234Thepotentialoftel5DefinitionDefinitionoftelehealthbytheWHO“Thedeliveryofhealthcareservices,wherepatientsandprovidersareseparatedbydistance.Telehealthusesinformationandcommunicationtechnologiesfortheexchangeofinformationforthediagnosisandtreatmentofdiseasesandinjuries,researchandevaluation,andforthecontinuingeducationofhealthprofessionals.”6Whilethescopeoftelehealthservicesvariesamongdifferentplaces,telehealthbroadlyrefersto“teleconsultation”and“telemonitoring”services.ThisStudyprimarilyfocuseson“teleconsultation”intheprivatesector,underthebroaderumbrellaoftelehealthapplication.13healthcareprofessions*arerequiredtoundergostatutoryregistration/enrolmentinordertopractiseinHongKong.Amongthoseofferingtelehealthservices,theStudyfocusesonmedicalpractitionersandChinesemedicinepractitioners(CMPs)(collectivelyreferredtoasMPsinthisStudyunlessotherwisespecified),onlyforwhomguidelinesontelemedicinearecurrentlyavailable.Thetermsdescribingtheprovisionofhealthcareservicesbyinformationandcommunicationtechnologies,suchas“telemedicine”,“teleconsultation”,and“virtualcare”arereferredas“telehealth”inthisStudy.TelehealthTelehealthTeleconsultationTelemedicineTelemonitoring*13healthcareprofessionsincludemedicalpractitionephysiotherapists,occupationaltherapists,medicallaboratorytechnologists,optometrists,radiographers,chiropractors,dentalhygienists,midwivespharmacists.7TheoutbreakofCOVID-19pandemicledtoquarantineandsocialdistancingmeasures,acceleratingtheadoptionoftelehealthservices.??InJan2021,theHospitalAuthority’s(HA)mobileapplication“HAGo”launchedfeaturesenablingtelehealthforsuitablepatients.?AccordingtoaLegislativeCouncilpaper,asofJan2025,>265,000“telemedicine”caseshadbeenconducted.?Telehealthhasbeenintroducedinvariousclinicservices,suchasGeriatric,PalliativeMedicine,PsychiatricandDiabetic,aswellasAlliedHealthclinicofvariousdisciplines,e.g.ClinicalPsychology,PhysiotherapyandSpeechTherapy.?TelehealthserviceshavebeenprovidedbyMPsindividuallyorthroughprivatehealthcarefacilities(PHFs),telehealthplatformsandinsurancecompanies.?Marketsize/sharestatisticscouldnotbeassessedduetotheabsenceofanexhaustivelistofserviceproviders.TheTheCouncilreceived7complaintcasesrelatedtotelehealthservicesfromJan2020toJun2025,withnon-delivery/refund(57.1%)beingthemostcommonreasonforcomplaints.8TelehealthisstillinthedevelopingstageinHongKong,andtheGovernmentandprofessionalmedicalorganisationshavegraduallyintroducedregulatoryframeworksandguidelinesontelemedicinesince2019.Amongthetelehealthserviceproviders,onlyPHFsandMPsaresubjecttorelevantregulatoryframeworks/guidelinescurrently.Meanwhile,thereisnospecificmonitoringauthoritygoverningtelehealthplatformsoperatedbynon-PHFsandinsurancecompanies,whicharenotsubjecttothe“premises-based”P(pán)rivateHealthcareFacilitiesOrdinance(Cap.633)andrelevantguidelines,butrelyonethicalguidelinesforMPs.?DepartmentofHealth(DH)?CodeofPracticeforPrivateHospitals(CoPforPH)(2024)(Para.12.9.1-12.9.?CodeofPracticeforDayProcedureCentres(CoPforDPC)(2024)(Para.1.3?CodeofPracticeforClinics(CoPforClinics)(TobeeffectiveinOct2025)Keyhighlightsrelatedtotelehealth:EstablishmentofpoliciesandEstablishmentofpoliciesandQualifiedandcompetentQualifiedandcompetentstaff,andthSafeguardingSafeguardingprivacyand9?MedicalCouncilofHongKong(MCHK)?ChineseMedicineCouncilofHongKong?GuidelinesonProfessionalEthicsforTelemedicineServices(2025)Theguidelinesprincipallystressthatwhenpracticingtelehealth:asequaltoface-to-“doctor-patientrelationship”beforepracticing“telemedicine”fora“telemedicine”intonthesystem,ensurethattheelectroniccommunicationsconsultationwiththatpatiThefollowingrequirementsareadditionallyapplicabletoCMPs:irregularitiesofthemedicationsdeGovernment&PublicBodiesPatient?HongKongAllianceofPatients,OrganizationsOrganisation,?TheHongKongFederationofInsurersInsurersand?3telehealthplatformsTraders?HongKongAcademyofMedicine?HongKongRegisteredChineseMedicinePractitionersAssociation?HongKongTelemedicineAssociation?TheHongKongMedicalAssociation?TheHongKongPrivateHospitalsAssociation?HealthBureau?HospitalAuthority?OfficeforRegulationofPrivateHealthcareFacilitiesHealthcareFacilities&MPsAnalysisofcomplaintcases?MPsurveyAnalysisofcomplaintcases?MPsurvey833MPs(Jun–Oct2024)?Tradersurvey14telehealthserviceproviders(Jun–?ConsumersurveyAug2024)?ConsumersurveyAug2024)websites,promotionalmaterialsandmobileapplications(ifavailable);or(2)conductedphone/onlineenquiriesto?Regulatoryregimes/measuresinHongKongandMainlandChina,Singapore,andtheUnitedStates(California))19telehealthserviceproviders(May–Sep2024)?MajorityoftheMPsandconsumerscommencedusingteleconsultationaftertheoutbreakofCOVID-19.?WhatsAppwasthemostcommonlyusedchannel.?Inthepost-COVID-19era,73.7%ofprivateMPsthatprovidedteleconsultationcontinuedtoprovidetheservice.MPSurveyConsumerSurveyAbouthalfofMPshadprovidedtelecOftheprivateMPsthat?Consumersusedtelehealthforbothacuteandchronicconditions.?Themostcommonconditionswerecommoncold/influenza(77.5%)andcough(45.8%). Arthritis/Osteoarthritis mm3.6Note:Multipleanswersallowed?“Unabletoconductphysicalexamination”wasthebiggestbarrier/concernofconductingtelehealthforconsumers(44.5%)andMPs(77.0%).?“Medicalincidentorinaccuratediagnosisconcerns”rankedsecond(consumers(27.8%);MPs(41.0%)).BarriersBarriersofUsing/ProvidingTelehealth(%)UnabletoconductphysicalexaminationtofConcernsovermedicaliPatientslackingtechnologicalkNote:Multipleanswersallowed?99.5%oftheMPsthoughtimprovementinrelationtotelehealthservicesinHongKongwasneeded.?66.5%ofMPsdeemedrevisionoftelehealthrelatedguidelinesandestablishmentoflawsimportanttoclearlyspecifyresponsibilityofeachpartyandprotectbothMPsandpatients. Revisionofrelevantguidelines/establishmentGovernment/relevantprofessionalbodProvisionoflegalsupportanPromotionoftelehealthservicestogeneralProvisionoftechnicalandadministrativesupportbytelehealthplatforms/toolsSubsidyforMPstopurchaserNote:MultipleanswersallowedFragmentedandinadequategovernanceframeworkUncertaintyininsurancecoverageoftelehealthservicesUnclearliabilitybetweenFragmentedandinadequategovernanceframeworkUncertaintyininsurancecoverageoftelehealthservices?Whenpatientsusetelehealth,multipleserviceprovidersmaybeinvolvedintheprovisionofservices(e.g.PHF,telehealthplatform,MP,pharmacist,medicinedelivery,etc.).SaveforthoseforPHFsandMPs,thecurrentregulatoryframeworksandguidelinesoftheotherprovidersmaynothaveaccountedforthecontextoftelehealth.?Ofthe19reviewedtraders,4claimedthattheteleconsultationservicesprovidedwerenotintendedfordiagnosingortobeperceivedasgivenadiagnosisortreatment,eventhoughtheirservicesmightinvolvetheissuanceofmedicalcertificatesandprescriptions.?IncreasingadoptionofArtificialIntelligence(AI)solutionsinhealthcare(e.g.providingassistanceindiagnosingdiseasesandrecommendingtreatments)mayposehigherrisksandrequiresmoresupervision. theprovisionoftelehealthservices?8reviewedtradershavesetT&Csforavoidingliabilityforlosses/damagescausedbytheuseoftheirtelehealthservices.medicalconsultations,andthereweresectionsatitswebsiteforweightmanagementandtreatmentthetext-basedmedicalconsultatio?9reviewedtradersclearlystatedwhetherinsuranceclaimswereapplicablefortelehealthornot.?Itwasuncertainfortheremaining10reviewedtraders,whichadvisedtocheckwiththeirinsurancecompany/providedwithnoreply.Example:AclinicadvisinUnclearinformationprovisioninsufficient/unclearLackofconsumerchoicesInsufficientoperationalsupportPrivacyandsecurityconcerns5.Worriesaboutsoftelehealthplatforms/teleconferencingtools1.Non-transparentpriceandserviceinformation?Feeinformationofsomereviewedtraderswasnottransparentenough?Refundmechanismwasunclear?Listofproblemsamenablefortelehealthwasnotavailable.?NoinformationonthesuitablamongdifferenttraderscouldAtelehealthplatformstated“dizziness”asasuitableconditiExample:Screencapturesfromtwotelehealthpl ?ServicescopeinformationpublicisedbysomereviewedtraderscouldbeExample:Screencapturesfromtwotelehealthpl deliveryserviceswouldbemandatedaccountreg2.Potentiallyunfair/insufficient/unclearserviceterms?T&Csnotavailablefromafewtradersprivacypolicyorotherprocedure/mechanism/?UnfairT&Csmightputconsumersatadisadvantagedpositionandunderminetheirrights 平臺(tái)平臺(tái) 平臺(tái)平臺(tái)?Limitedchoicesforconsumersmightleadtodissatisfaction?44.9%ofdissatisfiedconsumersstatedthatthechoicesofMPsandcoReasonsofDissatisfactionReasonsofDissatisfactionChoicesofMPsandconsultationtimeslotswere44.9FeesweretoohighTheinstructions/technicalsupportwereinsufficientFeeinformationnottransparentTheoriginalappointmentwascancelled/changedbytheplatform/MPTheMPwhoconductedtheteleconsultationwasnottheoneoriginallychosenTeleconsultationsessioncouldbetrackedandmonitoredTeleconsultationsessioncouldnotberescheduledConsumer(n=78)Note:Multipleanswersallowed25.69.0 4.DifficultiesingettingsupportbyprivateMPson“there?17.9%consumersopin 5.Worriesaboutsecurityoftelehealthplatforms/teleconferencingtools?29.9%consumersalsowReasonsofDissatisfactionwithTeReasonsofDissatisfactionwithTeTeleconsultationsessioncouldbetrackedandmonitoredThetoolcollectedexcessivepersonalandpaymentinformation40.342.729.97.3ThetermsandconditionswereinsufficientThetechnicalsupportwereinsufficientFeesweretoohighWrongdeliveryofdrugsPrivateMP(n=82)Consumer(n=67)28.422.020.925.620.94.99.0 reckonedtheplatform/twhichmightleadtopotentiallywrongdeOfwhich,thetoolsusedwere:?WhatsApp?Zoom?MicrosoftTeamsOfwhich,thetoolsusedwere:?WhatsApp?Zoom?MicrosoftTeamsTelehealthPlatforms/TeleconferencingTelehealthPlatforms/TeleconferencingAccreditationStatusonPr331411Remark:1surveyedtraderrespondedthatitGovernmentGovernmentbodiesacknowledgedtheincreasingadoptionoftelehealthservices.Withinthepublicsector,clinicallystablepatientsmeetingcertaincriteria(suchasnotrequiringahospitalvisitforphysicalexamination)wouldbeinvitedtoreceivetelehealthservices.Forthedevelopmentoftelehealthintheprivatesector,theGovernmentnotedthattherearecurrentguidelinesontelehealthforhealthcareprofessionals.Meanwhile,theGovernmentisopentofacilitatecommunicationwiththerelevantprofessionalregulatorybodiestodevelopguidelineswhichserveasguidepostsfortheirprofessionsinprovidingtelehealthservices.MedicalMedicalassociationsandhealthcarefacilitiesexpresseddivergingviewsonthefutureadoptionoftelehealth,withsomeopinedthatitisnotequivalenttophysicalvisits,whilesomeexpectedthatitsfutureusewouldincrease.SomeMPsandprofessionalbodiesexpressedthattheexistingregulatoryframeworksandguidelinesontelemedicinewereinsufficient,whichmightdisincentiviseMPstopracticetelemedicineduetoliabilityconcerns.Besides,conventionalmedicaltrainingplacedemphasisonmakingdiagnosisthroughphysicalconsultation,trainingonteleconsultationdiagnosisshouldbeincorporatedtoenhancediagnosisaccuracy.InsurerInsurerrepresentativespointedoutthatinsuranceclaimsconcerningtelehealthserviceswerereviewedthesameastraditionalmedicalservices,bothregard‘medicalnecessity’asakeyfactorindeterminingreimbursement.Theynotedtherisingdemandforextendinginsurancecoveragetotelehealthservices,andopinedthatinsurancecompanieswouldcontinuouslyreviewtheservicedemandandcost-benefitwhendesigninginsuranceplans.