CYIL vol. 14 (2023)

CYIL 14 (2023)

TELEMEDICINE IN THE CZECH REPUBLIC AND THE CONVENTION …

b) Provision of telemedical services by a health services provider who already has the patient in their care.

From the legal perspective, this type of situation is the least problematic. Providers and their patients can benefit from the options telemedicine offers (such as telemonitoring) for refining diagnosis, evaluating and adjusting the patient’s treatment, carrying out consultations replacing some of the outpatient personal visits, etc. Some hospitals have already been running larger projects focusing on telemedicine in this sense. 15 It is the only form of telemedicine that is approved by the official position of the Czech Medical Chamber, 16 a medical association

with obligatory membership of all practicing physicians in the country. c) Provision of telemedical services by a health services provider who has not yet had the patient in their care.

In spite of the efforts of some relevant agents – including the above-mentioned Czech Medical Chamber – to limit telemedical services exclusively to providers who already have the patient in their care (or to services based on the indication of such a provider), 17 the provision of telemedical services by other providers is still legally permitted. However, given the level of legal uncertainty that exists in this area, such services can be safely provided only to a limited extent. Since the above-mentioned amendment to Act on Health Services from early 2022, a provider who does not “physically” care for the patient can safely provide consultation services (including the second opinion) remotely. However, they may not exceed this limitation; in particular, they are not allowed to remotely determine the basic diagnosis and make clinical decisions on the course of treatment. 18 Based on the amendment to the Act on Health Services proposed in the bill of 2023, providers who do not have the patient in their “physical care” will be allowed to provide partial services within the framework of diagnosis and treatment. The condition is that these partial activities fall within the scope of telemedical health services which can be provided outside a medical facility, as we have cited their proposed definition above. As a result, the provider will be able, for example, to remotely evaluate the outcomes of imaging methods or monitor and evaluate the patient’s telemetric data. For this purpose, the necessary patient data may be shared with the telemedical services provider. Compared to the existing legislation, the said change introduces an element of legal certainty into these telemedical services. 2. Comparative Remarks The emerging nature of telemedicine, coupled with a lack of specific regulations at both European and international levels, results in a variety of approaches across different 15 See for example Národní telemedicínské centrum. [The Czech National EHealth Center.] Fakultní nemocnice Olomouc. [Olomouc University Hospital.] accessed 25 August 2023. 16 See for example Ministerstvo chce legalizovat telemedicínu, sešly se desítky námitek. [The Ministry Wants to Legalise Telemedicine, There Are Dozens of Objections.] Medical Tribune. (14 February 2023.) accessed 25 August 2023. 17 See ibid. 18 See ŠUSTEK, P., ŠOLC, M. Principy GDPR a legální aspekty distanční medicíny. [Principles of GDPR and Legal Aspects of Remote Medicine.] In TÁBORSKÝ, Miloš (ed.). Digitální medicína 2022. [Digital Medicine 2022.] EEZY Publishing, Praha 2022, p. 64.

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