Telemedicine is one of those areas in which our country has made significant progress over the past two years. The military operation in Ukraine has not yet negatively affected this industry, and demand in it will even increase by the end of the year
About expert: Maria Kolomentseva, CEO of the Doctor Nearby medical service.
The project began in 2013 as a network of private clinics within walking distance. Telemedicine service was separated into a separate area in 2017. Doctor Nearby became the first company to provide telemedicine services, including with the participation of specialists from its own clinics.
Changes in Russian medical technology
The events of February 24, 2022 and the actions that followed – anti-sanctions, currency fluctuations, disruption of supply chains – affected almost all areas of the economy. Telemedicine was less affected by what is happening, but indirectly felt the impact of the crisis. And it has already been transformed under the influence of external factors.
Demand. Telemedicine as a paid service has become widespread in our country with the onset of the coronavirus pandemic. Many people at this time tried to avoid medical facilities as places for the possible spread of infection. However, the need for medical advice remained high. During the lockdown, many patients tried to get help online.
Remote consultations began to be offered not only by paid clinics, but also by the state. For example, in 2020, the Moscow Health Department opened a large telemedicine center for covid patients.
In 2020, the total number of consultations using telemedicine technologies in our country reached almost 4,5 million. Compared to 2019, this is almost 4 times more. The figures show that telemedicine has become a familiar and understandable service for users in just a year. Many patients and doctors have found this to be a very convenient way to interact.
In March 2022, some telemedicine services noted a drop in demand – by almost 30%. But then demand returned to its previous level. It is expected that, despite the current situation, the volume of the telemedicine market in our country may grow by 17% this year. In favor of further growth is the fact that people, unfortunately, do not stop getting sick. Rather, on the contrary: against the background of stress, new ailments appear and old ones intensify. Some specialists are becoming more and more in demand: even in March 2022, the demand for their services continued to grow. Among the doctors in demand are neurologists, gastroenterologists, ENTs, dermatologists. The demand for psychotherapists has especially increased. Some clinics are already expanding the staff of these specialists.
Pricing. Far from all clinics increased the cost of telemedicine services for March-May 2022. For example, our company “Doctor Nearby” has left prices at the pre-crisis level, and we are not going to raise them. This is explained by the fact that the cost of consultations in telemedicine consists of two parts: the payment for the doctor’s working time and the cost of infrastructure for online communication between the patient and the doctor. Both of these items of expenditure have not yet had time to grow significantly. Now the price of an online appointment is on average lower than for a personal visit to a doctor in Moscow. At the same time, it slightly exceeds the average cost of a face-to-face appointment with a doctor in the regions.
Sanctions. Telemedicine should not suffer from the withdrawal of some IT services from the Russian market. Today, developers have full access to the necessary world technologies. At the same time, it should be noted that the platforms, solutions and services on which the companies operate were created by Russian programmers. For example, the Doctor Nearby platform is our own development.
Main difficulty. The development of Russian telemedicine is hindered not by the geopolitical situation, but by the imperfection of our legislation. According to the federal law “On Amendments to Certain Legislative Acts of the Russian Federation on the Application of Information Technologies in the Sphere of Health Protection”, a doctor cannot determine the primary diagnosis, prescribe treatment and write out a sick leave in the online appointment format. World experience proves that such restrictions can be dispensed with. For example, in France, a doctor has the right to decide when only an online consultation is necessary, and in certain cases, to make a diagnosis during a remote appointment.
One of the possible solutions to this legal problem in our country is the EPR, that is, the experimental legal regime. It is being introduced for some time in one area or another, where legislation still lags behind technology. The need to liberalize the law on medicine is long overdue, especially since telemedicine has proven to be effective and safe during the pandemic.
How telemedicine companies adapt to the crisis
Diversification of sales channels. In any crisis, the most stable are companies with several sales channels aimed at different audiences. For example, our company attracts not only “end customers”. We cooperate with banks and insurance companies, we work in the b2b segment. This approach allows you to compensate for the “drawdowns” of one sales channel at the expense of the others.
Partner support. Many of our B2B clients are experiencing difficulties right now. This is reflected in our company – telemedicine services may well be subject to cost reductions. We try to offer our partners new solutions and interaction formats. In a crisis, it is very important not only to fight for your business, but also to support each other so that everything does not collapse like a house of cards.
Budget DMS. In connection with the crisis, many companies are reducing their costs, including in the social sphere. We understand that medical insurance will be a product that not every employer can afford in the current situation. I think that telemedicine can be a good solution in this situation. It is able to take over the bulk of repeated appointments with a doctor for employees with a VHI policy. So you can somewhat reduce the cost of medical insurance, and at the same time increase its effectiveness.
Participation in public-private programs. Cooperation with the state is a very complex area, with many nuances. There are a lot of difficulties here. But, if you manage to overcome them, then the prospects for medical companies are obvious. This will significantly increase the number of customers. In the spring of 2022, our company began scaling up a project to introduce telemedicine and artificial intelligence-based solutions into regional CHI systems.
In most regions, public clinics receive a set amount for each registered patient. They are not interested in developing online services: for them, it is just an extra expense. However, the situation with the development of telemedicine is very different from subject to subject. In some regions, local telemedicine centers have already been opened and pilot projects have been launched to include telemedicine in CHI. This is, in fact, not only about convenience for patients, but also about saving public money. In any case, the cost of an online appointment is lower than an in-person visit to a doctor. For crisis realities, this is another important plus.
Do not forget another important point – social. Medical companies and the state have one common “social” goal – to counter self-medication. I think that today it is one of the key problems in medicine. People who do not have access to a doctor due to geographic location or lack of funds for face-to-face appointments begin to turn to Internet search engines or “folk remedies”. The availability of quality online medicine is an important step in solving this problem. When people have a professional doctor “in touch”, they no longer need to climb dubious sources of information, putting their health at risk.
Turning business towards b2c. Due to recent events, working in the corporate market has become much more difficult than before. And here, a gradual shift of priorities towards the “end client” seems to be a logical solution. We will focus on the widest audience and offer people new personalized medical products at an attractive price.
Preparing for growth. Usually, during periods of market growth, those who prepared for it during the recession are the ones who win the most. The telemedicine market will continue to grow anyway. Telemed companies should constantly monitor the situation and understand which specialties and areas are becoming more in demand. Based on this, you should plan to hire certain specialists.
I am sure that our industry will grow and develop, despite any difficulties. Telemedicine helps people to preserve the most important thing they have – health. It helps to save time for residents of large cities. And in remote regions, it gives people the opportunity to consult a competent doctor without leaving anywhere. Medical assistance is needed anytime and anywhere, this makes our business stable.