Telemedicine is defined by the World Health Organization as “healing from a distance” which includes the use of telecommunications technology and information technologies to provide remote clinical services to patients. Telemedicine takes three primary forms, though several others exist:
- Interactive medicine, which enables patients and physicians to communicate with patients in real time, while maintaining legislative compliance;
- Store & Forward, which allows providers to share patient information with practitioners in other locations; and
- Remote Patient Monitoring, which permits remote caregivers to monitor patients residing at home by using mobile medical devices to collect data such as blood sugar or blood pressure.
Prior to 21 July 2020, there were no laws or regulations that directly governed telemedicine services. As a result, hospitals that wished to provide telemedicine services could freely operate without the need to obtain any specific remote licenses or permission from Thai authorities. They were also free to establish their own internal operating procedures, including security and IT guidelines. While not by any means minimal, telemedicine service providers only needed to adhere to general regulations that were applicable to other services in the medical field, namely the Medical Professions Act 1082, the Public Health Act 2007, the Medical Facilities Act 1998, the Electronic Transactions Act 2001, the National Health Act 2007, and the Personal Data Protection Act 2020 once it comes into effect.
Since which time, the Medical Council of Thailand have issued the ‘Notification on Guidelines in respect to Telemedicine and Online Clinics No. 54/2563’ which came into effect on 20 October 2020. This notification sets out the standards on how telemedicine service providers should operate, however it is not considered law, nor does it carry any legal force as it’s only a notification. Nonetheless, the Medical Council recommends that all practitioners who wish to provide telemedicine services follow the Guideline to avoid issues surrounding safety, security, and the privacy of patients.
In addition to the Guideline, the Department of Health Service Support has prepared and submitted a Draft Notification from the Ministry of Public Health regarding the “Standard Services in respect to Medical Facilities through Telemedicine Systems”. In it, several conditions and requirements for acquiring a license to operate a telemedicine service have been set out, including the fact that only private medical facilities are allowed to operate such services in accordance with the Medical Facilities Act 1998.
According to government sources from the Department of Health Services Support, the Draft is still under revision and amendments surrounding the definition of telemedicine are currently in progress. The current version of the Draft requires any service provider who wishes to operate a telemedicine service to apply for a license and comply with the technical requirements set out in the Draft.
What do the Guidelines and Draft Notification entail?
The Guidelines provided by the Medical Council stipulate that service providers must adhere to the prescribed professional medical standards such as the ‘Professional Standards for Medical Practitioners 2012’ and the ‘Criteria of Knowledge and Skills for the Assessment of License to Practice as Medical Personnel 2012.’ The Guidelines also state that service providers are required to inform patients of their rights, specifically:
- Being informed about the details of their treatment under the telemedicine service
- Making patients aware that not all diseases or medical conditions can be treated through telemedicine services
- Knowing that both the service provider and the patient have the right to reject the use of telemedicine
- Assuring patients that the telemedicine service complies with relevant laws governing medical devices and pharmaceutical practices when using Artificial Intelligence (AI)
The Guidelines also state that service providers must use a reliable IT system in line with international standards which is available for inspection. Likewise, service providers must be cognizant of regulations relevant to collecting data and processing electronic transactions, namely the Personal Data Protection Act 2019 (PDPA) and the Electronic Transactions Act.
Meanwhile, the Draft Notification is expected to yield more influence over the protection of patients’ safety, security, and privacy. The first key consideration is that telemedicine service providers have sufficient healthcare staff to ensure that telemedicine services will not affect the service provider’s traditional healthcare practice. Moreover, the Draft Notification also mandates service providers to install advanced communications and IT systems in line with the standards set out by law. It also requires service providers to file a form with the Department of Health Service Support adding telemedicine to their list of services as well as to monitor their practitioners, procedures, and risks that patients may face. In addition to these upcoming regulations and guidelines, telemedicine service providers must also obtain the relevant licenses required for all medical facilities.
Telemedicine services is an upcoming industry in Thailand which is supplemented by the growing adoption of IT and communication technologies across the health care sector. This is complemented by the Thai government’s ‘Thailand 4.0’ initiative which aims to bolster the country’s competitiveness in the realm of technology and innovation. Having said this, the upcoming regulations surrounding telemedicine signals the government’s support for this growing industry.
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