Telemedicine video consultations: where they add value

Telemedicine, the delivery of medical services at a distance, adds real value through video con­sul­ta­tions for follow-up visits, stable chronic con­di­tions, mental health and dis­cussing results. It does not replace the physical ex­am­i­na­tion: rules such as Poland's require a face-to-face visit at the first visit, when a chronic disease worsens and when cancer is sus­pect­ed.

What is telemedicine, and what is a video con­sul­ta­tion?

A video con­sul­ta­tion is the syn­chro­nous form of telemedicine: doctor and patient talk in real time, in dif­fer­ent places, through image and sound. Eurostat defines a tele­con­sul­ta­tion as direct and syn­chro­nous com­mu­ni­ca­tion between provider and patient, by tele­phone or video call. The World Health Or­ga­ni­za­tion (WHO) calls tele­health any care in which patient and provider are sep­a­rat­ed by distance.

In Romania, the Norms approved by Gov­ern­ment Decision no. 1133/2022 list six types of service: tele­con­sul­ta­tion, tele-ex­per­tise, tele-as­sis­tance, tel­era­di­ol­o­gy, telepathol­o­gy and tele­mon­i­tor­ing. This article deals only with the doctor-patient video con­sul­ta­tion.

Telemedicine is on the agenda of the "Digital Health Trans­for­ma­tion in Europe" event in Vienna on 15 October 2026, which looks at the ex­pe­ri­ence of Poland, Austria and Moldova. That is why we compare the rules of these three coun­tries and of Romania below.

How common are tele­con­sul­ta­tions after the pandemic?

The gap between coun­tries is very large: ac­cord­ing to Eurostat, tele­con­sul­ta­tions made up 36% of doctor con­sul­ta­tions in Estonia in 2024, while Romania reported 0.0 tele­con­sul­ta­tions per in­hab­i­tant, a figure that shows what enters national re­port­ing, not that the service is absent. Portugal reaches about 26%, Denmark and Finland 23-24%. In 7 of the 18 coun­tries where the share can be cal­cu­lat­ed, fewer than 1 con­sul­ta­tion in 10 was remote.

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Three caveats change how to read the chart. First, Eurostat notes that coverage is in­com­plete in some coun­tries; Sweden (about 26%) is left out of the chart because its figure includes written con­sul­ta­tions and only some regions. Second, Romania is left out because its reported value (0.0 tele­con­sul­ta­tions per in­hab­i­tant) cannot be read as an absence of telemedicine; remote con­sul­ta­tions have had a legal basis since 2020 and are covered by the CNAS Frame­work Contract. Third, Austria reports only total con­sul­ta­tions, without sep­a­rat­ing remote ones, and tele­con­sul­ta­tion data for Moldova are not avail­able.

In Poland, where tele­con­sul­ta­tion (tele­po­ra­da) is reg­u­lat­ed as a primary care service, the share was about 8%. For Moldova there is no pub­lished baseline: the National Pro­gramme for Dig­i­tal­i­sa­tion and In­no­va­tion in Health 2025-2030 lists the share of remote con­sul­ta­tions as "n/a" and sets a 15% target for 2030.

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The lack of com­pa­ra­ble data is not limited to one country. The WHO/Europe survey of 2022, pub­lished in 2024, shows that most states in the region use tele­health, but few evaluate it.

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Where do video con­sul­ta­tions add real value?

The evidence shows that a well-chosen video con­sul­ta­tion is as ef­fec­tive as an office visit for a large share of patients in primary care and mental health. The sys­tem­at­ic review by Carrillo de Albornoz and col­leagues in Family Practice (2022) compared tele­phone and video con­sul­ta­tions with face-to-face visits. The con­clu­sion: com­pa­ra­ble clinical outcomes, high sat­is­fac­tion and time saved for patients.

