THE CONCEPT OF E-HEALTH IN UKRAINE: LEGAL ISSUES AND IMPLEMENTATION PROSPECTS (E-здоров'я в Україні: правові питання та перспективи впровадження)
Journal Title: Медичне право - Year 2017, Vol 1, Issue 2
Abstract
This article deals with the concept of such new phenomenon at health care sphere, as E-health, revealing the essence and importance of this concept. The author considers its correlation with the category of telemedicine and other relevant categories (m-health). E-health actually covers all relations with the use of information technologies in health care sphere. The scope of author’s interest consists in researching the main features of e-health in relation to the provision of medical care, in other words, it is built up to the relationships between the following participants: 1) citizens and doctors; 2) citizens and health care institutions. E-health serves the purposes of all healthcare system components integration, in particular the following: provision of health services; management of labour, material and financial resources; information system. It should be noted that e-health relates to the following aspects: 1) health services provision (area covered by the term “telemedicine”); 2) information systems (various electronic registers, computer programs, internal documents of health care); 3) production (use of new technologies, products for therapeutic, prophylactic or other health-related purposes). However, author believes that e-health is not a new legal phenomenon but the only method or manner by which the relationships in health care sphere can be carried out. Legal regulation of e-health directly depends on the approach to its understanding. Nowadays, initiatives to introduce e-health in the national legal order are being vividly discussed in Ukraine. The following conclusions can be made basing on the analysis of current political documents: 1) introducing e-health in Ukraine means the creation of functional public, efficient electronic system; 2) the relationships of telemedicine, legal regulation of which is also at the stage of development, are considered to be apart from e-health. Based on these approaches to its understanding, the concept of e-health can be narrowed in its meaning to some electronic system (perhaps, at the state level,) which aims primarily to reduce documentation flow in health care sphere. The implementation of e-health has a significant number of benefits to all participants in the health care sphere: both members of the healthcare industry and patients. The main advantage of the introduction of e-health is increasing efficiency and improvement of health care services delivery quality. The article focuses on the potential risks of e-health in terms of human rights in health care consideration. The risk of the lack of access to health care. Access to health care is a key element in the realization of human rights in this sphere. Potential risks associated with access to health care, to be exact are connected with the services accessibility. Such accessibility is difficult to measure and determine. Usually, the reasons, lowering accessibility (especially at rural areas) to healthcare are the following: long time to wait, distance, financial costs of medical care. E-health, in its present state, do not have a significant impact to the accessibility of health care. Risks related with the consent to such issues as: the processing of personal data / access to information about health. The issue of consent to the processing of personal data results from the human right to information. An electronic system can envisage patients’ personal data. Such information as personal data and health information should be logically included in the electronic system of information relating to a different legal regime. Each one of these types of data has its own regulation, which requires both coordination and regulation. The Law of Ukraine "On Personal Data Protection" sets specific requirements for the processing of so-called sensitive personal data, which among other information, includes such on health care, especially, person’s health status. In practice, there may arise a situation when medical care provision may depend on the person’s consent to the processing of personal data. The consent to treatment and consent to the processing of personal data should be strictly distinguished. Risk related to confidentiality of health information. The state "wants" to know about the decease incidence and prevalence, and any other special medical statistics. Such information is effective tool for the rational use of resources, in order to provide the public with a guaranteed level of medical care. Regarding individual consent to the processing of personal data and special medical statistics, it should be noted that there are two different levels of information: meso (at health care institutions) and macro (at regional and national level). Health care institutions are responsible for keeping health information (incl. personal data) at meso level. Information at macro level, which consists of such about patients, their personal data should be impersonalized, which means that the information that may allow identification shall be removed. In the absence of most of the regulatory framework for e-health, it seems to be difficult to make certain conclusions on its compliance with national law to provide and protect health information, ensuring patients' rights to privacy. The rapid development of modern technology improves various aspects of human life. The health care sphere has always been priority for scientific research. The idea of e-health bears many advantages. Probably, the concept of patients’ rights should be redefined in connection with the advent of the new method of e-health. In terms of legal issues of e-health, several considerations shall be made: 1) E-health can be covered simultaneously by different legal regimes, and that does not mean that these modes are mutually exclusive. It is necessary to distinguish legal regimes ratio relationship for the provision of care in respect of telecommunications systems from the impact on these relations provisions on human rights law; 2) existing legal framework governing the health information, which can be available for the public, is unclear, and legal definition of e-health can make it even worse in case of contradiction and conflict situation; 3) e-health is governed by civil, constitutional, administrative, medical, pharmaceutical, information, and criminal law. This combination leads to the large, complex regulatory framework. Settlement through the existing regulatory framework of more complex and comprehensive relationships in the field of e-health can lead to further contradictions, conflicts and problems in legal practice. Such collision should be reviewed and examined, and scientific the comments should be included to its legal concept. The priority research areas for academics, policy makers and legislators are: the development of legal framework in accordance with the current legislation of Ukraine, the emphasis on ensuring human rights (the right to health care, consent to medical intervention, information about health, privacy of the latter); issuance administrative regulation of the e-health, and development of technical documentation in this sphere.
Authors and Affiliations
Ivan Demchenko
Keywords
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