Council regulates distance medical care, and price will be the same as face-to-face

The CFM (Federal Council of Medicine) publishes this Thursday (5) in the Official Gazette of the Union the regulation of telemedicine in Brazil. The rule will replace another one from 2002 that was in force until today.

The text establishes the rules for distance service, disciplining the different modalities and defining that this type of action is auxiliary. Remote consultations cannot be cheaper and must have the same price as face-to-face consultations.

“We are going to encourage face-to-face consultations. Telemedicine will be used at times when there is perhaps no specialist nearby. [Mas] we will continue to encourage face-to-face consultation”, said the president of CFM, José Gallo.

Any problems involving telemedicine will be supervised by the Regional Councils of Medicine (the CRM). “The councils will stand sentinel to see what might happen,” he explained. The doctor who performs consultations or other remote procedures will only need to be registered in the CRM of the state where he lives.

The resolution does not make remote service mandatory. Adherence will depend on health managers, whether private or public, and physicians. To carry out a remote consultation, the patient and the healthcare professional must sign a consent form.

To create the standard, the CFM carried out a public consultation and was inspired by the model in England, a country that also has a universal public health system and where 10% of care is provided remotely.

Federal councilor Donizetti Giamberardino, the text’s rapporteur, says that the country’s inequalities, with poor distribution of doctors and in different concentrations in each region, are obstacles to serving the population.

“In this sense, is the importance of telemedicine in bringing due access”, said Giamberardino, who, however, did not estimate how the penetration of the modality would be in Brazil.

“In supplementary health systems, today we see a use of telemedicine, but also with contracted doctors and not by production. There is also the use in the office, where we still do not see great interest in accrediting doctors for telemedicine consultation”, he evaluated.

The scenario, however, may change. “Many people had an opinion in March 2020 and changed it in March 2022”, he said, referring to the Covid-19 pandemic – which has led many people to seek distance consultations to maintain social isolation.

The emergence of Covid-19 was even the catalyst for regulation. “With the pandemic, there was a real need for this modality of medicine practice, with the need to establish ethical criteria within this normative”, pointed out the first secretary of the CFM, Hideraldo Cabeça.

The resolution defines seven modalities of distance procedures: teleconsultation (when a doctor sees a patient); teleinterconsultation (when two doctors talk remotely to discuss professional issues); telediagnosis (use of the internet to transmit reports and analyze exams); telemonitoring (monitoring of the patient’s clinical evolution); teletriage (when the patient’s hospitalization is regulated remotely); telesurgery (which involves the use of remotely operated robots for surgery); and teleconsulting (guidance given by the doctor to the patient).