Video consultation, which spread rapidly during the pandemic, is today a regulated service area in Türkiye. Bringing a physician and a patient together in a video app is technically easy; delivering it as a health service brings obligations around registration, permits, identity verification, consent and record keeping. This article explains why an online consultation is not an ordinary video call and what steps make up a secure flow. It is not legal advice; verify the conditions that apply to your organization from the Ministry of Health legislation and your health-law adviser.
What is remote healthcare?
Remote healthcare means a physician and a patient providing or receiving health services without being in the same place, through information and communication technologies. In Türkiye this activity is carried out under the Ministry of Health's regulation on remote healthcare services. The software used for services in the regulation's scope must be a Remote Health Information System (USBS) registered in the Ministry's registration and listing system (KTS), and the health facility providing the service must also hold a permit for remote health activity.
These two conditions are separate and do not replace each other:
- Registration of the software. The system used must be registered in KTS as a USBS.
- Permit of the facility. The health facility providing the service must hold the necessary permit for remote health activity.
Even if the software provider is registered, the service cannot be offered if the facility has no permit. Even if the facility is permitted, the problem remains if the software used is not registered. A clinic that wants to offer online consultation must verify both conditions on its own behalf. For official sources, you can check the registration and listing information on the KTS(opens in a new tab) site.
"But I already do video calls"
Many physicians have been talking to patients from their own phone or from a general video app for years. That app may not substitute for the remote health service described in the regulation. The risks are:
- The call record is not linked to the clinical record; the examination trail is not in the patient file.
- There is no identity verification; you cannot be sure the other person is really the patient.
- No separate information or consent is obtained from the patient for camera, microphone and data processing.
- Files and messages shared during the call stay outside audit.
- Data passes through infrastructure outside the facility's control.
In short, a general call app falls short both legally and clinically. For the legal consequences, assess your situation with an adviser; but from a clinical and data-security viewpoint it is important to know the gap that an unrecorded consultation creates.
A secure online consultation flow
A well-designed online consultation passes through these steps, from appointment to the clinical record:
Attach to encounter and audit trail
The consultation attaches to the patient's encounter; duration, participants and connection events are written to the audit log.
- The process is complete here.
All steps
- 01 Online appointment (Patient) The patient picks the online appointment type; the slot comes from the physician's real calendar.
- 02 Identity check and separate consent (System) The patient's identity is verified; the remote-service notice and camera-microphone consent are obtained as separate actions.
- 03 Waiting room (Patient) The consultation does not start before the physician arrives. The patient runs the device test and waits.
- 04 Physician or moderator admits (Physician) The physician admits the patient. Access is for a single consultation and a single role.
- 05 Consultation (Physician) Encrypted audio and video; secure messaging and file sharing. Recording is off.
- 06 Ending (Physician) Either party ends the consultation; audio and video stop and the room closes.
- 07 Attach to encounter and audit trail (System) The consultation attaches to the patient's encounter; duration, participants and connection events are written to the audit log.
Alternative path from 05 Consultation; it returns to the main flow at 05 Consultation.
- 05a Connection lost (System) One party's connection dropped; the session stays open and the event is logged.
- 05b Reconnection (Patient) Participants reconnect to the same session; the short-lived access is renewed.
Alternative path from 05 Consultation; it returns to the main flow at 07 Attach to encounter and audit trail.
- 05a Continue by phone or in person (Physician) If reconnection fails, the physician applies the predefined continuation plan; the status is written to the encounter note.
07 Attach to encounter and audit trail
- Online appointment. The consultation type is scheduled in the physician's calendar like other appointments. The physician and facility must be eligible for online appointments.
- Identity verification and information. The patient verifies identity before the consultation. A separate notice on camera and microphone use and on data processing is shown, and the necessary consent is obtained. Privacy notice, explicit consent and clinical consent are not mixed up.
- Waiting room. When the patient connects, they do not go straight into the physician's session; they wait in a virtual waiting room and the physician or a moderator admits them. This prevents the wrong person from entering.
- The consultation. Audio and video are transmitted encrypted. Secure messages and file sharing happen inside the consultation; the physician can show their screen to the patient.
- Ending. When the consultation ends, the connection closes.
- Record linkage. The consultation is linked to the patient's examination (encounter) record; who talked, when and for how long is kept as a trace. The physician still writes the examination note, prepares a prescription draft if needed, and the record is signed.
This flow has branches too: what if the patient cannot connect? If the connection drops mid-session, how does the physician reach the patient? If an emergency is noticed, how is the patient referred? Every clinic should put the answers to these questions in writing beforehand.
When is online consultation not suitable?
