Photo: fvw.de
How does Russian telemedicine work today?
Telemedicine is a transparent tool for accessing care, particularly when patient and physician are in different cities or countries. However, it's important to note: this isn't a complete in-person appointment via screen, and not all care can be provided remotely. Federal Law No. 323-FZ and regulatory acts clearly define telemedicine's role: digital tools are used not "instead of" but "alongside." Remote consultations, adjustment of previously prescribed therapy, patient monitoring, and chronic disease management are permitted, but establishing an initial diagnosis without an in-person appointment remains impossible.
Legally, it's also important that during teleconsultations, information about care provided must be documented: entered into the patient's medical record, with the protocol signed by the physician's enhanced qualified electronic signature. Article 36.2 of the law requires documentation of information about medical care provided using telemedicine technologies accordingly.
Why is telemedicine needed if diagnosis isn't allowed?
Telemedicine is gradually becoming a fully integrated component of the healthcare system. Despite fairly strict legal frameworks, the range of tasks it enables is broader than it might initially appear.
If a patient is consulting for the first time, diagnosis, sick leave issuance, and prescriptions are permitted exclusively during in-person examination. However, general practitioners, pediatricians, and other primary care specialists can provide preliminary assessment: clarify symptoms, determine the need for an in-person visit or additional diagnostics. This format doesn't replace examination but allows rapid professional evaluation and helps determine the appropriate next step. This is particularly important when rapid condition assessment is required. For acute symptoms, remote contact allows the physician to assess the overall clinical picture, clarify key indicators, and help the patient navigate necessary actions before specialized help arrives. This is how telemedicine is utilized, for example, in transmitting ECGs from remote hospitals to vascular centers: specialists confirm the need for emergency hospitalization without replacing emergency care.
In the practice of many major Russian medical institutions, remote consultation based on submitted medical documents has become a standard service. Consultations with gastroenterologists, cardiologists, neurologists, oncologists, and other specialists often rely on analysis of already-completed studies – imaging, laboratory data, colleagues' conclusions. This is particularly important in high-complexity fields requiring preliminary discussion of potential treatment options. Especially if the patient is distant from a specialized center or desires an independent expert assessment as a "second opinion." Through telemedicine consultation, patients can obtain advance clarification about methodology, preparation stages, and the appropriateness of a particular intervention before planning an in-person clinic visit.
A separate area involves supporting patients with established diagnoses and palliative care. Remote consultations help family members and patients themselves receive care recommendations, adaptation guidance, and condition monitoring. This format reduces the need for frequent travel and makes the connection with the medical organization more stable and humane, which is particularly important during recovery and with chronic illnesses. Russia has already implemented projects where patients who received a diagnosis at an in-person appointment are provided the ability to maintain therapy remotely and adjust treatment based on remote data monitoring.
Who can provide consultations and in what format?
Telemedicine is not considered a separate medical specialty. Legally, it's a "form of medical care delivery." Organizations holding medical service licenses can provide such services. Teleconsultations can be conducted by physicians of various specializations: orthopedists, cardiologists, neurosurgeons, endocrinologists, otolaryngologists, and others. In Russian clinics, telemedicine consultations occur in two main formats – in real-time via videoconference, telephone consultation, or chat, or in deferred document review format.
In Russia, telemedicine projects are built on unified digital frameworks. Clinics participating in the experimental legal regime (ELR) since 2023 operate through the government service "Gostelemed." Patients need only register on the portal, install the mobile application, and use built-in tools for video communication and document exchange. The scheme is similar in insurance programs: if telemedicine is included in the policy, patients gain access to a personal account on the platform used by their chosen clinic. This account stores consultation history and test results, with options for video calls or messaging physicians. For users, such services are free – regardless of whether they access them directly or through an insurance company.
For medical organizations, telemedicine requires a higher level of preparation. Online consultations must be conducted in specially equipped rooms with computers, cameras, microphones, stable internet, and medical information systems integrated with EGISZ. Exceptions exist for emergency care or work in hard-to-reach areas, where telemedicine consultations outside designated offices are permitted.
Legally, clinics must ensure consulting physicians have enhanced qualified electronic signatures (UKEP), register with Rosreestr as personal data operators, post information on their website about the organization, information system used, personal data operators and physicians conducting teleconsultations, and use only specialized services and secure communication channels. These requirements are established in paragraph 46 of Ministry of Health Order No. 965n and apply to all medical organizations providing remote care.
