The document discusses eHealth, telehealth, and regulations surrounding telehealth services. It provides definitions and examples of eHealth and telehealth. Telehealth involves using technology to provide remote healthcare services and exchange medical information. It describes six key areas of telehealth services. The document also discusses the growth of telehealth during the COVID-19 pandemic and barriers to adoption. It provides examples of telehealth regulations in various countries like France, the UK, Australia, the US, Saudi Arabia, UAE, and the need for regulations in Libya. Developing quality standards for telehealth in Libya would require input from all stakeholders.

1. Healthcare and
Technology
Safa Elrais

2. What is ehealth?
ehealth is the use of electronic systems to support healthcare delivery.
Some examples of ehealth include:
● Using electronic health records that can be transmitted online between
services
● Utilising artificial intelligence to review scans
● Using 3D computing to devise suitable treatment plans

3. What is Telehealth ?
Involves the use of telecommunications and virtual technology to deliver
healthcare services remotely outside of the traditional healthcare facility setting
and without a physical presence and examination of the patient.
This term is interchangeably used with telemedicine. However, Telehealth refers
to both clinical and remote non-clinical services, including providing training and
continued medical education for practitioners

4. What is Telehealth ? cont
It is used to exchange patient’s medical information from one site to another via
the available electronic communication platforms such two-way video, email,
smart phones, wireless tools and other forms of telecommunication technology,
Involves patient assessment, diagnosis, treatment, therapy, referral, provider and
patient education and self-care, exchange of health information services via
telecommunications and digital communication technologies

5. Telehealth Services :
6 key areas :
1. Teleconsultation
2. Telediagnosis
3. Telemonitoring (remote patient monitoring)
4. Mhealth (Mobile Health)
5. Telerobotics and robot-assisted services; and
6. Telepharmacy.

6. Pandemic triggered adoption of telehealth !
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7612439/#!po=17.1233

7. Accompanied by changes in people attitude !
https://www.acuitykp.com/blog/telemedicine-trends-in-2022/

8. Accompanied by growth in market !
https://www.precedenceresearch.com/telemedicine-market

11. participants’ perception of the usability of telehealth services during the
COVID-19 pandemic.

12. However , widespread adoption has
been hindered by regulatory, legal, and
reimbursement barriers

13. Why telehealth should be regulated ?
● To provide a quality benchmark for telehealth service providers
● To address the way that services, related procedures and practices are
organised; and the way that risks are addressed.
● To determine the skills, knowledge and competencies that are required by
service staff.
● To define the way in which communication takes place with users and carers.
● To set out requirements that will help to minimise the potential for people’s
privacy or autonomy to be undermined

14. What kind of
regulations should
be discussed ?

15. Majority have no
specific laws for
telehealth .

16. France
This system is governed by articles L. 6316-1 and L. 6316-2 and R. 6316-1 to R. 6316-6 of
the French Public Health Code (the "CSP").
Telehealth is divided into "telemedicine" and "telecare".
On one side, "telemedicine" is defined as "a form of remote medical practice using
information and communication technologies" that "brings a medical professional into
contact with one or more health professionals, among themselves or with the patient and,
where appropriate, other professionals providing care to the patient".
Telemedicine is therefore aimed at "medical professionals" (doctors, dental surgeons and
midwives).

17. France
On the other side, "telecare" is defined as "a form of remote care practice
using information and communication technologies", which "connects a
patient with one or more pharmacists or medical auxiliaries in the exercise of
their skills".
Telecare therefore targets pharmacists and medical auxiliaries (nurses,
masseur-physiotherapists and chiropodist-podiatrists, occupational therapists
and psychomotor therapists, speech therapists and orthoptists, medical
electro-radiology manipulators and medical laboratory technicians, audio
prosthetists, optician-lunar therapists, prosthetists and orthotists for the fitting
of handicapped persons, and dieticians).

18. United Kingdom / Australia
● There are no specific laws regulating telehealth.
● Subject to same codes of conduct as face to face practice
● Some guidance have been issued by different agencies

19. United Kingdom :
1. The General Pharmaceutical Council issued
guidance in April 2019 on providing online
pharmacy services, detailing the steps that
pharmacists could take to ensure that they
continues to meet the standards expected of
them.
2. The General Medical Council issued guidance
in response to the COVID-19 pandemic, to
assist doctors in providing remote
consultations and steps they could take to
manage patient safety.
3. The British Medical Association, and trade
union and professional body for doctors in the
UK, has also issued guidance on how to run
remote consultations with patients
Australia :
1. telehealth guidance for practitioners
("AHPRA Guidance").
2. The Medical Board of Australia has also
published online "Guidelines for
technology-based patient consultations"
3. The Royal Australian College of General
Practitioners ("RACGP") has published a
"Guide to providing telephone and video
consultations in general practice".

20. USA
The practice of telehealth is regulated at the state level, either by statute or by
regulations or professional guidelines.
It is established by the same state-specific regulatory institutions that establish
standards for in-person clinical treatment

21. Saudia Arabia
The relevant authorities in KSA have issued decisions, procedures and guidelines to
regulate the use of telehealth in KSA.
This includes but is not limited to the following:
1. Minister of Health Decision No. 7/88 dated 25/04/1441H, the official instrument
approving the Regulation Governing Telehealth (Telemedicine) in KSA
2. The Regulation Governing Telehealth (Telemedicine), issued by the National
Health Information Centre ("NHIC") ("Telehealth Regulation").
The Telehealth Regulations provide that a government agency shall be created to
regulate and monitor telemedicine and shall be named the Saudi Telemedicine Unit
of Excellence, which will operate within the NHIC of the Saudi Health Council.

22. UAE
At a federal level, the annex to Cabinet Decision No. 40/2019 On the Implementing Regulation of Federal
Decree-Law No. 4/2016 on medical liability ("ICT Health Law"), entitled "Controls and Conditions of
Providing Remote Health Services" ("Federal Telehealth Regulations") expressly covers a range of
telehealth services including:
1. Remote medical consultation;
2. Remote medical prescription;
3. Remote diagnosis;
4. Remote medical monitoring; and
5. Remote medical intervention
1.

23. UAE
At an Emirate level :
1. Standards for the Provision of Tele-Monitoring Services in the Emirate of Abu
Dhabi ("AD DOH Standards")
2. Standards for Telehealth Services ("Dubai HA Standards")

24. Although , there are existing forms of telehealth services
such as Speetar and individual practices by some
doctors and facebook groups .Currently, there are not
any initiatives to regulate telehealth from MoH or any
related agencies .

25. Purpose of standards :
1. To set out the minimum Standards for provision of Telehealth services within
Libya
2. To establish minimum requirements for physicians to provide efficient,
secure, safe and high-quality Telehealth services.
3. To support Healthcare Innovation and Health Technology development in the
field of medicine.
4. To set out the exclusions for the provision of Telehealth services
5. To set out the minimum requirements for monitoring and evaluation of
Telehealth services provided

26. Who should be involved !
All stakeholders , including health care providers , patients , business owners and
related governmental and non governmental bodies could contribute into
constructing these quality standards of telehealth .

27. Possible references resources
1. The Standards for Telehealth Services by Dubai Health Authority
2. International Code of Practice for Telehealth Services by Telehealth Quality
Group