Можно ли поставить диагноз дистанционно?

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Limitations for making diagnosis remotely which are contained in the Federal Law “On the fundamentals of public healthcare in Russian Federation” from 21.11.2011 N 323-ФЗ and entered into force on the 1st of January 2018, lead to great discussions in the professional society. In this article we describe hypothetical outcomes of remote diagnostic such as increasing of online consultations and as its consequence – increase in financial expenses, health facilities burden, participance of business representatives and decreased quality of medical care in connection to all of them. Situation is worsened due to the lack of real experience on applying telemedical technologies in clinical practice. The term «diagnosis» is not established in the Federal Law 323 «On the fundamentals of public healthcare in Russian Federation» which also worsens the prohibition of remote diagnosis. In this paper the examples of changing approaches from nosological method of patient management to a syndromal one are described. Attention is paid to an international experience of this method, its effectiveness and logic, and exceptions to the rule such as development of telemedical centers in Moscow in the period of COVID-19 pandemic that allowed to not only make a diagnosis remotely and prescribe treatment but also make a list of temporary incapacity for work. Technological development and appearance of new knowledges not only change diseases classification but also provide new possibilities for receiving objective information of patient health. Medical devices develop and improve becoming more compact and intuitive, available in price for wide range of people including persons without medical education. Now it’s possible for patients to make laboratory studies which previously were available only in clinics, by themselves at home and transfer data to any distance with applying of telemedicine technologies. Nevertheless, patients still need available medical care. Existing legislative limitations for remote diagnosis and treatment prescribing, which are established in the Federal Law 323, don’t allow to approach flexibly for new changing conditions and implement potential opportunities for people but all this possibilities are contained in one of the most powerful cross-cutting technologies – telemedicine.