Bulgaria Introduces Telemedicine with Strict Rules and Full Digital Traceability

Bulgaria now has its first official framework for telemedicine following the publication of the long-awaited ordinance on medical assistance from a distance. With this act, the Ministry of Health is digitising the healthcare sector by setting out rules for the use of modern technologies in treatment and diagnosis, while maintaining the highest standards of safety and quality of care.

The regulation stipulates that telemedicine may be used only when it can ensure a level of safety equivalent to an in-person medical examination. The decision to provide a remote consultation is made by a medical professional based on clinical assessment in each individual case.

The framework allows both real-time communication (synchronous consultation) and delayed exchange of medical data (asynchronous care). Healthcare providers are also permitted to establish joint centres for remote medical assistance.

A key element of the regulation is the mandatory documentation of all services within the National Health Information System. Every electronic consultation is recorded in the patient’s digital health record, ensuring full traceability of treatment and transparency. Oversight of these activities will be carried out by the Executive Agency “Medical Supervision”.

The new framework explicitly prohibits the remote performance of procedures that require physical contact, such as assisting in childbirth, certifying death, and certain dental interventions. The technological requirements for platforms are designed to ensure maximum cybersecurity and the protection of personal data in line with European standards.

With the adoption of the regulation, a key step is being taken towards the modernisation of Bulgaria’s healthcare system, ensuring faster and easier access to high-quality medical care, regardless of the patient’s location.