Teleconsultations

Teleconsultation is a remote consultation between a healthcare professional and a patient by means of a secure ICT solution that allows synchronous communication between the parties via telephone, video or web chat. Teleconsultation can be used instead of a contact consultation, i.e. it is an alternative way of offering medical consultation.

The aim of teleconsultations is to provide patients with a more convenient way to receive healthcare, while ensuring continuously high quality of the service. The healthcare provider will have the opportunity to introduce technological solutions that simplify the work process, and healthcare professionals will have the opportunity to organize their work more flexibly. Based on the available evidence, teleconsultations will potentially improve patient’s adherence and outcomes, reduce the number of non-attendances, the duration of consultations, the number of re-hospitalizations and hospital bed days, etc.

Implementation of teleconsultations contributes mostly to the development of the following areas in the health care system:

• PATIENT FOCUS - Patients are equal partners in solving their health problem, and taking their needs into account is important.
• COST-SHARING - Reduction of patient’s and their family member’s co-payment in result of reduced time and money spent on travel to the appointment.
• ACCESSIBILITY - Reduction of regional inequalities through improved access to health care in rural areas and quality convergence.
• INTEGRATED CARE PATHWAY - Supporting the concept of integrated care pathway by creating more opportunities for care pathway planning.
• EQUAL OPPORTUNITIES - Equalizing the selection of the health services market with other EU Member States.
• DEVELOPMENT OF HEALTH TECHNOLOGIES - Promoting the enterprises specialized in the development of health technologies in Estonia.

Teleconsultations are compensated to service providers by EHIF if the following conditions are met (unless otherwise specified):

1. In terms of content, teleconsultations are equal to contact consultations, i.e. the quality of health care is maintained or improved compared to contact consultations;
2. Teleconsultation is considered appropriate by the healthcare professional conducting or referring the patient to a teleconsultation session to address the patient's health problem;
3. When planning a teleconsultation, technical readiness of the patient to participate in the consultation session has been assessed as sufficient;
4. Teleconsultation is carried out with the patient's consent, which is documented;
5. Teleconsultation takes place at an agreed time and form, as synchronous communication;
6. The ICT solution used for teleconsultations should comply with the principles provided by legislation (including the Personal Data Protection Act, the General Regulation on Personal Data Protection);
7. The patient participating in the teleconsultation is identified, which is the responsibility of the healthcare provider.

Teleconsultation is not a contact for which a health care professional would not otherwise invite a person to a contact consultations:

1. making, changing or cancelling an appointment;
2. notifying of the issue of a referral;
3. notifying of a negative screening result;
4. notifying of test and/or examination results without the need for treatment reorganization and/or counselling;
5. issuing a repeat prescription without specifying treatment instructions.

Teleconsultations can be provided by:

1. medical specialists on recall (recurring appointment)
2. nurses at a medical specialist (incl. family physician) or midwife referral (in specialties where a referral is not required also at a nurse's recall)
3. midwives at a medical specialist (incl. family physician) referral or at a midwife’s recall
4. clinical psychologists, physiotherapists, occupational therapists and speech therapists. Read more here.