Yes, telehealth is permitted in Australia.
Prior to the COVID-19 pandemic, there were limited situations where telehealth could be used for the delivery of healthcare services in Australia. This was largely due to Medicare (Australia’s publicly funded universal healthcare system) restricting registered healthcare providers to delivering their services from a registered location (i.e., their medical practice), and limiting the availability of government subsidies for telehealth consultations to patients in rural and remote communities where pre existing provider-patient relationships existed.
On 30 March 2020, in response to the COVID-19 pandemic, the Health Insurance (Section 3C General Medical Services – COVID-19 Telehealth and Telephone Attendances) Determination 2020 (Cth) ("Telehealth Determination") came into force. As a result of the Telehealth Determination, a range of healthcare services delivered via telehealth that previously could not be subsidised under Medicare (including e.g., standard general practitioner consultations) became eligible for subsidy. That is, a variety of telehealth services became available at a subsidised cost or at no cost to the patient under Medicare.
When the Telehealth Determination was first introduced, it permitted the delivery of healthcare services via telephone or video-conferencing to patients where there was no pre existing provider-patient relationship (although an existing relationship was preferred).
The Telehealth Determination was subsequently amended so that from 20 July 2020, healthcare providers were required to have an existing and continuous relationship with a patient in order to provide telehealth services. Therefore, at present, unless an exception applies (e.g., the patient is less than 12 months old), a medical practitioner can only provide telehealth services to patients who have seen the practitioner for a face-to-face service in the last 12 months, or have seen another medical practitioner at the same practice for a face-to-face service during the same period.
Although the Telehealth Determination was scheduled to be revoked on 30 September 2020, the Australian Government has made the Telehealth Determination permanent, meaning that more than 200 telehealth services have become permanently available. These changes mean that video and telephone services are available nationally from general practitioners, medical specialists and other health professional via Medicare.
Telehealth in Austria is, in principle, permitted.
The applicable professional rules requiring doctors to exercise their profession "personally and directly" could imply a general prohibition of distance or remote treatments without definite prohibition. Whenever medical science requires physical contact (e.g. physical assessment) between a doctor and the patient, any treatment without such contact is a violation of the principle of directness. Consequently, without clear legal guidance any introduction of telehealth measures / devices requires careful assessment under the principle of directness and personal exercise in that specific context.
Yes, the use of telehealth is permitted in Bahrain.
In Belgium, no specific legal framework exists in relation to telehealth.
However, this could change in the near future as the COVID-19 pandemic has brought attention to the range of possible telehealth applications from which patients and healthcare professionals could benefit. In fact, the Belgian National Council of the Order of Physicians (“NCOP”) has already adapted its policy regarding the provision of teleconsultations, which was previously strictly limited. This is explained into more detail below (see the chapter about telehealth Regulation).
There is also a lot of attention going towards other aspects of telehealth, like tele-expertise, telemonitoring, tele-assistance and m-health. An example are the test projects that have been carried out by the national institute for sickness and disability insurance (RIZIV/INAMI) with the purpose of creating a framework to reimburse telehealth applications.
It is now expressly and extensively regulated.
Yes.
Yes, the use of telehealth is permitted in Canada.
Even when telehealth is not expressly regulated by law in Chile, it is permitted as part of the means through which healthcare can be provided to patients. Notably, Chile has been developing telemedicine services since 1993, with a particular focus on the provision of healthcare services in remote zones and in regions (i.e., islands and Chilean Antarctic territory), and the Government has fostered a digitalisation agenda that includes telemedicine as part of the main elements of it.
Yes, the use of telehealth is permitted in China. It is commonly referred to as "internet plus healthcare" in China.
Yes. However, it is important to note that Colombian regulation differentiates between telehealth ("telesalud"), being any activity related to health, services and methods, delivered using ICT, and telemedicine ("telemedicina"), which is the delivery of health services including prevention, diagnostic, treatment and rehabilitation of diseases and injuries, by health services providers using ICT. The definition of "telesalud" provided by the Colombian law compresses the concepts of telemedicine and health tele-education in health matters.
