New regulations expanding the scope of telemedicine and the issuance of prescriptions are to take effect on July 1, which are expected to benefit millions of people, the Ministry of Health and Welfare said yesterday.
The ministry has amended the Rules of Medical Diagnosis and Treatment by Telecommunications (通訊診察治療辦法) that would add five special circumstances in which telemedicine would be allowed, as well as ease the rules on issuing prescriptions and expanding the types of healthcare services provided through telecommunications.
According to Article 11 of the Physicians Act (醫師法), physicians may not treat or issue prescriptions or a certificate of diagnosis to people they have not examined in person, Minister of Health and Welfare Hsueh Jui-yuan (薛瑞元) said. However, they may use telemedicine to treat people residing in certain areas (such as mountainous or remote areas) or under special or urgent circumstances, Hsueh added.
Photo: Chiu Chih-jou, Taipei Times
As telemedicine became more widely used during the COVID-19 pandemic and is becoming a new normal for healthcare, regulations have been carefully modified to expand the special circumstances in which it might be used, he said, adding that it is expected to benefit up to 2.47 million people.
The five new special circumstances cover patients in a chronic care program, under hospice care, institutionalized at correction agencies, under disability care or under care for illness or injury from a disaster, infectious disease or other major incidents, Department of Medical Affairs Director-General Liu Yueh-ping (劉越萍).
These would bring the total number of circumstances eligible for receiving telemedicine to 10.
However, not all patients in any of the 10 circumstances are directly eligible for telemedicine, Hsueh said.
They must also be included in one of two categories: programs approved by the local health department and National Health Insurance (NHI) bundled payment programs.
“This means that when healthcare facilities want to provide telemedicine to patients under special circumstances, they must write a proposal and obtain approval” from the competent authority, he said. “It does not mean every patient who fall under any of the 10 special circumstances can directly book a telemedicine appointment with a doctor.”
Physicians who use telemedicine on patients who do not meet these qualifications may be fined between NT$20,000 and NT$100,000 for breaching the Physicians Act, Hsueh said.
The amendments would also allow physicians to issue prescriptions through telecommunication methods under certain conditions, and expand the types of healthcare services they can provide, including medical consultation, physician-to-physician consultation, psychotherapy, and issuing examination and check-up sheets, Liu said.
Asked why the draft amendments were announced last year, but it took almost a year for the ministry to announce their formal implementation, Hsueh said that some clinics expressed concern that the changes would encourage people to ditch clinics in favor of telemedicine consultation in hospitals.
However, clinics have since accepted the changes, as only clinics can provide healthcare services from the NHI bundled payment programs, such as the home-based medical integration program and the family physician care program, he added.
To prepare for the implementation of the amendments on July 1, the ministry is preparing and working on supplementary measures, including the digital NHI card system, e-prescription system, drug delivery method and information security verification standards.
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