The 2023 report of the OECD (Or­gan­i­sa­tion for Economic Co-op­er­a­tion and De­vel­op­ment) on the future of telemedicine reaches the same point: when well used, telemedicine can be ef­fec­tive, safe, patient-centred and cost-ef­fec­tive. A survey cited by the OECD, of about 1,000 general prac­ti­tion­ers in Norway, shows where it works best:

• with patients the doctor already knows, rather than at first contact;
• for fol­low­ing up ongoing care, rather than for a new problem;
• for anxiety and de­pres­sion;
• for ad­min­is­tra­tive matters;
• for chronic con­di­tions that need repeated follow-up.

Patients agree. In Austria, a survey of 1,000 people cited by the OECD found that nine in ten re­spon­dents were sat­is­fied or very sat­is­fied with their tele­con­sul­ta­tions. In Poland, ac­cord­ing to the National Health Fund (NFZ), 96.8% of almost 14,000 patients surveyed were sat­is­fied.

A good video con­sul­ta­tion is not an office visit moved to a screen. It is a con­sul­ta­tion chosen because it does not need the doctor's hands.

Where does it not work, and who draws the line?

The line is the physical ex­am­i­na­tion. The OECD warns that telemedicine will not fully replace face-to-face care and that some patients prefer the practice. The Family Practice review notes high dis­con­tin­u­a­tion rates with tele­con­sul­ta­tions, so the format does not suit everyone.

Poland wrote the line into law. The Ministry of Health reg­u­la­tion of 12 August 2020 on the standard of tele­con­sul­ta­tion in primary care (con­sol­i­dat­ed text: Dz.U. 2022 poz. 1194) requires direct contact in specific cases:

1. when the patient has not agreed to a tele­con­sul­ta­tion;
2. at the first visit to the chosen doctor, nurse or midwife;
3. when a chronic disease has worsened or its symptoms have changed;
4. when cancer is sus­pect­ed;
5. for children under 6, except follow-up visits in a treat­ment set after a personal ex­am­i­na­tion.

Romania is moving towards a similar rule, per spe­cial­ty. Gov­ern­ment Or­di­nance no. 2/2026, pub­lished in Official Gazette no. 75 of 30 January 2026 and in force since 2 February 2026, added article 30^12 to Law no. 95/2006 on health sector reform. It requires the norms to set, for each spe­cial­ty, the services allowed, their limits and the cases where a face-to-face con­sul­ta­tion is manda­to­ry. The bill ap­prov­ing the or­di­nance was adopted by the Senate on 18 March 2026; the Chamber of Deputies is the deciding chamber, and we could not confirm its final vote or the per-spe­cial­ty norms (status checked on 7 October 2026).

Until the new norms arrive, Gov­ern­ment Decision no. 1133/2022 (Official Gazette no. 909 of 15 Sep­tem­ber 2022) already sets two clear rules. The platform must display the limits of the service and the option for doctor and patient to turn it into a face-to-face con­sul­ta­tion at any time. Telemedicine is not used when doctor and patient do not speak the same language well enough. The OECD adds two risks flagged by experts: wider in­equal­i­ties and exposure to data breaches and ran­somware.

What do Romania, Moldova, Austria and Poland require?

Romania, Austria and Poland require, through law, norms or the insurer's rules, the patient's agree­ment, a secure con­nec­tion and doc­u­men­ta­tion of the con­sul­ta­tion in the medical record; Moldova will set these rules in its planned reg­u­la­tion. The legal basis, iden­ti­fi­ca­tion and payment differ.

