natszdravНациональное здравоохранениеNational Health Care (Russia)2713-069X2713-0703Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)10.47093/2713-069X.2024.5.4.5-19natszdrav-408Research ArticleОБЗОР НОРМАТИВНО-ПРАВОВЫХ ДОКУМЕНТОВREVIEW OF REGULATORY DOCUMENTSОрганизационно-правовые аспекты оказания медицинской помощи с применением телемедицинских технологий в Российской Федерации и зарубежных странахOrganizational and legal aspects of providing medical care using telemedicine technologies in Russian Federation and foreign countrieshttps://orcid.org/0000-0002-4426-0088МурашкоМ. А.MurashkoM. A.

Мурашко Михаил Альбертович – д-р мед. наук, профессор, Министр здравоохранения Российской Федерации 

Рахмановский пер, д. 3, г. Москва, 127994

Mikhail A. Murashko – Dr. of Sci. (Medicine), Professor, Minister of Health of the Russian Federation

Rakhmanovsky Lane, 3, Moscow, 127994

ПанинА. И.PaninA. I.

Панин Артем Игоревич – помощник Министра здравоохранения Российской Федерации

Рахмановский пер, д. 3, г. Москва, 127994

Artyom I. Panin – Adviser Minister of Health of the Russian Federation

Rakhmanovsky Lane, 3, Moscow, 127994

https://orcid.org/0000-0002-5044-4836ЧигринаВ. П.ChigrinaV. P.

Чигрина Валерия Петровна – ведущий специалист управления стратегического развития здравоохранения

ул. Добролюбова, д. 11, г. Москва, 127254

Valeriya P. Chigrina – Leading specialist, Department of Strategic Health Development

Rakhmanovsky Lane, 3, Moscow, 127994

chigrinavp@mednet.ruhttps://orcid.org/0000-0002-9174-6419ТюфилинД. С.TyufilinD. S.

Тюфилин Денис Сергеевич – начальник управления стратегического развития здравоохранения

ул. Добролюбова, д. 11, г. Москва, 127254

Denis S. Tyufilin – Head of the Department of Strategic Health Development

Rakhmanovsky Lane, 3, Moscow, 127994

ХодаковаО. В.KhodakovaO. V.

Ходакова Ольга Владимировна – д-р мед. наук, начальник отдела научных основ организации здравоохранения

ул. Добролюбова, д. 11, г. Москва, 127254

Olga V. Khodakova – Dr. of Sci. (Medicine), Head of the Department of Scientific Foundations of the Health organization

Rakhmanovsky Lane, 3, Moscow, 127994

https://orcid.org/0000-0002-4449-4810ДеевИ. А.DeevI. A.

Деев Иван Анатольевич – д-р мед. наук, профессор, директор Департамента мониторинга, анализа и стратегического развития здравоохранения

Рахмановский пер, д. 3, г. Москва, 127994

Ivan A. Deev – Dr. of Sci. (Medicine), Professor, Director of the Department of Monitoring, Analysis and Strategic Development of Healthcare

Rakhmanovsky Lane, 3, Moscow, 127994

https://orcid.org/0000-0003-0098-1403КобяковаО. С.KobyakovaO. S.

Кобякова Ольга Сергеевна – д-р мед. наук, профессор, директор

ул. Добролюбова, д. 11, г. Москва, 127254

Olga S. Kobyakova – Dr. of Sci. (Medicine), Professor, Director 

Rakhmanovsky Lane, 3, Moscow, 127994

Министерство здравоохранения Российской ФедерацииРоссияMinistry of Health of the Russian FederationRussian FederationФГБУ «Центральный научно-исследовательский институт организации и информатизации здравоохранения» Министерства здравоохранения Российской ФедерацииРоссияRussian Research Institute of HealthRussian Federation20242101202554519Copyright © Мурашко М.А., Панин А.И., Чигрина В.П., Тюфилин Д.С., Ходакова О.В., Деев И.А., Кобякова О.С., 20252025Мурашко М.А., Панин А.И., Чигрина В.П., Тюфилин Д.С., Ходакова О.В., Деев И.А., Кобякова О.С.Murashko M.A., Panin A.I., Chigrina V.P., Tyufilin D.S., Khodakova O.V., Deev I.A., Kobyakova O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.natszdrav.ru/jour/article/view/408

В настоящее время ситуация с регулированием телемедицинских технологий (ТМТ) в мире складывается поразному. Цель – провести аналитический обзор организационно-правового регулирования оказания медицинской помощи с применением ТМТ в системах здравоохранения Российской Федерации и зарубежных стран. В итоговую версию обзора включили нормативное правовое регулирование 22 систем здравоохранения зарубежных стран. По результатам проведенного нами обзора можно выделить ключевые организационно-правовые аспекты оказания медицинской помощи с применением ТМТ в зарубежных странах: отсутствие полноценного нормативного правового регулирования применения ТМТ при оказании медицинской помощи в большинстве зарубежных стран; возможность установления диагноза в рамках телемедицинских консультаций (ТМК) только после предварительного очного приема врача; проведение ТМК только лицензированными медицинскими работниками и медицинскими организациями; возможность проведения ТМК через общедоступные информационные платформы и специально разработанные государственные платформы; обязательное информирование пациента о преимуществах и недостатках ТМТ перед проведением консультации, а также получение информированного согласия в устной или письменной форме; обязательное соблюдение стандартов и рекомендаций в ходе проведения ТМК, применяемых и при очном приеме пациента. Проведенный нами анализ свидетельствует о широком применении ТМТ в зарубежных странах. При этом наблюдается отсутствие четко установленных как организационных, так и правовых критериев оказания медицинской помощи с применением ТМТ, что обусловливает необходимость дальнейшего изучения международного опыта и выделения лучших практик, которые могут быть масштабированы на территории Российской Федерации.

The global telemedicine technology (TMT) regulatory landscape is currently evolving in a number of ways. The goal is to carry out an analytical examination of the institutional and legal frameworks for medical treatment including telemedicine consultation (TMC) in Russian Federation and foreign countries. The regulatory legal regulation of 22 international healthcare systems was included in the final version of the review. The review’s findings allow for the identification of the most important organizational and legal facets of delivering healthcare via TMC abroad: the majority of foreign nations lack comprehensive legal regulations governing the use of TMT in healthcare; the ability to establish a diagnosis within the context of TMC only follows an initial in-person consultation with a doctor; conducting TMC exclusively by licensed medical professionals and medical organizations; the option to conduct TMC via government-designed platforms and publicly accessible information platforms; requiring the patient to be informed about the benefits and drawbacks of TMT prior to consultation and to provide written or verbal informed consent; and requiring adherence to standards and recommendations during TMC, application, and in-person admission of the patient. The analysis demonstrates how commonplace TMC is abroad. However, there are currently no well-defined organizational or regulatory requirements for the use of TMC in the delivery of medical care, which calls for additional research into global experience and the identification of best practices that may be expanded throughout the Russian Federation.

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The authors declare that there are no conflicts of interest present.