Ivan Timashkov, Head of the Expert Center for Diagnostic Imaging at SM-Clinic, radiologist: "For telemedicine consultations to truly work, two key things are necessary: high-level experts and reliable partnerships. Only with trust between organizations developing telemedicine solutions and sufficient specialist qualifications can quality remote contact between physician and patient be ensured."
How does Russia ensure telemedicine security?
One key issue raised at all levels when discussing telemedicine is data protection. Russian regulations approach this topic with particular stringency: personal medical information belongs to a "special category" of personal data, and technical protection requirements are significantly higher than for ordinary digital services. Government service technological infrastructure is built around several mandatory elements: EGISZ participation, secure channels, electronic signatures, access restricted to specialists only, and specialized medical information systems instead of regular video services and messengers. All this creates conditions where remote consultation becomes not only convenient but legally and technically secure for both patient and physician.
Government services use certified tools: cryptographic information protection (SKZI), VPN channels and closed data transmission circuits; data storage is permitted only in data centers on Russian territory. Commercial telemedicine services implement similar measures. They use servers and data centers located in Russia, physicians' electronic signatures to validate consultation protocols, and encrypted video communication channels. As a result, patients receive documents legally equivalent to in-person conclusions – which is why physicians' qualified electronic signatures are mandatory elements of telemedicine protocols.
Dmitry Ivanov, Director of Medical Technology Coordination, Millennium Clinic: "Regular messengers don't provide secure communication channels, so at Millennium Clinic we use a unified tool that allows patients to safely transmit documents and receive post-treatment consultations. The communication format can vary – video, audio, or messaging, depending on the situation. Recently we consulted a patient from Tajikistan: we connected via video, displayed his images on screen, and explained in detail what treatment methods we would use. For patients, it's important not just to hear the physician but to see what will be done and feel that the specialist understands their situation."
Today, Russian clinics use a wide range of telemedicine and remote diagnostics solutions. These include the SONORUS system, enabling ultrasound data transmission for remote analysis by federal center specialists. For cardiology, remote ECG transmission platforms like "Medscan-Telekard" and "Telekard-ONLINE" are widely used, allowing real-time ECG transmission to vascular centers. In radiology, cloud complexes N3.Health Telemed and AGFA Enterprise Imaging support remote image interpretation. Regions use video consultation systems "Medved.Telemed" and telemedicine modules built into regional MIS versions, such as EGISZ-Moscow Standard. Through such solutions, clinics can connect remote experts to complex diagnostic cases and provide patients consultations regardless of location.
How do wearable devices and remote monitoring work?
Telemedicine development is impossible without hardware – devices that collect medical data outside hospitals and transmit it to physicians. This expands monitoring capabilities, particularly for patients with chronic diseases, post-surgical patients, or those with limited mobility.
Vladislav Mohamed Ali, Medical Director of SberZdorovie: "One of the activities of the medical company "SberZdorovie" is remote monitoring of patients with type 2 diabetes, cardiovascular diseases, and ENT disorders. Smart gadgets are used for monitoring. Patients with cardiovascular diseases use a smart blood pressure monitor from SberZdorovie with remote observation capability by a cardiologist. The process is very simple: the patient takes measurements using the device, which are automatically transmitted to the "Smart Monitoring" mobile app without needing manual entry. The doctor receives the patient's data, sees the dynamics of changes, and if indicators go beyond normal limits – proactively contacts the patient to promptly adjust treatment for stabilization or take emergency measures in time, for example, recommend calling an ambulance. Similarly, patients with type 2 diabetes are monitored using glucometers for blood sugar measurements. For people with ENT disorders, a "Smart Health Camera" is provided, which allows taking images of the internal cavities of ears, nose, and throat and sharing them with a doctor during an online consultation."
In practice, one of the first areas where wearable technologies became widely utilized was cardiac rhythm monitoring. Today, portable ECG recorders exist that patients can wear for 24 hours or longer, with physicians receiving recordings remotely. Such devices have become an important component of monitoring patients with arrhythmias and other rhythm disorders. Electronic blood pressure monitors for hypertension control and continuous glucose monitoring systems also play significant roles. Devices automatically transmit data to physicians, greatly simplifying observation for hypertension and diabetes when trends matter more than single measurements. In Russia, glucose monitoring sensors are provided free to children and pregnant women.
