After the birth of a child, a young mother needs to be in touch with a doctor practically all the time - to seek help in an emergency, for advice about the health of the baby, or even psychological support.

One couple, who found themselves in a situation where they desperately needed assistance with their child, decided to do something about it. The father set up a portal enabling parents to receive long distance medical consultations in 2013 - the Pediatrician 24/7 service was born.

The leading Russian pediatrician, Leonid Roshal, president of the Institute of Emergency Children's Surgery & Traumatology, supported the idea. The first step was the development of a platform for doctor-patient communication. The founders of Pediatrician 24/7 discovered that patients needed, above all, to be able to urgently contact a doctor and have a guaranteed quality of service.

It’s simply not enough to bring doctors together with the help of a website and give them an opportunity to provide consultations, explains the head of the project, Denis Yudchitz. It’s very important to create a clear format for the provision of health care and quality control. Doctors undergo training prior to providing consultations in line with established criteria. Each patient gets an online medical card and access to a virtual waiting room and a private consulting room. When evaluating the quality of services, the views of both the patients and doctors are taken into account.

Waiting time of three minutes

In the wake of Pediatrician 24/7, Denis and his team opened a portal for adults: Online Doctor. Most patients are people from the regions where quality medical care is harder to access. The online service has also proved a hit with elderly patients - in addition to practical information, they value the possibility of regular contact with a doctor.

Clients are offered a subscription with an unlimited number of consultations. Teledoctor 24 operates in Russia along the same lines. Its list of services also includes help in finding medicines at the best prices and answers to legal questions related to medicine.

In 2016 another telemedicine project was launched in Russia, the Doc+ platform, for calling a doctor for a home visit based on the Uber principle. Calls are received via a mobile app for a fixed tariff of 2000 rubles ($34) per callout. Admittedly, for the time being the service is only available in Moscow and the Moscow Region. According to Forbes, the project generated a revenue of about 70m rubles ($1.17m) in 2016.

Medicine without legislation

Doc+ is similar to Heal in the U.S., a country where, according to statistics available at the beginning of 2016, 15 percent of American doctors practice telemedicine. In Russia, no official data is available because there’s still no legislation regulating the provision of remote medical care. Doctors in Russia still have no right to diagnose and prescribe treatments online, but the situation may change with the adoption of a telemedicine law.

Two bills have been submitted to the State Duma for consideration. The first was drawn up by the Health Ministry and the other with the participation of the Institute of Internet Development, the Russian internet company Yandex and the Internet Initiatives Development Fund. The key difference is that the bill proposed by the internet community allows for remote medical intervention.

The law is to determine what medical services can be provided with the use of telemedicine, establish requirements for the identification of participants, and develop mechanisms for the payment of services.

"This law is long overdue. Even in the effective absence of a legislative base, remote consultations are successfully provided by many medical institutions," RBTH was told by the press service of the Russian Health Ministry. The law will legalize the current practice and provide protection to doctors and patients. In addition, doctors will be trained to use the methods and tools of remote diagnostics.

Risks and expectations

There are three main risks connected to the development of telemedicine in Russia, Georgy Lebedev, a representative of the Institute of Internet Development, observed in an interview with RBTH. The first is the possible deterioration of the quality of medical care owing to unqualified practitioners arriving on the scene. The second is that the doctor may be at a greater risk if the patient becomes aggressive, given there will be no security present (unlike at hospitals). Finally, the market could be seized by major foreign companies.

German Klimenko, internet adviser to the Russian president, has recently urged work on telemedicine legislation be stepped up. "We have an opportunity to receive Yandex-medicine or Rambler-medicine - then it will be in our hands [Yandex and Rambler are Russian companies]. If we procrastinate for another two years, we will receive Google-medicine and Apple-medicine," Klimenko said, as cited by TASS. Klimenko also pointed out the importance of preventative monitoring of patients' health, for which the development of mobile devices will be required.

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https://www.rbth.com/science_and_tech/2017/06/27/dial-a-doc-how-the-internet-is-revolutionizing-medical-care-in-russia_790770