The advancement of technology has influenced every sector, including the healthcare industry. In this context, innovative approaches like telehealth services have not only transformed healthcare services but have also sparked ethical debates. In this article, we will briefly explore telehealth services, its legal framework in Türkiye, advantages, and the views of the Turkish Medical Association (TTB) regarding remote healthcare.
- Legal Framework in Türkiye
With the emergence of the COVID-19 pandemic, the presentation of remote healthcare services gained significant attention from the Turkish Ministry of Health (MoH), especially considering the challenges posed by the pandemic, making hospital visits difficult for individuals. Consequently, private hospitals began offering online healthcare services to patients. To address potential legal gaps in this area, the MoH issued the “Regulation on the Presentation of Remote Healthcare Services” on February 10, 2022. However, this regulation has faced criticism due to concerns about its alignment with constitutional rights, with some arguing that it should have been prepared by the Turkish Grand National Assembly rather than solely by the Ministry of Health.
Within the scope of this regulation, a remote healthcare information system infrastructure will be developed or authorized by the MoH. Healthcare centers will employ this healthcare information system for written, voice, or video communication. The remote healthcare information system infrastructure developed will be registered in the MoH’s database.
Consequently, individuals seeking remote healthcare services can be examined to the extent allowed by the service. Their medical observations, monitoring, evaluation, and diagnoses of diseases can be conducted remotely, alongside providing medical consultation. When necessary, individuals may be recommended to physically visit a healthcare facility.
- Advantages of Telehealth Services
Below, we have outlined the primary three advantages of telehealth services.
- Improves Patient Engagement:
Telehealth services enable patients to actively monitor and manage their health conditions. This approach helps patients to become more engaged with their health outcomes and take responsibility. Patient-healthcare professional interaction increases through regular remote monitoring and consultation. Patients can establish more consistent and personalized communication with healthcare providers, which aids them in effectively managing their health.
- Expands Healthcare Services to More Patients:
Telehealth services overcome geographical limitations, allowing access to a wider range of patients. Individuals living in remote areas or with limited access to healthcare can communicate with expert healthcare professionals through telehealth services. As a result, healthcare providers can reach a larger patient base and distribute healthcare services more equitably.
- Cuts Patient Costs and Positively Impacts Patient Experience:
Telehealth services reduce the need for patients to physically travel to healthcare facilities, minimizing travel time and waiting periods. This reduction in travel-related expenses and time commitments lowers patient costs and enhances the healthcare experience. Additionally, early intervention in health issues through remote consultation and monitoring can prevent serious complications and reduce treatment costs.
In conclusion, telehealth services offer numerous advantages in the delivery of healthcare. They enhance patient engagement, broaden access to healthcare services, and contribute to cost savings while positively impacting the patient experience. These benefits are valuable gains for both patients and healthcare providers.
- Ethical Approach of the Turkish Medical Association on the Matter
TTB has shared its views on the regulation regarding the presentation of remote healthcare services on its web site on April 3, 2022. In summary, the TTB has indicated that the provision of remote healthcare services contradicts the 23rd rule of the Medical Profession Ethics Rules, which states that a physician cannot initiate treatment without a personal examination, as well as the 32nd rule, which allows a physician to issue reports to patients they have personally examined and treated. In the TTB Ethical Committee Opinion on telemedicine applications, it has been emphasized that only remote applications consistent with in-person services, complying with professional standards, respecting patient rights, and adhering to the universal values of the medical profession, can be used to access the right to healthcare.
Regarding the protection of personal data and patient confidentiality, in line with the TTB ethical committee’s opinion that we also agree with, it is necessary to clarify aspects such as how, where, and for how long data collected before establishing a telemedicine relationship will be stored, whether they will be processed, who will have access to this information, and how their privacy will be protected. Furthermore, the TTB has rightly emphasized the importance of ensuring a private environment for maintaining patient confidentiality and dignity during the provision of healthcare services, as well as preventing third parties from monitoring the process during telemedicine applications without the patient’s consent.
- Conclusion
The TTB’s ethical committee opinion on telemedicine applications should not be overlooked. However, when considering the beneficial effects of these services on patient well-being, it becomes evident that they hold great potential for improving healthcare accessibility and quality. Therefore, the expansion of remote healthcare services should be encouraged, keeping in mind the ethical considerations put forth by the TTB. In addition, just like the American Medical Association (AMA), the TTB should establish ethical guidelines for healthcare professionals providing remote health services, in line with the advancements in technology. This way, healthcare professionals can provide higher quality services to patients within the framework of principles set by their professional association, in addition to the existing regulation.
With a focus on maintaining patient privacy, data security, and professional integrity, the utilization of remote healthcare services could lead to a more inclusive and patient-centered healthcare system. As technology continues to evolve and the demand for accessible healthcare grows, a collaborative effort between medical professionals, regulatory bodies, and technological innovators can pave the way for a future where telehealth becomes an integral part of healthcare delivery.
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