Aspect	Romania	Moldova	Austria	Poland
Legal basis	Law 95/2006, art. 30^1-30^12; GD 1133/2022; GO 2/2026 (in force since 2.2.2026)	National programme 2025-2030 (GD 556/2025); regulation planned Q3-Q4 2026	Physicians Act, § 49(2), since 1.1.2024	Ministry of Health regulation of 12.08.2020 (Dz.U. 2022 poz. 1194)
Consent	Express, except emergencies; the provider must prove it	To be set by the regulation	Express (ÖGK agreement)	Teleporada only with the patient's agreement; otherwise direct contact
Identification	The norms do not specify the method	To be set	Doctor verifies identity with available technical means	ID shown on video or electronic patient account
Face-to-face	Doctor decides; per-specialty norms in preparation	To be set	Under the ÖGK contract, only patients already seen, with exceptions	First visit, worsening, suspected cancer, children under 6
Public payment	CNAS: chronic conditions and endemic-epidemic diseases with isolation, under the norms	Not specified	Same fee as in the practice	Primary care service reported to the NFZ

Romania

In Romania, telemedicine entered Law no. 95/2006 through Gov­ern­ment Emer­gen­cy Or­di­nance no. 196/2020, and Gov­ern­ment Decision no. 1133/2022 approved the im­ple­ment­ing norms. The norms require in­fra­struc­ture and pro­ce­dures for the secure use of audio or video plat­forms, staff training, and ar­chiv­ing of all doc­u­ments in an elec­tron­ic health record of the patient. The platform must display the names and qual­i­fi­ca­tions of the doctors, the fees, tech­ni­cal support, the limits of the service and the con­di­tions for pro­cess­ing personal data.

For patients insured with CNAS (the National Health In­sur­ance House), the Frame­work Contract approved by Gov­ern­ment Decision no. 521/2023, in the updated text of January 2026, allows remote con­sul­ta­tions for chronic con­di­tions and for endemic-epidemic diseases that require iso­la­tion. The pro­vi­sion applies in family medicine and out­pa­tient spe­cial­ist care, under the con­di­tions in the norms. Psy­chi­atric therapy, genetic coun­selling and some psy­cho­log­i­cal services may also be de­liv­ered remotely.

Moldova

In Moldova, telemedicine is moving forward through the national pro­gramme. Gov­ern­ment Decision no. 556/2025 approves the National Pro­gramme for Dig­i­tal­i­sa­tion and In­no­va­tion in Health 2025-2030, with mea­sur­able targets:

• 50% of medical in­sti­tu­tions offering telemedicine services by 2030;
• a telemedicine platform in­ter­op­er­a­ble with the elec­tron­ic health record, used in at least 20 in­sti­tu­tions;
• at least 200 medical staff trained;
• a telemedicine reg­u­la­tion, with def­i­ni­tions, el­i­gi­bil­i­ty con­di­tions and re­port­ing, planned for Q3-Q4 2026.

The pro­gramme's starting point is weaker rural access to spe­cial­ists. In its public con­sul­ta­tion, answered mostly by patients, 11.3% of re­spon­dents said they had used remote con­sul­ta­tions.

Austria and Poland

In Austria, the Physi­cians Act (Ärztege­setz) has stated since 1 January 2024 that doctors practise per­son­al­ly and directly, "in­clud­ing through telemedicine". The agree­ment with the ÖGK health insurer, sum­marised by the Tyrol Medical Chamber, pays a video con­sul­ta­tion the same as an office visit and requires end-to-end en­cryp­tion for the whole trans­mis­sion. It also requires com­pli­ance with Austria's health telem­at­ics law (GTelG 2012) and the GDPR. In Poland, tele­con­sul­ta­tion is tied directly to the Internet Patient Account (IKP), the e-pre­scrip­tion and the e-referral: the provider must explain to the patient how to use all three.

What tech­ni­cal and data pro­tec­tion re­quire­ments apply to a video con­sul­ta­tion?

A proper video con­sul­ta­tion has four links: doc­u­ment­ed consent, verified identity, a secure con­nec­tion and an entry in the record, con­nect­ed to the e-pre­scrip­tion and e-referral. The an­i­ma­tion below follows one con­sul­ta­tion.

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Three points need special at­ten­tion. The first is record­ing the call. The Romanian norms do not require video record­ing, only an entry in the record; if you choose to record anyway, you need a legal basis, patient in­for­ma­tion and a re­ten­tion period, as for any health data. Roles and con­tracts are covered in our guide to GDPR in health­care, and any later reuse of con­sul­ta­tion data, for example for research or AI, falls under the rules in our guide to the sec­ondary use of health data.

