{"id":2445,"date":"2020-04-07T06:48:57","date_gmt":"2020-04-07T06:48:57","guid":{"rendered":"https:\/\/www.rtpr.ro\/uncategorized-ro\/telemedicine-a-weapon-in-the-fight-against-covid-19\/"},"modified":"2022-06-27T14:22:03","modified_gmt":"2022-06-27T14:22:03","slug":"telemedicine-a-weapon-in-the-fight-against-covid-19","status":"publish","type":"post","link":"https:\/\/www.rtpr.ro\/ro\/rtpr-emergency-journal\/telemedicine-a-weapon-in-the-fight-against-covid-19\/","title":{"rendered":"Telemedicina \u2013 o arm\u0103 \u00een lupta \u00eempotriva COVID-19"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"2445\" class=\"elementor elementor-2445 elementor-1482\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6499cb08 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6499cb08\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3e020a62\" data-id=\"3e020a62\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ab1e61d elementor-tabs-view-horizontal elementor-widget elementor-widget-tabs\" data-id=\"ab1e61d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"tabs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-tabs\">\n\t\t\t<div class=\"elementor-tabs-wrapper\" role=\"tablist\" >\n\t\t\t\t\t\t\t\t\t<div id=\"elementor-tab-title-1791\" class=\"elementor-tab-title elementor-tab-desktop-title\" aria-selected=\"true\" data-tab=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"elementor-tab-content-1791\" aria-expanded=\"false\">Rom\u00e2n\u0103<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t<div class=\"elementor-tabs-content-wrapper\" role=\"tablist\" aria-orientation=\"vertical\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-tab-title elementor-tab-mobile-title\" aria-selected=\"true\" data-tab=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"elementor-tab-content-1791\" aria-expanded=\"false\">Rom\u00e2n\u0103<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-1791\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-1791\" tabindex=\"0\" hidden=\"false\"><p>\u00cen absen\u021ba unui vaccin \u0219i a unui tratament \u00eempotriva COVID-19 care s\u0103 fie deja disponibile, cea mai eficient\u0103 m\u0103sur\u0103 preventiv\u0103 pare a fi <span style=\"color: #b23400;\"><strong>distan\u021barea social\u0103<\/strong><\/span>. O astfel de m\u0103sur\u0103 ar trebui s\u0103 fie luat\u0103 \u00een considerare \u0219i cu privire la consulta\u021biile pe care medicii le acord\u0103 pacien\u021bilor lor. Prin urmare, \u00een contextul pandemiei COVID-19, se recurge la telemedicin\u0103 din ce \u00een ce mai des.<\/p><p><strong><span style=\"color: #b23400;\">Consulta\u021bii medicale la un clic distan\u021b\u0103.<\/span> <\/strong>\u00cen lumina celor de mai sus, Guvernul Rom\u00e2niei a adoptat Hot\u0103r\u00e2rea nr. 252 din 30 martie 2020 privind stabilirea unor m\u0103suri \u00een domeniul s\u0103n\u0103t\u0103\u021bii pe perioada instituirii st\u0103rii de urgen\u021b\u0103 pe teritoriul Rom\u00e2niei (<strong>Hot\u0103r\u00e2rea<\/strong>). Pentru a reduce num\u0103rul de vizite ale pacien\u021bilor \u00een unit\u0103\u021bile de asisten\u021b\u0103 medical\u0103, de natur\u0103 a expune at\u00e2t medicii c\u00e2t \u0219i pacien\u021bii la poten\u021bialele infec\u021bii cu COVID-19, Hot\u0103r\u00e2rea reglementeaz\u0103, <em>inter alia<\/em>, accesul de la distan\u021b\u0103 al pacien\u021bilor la serviciile de asisten\u021b\u0103 medical\u0103. Cu toate acestea, acordarea la distan\u021b\u0103 a serviciilor medicale nu \u00eenseamn\u0103 c\u0103 pacien\u021bii nu mai au dreptul s\u0103 beneficieze de consulta\u021bii acordate fizic \u00een cabinetele medicale relevante.<\/p><p>Mai jos se reg\u0103sesc c\u00e2teva dintre cele mai importante reguli stabilite prin Hot\u0103r\u00e2re aplicabile cu privire la efectuarea de consulta\u021bii medicale la distan\u021b\u0103 \u00een contextul pandemiei de COVID-19:<\/p><p><strong><span style=\"color: #b23400;\">1. CE FEL DE SERVICII POT FI FURNIZATE PRIN INTERMEDIUL TELEMEDICINEI?