Remote monitoring is currently applied in work with elderly populations. Particularly when patients live alone or have limited mobility and physicians need regular basic condition information. Wearable sensors track activity, pulse, respiration, and other parameters.
Regional projects demonstrate that wearable devices are gradually integrating into medical practice. Additionally, the number of connected devices and patients is tracked within the ELR "Personal Medical Assistant." In 2023, the Russian government launched an experimental legal regime (ELR) for telemedicine consultations and wearable devices for chronic disease remote monitoring. According to the Ministry of Economic Development, during 2023–2024 in this pilot, over 51,000 people used telemedicine consultations or remote monitoring, and by March 2025, over 205,000 health monitoring devices were connected to the "Personal Medical Assistant" platform. Most devices monitor glucose levels and blood pressure in patients with diabetes and hypertension; the project also includes pregnant women with gestational diabetes and complicated pregnancies.
However, reviews of Russian practice note that implementing such technologies faces technological, legal, and economic barriers. One of the most pressing problems is foreign software for devices not included in the Ministry of Digital Development's white lists. For example, the most common glucose monitoring applications, FreeStyle LibreLink and Hematonix, are used by parents of children with type 1 diabetes. However, when internet connectivity is unstable, users don't receive timely notifications that glucose levels are dropping too low and cannot provide timely assistance to children.
How does online psychological support work?
When discussing telemedicine, attention typically focuses on "somatic" medicine: physician consultations, diagnostics, and monitoring. However, parallel to this, Russia has developed a substantial online psychological support segment. In foreign countries like the USA, remote psychologist and psychotherapist consultations are often offered through subscription models at high cost.
The Russian psychotherapeutic care market developed more rapidly than classic telemedicine and became one of the most accessible remote formats. Russian-speaking patients have access not only to private consultations arranged with specialists maintaining legal private practices, for example on the professional site B17, but also platforms operating on flexible schemes – Alter, Yasno, Zigmund.Online, Yandex.Health, YouTalk, and others. Many platforms have multi-stage specialist selection processes verifying not only appropriate education and work experience but conducting ethical assessments. Users can choose specialists, communication format (video sessions, audio, chat), treatment duration, and payment from anywhere in the world.
This made the market accessible to Russian-speaking audiences, including people living abroad. Moreover, services attempt to adapt and enable payment with foreign cards. Sessions occur in secure digital offices where correspondence is maintained and materials stored. For many users, this lowers barriers to seeking help: no need to visit clinics, explain situations at registration, or find "their" specialist in an unfamiliar city.
Vladislav Mohamed Ali, Medical Director of SberZdorovie: "It's worth noting that demand for telemedicine psychology services is growing. In 2024 compared to 2023, the number of appointments for online consultations increased by 60%. Growth also occurred in the first half of 2025 compared to the same period last year, by 87%."
How to obtain a teleconsultation?
When a patient in Russia, including foreign nationals, wants to request a teleconsultation, the procedure in Russian clinics is usually quite straightforward. First, choose a medical organization or telemedicine service: some federal centers explicitly state on their websites that they accept inquiries from other countries. For example, St. Petersburg Research Institute of Phthisiopulmonology works with foreign patients through a correspondence consultation office: documents are accepted electronically, and conclusions sent by email. Similar formats operate at Turner Scientific Research Institute for Children's Orthopedics and National Medical Research Radiological Center. In the private sector, second opinion services offer similar options: TeleDoctor24, several large multidisciplinary clinics and specialized centers indicate they consult patients "from any country" with medical documents. However, obtaining services may require not only identification but migration cards, and for payment – Russian bank cards.
Daria Sobol, Operations Director, RAMI Clinic: "The main limitation working with foreign patients in telemedicine is their identification. If someone can verify identity through Gosuslugi, the process becomes clear and transparent. However, when foreign patients don't have this capability, or Russian patients don't want or can't verify, the system treats them as anonymous users. We cannot send medical documents and test results to anonymous patients: they're accessible only in personal accounts after identity confirmation. Nevertheless, we're considering expansion options and seeking solutions enabling safe work with patients outside Russia."
After choosing a clinic, patients complete applications on websites or contact registration. Many institutions require signed informed consent for remote consultation – it's attached in personal accounts or sent by email. Then medical documents are uploaded: discharge summaries, test results, histological conclusions, MRI or CT scans. In some cases, clinics request Russian translation if documents are in other languages; this is particularly relevant for complex conclusions where formulation accuracy matters.
