Medical technology is one of the fastest developing industries worldwide. This development and new technologies have had a significant impact on the manner in which medical services are provided.
Telemedicine has undergone an incredible surge in popularity in recent years, not only due to its cost efficiency but also to the time and resources that may be saved through its use.
During the COVID-19 pandemic, new technologies such as telemedicine and remote medical services have become even more relevant due to the risks associated with close physical contact in hospitals and other places where COVID-19 sufferers may be present.
However, telemedicine is not applicable to all medical services, as some must be provided in a direct and personal manner to patients, either by virtue of their maladies or personal situation or the need to physically execute a procedure irrespective of whether the patient is in a hospital or specialised medical facility.
Medical services in Mexico are regulated in a general manner under the General Health Law and its Regulations Regarding Medical Services Rendering. These are the main provisions governing health professionals when prodiving general or specific kinds of medical or health-related service.
In addition to these legal bodies, other provisions focus on more detailed or technical characteristics for these kind of services, as well as the premises or equipment that should be used.
Among these are the diverse Norma Oficial Mexicana (Official Mexican Standards) (NOMs) which, although not formally laws or regulations, establish technical and specific guidelines and criteria that must be followed by many services in Mexico.
For medical services for patients who do not require hospitalisation (ie, outpatients), the technical requirements for facilities are set out in NOM-005-SSA3-2010, which also refers to minimal infrastructure and equipment for outpatient medical care facilities.
NOM-005-SSA3-2018 (New NOM-005), which was published in the Federal Official Gazette on 9 July 2020, sets out the new minimum requirements applicable to infrastructure and equipment required for outpatient medical care facilities.
New NOM-005 will enter into force on 7 September 2020 and replace NOM-005-SSA3-2010, which will remain in force until 6 September 2020.
Compared with NOM-005-SSA3-2010, New NOM-005 introduces the following requirements:
- Medical offices that are attached to or form part of a hospital where healthcare professionals offer outpatient medical care services may operate under said professionals' health licences and will not be required to file individual premises operation notices with the health authorities.
- In addition to appointing a health compliance officer, it will be necessary to submit only a notice regarding said appointment to the health authorities.
- Evidence of proper disinfection procedures must be kept on premises that offer outpatient medical care services. Although it will not be necessary to file this evidence with the competent authorities, these documents must be readily available if required during a verification procedure.
- Outpatient medical care facilities must have on-site evidence of NOM-001-SEDE-2012 (Electrical Installations) compliance. This requirement derives from the relationship between available electric energy sources and procedures that may be carried out on such premises.
- Outpatient medical care facilities must retain on-site physical copies of patient's clinical records. However, NOM-005 does not specify whether physical files may be preserved electronically, as established in the applicable provisions.
- The new requirements also apply to premises that offer homeopathy and optometry services and that fall within the definition of 'outpatient medical care facilities'.
- Certain new requirements will apply to premises offering acupuncture medical procedures and these sites must comply with NOM-017-SSA3-2012 (Health services regulation. For the practice of human acupuncture and related methods), rather than the previous references to NOM-172-SSA1-1998 which used to regulate these kinds of service.
- New NOM-005 is silent on exceptional situations such as attending medical emergencies in general or family medicine offices and the requirements for emergency equipment that should be available at outpatient medical care facilities.
- New NOM-005 provides a general list of pharmaceutical products and medicines that must be available in outpatient medical care facilities, rather than a specific list as was established by the previous NOM.
Arguably, the New NOM reflects diverse situations that were effectively not contemplated by the prior NOM and reflects the modernisation of the medical services on offer and technological advances.
However, the New NOM sets out no clear guidelines on the availability of information via different kinds of media and new technologies, the possibility of combining telemedicine and physical recognition medical services, nor the fact that in many cases, minor surgical processes may be required in outpatient medical care facilities.
One of the greatest lessons of the COVID-19 pandemic has been the need for professionals in all sectors to adapt and use new technological tools that, where possible, permit the delivery of services without the need for physical contact.
This has been particularly true for healthcare professionals, whose risk of becoming sick is far greater than that of most of the population.
The COVID-19 crisis should encourage relevant changes to other health-related provisions in Mexico in order to avoid loopholes or poorly regulated processes and activities that may have an adverse effect on patient care.
