Telemedicine is the practicing of medicine using interactive means of audiovisual and data communication for health care, education, and research, which is to contribute to a better doctor-patient relationship.
Even though the Federal Medical Council has already issued specific regulation on telemedicine (Resolution No. 1643/2002), on February 6, 2019 it published a new regulation (Resolution No. 2227/2018) updating the rules on Telemedicine, to include certain telemedicine services such as teleconsultation, telediagnosis, tele-inter-consultation, telesurgery, and tele-medical triage.
Although ground-breaking, Resolution No. 2227/2019 has been subject to criticism, discussion and debate by Regional Medical Councils even before coming into effect. Originally scheduled to come into force in May 2019, Resolution No. 2227/2019 was revoked in February by Resolution No. 2228, in a response to medical entities’ request for more time to analyze the new telemedicine rules.
This way, Resolution No. 2227 was revoked and the previous rule – Resolution No. 1643/2002 – was back into effect. Thus, according to the regulation in force, it is up to the doctor to decide, at its own discretion, whether to use or recommend the use of Telemedicine services to his or her patient. The doctor’s decision to use or refuse to use Telemedicine must prioritize the patient’s interests and the benefits of that decision for the patient.
When a doctor chooses to use Telemedicine, he or she is entirely responsible for it. The doctor has the duty to be diligent and carefully evaluate each piece of information he or she receives and to only give a diagnosis and opinions and to only propose treatment and medical intervention if the information received is sufficient and enough for him or her to come to that conclusion.
New information and communication techniques easing provider-to-patient and provider-to-provider interactions are created every day. Despite the highlights of such novelty, it is important to bear in mind that using such techniques involve ethical and legal aspects that must be considered, particularly because it involves the use of sensitive personal data.
Sensitive personal data is defined by the Brazilian general data protection act (LGDP) (Law No. 13,709 of August 14, 2018, which will come into force on August 16, 2020), as the data revealing racial or ethnic origin, religious belief, health information or sex life. These and some other categories of data get special protection under the LGDP, principally to ensure respect for the Principle of Non-Discrimination.
Resolution No. 1,643/2002 clearly states that the patient must give prior consent to the use of any information provided to other professional. But if we think of this subject in the context of the LGPD, the need for the patient’s consent to the use of sensitive information is even more pressing. Here, patients’ consent must be undeniable, which means that there should be no doubt that the patient actually gave his or her consent to the use of his or her sensitive information.
The use of Telemedicine has been growing exponentially and, even though Resolution No. 1,643/2002 is in line with the LGPD, what is necessary to keep in mind is that processing patient’s information must be done with caution and diligence, especially when it comes to the safe storage of patient’s personal data. It is up to doctors to ensure security of his or her patients’ data when such data is exchange using Telemedicine resources.
