According to the Smart Ranking study, in 2024, the telemedicine segment grew by 35% compared to 2023 and accounted for 30% of the total medtech market in Russia. Let’s talk about the reasons for the demand, technological features and limitations of remote medical services.
Prerequisites for the growth of telemedicine services
The government drew attention to the technology of providing remote medical services back in the mid-2010s: for example, in 2017, Federal Law No. 323-FZ “On the Basics of Public Health Protection in the Russian Federation” introduced Article 36.2 “Specifics of medical care provided using telemedicine technologies”, and the Ministry of Health issued Order No. 965n “On approval of the procedure for the organization and provision of medical care using telemedicine technologies”. At that time, prerequisites for the introduction of telemedicine systems began to appear on the market: in particular, there was a need to improve the quality of medical care and monitor the health indicators of patients living in remote and hard-to-reach areas of the country.
However, the main factor that influenced the massive spread of telemedicine services in Russia was, of course, the COVID-19 pandemic, when in 2020-2021 it turned out to be impossible for many patients to visit a doctor alive. Since a large proportion of deaths caused by the coronavirus were associated with complications in patients at risk, telemedicine has become an important tool for detecting signs of the disease and reducing mortality: for a certain period, remote primary care was even officially equated to face-to-face care.
Today, the situation has stabilized, but telemedicine is still in demand. According to a recent statement by the Minister of Health Mikhail Murashko, the number of telemedicine consultations in the country has increased 5 times recently. We believe that this is due to both social and technological factors.
Firstly, people have seen the benefits in practice and appreciated the availability of remote admission — an effective alternative to visiting a clinic, which is not always convenient, and sometimes even impossible. A culture of telemedicine consumption has developed in the industry, and it has begun to be perceived as a service that makes life easier, just like courier services or ordering a taxi through an aggregator.
Secondly, telemedicine is one of the growth points for commercial clinics, offering prospects for additional revenue related both to the provision of the service itself and to an increase in the level of patient loyalty. The practice of using telemedicine services has accumulated — companies understand what opportunities they have and what risks they need to consider. They are ready to invest in this area and cooperate with developers of specialized services and information systems.
Thirdly, telemedicine largely removes territorial restrictions for both patients and doctors, increases patient involvement in the treatment process, improves the quality and continuity of medical care, and stimulates the development of the labor market. For example, a qualified medical specialist living in a remote region can use his help to gain more opportunities for professional growth, as well as to provide care to a significantly larger number of patients, even if they are located in another region.
Fourth, the technological provision of telemedicine services has improved significantly recently: more special equipment (wearable medical devices, sensors, video communications, etc.) has appeared on the market, public and private medical organizations are introducing multifunctional medical systems, and creating automated workplaces for doctors. The development of digitalization in the country is also affecting: the coverage of the high-speed data transmission network is expanding, mobile devices are becoming more advanced and accessible, and citizens are increasing their level of digital maturity.
The relevance of telemedicine for the Russian healthcare system is confirmed by the fact that in April of this year the Ministry of Health of the Russian Federation released Order of 04/11/2025 No. 193n, which invalidates Order No. 965n and approves a new procedure for the organization and provision of medical care using telemedicine technologies. In particular, it optimizes algorithms for remote consultations and patient monitoring, and mentions systems for supporting medical decision-making based on AI technologies.
The main nuances of telemedicine
A telemedicine consultation (TMC) can replace a full-time doctor’s appointment today. However, it has several important limitations. So, if MRI is primary, during its course the doctor does not have the right to make a diagnosis (except for a number of emergency cases prescribed in the legislation), make medical reports and prescribe treatment. This type of service can be used, for example, to receive general recommendations or for routing — the doctor can determine whether an urgent hospitalization is needed, an emergency call is needed, or you can schedule an appointment with a specific specialist.
More options appear if the remote appointment is a continuation of the face-to-face treatment, when the doctor has already diagnosed, prescribed treatment, and prescribed prescriptions. In this case, he has the opportunity to monitor the dynamics of the treatment process and adjust therapy, select a new dosage of medications, and clarify prescriptions.
As part of any remote appointment, the patient must be provided with a telemedicine consultation protocol, a legally significant document signed with the electronic signature of the doctor. Only after that, according to the law, the consultation is considered completed.
The collection, processing, transfer and storage of personal data must be organized in accordance with the requirements of legislation in the field of information security described in Chapter 2 of Federal Law 152-FZ “On Personal Data”. For example, medical organizations use special secure communication channels for consultation and data exchange (video and audio streams, text messages and files between patients and doctors), and reliable data centers located inside a secure information circuit for storage. Today, there are many high-quality services on the market that allow to organize a secure communication channel for communication between a doctor and a patient, using domestic information security tools.
The clinic has the opportunity to connect the telemedicine consultation service either directly through a trusted developer or through its own MIS. When choosing a contractor, it is important to take into account such service criteria as safety, convenience for all participants (doctor-patient and doctor-doctor consultations), and versatility, that is, it should cover all the needs of both the medical organization and the patient.
Prospects of telemedicine in Russia in 2025
According to our forecasts, the telemedicine industry in Russia will continue to develop actively in 2025. Analysts at Sberzdorovyie note that over the past 4 years, the demand of citizens for online medical consultations by otolaryngologists has increased almost 19 times, cardiologists — almost 20 times, traumatologists — 25 times, and in general, 85% of large clinics in Russia have already implemented certain telemedicine services. This trend will continue, and the variety of technologies will expand. Already, various providers are engaged in providing remote services such as “medical concierge” (intermediary services between a patient and a doctor), pregnancy monitoring, psychological support, ordering laboratory diagnostic services and consulting a doctor
In our opinion, the issue of personal data security will be increasingly regulated in the healthcare industry in the coming years. Both telemedicine system vendors, medical organizations, and patients will pay more attention to ensuring confidentiality when providing remote consultations.
Users of digital products are becoming more demanding. The importance of the factors of convenience and functionality of the system for conducting telemedicine consultations when choosing this type of service by the patient will increase.
It is also worth paying attention to the fact that, in addition to the format of doctor-patient interaction, telemedicine technologies provide other routes, for example, doctor-doctor. In our opinion, this route will also be actively developing in the coming years. Remote communication between medical specialists can be used both in consultations and, for example, in complex operations, when an experienced colleague or a doctor of another specialization is watching the surgeon’s actions via video link, ready to give a qualified recommendation at any time.
It is no coincidence that the new Order of the Ministry of Health of the Russian Federation dated 04/11/2025 No. 193n, which comes into force on September 1, pays great attention to the possibilities of using AI-based medical decision support systems. Now they can be legitimately used for conducting consultations of doctors in real time and deferred consultations, for obtaining and processing patient health data, and remote monitoring.
Thus, today in Russia there is a wide practice of using telemedicine technologies, supported by a legislative framework that takes into account modern technological trends. As remote consultations become more functional and convenient, patients’ trust in them is growing. Conducting consultations of doctors using telemedicine services is also a promising area that will improve the quality and speed of medical care. However, it is worth remembering that telemedicine services will not be able to replace the initial face-to-face doctor’s appointment.
By Vlas Shishin, Head of Telemedicine Systems Development at ElNetMed (N3.Health integration platform)