The Regulation on the Cascading of Health Service Providers (“Cascading Regulation”) and the Regulation on the Delivery of Remote Health Services (“Digital Services Regulation”) by the Ministry of Health were published in Official Gazette dated 10 February 2022 and numbered 31746, entering into force on the date of publication.

In accordance with the Cascading Regulation, real persons who provide and/or produce health services, public and private legal entities and health service providers defined as their branches without legal personality are divided into three.

Health care providers that provide primary care outpatient diagnosis and treatment include: District health directorate which has a primary health care institution, community health center, family health center, public health laboratory, institution doctor, 112 emergency health service units, home care centers or units, units providing workplace health and safety services, municipal polyclinics, private polyclinics, private health institutions providing oral and dental health services, medico-social units within universities, primary health units of the Turkish Armed Forces, pharmacies operating independently within the scope of the Law on Pharmacists and Pharmacies, and clinics.

Secondary health service providers are as follows: State hospitals and treatment centers that do not have

training and research hospitals, district polyclinics affiliated to these hospitals, integrated district hospital, oral and dental health centers affiliated to the Ministry, hospitals licensed by the Ministry belonging to public institutions, medical centers and treatment centers, private hospitals, private medical and treatment centers, oral and dental health hospitals, dialysis centers, assisted reproductive treatment centers, hyperbaric oxygen treatment centers, independently licensed diagnosis and treatment centers such as medical laboratories.

Tertiary healthcare service providers are: High-level hospitals that include high technology and/or have the infrastructure to provide training and research services for diseases that require advanced examination and special treatment as defined in the relevant legislation.

Others specialized in diagnosis, treatment and supply centers licensed and/or authorized by the Ministry, which are not included in the levels specified in the Cascading Regulation, shall be considered as health service providers that cannot be cascaded in terms of health service delivery.

In accordance with the Digital Services Regulation, the remote health information system shall be developed by Ministry or non-Ministry authorized developers in accordance with the minimum standards determined by the Ministry. A remote health service activity permit shall be issued by the Ministry, provided that the health facility that wants to provide remote health services meets the necessary conditions.

The following services can be provided remotely, provided that they are suitable for remote healthcare service delivery by nature:

  • The person requesting remote health service can be examined to the extent that the remote health service allows, the person can be evaluated by medical observation and monitoring, diagnosed diseases can be controlled, medical advice can be given, consultation or secondary opinion may be requested. 
  • For the remote control and monitoring of diseases, clinical parameters such as blood sugar and blood pressure can be evaluated and monitored, and treatment and drug management can be provided.
  • Services can be provided to protect and monitor health, support a healthy life, and provide psychosocial support services.
  • Versatile assessment and monitoring of people with increased health risk or advanced age can be done.
  • Interventional or surgical operation services determined by the Ministry may be offered to individuals, provided that the technologic facilities are present and the necessary permissions are obtained from the Ministry.
  • In endemic or epidemic outbreaks, necessary medical procedures can be carried out to protect the health of people in line with national guidelines.
  • With wearable technologies and other medical devices, the health data of the person requesting health care can be measured and tracked.
  • An e-prescription and e-report can be issued by the physician to the person evaluated by the physician.

The person who will receive remote health service shall be informed about the issues listed in the Digital Services Regulation before the remote health service begins and to the extent that it is suitable for the nature of the health service to be provided.

The health facility shall take the necessary measures to verify the identity of the person receiving the service within the scope of remote health service delivery. The healthcare facility and healthcare professional shall be responsible for the protection of patient privacy and personal data in the delivery of remote healthcare services.

You can access the full text of the Cascading Regulation published in Official Gazette dated 10 February 2022 and numbered 31746 from this link, and the full text of the Digital Services Regulation from this link. (Both only available in Turkish)