Telemedicine market barriers and drivers

The telemedicine market in Russia is one of the fastest growing. But together with specialists and patients who appreciated the benefits of remote consultations, there are opponents of remote visits to doctors. In what areas of health care is telemedicine already actively used and what distribution will it receive in Russia in the next five years?

Growth of telemedicine due to pandemic

It seems to many that the concept of “telemedicine” arose literally in recent years. In fact, the technology of remote consultation with a doctor via the Internet appeared back in 1996. The first Russian company in this area started to work in 2012. However, telemedicine was seriously developed only during the coronavirus pandemic in 2020.

Why was its spread so slow? The main reason is the conservatism of doctors and patients. The doctors believed that no Internet could replace a personal examination, and the patients agreed with them. By 2018-2019, several telemedicine services were already operating in our country, but their total patient coverage was very small.

In 2020, the situation has changed “because of despair”. Doctors had to practice reception on the Internet, and patients had to forget their prejudices about this. And after the end of the pandemic, telemedicine became familiar – its popularity is growing.

Remote pre-trip inspection

I got into telemedicine largely by accident. My company has a pre-trip driver inspection service. According to the law, drivers of corporate fleets must undergo medical examinations before the start of each working day.

But it is not so easy for employers to comply with these laws. Pre-trip inspections can only be carried out in a certified office, and it is expensive to create it at the enterprise. Then we came up with a mobile inspection point – a minibus that comes to the enterprises of our clients. But even such points could not completely solve the problem.

The way out of the situation was a remote inspection. We assemble the device for its implementation ourselves. It can record temperature, pressure, pulse and blood alcohol content. All indicators are transmitted to our health worker, who digitally signs the results and issues a trip permit.

In addition to the data, the medic receives a video. Some drivers try to cheat the system and send another person in their place. The medic looks at the video whether the person is being examined, or there is a substitution.

Pre-trip examination is not quite a “classic” telemedicine, in which the patient and the doctor see each other on the screen and can communicate with each other. The tasks are also different: not treatment, but admission or non-admission to the line. Another important difference is that the doctor does not have the right to make diagnoses remotely. For pre-trip inspections conducted remotely, the law of 2023 makes an exception. Many experts consider this a breakthrough in the entire field of telemedicine.

Remote technology has largely changed the approach to pre-trip inspection. Firstly, now inspections can be carried out absolutely anywhere where there is Internet and electricity.

The second point – the “soulless machine”, which takes data on the state of human health, cannot be influenced. It sends all scan results instantly to the system. And if alcohol is found in the driver, the director of the enterprise receives immediately a corresponding SMS.

According to our statistics, cases of detected alcohol account for no more than 10% of driver suspensions from flights. Most of the inadmissibility is associated with high blood pressure. Many drivers suffer from this ailment.

If there are hypertensive drivers on the staff, we offer clients an on-site consultation with our therapist. He can make a diagnosis and prescribe treatment. We can also issue a document that expands the boundaries of the blood pressure norm for each specific driver, if there is a medical indication.

Our contribution to remote medicine

Already this year we plan to enter a new area for our company – “classic” telemedicine for private clients. Its prospects, in my opinion, are simply enormous.

I believe that to some extent it can solve one of the main problems of Russian medicine – a huge difference in the quality of medical services between Moscow and the regions. In provincial cities and towns, it is extremely difficult to get appointment to a good highly specialized doctor, get an adequate prescription, and monitor the results. Telemedicine makes the best “metropolitan” doctors more accessible to residents of other cities.

Now there is more and more equipment that facilitates the work of “remote” doctors. For example, special “pens” with a video camera and lighting – they help ENT doctors. The patient can take a video of the ear, throat or nose himself, and the doctor can see the picture through the application and give recommendations. In fact, this is a full-fledged technique at ENT, only at a distance. There are already devices for remote listening to the lungs, measuring saturation (oxygen content in the blood) and even taking an ECG.

Our task is to create a “bundle” of such devices and apparatus that will interact with each other. Many other companies are also engaged in the development of such systems. Diagnostic devices integrated with analytical programs have already appeared on the world market. They are gradually entering the Russian market, but we still have something to strive for.

Prospects for the telemedicine market in Russia

A feature of our time is the longevity trend. There is only one way we can achieve it: early prevention. The easiest way to identify problems in the body at the initial stage is a wearable device. AI analyzes all indicators and gives recommendations: how to eat, how to sleep, what to eat, which doctor to contact, and so on.

Technology is developing very quickly. Already today, using a conventional camera, it is possible to assess the microcirculation of the skin and, based on this, calculate pressure, pulse, and other indicators. Entrepreneurs are actively investing in this industry, and we are no exception. I think telemedicine in its development will outstrip even the most daring forecasts.

In 2023, the state launched a pilot project with the participation of private medical centers: their specialists conduct remote consultations. Any medical center that meets certain criteria and submitted an application can take part in the “pilot”. Now there are already 30 such clinics. Three years have been allocated for data collection and analysis. In 2026, the results will be discussed at a round table with the participation of several ministries. It will draw conclusions about the effectiveness of this method and the further development of legislation in this area. Probably, by 2029-2030 we will receive a full-fledged law that will allow remote diagnoses and treatment.

I would like to change the foundations of the medical services market altogether. This idea came to me a year ago. Now the patient goes to the clinic or to a private medical center to the doctor on almost any medical issue. In the future, the bulk of communication with a doctor will take place remotely, via the Internet. And the medical center will remain for global research or surgery.

An important reason for full-time treatment is an acute failure in the body, which requires a doctor’s consultation. There are two problems here: finding the right specialist and collecting all the necessary medical diagnostics in some device. Then, based on these data, the doctor will be able to remotely diagnose and prescribe treatment.

Telemedicine can and should be invested. A potential investor should start by traveling to China for a medical exhibition. There he will understand what is offered in the field of “remote” diagnostics. It is worth choosing a proven and successful device. Then the investor registers it in Russia and begins to produce the device’s casing, buying the rest from the Chinese.

There’s a whole community of people who develop similar business stories. These people are from different spheres: IT specialists, entrepreneurs, doctors. It seems to me that they need to be united, and this will give a new impetus to the development of telemedicine in our country.

By Sergey Vinogradov, founder and CEO of Pre-Trip

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