Yes. Telehealth, in particular telemedicine ("Telemedicine"), defined as the provision of healthcare services at a distance (i.e., when a healthcare worker and a patient or two healthcare workers are not in the same location) by using information and communication technologies, pursuant to Article 38 (1) of the Croatian Healthcare Act (Zakon o zdravstvenoj zaštiti – "Healthcare Act") and Article 2 (1) no 1 of the Croatian Ordinance on conditions, organisation and manner of performing telemedicine (Pravilnik o uvjetima, organizaciji i načinu obavljanja telemedicine – "TelemedicineOrdinance") in conjunction with Article 257 (1) no 22 of the Healthcare Act, is explicitly recognised and permitted in various aspects throughout the Healthcare Act as well as the Telemedicine Ordinance. Additionally, the Healthcare Act also recognizes Telemedicine as one of the main objectives of the Croatian healthcare realm, according to Article 7 of the Healthcare Act.
Some elements of telehealth could already be found in Czech law, but the legislation was fragmented. In order to set the general framework, basic rules and standards for the functioning of telehealth, a new Act No. 325/2021 Coll., on electronization of healthcare, was adopted with effect from 1 January 2022.
Yes, telehealth is permitted in Denmark.
Yes, telehealth (or "telemedicine") is permitted in Finland. The Finnish National Supervisory Authority for Welfare and Health ("Valvira") uses the term telemedicine for clinical consultations, diagnostics, observations, monitoring, treatment and clinical decisions and recommendations which are provided on the basis of information and documentation accessed by medical practitioners electronically, for example via video link or smartphone.
The Ministry of Social Affairs and Health has confirmed that, in terms of content, telehealth (or "telemedicine", which is a term more often used) services can be considered as a rule equivalent to traditional face-to-face consultations. Valvira approved in late 2015 the provision of healthcare services online, e.g. by means of a video call or a smartphone.
For example, the need for treatment may be evaluated by telephone or another telehealth service. Naturally, due to medical reasons, physical examinations may be required. In this case, where the condition of the patient or the situation requires it, the patient must schedule an appointment at a health centre. In addition, patients have the right to self-determination. Telehealth is not appropriate for consultations that leads to the patient’s right to self-determination being curtailed.
Telehealth is authorised in France, subject to specific requirements.
The French Public Health Code (“FPHC”) defines telehealth (“télémédecine”) as “a form of remote medical practice using information and communication technologies, which connects one or more health professionals, among them or with a patient, and, where appropriate, other professionals involved in the patient's care. It allows to establish a diagnosis; to ensure, for a patient at risk, a preventive or post-treatment follow-up; to request specialized advice; to prepare a therapeutic decision; to prescribe products; to prescribe or carry out services or acts; or to monitor the condition of patients” (Art. L.6316-1 of the FPHC).
The following telehealth procedures are more specifically defined under the FPHC (Art. R.6316-1 and Art. L.6316-2 of the FPHC):
- Teleconsultation: it allows remote consultation between a medical professional (i.e., doctors, dental surgeons and midwives) and a patient, who might be assisted by any healthcare professional or a psychologist;
- Tele-surveillance: it enables a healthcare professional to remotely interpret the data necessary for the medical follow-up of a patient and, if necessary, make decisions regarding the management of the patient;
- Tele-expertise: it allows healthcare professionals to seek the opinion of other experts or healthcare professionals on their patient's pathology;
- Tele-assistance: it allows a healthcare professional to remotely assist a medical professional carrying out a medical procedure;
- Medical response: it corresponds to emergency telephone calls and is carried out within the framework of medical regulation;
- Tele-care: it enables remote care by allowing patients to connect with pharmacists or paramedics, as well as other professionals listed by Decree (e.g., nurses, audio-prosthetists, dieticians, medical laboratory technicians) using information and communication technologies. Tele-care activities are defined by Ministerial Order.
Yes, telehealth is permitted as part of the regular healthcare services in Germany, within certain restrictions.
