From pilot to widespread implementation
In April 2020, during the peak of the COVID-19 pandemic, Hanoi Medical University Hospital piloted remote health care for the first time, connecting doctors in the capital with patients in many provinces and cities.
In 2023 alone, nearly 2,500 cases were consulted at more than 150 hospitals in Lao Cai, Ha Giang, Yen Bai, Tuyen Quang, Thai Binh provinces... to register to participate in online consultations and online training.
After being piloted by the Ministry of remote medical examination and treatment model in 2020, up to now, Hanoi Medical University Hospital has applied information technology in all weekly professional activities of Hanoi Medical University Hospital.
Director of Hanoi Medical University Hospital, Associate Professor, Dr. Nguyen Lan Hieu once commented: "Remote consultation has brought practical results, saving lives and treating many serious patients, through the cases analyzed and discussed, helping doctors at lower levels improve their professional qualifications, while enhancing the reputation of lower-level hospitals, helping patients save time and money".
In the current remote medical examination and treatment system, many central hospitals such as Hanoi Medical University Hospital, Bach Mai Hospital, Viet Duc and Pediatric Central Hospital play a pivotal role in the telehealth network of the Ministry of Health, regularly holding consultations and professional consultations for lower-level patients and patients online. These are also pioneers in implementing medical digital technology before the 2024 Health Insurance Law officially opens the right to health insurance payment from July 1, 2025.
In Hanoi, many major hospitals such as Hanoi Heart Hospital, Hanoi Obstetrics and Gynecology Hospital, Hanoi Oncology Hospital, Xanh Pon Hospital and Thanh Nhan Hospital have deployed remote medical examination and treatment platforms, connecting online with patients and lower-level health care. These are leading hospitals in applying the telemedicine system in Hanoi.
Quang Ninh is also one of the localities that recorded many long-distance consultations between the upper and lower levels, contributing to improving the quality of treatment at the facility. However, these activities are mostly professional support, not remote examination and treatment in the full sense to pay for health insurance on a large scale.
process of remote medical examination and treatment and health insurance payment
From July 1, 2025, remote medical examination and treatment and home examination will be officially paid by the Health Insurance Fund according to the Health Insurance Law 2024. After half a year of implementation, the policy is considered an important step forward in expanding the rights of health insurance participants, while creating a "push" for digital transformation of health care.
According to the 2024 Law on Health Insurance, remote medical examination and treatment; remote medical examination and treatment support; family medicine; home examination... are covered by the Health Insurance Fund, with specific levels, rates and conditions prescribed by the Government and the Ministry of Health.
In principle, the remote medical examination and treatment process can be carried out through the following steps:
Identify patients using electronic health insurance cards, VssID or VNeID applications.
Receiving information and medical data (symptoms, monitoring index, medical history).
Doctors examine, consult, and prescribe remote treatment through qualified digital platforms.
Create an electronic record, save data traces for health insurance appraisal.
Pay health insurance according to prescribed rates and conditions.
The Social Insurance Agency has issued instructions for handling cases where the electronic health insurance card lookup system has errors, allowing medical facilities to receive patients first, then coordinate verification, examination and payment. This shows the determination to ensure the rights of participants, but also reflects the fact that digital infrastructure is still lagging.
Benefits for the people, new pressure for fund management
The most obvious benefits are reducing travel costs, reducing waiting time, especially for people with chronic diseases, the elderly, people with disabilities and people in remote areas. remote follow-up helps maintain continuous treatment, limit complications and reduce pressure on upper-level hospitals.
However, when medical services are brought to the digital environment and associated with health insurance payments, management requirements also become more strict. In reality, there are three major problems.
First, there is no clear line between remotely examined and health consultation. If the criteria for a payment eligibility check-up are not standardized soon, the risk of implementing a disjointed and inconsistent implementation is inevitable.
Second, data infrastructure and system connectivity are not yet synchronous. remote medical examination and treatment depends entirely on identification and digital data, so just a small problem can affect the patient's experience and payment progress.
Third, the risk of abusing and profiting from the health insurance fund. When medical examination interaction does not take place directly, the verification of professional quality, frequency of appointment or authenticity of records requires a more strict monitoring mechanism.
Need for synchronization for policies to promote long-term effectiveness
After half a year of implementation, it can be affirmed that health insurance coverage for remote medical examination and treatment is a correct policy, in line with the digital transformation trend and the goal of taking people as the center. However, to get the policy into depth, experts say it is necessary to focus on three groups of solutions: standardizing services, connecting data and enhancing supervision and measuring real efficiency.
When these "bottlenecks" are removed, examined and treated remotely, it will not only be a support solution, but will become an important component of the modern health system, contributing to better ensuring the right to health care for all people.
