The main trends of the Russian MedTech market

Over the past year and a half, almost as much money has been invested in digital medicine as during the entire period of the industry’s formation. Remote consultations, AI and a robot as an assistant are already the realities of healthcare

Trend 1. Increasing investment interest in the field of MedTech from the state and business

Over the past year and a half (that is, since the beginning of 2020), over $77 million has been invested in digital healthcare projects in our country. This is almost the same amount as was invested in this area in all previous years. The 2020 figure ($47 million) was three times the 2019 level.

Of course, the pandemic has greatly affected the development of the telemedicine market. On the one hand, the demand for consultations with doctors has increased. On the other hand, it was physically impossible to get an appointment with many specialists during and after the lockdown. In addition, the availability of many areas of medicine has decreased – all the forces of the state have been thrown into the fight against the coronavirus. This provoked the active development of MedTech.

According to Webiomed, in 2020–21, in the Russian MedTech market, investors, both private and represented by the state, invested in telemedicine services, services for online appointments with a doctor, health insurance systems, medical information analysis systems based on artificial intelligence, digital diagnostic solutions and other digital products.

Trend 2. Accelerating the digitalization of medicine in the regions

People have realized that telemedicine can really help them. It allows them to be “in contact with the doctor”: the patient receives prompt consultations, which helps him avoid complications.

The spread of telemedicine in 2020 is a global trend. Over the past year, the audience of such services around the world has approximately doubled.

In our country, during self-isolation, patients actively used the opportunity to consult with doctors by phone or the Internet. This trend continues. In the context of growing demand for remote consultations, most of the major Russian insurers began to provide such a service – SOGAZ, RESO, Ingosstrakh, Rosgosstrakh life, Renaissance Health and others. At the same time, more and more clinics – both public and private – are trying to transfer online all interactions with the patient that do not require personal presence.

Now in six regions of our country – in Tatarstan, as well as in the Nizhny Novgorod, Ivanovo, Ulyanovsk, Sakhalin and Lipetsk regions – pilot projects have been launched to introduce telemedicine into the compulsory medical insurance system (CHI). Moreover, if in the first five regions a limited number of medical institutions participate in the project and only those citizens who are attached to them have access to free telemedicine, then in the Lipetsk region, which was the first to introduce telemedicine into compulsory medical insurance, remote consultations have become free since July 2021 for all residents of this region.

Remote consultation services with a doctor are beneficial to the state. The doctor may not go home to call, but communicate with the patient in the application. The same applies to the management of patients with chronic diseases. They do not have to go to the doctor every time to control their condition – part of the consultations can be done online. These formats are currently being tested in pilot projects.

It is important to make a clarification here: in our country there is no single regulation that defines chronic diseases, patients with which can use the services of remote monitoring by a doctor. Lists of diseases determine the regions. You can get acquainted with them directly at the clinic. Doctor Nearby has such information in its mobile application. For example, in the Lipetsk Region, remote management of chronic diseases is available to patients who are regularly seen by the attending physician in a polyclinic at the place of residence, with cardiovascular diseases, diseases of the gastrointestinal tract, diseases of the spine and joints, arterial hypertension, varicose veins, iron deficiency anemia, autoimmune thyroiditis and other diseases.

Trend 3. The emergence of fundamentally new products

Now new tools are coming to the aid of doctors and patients that help monitor their health, pay attention to alarming symptoms in time, and receive recommendations on further actions. Some of them are based on artificial intelligence.

One of the new products of digital medicine is a chatbot for collecting anamnesis of patients who want to visit a doctor in a polyclinic. So far, only residents of Moscow who make an appointment with a doctor through EMIAS (Unified Medical Information System) can use it. During the recording process, the patient, using this chatbot, can transmit information about what he is complaining about to the doctor he is going to visit, even before the appointment. The bot can ask leading questions – what hurts, how it hurts, what are the symptoms, and so on. He is “trained” on the medical records of real patients, so he can competently conduct such a survey.

Then this information goes to the doctor. When accepting a patient who has already talked to the chatbot, the doctor may not waste time on the “initial survey”, but immediately ask clarifying questions. The bot does not have the right to make a diagnosis (only a doctor should do this), but it can predict it based on the collected symptoms and complaints – the doctor also receives this information.

So far, only therapists can appreciate the benefits of a chatbot, but in the future, the chatbot system will be used for appointments with doctors of other specialties. The first “next in line” are gynecologists, urologists, pediatricians and ENT specialists. It will take from two to five months to “train” a bot in a new specialty.

IT products that are already in use in telemedicine often focus on prevention. Their task is to help users avoid serious illnesses and detect them at an early stage. One of these services, Webiomed, in particular, analyzes the likelihood of developing certain diseases in patients at risk. Based on the information collected, it predicts the patient’s condition and helps doctors make medical decisions.

Trend 4. Further development of telemedicine will require the removal of legislative and other obstacles

The active development of online medicine in our country can be helped by the liberalization of the legislative framework. The law on telemedicine, adopted in 2018, prohibits doctors from making diagnoses without personally examining the patient. That is, the patient in any case must appear in person for an appointment with a doctor so that he can examine him and voice the diagnosis. Even if the picture of what is happening during the teleconsultation and after receiving the results of the research becomes clear to the specialist. Russian legislation is conservative in matters relating to the admission of patients.

In countries where telemedicine is developing rapidly and effectively, for example, in England, France, Estonia, and some US states, there is no ban on online diagnosis. Under the influence of the pandemic, remote diagnosis was allowed in Brazil. Estonia is considered the most advanced country in terms of the penetration of telemedicine – almost all residents use it there.

In Europe and the United States, telemedicine laws focus on protecting patient personal data. There, special attention is paid to the channels of transmission of personal information and its confidentiality. Doctors in Europe work under license. And it is her deprivation that is fraught with unscrupulous treatment or accompanying the patient. But doctors themselves can decide how to conduct an appointment – face-to-face or via telemedicine.

Another obstacle to its development is the financing of teleconsultations within the framework of CHI. Now remote doctor’s appointments are paid from the per capita rate (or standard). In the compulsory medical insurance system, each patient assigned to a specific polyclinic is allocated a certain amount of funding every year – the same per capita rate. These funds form the budget of the medical institution, first of all, the current activities of the polyclinic are financed from it, but there is often no money left for the development of remote counseling or the involvement of third-party services, despite the active support of the digitalization of healthcare by local authorities. Therefore, telemedicine must be removed from the CHI per capita rate, otherwise it will not develop in the CHI system.