In Germany, the term ‘telehealth’ is used, often interchangeably, with the term ‘telemedicine’. However, there exists no uniform definition of ‘telehealth’ or ‘telemedicine’ under German law. The German Medical Association ("BÄK") describes ‘telemedicine’ as a collective term for various medical care concepts which have in common that healthcare services for patients including diagnostics, therapy and rehabilitation, as well as medical decision support are provided over spatial distances (or temporal offset) using information and communication technologies ("ICT"). Telemedicine may generally comprise, inter alia, eCare, ePrevention, eAdministration, eResearch, and eLearning.
Telehealth is subject to certain restrictions under German law. As a general rule, physicians, dentists, psychotherapists as well as other healthcare professionals may advise and treat patients in in-person visits exclusively. However, ICT, e.g. authorised e-mail or audio-video chat platforms, may be used to assist in-person treatment of and communication with patients. By contrast, exclusively remote visits, diagnostics and / or treatments, i.e. without any prior real life interaction between healthcare professionals and patients, are only permitted within very strict limitations requiring a case-by-case evaluation of the medical appropriateness. However, based on experiences during the COVID-pandemic, Some German local Medical Associations (“ÄK”) seems to interpret and enforce these requirements less strictly than others permitting video-consultation also without prior in-person contact between patient and physician.
Yes, telehealth is permitted in Greece.
Yes. Telehealth is referred to as ‘telemedicine’ in Hong Kong SAR, which is defined as "… the practice of medicine over a distance, in which interventions, diagnoses, therapeutic decisions, and subsequent treatment recommendations are based on patient data, documents and other information transmitted through telecommunication systems" in the Ethical Guidelines on Practice of Telemedicine issued by The Medical Council of Hong Kong in December 2019 (the "Guidelines"). This follows the definition of telemedicine in the World Medical Association ("WMA") Statement on the Ethics of Telemedicine, last amended in October 2018 (page 2, para. 8).
Telehealth services are permitted as part of the healthcare services in Hungary. The terminology in Hungary for telehealth services is "telemedicine". We use the terms ‘telehealth’ and ‘telemedicine’ interchangeably hereinafter.
Note that telehealth is considered as a means of providing certain healthcare services in Hungary. Therefore, it is unprecedented so far to have a healthcare services operation license obtained solely for the provision of telehealth services. It follows, that telehealth services may only be performed by healthcare service providers already obtaining a “regular” healthcare service operation license. Telehealth services therefore are considered as part of healthcare services, where the " form of communication" of the provision of such services is different than the default face-to-face set-up.
Telemedicine is defined as an activity which, in the absence of the patient, aims to
- the professional assessment of the patient's state of health,
- the detection of diseases or their risk,
- identify the specific disease(s),
- ordering further tests necessary to assess the patient's condition more accurately, and initiating treatment,
- determining the effectiveness of the treatments referred to in points (a) to (d) (teleconsultation); and
- monitoring and diagnosing the patient's condition
based on information available through remote monitoring tools and other info-communication technologies.
Yes, telehealth is permitted in Ireland.
Yes, telehealth is permitted in Italy. Italian authorities refer to telehealth as "telemedicine" (telemedicina).
Over the last three (3) years, Italian authorities have adopted several rules and guidelines on telehealth.
Yes. Telehealth is defined under Article 1 of the Regulation of Minister of Health of the Republic Indonesia Number 20 of 2019 regarding the Organisation of Telemedicine Services through Health Service Facilities, as the provision of long-distance health services by health professionals by utilising information and communication technology, consisting of information exchange on diagnosis, medication, disease and injury prevention, research and evaluation, and sustainable education of health service providers in order to improve individual and public health.
Yes, ‘telehealth’ is permitted in Japan. Medical institutions are allowed to decide whether to adopt telehealth systems.
Yes, in Kenya telehealth is known as e-Health and is permitted under section 103 of the Health Act 2017 (‘the Health Act’), which recognises e-health as a mode of health service.
The term “e-Health” is defined in the Health Act as “the combined use of electronic communication and information technology in the health sector including telemedicine.” The term “telemedicine” is, in turn, defined as “the provision of health care services and sharing of medical knowledge over distance using telecommunications and it includes consultative, diagnostic, and treatment services.”
Yes, telehealth is permitted in Kuwait.
Yes, telehealth is permitted in Luxembourg.
