Telemedicine and e-Health in Russia:
development, challenges and the future
Market research conducted by P&S states that the world telemedicine market was worth an estimated $17.9 billion in 2015, with its growth rate estimated at 18.7% per annum between 2016 and 2022. With this is mind, the question of the telemedicine market in Russia is posed, particularly the development, the challenges and the possible future.
Regulating the telemedcine market in Russia
The Ministry of Healthcare (‘MoH’) of Russia adopted “The Concept of Development of Telemedicine Technologies No 76” on 27 August 2001, thereby attempting to regulate the telemedicine and e-Health market for the first time. This attempt was simply based on a declaration to regulate the market, rather than provide legal regulations, therefore was at that stage only able to provide useful definitions. This included the definition of telemedicine as “medical-diagnostic consultations, administrative, education, scientific measures in healthcare carried out via telemedicine technologies”.
Over a decade later and according to Article 32 (3) of the Law concerning “the basics of Healthcare of the citizens of the Russian Federation”, telemedicine is still not legal or fully regulated, as the law does not allow the provision of remote medical diagnosis or assistance.
An amendment to the law was submitted to the lower house of the Russian Parliament in May 2016, which introduced a more contemporary way in which medical services can be delivered in Russia. (Bill No. 1085466-6 “On Introducing Amendments to the Federal Law “On the Fundamentals of Public Health Protection in the Russian Federation” and Article 10 of the Federal Law “On Personal Data”).
The development of e-health in Russia
Regardless of legislative boundaries, an increased number of Russian pharmaceutical and technology companies are showing an interest in telemedicine and e-health. This is in part due to the very evident development of this sector, but equally the companies see their benefit in participating in e-health while the legislation is being created, making it easier for them to shape the future for themselves.
Large Russian enterprises such as Yandex (a Russian multinational technology corporation specialising in online services and products) and New Medicine (Novaya Meditsina, Новая медицина) have both launched online-consultation services, with which the patient can discuss health issues directly with a doctor. Yandex even went a step further and has created Yandex.Health, a mobile application which allows the user to have a discussion with a qualified doctor online and in turn get sound medical advice. The application has had over 10,000 downloads in Russia alone since November 2016.
Barring Yandex, Doctor ryadom (Доктор рядом, English: Doctor near), also launched its own e-health project in early 2017 and saw similar results. The application has been downloaded 10,000 times and half of the user have a registered account with Doctor ryadom.
While some of these e-health projects are still in their testing phase and only allows patients to have an online consultation with a GP, Ruslan Zaydullin (Director and co-founder of Novaya Medicina), states it will be possible to consult with a specialist in the future.
The interest in the Russian e-health market is not only from the side of Russian corporations, even foreign companies have shown an increased activity. Companies such as Huawei, who provide multi-channel solution for telemedicine, Bayer and Avaya. Particularly interesting, the FIID (Internet Initiatives Development Fund) has focused on developing Russian IT start-ups with the focus on medicine and e-health, while Cisco, a world leader in IT and networking has been supporting the Russian school of telemedicine.
What are the biggest challenges of telemedicine in Russia?
With Russia a few years behind the development of the e-health market of the US and the EU, she has yet to face the challenges, which are dominated by the conservatism of the patients, doctors and healthcare professionals, all of which have will hinder the introduction of current and modern e-health technologies.
The second largest challenge that the e-health sector will have to face in Russia, is the payment for online consultations. The in Russia compulsory medical insurance does currently not cover telemedicine and its services, while the legislation to adjust this can take years to be implemented and come into force. Contrastingly, providers of voluntary medical insurance will see a huge economic benefit of telemedicine due to this challenge.
With the Russian attitude towards telemedicine being customer centric, monetisation will be another challenge for this sector to surmount. At present, companies that provide telemedicine, do so in order to improve their image, or as stated above, improve the patients’ experience. For example, Renessans strahovaniya (Ренессанс страхования, English: Renaissance of Insurance) provides telemedicine as an additional service, which allows for an increase in customer loyalty and the acquisition of new customers, but it is not their main focus.
Additionally, telemedicine and e-health enterprises are now mostly run by IT startups, while clinics and doctors themselves do not see their possibility of monetisation in the telemedicine industry. This is also due to the fact that patients are not necessarily willing to pay for the online consultation service, as much as they may be inclined to pay for a face-to-face appointment. And with the rise of IT startups such as RuHeath, which offers software for the safe storage and management of patients medical information, and Helfine Medical, which offers Russian patients a second opinion from a German doctor, the clinics will fall behind and the market will be shaped by those who are willing to create a new sector and market space.
What is the future of telemedicine in Russia?
As stated by estimations, 15% of the 50 million Russians who apply for medical assistance will do so by using online consultations, therefore proving that telemedicine is in high demand in Russia and will have approximately 7.6 million users in the future. Additionally, the Ministry of Health has confirmed that by 2018, 25% of hospitals will be introduced to online medical technologies.
In terms of the legal ramifications, Denis Shvetsov (Director for the development of the network Doktor ryadom) has stated that if the telemedicine legislation will come into effect in 2017, as it is hoped, by 2018 more than 1 million consultations will be made in Russia. By 2020, the telemedicine market could reach 300 billion Rubles (app. $5 billion).