doctor?

What are the benefits of using the benefits of telemedicine? Let’s list the basic:

1. the possibility of a very quick initial consultation with a specialist. This first e-visit usually takes place within 48 hours, while access to a specialist doctor in the facility may be possible only after a few weeks. The specialist sends the patient for tests and makes an appointment, perhaps after a few more weeks,
2. no territorial restrictions,
3. quality – online consultation is practically no different from a traditional visit,
4. saving time for the patient and the doctor,
5. during the e-visit, the doctor may always decide to meet in person at the facility,
6. safety during the coronavirus pandemic
7. doctors already have the option of issuing e-referrals or other documents in electronic form, so the patient does not have to collect them physically in the facility.

Dozens of amendments tabled

In July, the draft was subject to public consultations, it was sent to over 30 entities, which submitted several dozen amendments to the regulation.

According to the Telemedicine Working Group (comprising 22 entities offering telemedicine services and stationary services), the regulation does not take into account the will of the patient or his legal representative. TGR points out that «in individual cases of the indicated project, the patient is deprived of the possibility of using the telemedicine service, even if he explicitly wants to (or his legal representative expresses such a desire), medical reasons justify telemedicine contact, and the medical professional allows the possibility of remote implementation of healthcare services«.

1. Namysłów without a delivery room, Zamość without paediatrics. Several dozen hospital departments have already been closed in Poland [LIST]

The My Patients Foundation points out that «The introduction of administrative restrictions in this respect deprives patients of the opportunity to decide in what form they want to meet their need for contact with medical personnel, especially since the regulation applies both to services provided under the system of financing services from public funds, as well as those financed individually by patient«.

We also read that «It seems unjustified to exclude the possibility of teleporting in any situation where the patient has not previously used the services in a given entity or if he reports a new health problem«.

According to the foundation, the project «leads to the elimination of teleporting in situations where they clearly generate benefits and are more effective than a personal visit«. It goes, among others o situations where the advice does not require a personal examination of the patient, concerns minor matters that supplement and continue the existing care, or when patients have difficulty moving or reaching a medical point.

The Federation of Healthcare Employers’ Associations “Zielona Góra Agreement” emphasized in a letter to the Minister of Health that “The standard should apply to all scopes of services – without excluding dentistry, psychiatry and rehabilitation. Within each of these ranges there are situations where telepaths can be and do have clinical application. It is therefore worthwhile for the regulations to cover all benefits as a whole. Telepainting should be possible also when another service is not possible and the patient expects / needs advice. In various life situations, teleporting may be the only method of contact and should not be forbidden ».

The Polish Society of Cardiology, in turn, pointed to «on the need to bypass provisions that exclude the use of telepathics in relation to individual patients or diseases«.

The attention of cardiologists – as one of the few – was taken into account by the Ministry of Health, but most were rejected.

Teleporting – what does it look like in other countries?

In many European countries, including Switzerland, the Netherlands, Germany and Great Britain, the principle of initial contact with a doctor via remote channels has been introduced in public health care. This is to reduce the number of unnecessary stationary visits, visits to emergency departments, as well as ambulance calls and emergency calls. In many cases, telemedicine is reimbursed, including self-help mobile applications for problems with insomnia.

«The Dutch government wants to encourage the use of digital applications in healthcare and support. Smart solutions have become increasingly important in daily care since the coronavirus crisis. Many smart healthcare solutions already exist, but they could be used more frequently in daily care. These include applications that allow you to contact your family doctor or help you stay at home longer »- we read on the Dutch government website.

1. “The ambulance service in Poland will cease to exist”. All the rescuers threw their papers

«In 2021, the Dutch Healthcare Authority increases funding for e-health. This important change means that telehealth costs – for example, online consultations over a video link – can be reimbursed in the same way as direct healthcare services provided by a GP or medical specialist, »the further reads.

New rules of teleport advice – threats

The authors of the proposed amendments draw attention to the dangers arising from the new provisions. This applies in particular to:

1. limitations of patients’ rights in terms of the possibility of choosing whether they want to take advantage of teleconsultation or stationary advice (both within the NHF and privately)
2. limitations in the availability of telepaths – for people excluded from communication, temporarily staying abroad, elderly people with disabilities 
3. limitations or closure of telemonitoring programs – including those supported by the government and the activities of the National Health Fund in its current shape.  
4. increasing the number of patients in clinics, in HEDs, when we expect the next wave of COVID-19 cases 
5. limit the possibility of consulting a doctor other than the one available to you in order to obtain a second opinion
6. the need for a stationary visit with a sick child, which, in the face of the threat of the Delta variant, which attacks mainly the youngest, vaccinated persons in a small percentage, creates a greater risk of infection or virus transmission.

Many experts emphasize that telemedicine is indicated all over the world as a remedy for improving the quality of treatment, a tool for democratizing access to health care and a way to reduce costs and problems related to the decreasing number of doctors. It enjoys more and more trust, also among older patients for whom there were doubts as to whether such a possibility would meet with understanding.

Importantly, the use of telemedicine solutions does not deprive the patient of the possibility of making in-patient appointments, but increases the sense of security and access to care.

1. Which European countries have the most infections? Latest ECDC data

One cannot forget about the dangers of COVID-19. The end of the coronavirus pandemic is still not in sight. During the epidemic, 80 percent. medical consultations took place in the form of teleportation. Last year’s patient satisfaction survey conducted for the Ministry of Health and the National Health Fund shows that 92 percent. of those polled said their problem had been solved via teleportation.

Telemedicine is still one of the most effective ways to limit direct contact in an emergency. It is a key element of COVID-19-related prevention for many patients, but also for doctors.

This may interest you:

1. Should children go back to school? The contagious doctor appeals to the parents
2. TV screens – check how it works!
3. The mystery of the Delta variant solved? Dangerous “window”

The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website. Do you need a medical consultation or an e-prescription? Go to halodoctor.pl, where you will get online help – quickly, safely and without leaving your home.