At present, to limit the transmission of the virus during the COVID-19 pandemic, health professionals are being encouraged to use teleconsultation methods (e.g. telephone, and video call applications). Furthermore, the Luxembourg government has launched the "eConsult" teleconsultation platform as an emergency measure in order to limit physical contact. The eConsult platform provides a secure environment for carrying out teleconsultations, allowing for remote consultations.
Yes, telehealth is permitted in Mexico, though it is not expressly provided for under relevant local laws.
Yes, telehealth is authorized in Morocco. Due to the COVID-19 pandemic, interest in telehealth has grown significantly which led to an adjustment of the regulations. We are also witnessing a growth in terms of telehealth services in the country, as these services are a quick and easy alternative to address the flaws of the current health care system which is currently under review.
Yes, the use of telehealth is permitted in Namibia, as there is nothing prohibiting the use of telehealth in Namibia.
Yes, telehealth is permitted in the Netherlands and use thereof has increased considerably as a result of the COVID-19 pandemic. Even more so, telehealth (also called E-health in the Netherlands) is part of a stimulus package (Stimuleringsregeling E-Health Thuis) by the Dutch Government in order to stimulate innovations in healthcare, particularly as it is believed that E-health can make healthcare more efficient and cost effective. The stimulus package of 2021 was reopened in 2022. It is not yet clear whether it will be reopened in 2023 again.
Yes, telehealth is permitted as a means of delivery of health care services in Nigeria.
Yes, the use of telehealth is permitted in New Zealand.
Yes.
Yes, telehealth is permitted in Oman.
Yes, it is expressly stated in the Act of 5 December 1996 on the Professions of Physician and Dentist that professional activities of a physician / dentist may be performed using ICT.
Yes.
Yes, telehealth is permitted and is currently being practiced in the public and private healthcare sectors in Qatar.
Yes, telehealth is permitted in Romania.
Yes. In Russia, rules on telehealth were adopted in 2017. On 29 July 2017, Article 36.2., governing telemedicine, was added to the Federal Law "On Basics of Health Protection of Citizens in Russia" No. 323-FZ dated 21 November 2011 (the "Health Protection Law"). On 30 November 2017, the Russian Health Authority also adopted Order No. 965n "On Endorsement of the Order of Providing Medical Assistance with the Aid of Telemedicine Technologies" (the "Order") which sets out the requirements relating to the provision of medical services through telehealth technologies.
Yes, the use of telehealth is permitted in the Kingdom of Saudi Arabia ("KSA").
Yes, telehealth is permitted in South Africa but subject to certain limitations as found in the General Ethical Guidelines for Good Practice in Telehealth (formerly called "Telemedicine") ("Guidelines") first published by the Health Professions Council of South Africa ("HPCSA") on their website in 2014 and revised during December 2021.
Yes, subject to certain restrictions as set out below.
Telehealth has been allowed by Slovak legislation only for the duration of the crisis situation regarding COVID-19.
Yes, the use of telehealth in Slovenia is permitted. Broadly speaking, Slovenian law explicitly recognises and allows two types of telehealth services, namely:
- "Telemedicine" (in Slovene: telemedicina) which isdefined as provision of healthcare services through the use of information and communications technology where the health professional and the patient (or two health professionals) are not in the same location, according to Article 3 (3) of the Slovenian Health Services Act (Zakon o zdravstveni dejavnosti – "ZZDej") ("Telemedicine"); and
- "Telepharmacy" (in Slovene: telefarmacija) which is defined as means of remote counseling through modern telecommunication technologies within the context of pharmaceutical activities, according to Article 4 (1) no 18 of the Slovenian Pharmacy Practice Act (Zakon o lekarniški dejavnosti – "ZLD-1") ("Telepharmacy").
Telehealth (or ‘telemedicine’) is generally permitted in Spain as there are no specific limitations or prohibitions regarding telehealth under Spanish law.
However, it should be noted that in Spain, health competences are transferred to the 17 different self-governing regions. Hence, each regional healthcare authority has the autonomy to allow, plan, or limit their healthcare system, including the types of services they offer such as telehealth.
Furthermore, the professional code of the Doctors and Dentists Bar Association limits teledentistry to patient orientation (during medical revisions) and second opinions, and only as long as it is clear that mutual identification and privacy is ensured.
