Why is telemedicine a challenge to the regulators?

Regulators feel that telemedicine presents challenges. In part this is because of the assumption that telemedicine is new and unproven, and must therefore be regulated in order to protect the patient. Regulation requires clear and careful definition of what is to be regulated. The Health Professions Council of South Africa’s proposed definition of telemedicine has deficiencies. Telemedicine is not new, nor is it a special discipline or a new branch of medicine. It involves the use of information and communication technologies in the provision of health care over distance. This includes the telephone. Instead of proposing a one-size-fits-all approach to regulations and guidelines, a more pragmatic approach to issues such as signed, written consent, prior doctor-patient relationship and licensure is required. It is proposed that regulators should seek to find deficiencies in existing guidelines and regulations and address these if required, and that clinical, operational and ethical guidelines should be developed by the governing bodies or associations of the various clinical disciplines using information and communication technologies in the provision of health care. An enabling regulatory environment is required if we are to realise the goals of improved access, service delivery and quality of care for the rural communities of South Africa through telemedicine.