Measures needed to make e-healthcare run smoothly in Lithuania

During the COVID-19 crisis, increased demand for remote health care services in Lithuania has been clearly visible. It is in the interest of both patients and healthcare providers that such services can be provided after the quarantine; however, this requires changes to the existing legal framework.

Use of remote healthcare services has increased by 68 times this year, compared to the same period last year. Clearly, the increased use of the remote healthcare services has been driven by restrictions on providing regular healthcare services during the quarantine and due to the COVID-19 crisis.

As patients and healthcare providers have already discovered the benefits of e-health, they are not only willing to continue using it after the quarantine is over, but are also making plans on expanding the variety of remote healthcare.

This means that legal regulation of telemedicine should find a way to catch up with the reality in Lithuania. So what are the main triggers for smooth e-healthcare and what measures could facilitate the processes? Here are some ideas:

  • There is no adequate legislation in relation to e-healthcare. Let’s start, for example, with the definition of “Telemedicine” – it is only defined in terms of doctor-to-doctor consultations. As regards remote doctor-to-patient healthcare services, the regulation only enables continuous primary healthcare services. At the moment healthcare services provided by a medical specialist, nursing services, etc. are only allowed by the orders of the Minister of the Health, the State-level Emergency Manager. This means that this regulation will expire after the quarantine is over.
  •  E-health regulation should aim to establish rules for safe use of e-health services – not to restrict their use. Remote consultations by medical specialists, remote patient monitoring, remote use of diagnostic devices – these are all now possible thanks to technology. Applicable laws should allow (not restrict) easy and safe access to e-health services.
  •  E-health regulation should clearly address whether e-health services would be tantamount to “regular” healthcare services. This is important in terms of setting rules for compensating costs of e-health services from the national health insurance fund or private insurance companies, also for liability for damage sustained by patients (and third parties) during or following remote medical diagnostics or treatment, or as a consequence of remote medical advice.
  •  E-health services could be more efficient if unanimous use of the electronic health system was adopted. The IS EHSCI – Information system for electronic health services and collaboration infrastructure (in Lithuanian: ESPBI IS – elektroninės sveikatos paslaugų ir bendradarbiavimo infrastruktūros informacinė sistema) was intended to combine various data registers, store electronic health records, utilize functions of e-prescriptions, as well as establish a database of medical images. However the IS EHSCI is still being used to a limited extent (by patients as well as by healthcare providers). Improved use of IS EHSCI could facilitate e-health services, minimize repeat services for patients and bring other benefits.
  • Proper attention should also be paid to adequate assistance to healthcare professionals. New possibilities and modern methods in e-health place more responsibilities on the shoulders of professionals. Hospital administrators and legislators should provide training, guidelines and other assistance that professionals need.