Yes, telehealth is permitted in Sweden.
Yes. In Thailand, telehealth is regulated as part of "telemedicine", which is the provision of healthcare services through the use of telecommunication technology. As there is no separate definition for telehealth under Thai law, any references to "telehealth" hereinafter will be covered under the scope of "telemedicine".
Recently, on 1 February 2021, the Ministry of Public Health ("MOPH"), which is the body responsible for overseeing public health in Thailand, has issued the Notification Re: Standards of Service in Respect of Medical Facility via Telemedicine System ("MOPH Notification ") which effectively legalised telemedicine businesses for medical facilities in Thailand.
Yes, telehealth is permitted in the United Arab Emirates (UAE).
Yes. Telehealth has been active in the UK for a number of years. Since the COVID-19 pandemic, the use of telehealth has grown significantly, and a range of different healthcare providers are making use of new and innovative technologies in order to provide services to patients.
Telehealth in the U.S., while generally permissible, is very complex and highly regulated, both from a general practice and coverage perspective.
There is no federal law that governs the practice of telehealth. Telehealth, and the associated practice of health care professions are regulated at the state level and the question of what constitutes permissible telehealth practices varies greatly. States often have different definitions of telehealth and the modalities permitted by telehealth, with some permitting asynchronous communications and others permitting only real-time interactive audio and video communications. Depending on a state’s definition, certain telehealth modalities such as text-messaging and secured email messaging may or may not be permitted, and may be subject to coverage limitations, either in the state Medicaid program or under insurance regulations.
Permissible telehealth practices can also differ by professional discipline, with state licensure boards adopting one standard for the practice of telehealth by physicians and another for the practice of telehealth by nurses, dentists, or mental health providers, among others. Licensed professionals are governed by professional licensing bodies in each state where they hold licenses. In order to provide licensed services to individuals, the professional must hold a license in the state where the patient is located. This means that a professional providing telehealth services to individuals in multiple states may be subjected to different standards of practice depending upon the location of the patient being served.
Requirements for an in-person examination prior to the use of telehealth have largely been abolished; however, some laws still require in-person examinations in order to prescribe certain medications via telehealth. The federal Ryan Haight Act in particular requires healthcare providers to conduct an in-person evaluation before prescribing or otherwise dispensing controlled substances "by means of the Internet," except when engaged in the practice of telemedicine.
During the COVID-19 public health emergency (“PHE”), the federal Drug Enforcement Administration ("DEA") helped ensure that patients could continue receiving life-saving medications by waiving the required in-person visit prior to prescribing controlled substances via telehealth. This flexibility allowed for continued treatment, while minimizing exposure to COVID-19 and supporting provider capacity. Although this waiver was slated to expire with the PHE, in February 2023 the DEA proposed telemedicine rules that establish pathways for the prescribing of certain controlled substances in limited quantities via telemedicine without an initial in-person medical examination; however, the Proposed Rules are complex and far more restrictive than the COVID-19-era tele-prescribing flexibilities. Therefore, the ability to prescribe controlled substances via telehealth will be limited under federal and potentially state law, depending upon the medication prescribed.
In addition to the regulations on the practice of telehealth, there are great variances in the coverage and reimbursement of telehealth as well, at both the state and federal level, as described more herein.
Yes, telehealth is permitted as, subject to privacy and medical ethics, there is no prohibition of telehealth under Zambian law. As such, medical practitioners have adopted, and the public has embraced, telehealth. Furthermore, the advent of the COVID- 19 pandemic has heightened the general acceptance of telehealth by the Zambian public.
Yes, telehealth in Zimbabwe is permitted.
In addition, the Public Health Act [Chapter 15:17] and the Health Professions Act [Chapter 27:19] currently regulate the offering of health services by medical practitioners and have several guidelines in place that must be met by the specific medical practitioner or service provider on a case-to-case basis. These are widely interpreted to apply to service providers and practitioners offering telehealth services.
Argentina
Is the use of telehealth permitted?
Yes, telehealth is permitted in Argentina.
Argentina
How is telehealth regulated?
