For telepsychiatry the decisive factor is the confidentiality block, and no separate norm for telepsychiatry exists in Georgia — this must be said plainly. The operative framework is four articles of the Law on Medical Practice: Article 90 — even a psychiatric consultation comes only from a subject of independent medical practice; Article 91 — the telemedicine specifics and anonymisation at the patient's demand; Article 48 — the general medical confidentiality standard; and Article 49 — the prohibition of interference in private and family life. Foreign telepsychiatry standards are not Georgian qualifications — the page is carried by the Georgian law.
The subject of the consultation and responsibility
The three conditions of Article 90 extend to mental-health consultations as well: the right to receive a consultation by means of telemedicine belongs only to a subject of independent medical practice; on the basis of a consultation received in this way, only the same subject gives recommendations to the patient; and responsibility for the results of the service is borne by the one who directly issues the recommendation. In the psychiatric field this is particularly significant: both the diagnosis and the recommendation are tied to the name of one responsible physician.
The telemedicine specifics and anonymisation
Article 91 determines the design of a telepsychiatry service: in the use of telemedicine means, the protection of the confidentiality of information about the patient is incumbent on the subject of independent medical practice. Mental-health data are precisely the category whose transmission demands the greatest care — and here the law gives the patient a special instrument: at the patient's demand, data on identity, state of health and private life may be transmitted anonymously by means of telemedicine. For telepsychiatry this is a decisive possibility: the patient can receive a consultation in such a way that the means of identification are removed from the data at the patient's own initiative.
The general confidentiality standard
Article 48 regulates confidentiality with a temporal extension: the subject is obliged, apart from the cases provided by the legislation, to protect the confidentiality of information about the patient's state of health and private life both during the exercise of medical practice and after its termination, both during the patient's life and after death. This means that the secret of a psychiatric episode does not depart with the end of the relationship — it outlives even death.