</>Telehealth</>TelehealthplatformoperatorssharedthatusageoftelehealthhadrisenaftertheCOVID-19pandemic.Intheabsenceofclearregulatoryguidance,theyexpresseddifficultiesinnavigatinguncertaintieswithconcernsoverinadvertentlyviolatingthelawswhileoperatingtheplatforms.Theywelcomedregulationsandguidelinestobeformulatedtoinstillinoperationcertaintyandpublicconfidence.Source:OECDSource:OECDHealthWorkingoverviewoftheuseoftelemedicineinOECDcOECDcountries-Regulatory?Asat2020,28OrganisationforEconomicCo-operationandDevelopment(OECD)countrieshavenationallegislation,strategyorpolicyontheuseoftelehealth;someofwhichalsohaveadoptedreimbursementstrategiesontelehealth.?ToselectthemarketsforreferencetoHongKong,thefollowingfactorsareconsidered:Advancedintegrationoftelehealth?Australia?Canada-Ontario?MainlandChina?Singapore?UnitedStates-California?Allthe5reviewedmarketshaveregulations/guidelinesonprovisionoftelehealthservices.services&（試行）、遠(yuǎn)程醫(yī)療服務(wù)管(2020);HealthcareServiAct(PHIPA)(2004))(MinistryofHealthproposestorolloutthe“HealthInformationBill”atend-2025)Guidelinesforconsul–BusinessAssociationAgreement)includecoverageforadliketelehealthservicesoutsi?Acrossthefivemarkets,therearerequirementsforinformedconsentandemphasisonpatientunderstandingontheinformationprovidedregardingtelehealthservices,includingpotentialrisksandlimitations.?However,themodeoftheinformedconsentvaries.telehealth;verbal/TheMCHK–TheMCHK–EthicalG?Allthereviewedmarketsallowtelehealthprescription,whileemphasisingtheneedforsafe/cautious/real-timeprescribingpractices,especiallyforcontrolledsubstances.?IntheMainlandChina,theprescriptionsneedtobereviewedandapprovedbyapharmacist.TheMCHK–TheMCHK–EthicalGHongKongpatient.Healthinformationcustodiansandecustodian,thecustodianremainsrespopersonalhealthinfordisclosed,retained,ordisposedofbyresponsibilitiesandliatelehealthplatformsOntarioHealthhasestablishedtechnicalrequirementsfortelehealthserviceproviders(e.g.videoconferencingandsecuremessagingsolutionproviders),whichinclude,amongothers:?comprehensiveliabilitytermsforvirtualvisitsolutions?dataprotectionagainstunauthoriseddisclosureandmodification?transferofvirtualvisitinformationtomedicalrecordsfordocumentationandauditing?accessibletechnicalsupportforbothclinicalusersandpatientsHIPAAdictatesthatatelehealthvendormustmonitordata,suchaselectronicprotectedhealthinformation,thatisstoredduringtransfer.Theyarerequiredtoprovidecustomerswithabusinessassociateagreement(BAA)whichmustincludeprovisionsforregularauditingofthedata’ssecurity.HIPAA-complianttoolsthatincludeaBAAarepermittedforuseintelehealthservices(e.g.ZoomforHealthcare,whichisthehealthcareversionofZoom)Public-facingvideoplatformsarenotallowedfortelehealthpurposes(e.g.FacebookLiveandTikTok)includetelehealthsertheAustralianGovernmentface-to-faceconsultatio(e.g.compensatedatthein-personfeeforconsultations).“Internet+”medicalservices.fairandconsistentwithofflinevisitsbeforereimbursinservicesorlimitthesettingsservices,provideequivalwithoutlimitingtospeapplythesamedeductibRealisingthefullpotentialoftelehealthservicescanhelpimprovetheaccessibility,quality,affordabilityandsustainabilityofhealthcareservices,aswellasmeetthegrowingdemandforhealthcareservicesbyintegratingsuchservicesintohealthsystemsandinclusivegovernance.TheCouncilputsforwardthefollowing5recommendationstoachievetheseoverarchinggoals:1.Strengthenguidanceforapp1.Strengthenguidanceforappropriateprofessionsprovidingtelehealthservices2.2.Enhancegovernancetocovertelehealthplatformsandcommunicationtools3.3.Promotemarkettransparencyontelehealth4.4.Improvetheusabilityoftelehealthservices5.5.EducateandsupportconsumerstosafelyusetelehealthservicesRecommendation1-StrengthenguidanceforappropriateprofessiTelehealthisanemergingfieldinHongKong,andtheGovernmentandprofessionalmedicalorganisationshavebeengraduallyestablishingregulatoryframeworks/guidelinestosupportitsdevelopment.SuchguidelinesweredesignedtobebroadandgenericinnatureintheviewthattelemedicineisstillinthedevelopingstageinHongKong.Inactualpractice,MPsexpressedconcernsoverthequalityandrelatedlegalandethicalissuesandtheydeemedfurtherguidanceimportanttoclearlyspecifyresponsibilityofeachpartyandprotectbothMPsandpatients.Withthegrowingadoptionoftelehealthinotherhealthcareprofessions,relevantprofessionalmedicalorganisationsarerecommendedtoalsodevelopcomprehensiveguidelinesforrespectiveprofessionstofollow.Overall,theGovernmentisrecommendedtoworkwithprofessionalmedicalorganisationstoconsulthealthcareprofessionals(includingMPs)regardingtheirexperienceandconcernsintheprovisionoftelehealthservices,inordertoprovidemoredetailedguidancetohealthcareprofessionalsasappropriate.StrengthenguidanceforappropriateprofeSuggestedSuggesteditemstobeincludedintheguideline:approvingtheprovisionsupportneeded,preparationofcontingencypltelehealthplatforms,outsourcedprovidersofcwellasidentityauthenticEnhancegovernancetocoverShortShort-Mediumterminformation,etc.).performancestandards(e.g.dataprotection,confidentiality,usersserviceproviders,includingnEnhancegovernancetocovertelehealthplatformsandcommunicationtools(Cont’d)Suggesteditemstobedisclosedonthewhitelistfortelehealthplatformsandcommunicationtools:?AccreditationsobtainedbyReference:InterfaceEnhancingEnhancinginformationtransparencycanempowerpatientstomakeinformeddecisions,increasetheirtrustintelehealthservices,andenablethemtousetheservicessmoothly.Thetradeisrecommendedtoproactivelypublicisepricerelatedinformationandenhancethetransparencythroughoutthewholetelehealthprocess:?Informationprovision:Provideclearchargeandoperationalinformation(e.g.termsandconditions,refundandmedicationdeliveryarrangements,problemsdeemednotamenabletotelehealthbytheprovider);?Trainingtostaff:Establishinternalguidelinesorprovidetrainingtoensureconsumer-facingstaffprovidepatientswithnecessaryandtimelyinformationandtechnicalsupport;?Advertising:Refrainfromexaggerationrepresentationatadvertisements,aswellasunconsenteddirectmarketing;and?Authenticationofidentity:EnableauthenticationoftheidentityofMPsandpatientsbeforeconsultation(e.g.viaiAMSmart).(i)ParticipateinandcontributetotheeHealthSystemMPshaveexpressedconcernsinusingtelehealthservices(e.g.inaccuratediagnosisduetoinfeasibilityofphysicalexaminationandlackofpatient’smedicalhistory).TheElectronicHealthRecordSharingSystem(Amendment)Bill2025wasgazettedinMarch2025aimingtoexpandandenhancethedatacollection,sharing,usageandprotectionmechanismoftheeHealthSystem.Toenhancediagnosticaccuracyundertheseconstraints,healthcareproviders,medicalprofessionalsandthepublicareencouragedtoparticipateintheeHealthSystemforsharingofhealthrecords.Asthedepositrateofprivatehealthcareprovidershasbeenlow–asofNovember2024,nearlyall(over99%)ofthesharableelectronichealthrecordsoneHealthcamefrompublichealthcareproviders,itisessentialtoreinforcedatacontributionbytheprivatesector,soastoenablecitizensreceivingseamlesscare.(ii)ExpandthecoverageofinsurancetomoretelehealthservicesTelehealth,asapracticeofmedicine,shouldbetakenintoaccountbyinsurancecompanieswhentheydesignhealthinsuranceplans.Yet,currently,whethertelehealthiscovereddependsonthedesignofindividualinsuranceplanoftheinsurancecompanies.Insurancecompaniesar