The second is in­te­gra­tion. A video platform that does not write to the elec­tron­ic record and cannot issue the pre­scrip­tion in the same flow shifts work onto the doctor. See our article on hospital digital in­fra­struc­ture and in­ter­op­er­abil­i­ty.

The third is the channel. The norms require plat­forms that IT staff can check "for the accuracy and security of data trans­mis­sion". A call on a personal mes­sag­ing app, with no contract with the provider and no access log, does not allow that check. The video platform becomes part of the hospital's in­fra­struc­ture, with the same security duties de­scribed in our article on hospital cy­ber­se­cu­ri­ty and the NIS2 Di­rec­tive.

What this means for a hospital in Romania or Moldova

A clinic or hospital can start video con­sul­ta­tions in a few clear steps, with a narrow scope and written rules before the first call.

1. Choose the in­di­ca­tions. Start with follow-up of stable chronic con­di­tions, dis­cussing results, treat­ment ad­just­ments for known patients, and psy­chi­a­try or psy­chol­o­gy. Write down, per spe­cial­ty, when a con­sul­ta­tion au­to­mat­i­cal­ly becomes face-to-face.
2. Write the consent flow. Clear text, the same in­for­ma­tion as on the platform (art. 5 of the norms), proof kept in the system.
3. Set the iden­ti­fi­ca­tion method. ID shown to the camera, au­then­ti­cat­ed account or data from the record, noted each time.
4. Check the platform. En­cryp­tion for the whole call, known servers and sub­con­trac­tors, a data pro­cess­ing agree­ment, access logs.
5. Connect the platform to the record. Booking, con­sul­ta­tion, e-pre­scrip­tion and referral in one flow, with no manual copying.
6. Prepare plan B. What happens when the con­nec­tion drops: the doctor calls back, the incident is recorded, the visit is resched­uled.
7. Train doctors and nurses. The Romanian norms require it ex­plic­it­ly; Moldova's pro­gramme targets at least 200 trained staff.
8. Measure. How many video con­sul­ta­tions still sent the patient to the practice, how many were in­ter­rupt­ed, what patients say. Only 37% of states in the WHO European Region evaluate their tele­health services; a hospital can do it from the first month.

Ques­tions to ask a video platform vendor. We are a vendor too; the ques­tions apply to us as well.

• Is the call en­crypt­ed for its whole duration, and who holds the keys?
• Where do the servers run, and which sub­con­trac­tors have access to data?
• Is the con­sul­ta­tion written au­to­mat­i­cal­ly to the elec­tron­ic record, with the fields required by Gov­ern­ment Decision no. 1133/2022?
• Can the doctor issue the pre­scrip­tion and the referral from the same screen?
• How is the patient's identity verified, and how is proof of consent kept?
• What happens to the data when the contract ends?

Cons­d­i­nam­ic, a company from the Republic of Moldova that builds software and AI to order and goes deepest in health­care, works on projects in Romania and has built, among other things, doctor-patient video con­sul­ta­tions (telemedicine). Our approach starts from the same rules: data pro­tec­tion from the first day of a project, access limited to what is strictly nec­es­sary, and data that stays under the clinic's control.

Con­clu­sion

After the pandemic, the video con­sul­ta­tion has remained a tool, not a sub­sti­tute. The evidence supports it for known patients, stable chronic con­di­tions, mental health and dis­cussing results, and the limit comes from the need for a physical ex­am­i­na­tion. Romania has a legal frame­work and limited CNAS re­im­burse­ment, and is pre­par­ing rules per spe­cial­ty. Austria and Poland show two models already in use: payment equal to an office visit, and explicit lists of face-to-face cases. For a hospital, what makes the dif­fer­ence is the rules written before the first call and the con­nec­tion to the patient's record.