<\/span><\/strong><\/p><p><strong><span style=\"color: #b23400;\">1.1 Consulta\u021bii medicale obi\u0219nuite<\/span><\/strong><\/p><p>Conform Hot\u0103r\u00e2rii, telemedicina poate fi utilizat\u0103 de medicii de familie \u0219i de medicii de specialitate din ambulatoriile clinice pentru a acorda <span style=\"color: #b23400;\"><strong>consulta\u021bii medicale<\/strong><\/span> incluse \u00een pachetele minimal \u0219i de baz\u0103 de servicii medicale, astfel cum acestea sunt stabilite prin contractul-cadru care reglementeaz\u0103 condi\u021biile acord\u0103rii asisten\u021bei medicale, a medicamentelor \u0219i a dispozitivelor medicale \u00een cadrul sistemului de asigur\u0103ri sociale de s\u0103n\u0103tate.<\/p><p>Consulta\u021biile medicale includ, de exemplu, consulta\u021bii de specialitate pentru afec\u021biuni cronice, consulta\u021bii de monitorizare activ\u0103 prin plan de management integrat (hipertensiune arterial\u0103, diabet zaharat de tip 2, boal\u0103 cronic\u0103 respiratorie obstructiv\u0103, astm bron\u0219ic, boal\u0103 cronic\u0103 de rinichi). Asemenea servicii medicale sunt acordate de c\u0103tre medicii men\u021biona\u021bi mai sus \u0219i decontate de casele de asigur\u0103ri de s\u0103n\u0103tate, similar celor incluse \u00een pachetele de servicii medicale care sunt furnizate fizic \u00een cabinetele medicale relevante, cu respectarea prevederilor legale incidente.<\/p><p><strong><span style=\"color: #b23400;\">1.2 Consulta\u021bii medicale aferente simptomatologiei de COVID-19<\/span><\/strong><\/p><p>Potrivit Hot\u0103r\u00e2rii, pacien\u021bii care prezint\u0103 manifest\u0103ri clinice sugestive pentru COVID-19 beneficiaz\u0103 de consulta\u021bii medicale de la distan\u021b\u0103 ce pot fi efectuate de c\u0103tre medicii de familie \u0219i de medicii de specialitate din ambulatoriile clinice. Aceste consulta\u021bii sunt disponibile oric\u0103rui pacient simptomatic localizat pe teritoriul Rom\u00e2niei.<\/p><p>Serviciile medicale astfel furnizate sunt asimilate consulta\u021biilor incluse \u00een pachetul de baz\u0103 de servicii medicale care sunt acordate fizic \u00een cabinetele medicale \u00een leg\u0103tur\u0103 cu afec\u021biuni acute, subacute \u0219i acutiz\u0103ri ale unor afec\u021biuni cronice.<\/p><p><strong><span style=\"color: #b23400;\">2. CARE SUNT MODALIT\u0102\u021aILE PRIN CARE CONSULTA\u021aIILE MEDICALE POT FI ACORDATE DE LA DISTAN\u021a\u0102?<\/span><\/strong><\/p><p>Prin defini\u021bie, telemedicina const\u0103 \u00een servicii medicale furnizate prin utilizarea tehnologiei de telecomunica\u021bii. De\u0219i Hot\u0103r\u00e2rea utilizeaz\u0103 o no\u021biune larg\u0103 \u0219i vag\u0103 atunci c\u00e2nd explic\u0103 modul \u00een care serviciile medicale la distan\u021b\u0103 pot fi prestate din punct de vedere tehnic (<em>i.e., prin orice mijloc de comunicare<\/em>), este de a\u0219teptat ca \u00een acest scop s\u0103 fie utilizate mijloace obi\u0219nuite de tehnologie a informa\u021biei, precum orice aplica\u021bie software care permite medicilor s\u0103-\u0219i examineze pacien\u021bii de la distan\u021b\u0103 prin video-chat, apeluri telefonice, schimburi de e-mail-uri etc.<\/p><p><strong><span style=\"color: #b23400;\">3. CARE SUNT DETALIILE PROCEDURALE REFERITOARE LA TELEMEDICIN\u0102?<\/span><\/strong><\/p><p>Serviciile medicale furnizate de la distan\u021b\u0103 vor fi \u00eenregistrate \u00een registrul de consulta\u021bii \u0219i \u00een fi\u0219a pacientului, dup\u0103 caz, cu indicarea (i) mijlocului de comunicare utilizat pentru acordarea consulta\u021biei medicale, \u0219i (ii) a intervalului orar \u00een care aceasta a fost efectuat\u0103. Prin grija medicului care efectueaz\u0103 consulta\u021bia la distan\u021b\u0103, toate documentele necesare ca urmare a unei asemenea consulta\u021bii (inclusiv prescrip\u021biile medicale) vor fi emise \u0219i trimise pacientului \u00een cauz\u0103 prin mijloace de comunicare electronic\u0103.