Do regulations vary from one country to another?

In a word, yes! As the demand and scope for telemedicine (and the available technology to provide it effectively) varies widely from place to place, different countries have adopted their own approach to regulations. This can go from no specific rules at all, to government-led departments purely for the purpose of managing telemedicine and its practitioners. As a brief overview:

In Europe, doctors need to be licensed to practice medicine (and therefore telemedicine) with the regulator in their own jurisdiction. In addition to this, the guidance for UK doctors is that their medical indemnity will only cover them for telemedicine consultations when their patients are also physically located in the UK, unless they have extended their cover to include the patient’s country.

In the USA & Canada, doctors must be licensed with the regulator in the patient’s jurisdiction. The USA has the option to provide ‘abbreviated’ telemedicine licences, but the existence of them in reality is rare. Canadian regulations differ depending which of their provinces and territories are involved.

In Mexico, specific laws relating to telemedicine do not exist. However, all of their healthcare services are centrally regulated, and existing legislation includes remote medical services as standard.

In China, the provision of telemedicine is limited to locally-licensed physicians and foreign physicians holding the Short-Term Foreign Practice License at approved hospitals. Remote second opinions from doctors outside of China may not automatically fall within telemedicine regulations, as they are not always included within the term ‘medical practice’.

In the Kingdom of Saudi Arabia, they have had specific telehealth legislation since June 2018 in the form of the Saudi Telemedicine Unit of Excellence.

Even in countries and jurisdictions where telemedicine legislation is more advanced, it appears incredibly difficult to regulate the practice of doctors from other countries who could now theoretically treat patients across borders remotely.