The biggest obstacles: regulation and practice

Varied licensing rules and unclear reimbursement of remote services by insurers slow development, as do questions of data protection and liability. A unified definition of telemedicine and technical standards are lacking, and closed platforms often cannot 'talk' to one another. Quality and safety standards are not in place everywhere, which heightens patients' concerns about data confidentiality. Finally, the digital divide persists: people in remote regions and older populations have poorer access and lower technology literacy – even though they would benefit the most from telemedicine.

What works and what follows from it

Open and integrated solutions are taking hold worldwide—from apps for patient–doctor communication to large national networks that enable different platforms to 'understand' each other. Public–private partnerships are strengthening, and cross-border collaboration is increasing, especially in the European area and among smaller states. The results include better-managed chronic conditions and fewer unnecessary hospital visits thanks to virtual check-ups and remote monitoring. Satisfaction is rising among both patients and healthcare professionals.

Multiple systematic reviews and meta-analyses, including those from 2023, show that telemedicine is not 'second-rate': it improves quality of life and physical and social functioning without demonstrated negative effects on depression, anxiety, fatigue, or self-care. The key is to build out infrastructure and digital literacy, with an emphasis on vulnerable groups, and to align rules, reimbursement, and clinical workflows. It is worth seeking innovative financing—for example, models that cover costs through savings from avoided travel and carbon credits, as has been achieved in Brazil. And finally: let's shed the notion that this is a 'lower standard' of care; it can already be used today between providers themselves, where it complements and expands specialist teams.