Then the consultation format is scheduled. If conversation is required, video or audio call time is selected – most clinics use proprietary secure platforms or government services. In situations where expert evaluation is important but direct conversation unnecessary, correspondence consultation is conducted: physicians review documents and prepare detailed conclusions. This format is often chosen by foreign nationals needing independent opinions from Russian specialists in oncology, neurosurgery, orthopedics, or rare diseases.
Konstantin Antonov, MD, urologist, andrologist, ultrasound diagnostics physician, preventive medicine specialist, Head of Atlas Clinic on Serpukhovsky Val: "Today we receive inquiries from patients in Russia, CIS countries, Europe, UAE, Southeast Asia, and South America – approximately 600 people annually receive telemedicine consultations. Main difficulties relate not to medical aspects but technical and organizational limitations. Communication channels on patients' side aren't always stable, immediate physical examination or instrumental diagnostics is impossible, and prescribing prescription medications is sometimes complicated by their absence in other countries' markets."
Upon completion, patients receive written conclusions, typically in PDF format, signed with physicians' qualified electronic signatures. Documents are sent to email or personal accounts. For foreign citizens, this is often a more convenient pathway than in-person visits: it doesn't require country entry but allows medical document review by specialists difficult to access physically.
Besides federal centers and private clinics, remote consultations are offered by major mobile operators and insurance companies. The market already has several services oriented toward people without permanent medical attachment or Russian OMI policies. For example, Beeline has a "TeleMed: Personal Doctor for Migrants" program enabling 24/7 general practitioner or pediatrician consultations remotely. Similar solutions are offered by other market participants: Tele2 integrates telemedicine services into packages through partner services; MegaFon provides consultation access based on the SberZdorovye platform, making services accessible to users regardless of citizenship. In the corporate sector, telemedicine consultations for foreign employees are offered by "Doctor Nearby," DOC+, and other insurance company partners, providing 24/7 access to general practitioners and remote medical document review capabilities.
How to integrate telemedicine into your life?
For people living in Russia or abroad, telemedicine becomes one method to navigate the healthcare system, particularly when specialized consultations or preliminary examination reviews are needed. In practice, remote format works best in situations requiring document analysis, established diagnosis discussion, or treatment progress monitoring. For complex or disputed medical conclusions, "second opinion" format is appropriate: Russian federal centers and private services offer written expert conclusions on uploaded medical data, enabling independent reviews without traveling to the country.
If patients are already under physician care and the main task is therapy monitoring, adjustment based on test results, or wearable device data evaluation, regular teleconsultations can become part of the care pathway. Preparation is important: collect discharge summaries, examination protocols, and laboratory test results in advance. When using remote monitoring devices – ensure data transmits correctly to physicians and is accessible for analysis.
For remote format to be effective, clarify several things in advance: whether the clinic fits your clinical profile, whether it accepts documents from abroad, whether it has valid licenses, how data protection is ensured, whether document translation is required, and what language physicians are prepared to communicate in. These details determine interaction quality just as in in-person systems. Today, patients don't need to determine all nuances themselves. Marus managers are prepared to handle this task and ensure high-quality service.
How this can be accomplished:
- Expert clinic selection: Marus carefully selects clinics considering clinical profile and needs. Patients save search time.
- Document acceptance: Marus specialists resolve all document verification issues from patients' countries (without intermediaries).
- Licenses and certificates: Marus verifies clinics have all necessary documentation to work with foreign patients.
- Data security: Marus guarantees personal data confidentiality compliance.
- Translation and communication language: if patients need translation, Marus provides necessary physicians or translators in needed languages, or selects physicians who understand patients.
Why this benefits patients:
- Save time and stress negotiating with foreign clinics.
- Ensure reliability of chosen clinics and physicians.
- Access high-quality medical care with minimal bureaucratic complexity.
- Always know professionals are looking after you.
Partnering with Marus, you can delegate complex clinic search and adaptation questions to professionals – this makes telemedicine consultations more effective and successful.
Telemedicine in Russia is gradually becoming part of routine practice – not replacing physicians but supplementing methods to connect with them. For people living in the country or collaborating with Russian medical centers remotely, it becomes a convenient tool for receiving care and expert conclusions in cases where it's truly feasible.
All information on this website is provided for informational purposes only and does not constitute medical advice. All medical procedures require prior consultation with a licensed physician. Treatment outcomes may vary depending on individual characteristics. We do not guarantee any specific results. Always consult a medical professional before making any healthcare decisions.