In 2019, the Argentine Ministry of Health published a guide of recommendations for the supply of ‘telehealth’ (Disposition No. 21/2019). The "Recommendations for the use of telehealth: meeting between the health professional and the patient using real-time ICT" guide was prepared by a group of healthcare providers, coordinated by the Ministry of Health, with the objective of creating a guideline for the provision of telehealth in a safe, efficient and ethical way.
Pursuant to the General Resolution No. 282/2020 issued by the Superintendency of Health Services ("Superintendencia de Servicios de Salud"), all private health insurers must employ and promote the use of teleconsultation platforms in order to provide healthcare treatments. In all cases, they must guarantee that the data and information collected from the patient through the use of teleconsultation platforms is protected in the terms of the Personal Data Protection Law No. 25,326. Moreover, telehealth platforms are, in all cases, subject to a subsequent audit carried out by the Superintendency of Health Services.
In 2022, pursuant to the General Resolution No. 581/2022, the Argentine Ministry of Health published a new guide with recommendations in the telehealth field: “Recommendations for the use of telehealth and good practices for healthcare providers”.
It should be highlighted that these guides are recommendations provided by the Ministry of Health in order to ensure the good practices in the use of telehealth. Notwithstanding, each of the Argentine Provinces may complement these recommendations by issuing their own regulations and laws.
Argentina
Are there specific fields of healthcare in relation to which telehealth services are currently available, and do they involve the use of proprietary technology or platforms?
Pursuant to Section 6 of the Law No. 27,553, the healthcare services currently available through telehealth methods are: general practice, dentistry and collaborative activities related to them, and psychology. In all cases, these activities should be previously authorised by the competent authority, and they should comply with the provisions of the Patient Rights Law No. 26,529. These services are available by proprietary platforms and general videoconferencing apps. As both forms are permitted, the platform used will depend on each particular case.
Argentina
Does the public health system include telehealth services, and if so, are such services free of charge, subsidised or reimbursed? Where the public health system does not include telehealth services, are such services covered by private health insurance?
The public health system is free of charge but generally does not include telehealth services because it lacks the infrastructure to provide them. However, pursuant to the electronic prescriptions of medicines and healthcare treatments Law No. 27,553, all the healthcare providers of the public health system are empowered to do so, and can issue electronic prescriptions.
Most of private health insurers offer some telehealth services such as appointments with a medical doctor via videoconference. No additional fees are charged to the patient as this is typically covered in the health insurance policy.
Argentina
Do specific privacy and/or data protection laws apply to the provision of telehealth services?
There are no specific data protection laws relating to telehealth services precisely. However, the Ministry of Health’s guides and recommendations include a section related to data protection and, in all cases, healthcare providers should comply with Law No. 25,326 of Personal Data Protection.
Argentina
How should the cross-border transfer of personal information collected and processed in the course of telehealth services be carried out to ensure compliance with applicable privacy laws?
Pursuant to Law No. 25,326 of Personal Data Protection, the cross-border transfer of personal data of any kind is prohibited. However, this prohibition shall not apply in the following cases:
- International judicial collaboration;
- Exchange of medical data, when required by the treatment of the affected person, or an epidemiological investigation;
- Bank or stock transfers;
- When the transfer has been agreed within the legal framework of international treaties to which the Argentine Republic is a party; and
- When the transfer is aimed at international cooperation between intelligence agencies to fight organised crime, terrorism and drug trafficking.
In all cases, for the transfer of data, the owner’s consent is required.
Argentina
Are there any currently applicable codes of conduct on the use of telehealth systems and/or security of telehealth data in your jurisdiction?
Yes, as discussed in Availability of Telehealth, the Ministry of Health has published two guidelines: (i) "Recommendations for the use of telehealth: meeting between the health professional and the patient using real-time ICT"; and (ii) “Recommendations for the use of telehealth and good practices for healthcare providers”.
Argentina
Are any specific laws, regulations, or self-regulatory instruments expected to be adopted in the near future?
The government has recommended that public and private healthcare providers implement and promote the use of teleconsultation platforms in order to provide essential health services.
Moreover, further regulations will be issued to implement Law No. 27,553 as discussed in Regulation of Telehealth.
Argentina