<\/p><p>\u00cen principiu, medicii de familie \u0219i medicii de specialitate din ambulatoriile clinice pot acorda maxim 8 consulta\u021bii pe or\u0103.<\/p><p>Dispozi\u021biile Hot\u0103r\u00e2rii referitoare la serviciile medicale la distan\u021b\u0103 sunt aplicabile numai pe durata st\u0103rii de urgen\u021b\u0103 din Rom\u00e2nia declarate prin Decretul Pre\u0219edintelui Rom\u00e2niei nr. 195 din 16 martie 2020.<\/p><p><span style=\"color: #b23400;\"><strong>Concluzii. <\/strong><\/span>Hot\u0103r\u00e2rea reprezint\u0103 un pas c\u0103tre dezvoltarea telemedicinei \u00een Rom\u00e2nia, sector \u00een care p\u00e2n\u0103 \u00een prezent au fost \u00eenregistrate evolu\u021bii timide la nivel na\u021bional (e.g., anumite proiecte \u00een sectorul militar \u0219i al s\u0103n\u0103t\u0103\u021bii publice \u00een zonele rurale, numere de urgen\u021b\u0103\/ de informare (e.g., Peditel, Toxapel)).<\/p><p>Cu toate acestea, Hot\u0103r\u00e2rea stabile\u0219te mai degrab\u0103 principiile acord\u0103rii la distan\u021b\u0103 a serviciilor medicale pe durata st\u0103rii de urgen\u021b\u0103, f\u0103r\u0103 a lua \u00een considerare toate poten\u021bialele aspecte de ordin practic \u0219i juridic, cum ar fi: (i) poten\u021bialele implica\u021bii din perspectiva protec\u021biei datelor cu caracter personal \u00een ceea ce prive\u0219te datele pacientului; (ii) complexitatea consulta\u021biilor medicale care pot fi sau nu furnizate de la distan\u021b\u0103; (iii) metodologia exact\u0103 de decontare de c\u0103tre casele de asigur\u0103ri de s\u0103n\u0103tate a serviciilor furnizate etc. Prin urmare, revine practicienilor din sectorul asisten\u021bei medicale rolul de a implementa generalitatea noilor dispozi\u021bii.<\/p><p>\u00a0<\/p><p><em>*Aceast\u0103 ePublica\u021bie este furnizat\u0103 de Radu T\u0103r\u0103cil\u0103 P\u0103durari Retevoescu SCA \u00een scop exclusiv de informare \u0219i nu reprezint\u0103 asisten\u021b\u0103 juridic\u0103 sau o ofert\u0103 pentru acordarea de asisten\u021b\u0103 juridic\u0103. Distribuirea acestui document nu d\u0103 na\u0219tere unei rela\u021bii avocat-client. \u00cen cazul \u00een care dori\u021bi s\u0103 solicita\u021bi asisten\u021b\u0103 juridic\u0103 cu privire la oricare dintre aspectele analizate \u00een acest document, v\u0103 rug\u0103m s\u0103 v\u0103 adresa\u021bi persoanei obi\u0219nuite de contact \u00een cadrul Radu T\u0103r\u0103cil\u0103 P\u0103durari Retevoescu SCA la +40 31 405 7777.<\/em><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>\u00cen absen\u021ba unui vaccin \u0219i a unui tratament \u00eempotriva COVID-19 care s\u0103 fie deja disponibile, cea mai eficient\u0103 m\u0103sur\u0103 preventiv\u0103 pare a fi distan\u021barea social\u0103\u2026<\/p>\n","protected":false},"author":3,"featured_media":2165,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[76],"tags":[],"class_list":["post-2445","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-rtpr-emergency-journal"],"_links":{"self":[{"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/posts\/2445","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/comments?post=2445"}],"version-history":[{"count":6,"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/posts\/2445\/revisions"}],"predecessor-version":[{"id":3846,"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/posts\/2445\/revisions\/3846"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/media\/2165"}],"wp:attachment":[{"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/media?parent=2445"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/categories?post=2445"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.rtpr.ro\/ro\/wp-json\/wp\/v2\/tags?post=2445"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}