Clinical decisions always belong to the physician, but some situations are not suited to remote assessment: complaints that need physical examination, conditions that may require urgent intervention, cases where the patient's identity cannot be verified, and situations where the patient cannot be adequately safe and private in the video environment. The physician's decision to convert the consultation to an in-person visit is a natural branch of the flow, and the system should make it easy: quick referral to an in-person appointment and carrying the consultation note over.
Which specialties benefit most?
Online consultation does not create the same value in every specialty; it is most useful in checkups and follow-ups where physical examination takes a back seat.
- Chronic disease follow-up: regular checks, medication adjustment and result review do not always need the patient to come to the clinic.
- Psychology and psychiatry: therapy sessions and follow-up are among the areas well suited to remote delivery; privacy and record rules carry extra weight.
- Dietitians and nutrition counseling: sharing measurements and following a plan can be done remotely.
- Post-treatment checkups: short checks after surgery or procedures can be valuable when travel is difficult.
- Result review: evaluating test results together with the physician.
- Pre-assessment: a first consultation before treatment, especially for patients who are far away.
On the other hand, examinations where the physical finding is decisive, emergencies and first-time assessment of unclear conditions should mostly be in person. The decision on which consultation can be done remotely belongs to the physician; the software's job is to offer a flow that supports it.
The patient side: access and privacy
Online consultation should be easy and safe for the patient. When the link is sent, the message should contain no health information, and the link should be personal and time-limited. The patient should be able to join from a browser without complicated setup. For privacy, the patient is sent a short note reminding who can see the screen during the consultation. On the physician's side too, telling the patient if a third person is in the room is a principle of trust.
After the consultation, a file, prescription draft or report can be published via the patient portal after physician review. Publication is made by the physician's explicit decision, and the patient notification contains no health information.
Pre-assessment in medical tourism
For patients abroad, remote pre-assessment before treatment is a frequent request. There is an extra gate here: an online pre-assessment can only be done with a registered USBS and the necessary permits. Language, time zone and translation are part of the flow. Clinical translation and legal texts should be published only with human approval and version evidence. For this journey, see our medical tourism patient journey guide.
Fees, invoicing and records
An online consultation is a health service; its fee, charge and collection should be recorded with the same care as an in-person examination. The patient should know the fee and the cancellation and refund terms before the consultation. The consultation fee enters the charge and collection flow like other services, so it does not go missing from revenue share and cash reports. Card details are not kept in the clinic; payment is taken through the payment provider. Documents issued after the consultation (report, prescription draft, information) are added to the patient file.
The rules on advertising and promotion of health services also apply to online services. Without using expressions such as "doctor 24/7" or "guaranteed results," stating the scope and limit of the service clearly is safer both legally and ethically.
Technical quality expectations
On the user side, technical quality determines trust. Automatic reconnection when the connection drops, an audio-first mode at low bandwidth, a camera and microphone test before the consultation, and smooth operation in common browsers reduce the disappointment the patient feels in the first consultation. On the physician side, working with two screens (one for the consultation, one for the patient file) makes it easier to keep notes during the session. When the patient gets the feeling that "the technology isn't working," the medical value of the consultation falls too.
Three topics should be asked on the security side: in which country the consultation's media stream is processed, whether the consultation is recorded and, if so, where and for how long it is kept, and through which identity verification steps the consultation is entered. A consultation should not be recorded without informing the patient and without a legal basis.
HekimBis's approach
In HekimBis, online consultation is designed as one flow from the appointment to the record after the visit: the patient books an appointment, verifies their identity, gives a separate notice and consent, and waits for the physician in a waiting room; when the visit ends, the record is linked to the examination record in the patient's file. Recording is off by default. The feature is set up by verifying the activity permit of the facility providing the service and the related registration details.
You can see the scope of the feature and the flow of the consultation on the online consultation page. For privacy and consent records, see forms, consents and documents, and for security principles, the security page.
Readiness checklist for an organization
A practical readiness checklist for a clinic that wants to offer online consultation:
- Does the facility have a remote health activity permit; what are its scope and validity?
- Has the system to be used been verified as a USBS in KTS?
- Is the patient identity verification method defined?
- Are the notice and consent text for camera/microphone and data processing ready?
- Is the consultation linked to the patient file and the encounter record?
- Is the procedure for dropped connections and emergencies in writing?
- Do physicians have a suitable, private environment for consultations?
- Are fees and refund policy told to the patient in advance?
- Is there an in-person referral path for situations not suited to consultation?
Conclusion
Done correctly, online consultation is a service that increases access, speeds up checkups and protects the patient's time. But without a registered system, facility permit, identity verification, separate information, a waiting room and record linkage, it stops being a health service and turns into a risky video call. When choosing a solution, look not only at video quality but at every link of this chain. For the portal-side experience of physician and patient, you can read the doctor portal guide.
