Telemedicine keeps its distance

The White House wants to limit the use of telemedicine – remote checks of pressure, pulse and sobriety of drivers in the transport industry. This follows from the amendments approved by the government commission for legislative activity. Remote medical examinations will be prohibited for drivers of intercity buses carrying passengers over distances of more than 300 km or transporting children. For the rest of the carriers, as planned, remote control of personnel will be allowed, but drivers will need to be additionally tested for drugs twice a year.

The Government Commission on Legislative Activities has approved amendments to the bill on telemedicine as part of the health checks of employees of drivers. This was reported to Kommersant at the Russian Bar Association (AJUR).

Today, employers must check the health of taxi, truck or bus drivers as part of pre-trip and post-trip medical examinations – this is the responsibility of in-house or external doctors. However, according to experts, the procedure has become a formality in recent years. Drivers do not pass checks, says, in particular, the president of the Gruzavtotrans association, Vladimir Matyagin, and traffic police inspectors are shown waybills with stamps about the allegedly passed medical examination. Against this background, the authorities are discussing the introduction of telemedicine capabilities into the industry, when the pressure, temperature, pulse, alcohol content in the driver’s exhalation is checked by a special terminal with sensors. President Vladimir Putin instructed to prepare the necessary bill back in 2017, but work on it was delayed. Finally, at the end of 2021, a group of deputies (Alexander Zhukov, Dmitry Khubezov, Evgeny Moskvichev, Yaroslav Nilov) submitted a relevant document to the State Duma, in May 2022 it was adopted in the first reading. Mr. Khubezov explained: in the case of switching to telemedicine, the cost of examining a driver for an employer will be halved. At the same time, the deputies mention the existence of 15 domestic systems for remote testing.

The government proposed to finalize the bill (“Kommersant” got acquainted with the amendments), partially limiting the use of telemedicine capabilities. A driver who undergoes remote examinations without an in-person examination by a doctor will additionally, at least twice a year, undergo an in-person chemical and toxicological examination for drugs and psychotropic substances. This need is enshrined in the current version of the amendments, but it does not disclose the frequency of inspections and does not say that they should be held in person. In addition, the White House proposes to ban telemedicine examinations for drivers who carry passengers over 300 km (as part of intercity traffic) or are engaged in organized transportation of children (for example, to a camp).

“The use of telemedicine technologies in conducting medical examinations of drivers will increase the availability of such examinations, reduce the financial and time costs of enterprises,” says Vladimir Gruzdev, Chairman of the Board of the Ayur.

“The introduction of telemedicine is taking place in stages – this is right,” says Sergey Lezhnin, CEO of the Doctis telemedicine company. “First, you need to make sure that the technologies work well when assessing the driver’s condition before a regular flight with a standard load. Only then, if it shows effectiveness, it will theoretically be possible to connect telemedicine to assess the condition of drivers at a higher load.”

Today, only large transport companies with a fleet of 50 trucks or more can hire a doctor, Vladimir Matyagin explained to Kommersant. Individual entrepreneurs and small companies cannot afford this for financial reasons, therefore they issue fictitious pre-trip permits. Telemedicine will be affordable for all market participants, Mr. Matyagin is sure. At the same time, the expert says, it is necessary to decide how to confirm the passage of a medical examination. Telemedicine terminals issue stickers with permission, but now traffic police inspectors do not accept them as an established document. Vladimir Matyagin also believes that telemedicine terminals should be at all gas stations so that drivers can go through control at any time of the trip.

For some regional carriers, it will be cheaper to maintain a full-time doctor than to use telemedicine, says Tatyana Rakulova, director of the Association of Passenger Carriers. The amendments proposed by the government to limit technology depending on the distance and type of passengers, she considers strange. “Either we recognize remote medical examination, or not,” she says. “If we don’t recognize it, then what is the difference between transporting passengers for 290 km and 350 km? Or why is the life of a 12-year-old student more valuable than the life of a 17-year-old student?

“It’s time for us to come up with some kind of solution, launch telemedicine faster and then see how it will work in practice. Even with some restrictions, which can then be lifted,” Yaroslav Nilov, deputy head of the LDPR faction in the State Duma, co-author of the amendments, Yaroslav Nilov, believes.

Ivan Buranov, Natalia Kostarnova