By means of telecommunications, telemedicine bridges a given distance between physicians and patients or consulting physicians among themselves for purposes of diagnosis and therapy. This increases the availability of evidence-based therapies, so has recently emerged from the symposium Telemedicine and Health Services Research.
Increased efficiency thanks to digitization
Digitization is already shaping the daily routine of many medical practices. Numerous practice processes can be made more time-saving through digital solutions, such as administrative tasks like appointment management. Around 60 percent of all GPs now use digital appointment scheduling. They often use external service providers who provide ergonomic software products and technically skilled support. As a result, employees do not need any prior knowledge to benefit from greater efficiency within their day-to-day practice by integrating appropriate solutions. Telemedicine is another example of how digital building blocks can make the medical practices of the future more efficient. Experts believe that telemedicine services will be particularly relevant in rural areas in the future. Unlike in the city, there are still only a few specialists available there. Telemedicine solutions could close the gap between urban and rural areas. The availability of specialists could be increased, for example, to ensure a better care situation for patients living in rural areas.
Better exchange through teleconsil
Already today, many specialists in cities such as Berlin offer themselves for teleconsil. This involves physicians exchanging information over the network in real time to treat specific patients, and they do not have to be in the same room to do so. In some rural hospitals, there are no neurology departments available. In such cases in particular, it can make sense to schedule teleconsultations. Where there is no expert on site, evidence-based therapy can be established in these cases without loss of quality. Neurological assessment of patients has also been shown to be possible via video chats. As the TEMPiS stroke project has proven, teleconsultations can even reduce the severe late consequences of strokes within a clinic by up to ten percent.
Facilitating patient care via viedeo consultations
Aside from increased expert availability, telemedicine applications also enable new treatment options. Telemonitoring allows patients to be monitored in the comfort of their own homes, such as those with chronic conditions who require regular medication adjustments. Telemedicine also makes it easier to monitor chronic conditions. This is the case, for example, with diabetics, who from now on do not necessarily have to make time-consuming appointments at the doctor’s office to check their values. According to experts, chronic illnesses will increase throughout Germany in the future. In times of demographic change, it is assumed that German society will continue to age. The older society gets, the more chronically ill people there will be. In order to ensure that medical care continues to be provided nationwide against this background, new concepts are essential. Telemonitoring is one such concept, and it will be hard to imagine the future without it. Video consultations can also be used to examine patients who, due to mobile restrictions, are hardly able to attend doctor’s appointments in person. Cases like these will also be on the rise in an aging society and will require a rethink of how care is delivered. For some patients, it is not distance or lack of mobility that keeps them from seeing a specialist, but shame. This is true, for example, of visits to the urologist or gynecologist, which are still generally frowned upon in some cultural circles. Telemedicine consultations could be a solution for this as well. In this respect, consultations at a distance can make it easier for young girls to visit the gynecologist, for example, or enable women from other cultural groups to have a relatively anonymous consultation.
Does the ban on remote consultations no longer apply?
Until just over two years ago, telemedicine approaches were almost inconceivable. The reason for this was the ban on remote treatment that applied throughout Germany at the time.Until 2018, the rule enshrined in Section 7(4) of the MBO stated that physicians may not provide treatment and advice “exclusively through print and communication media.” In the meantime, this rule has been relaxed. Thus, in individual cases, it is even permitted to advise previously completely unknown patients via telemedicine, as long as it is justifiable from a physician’s point of view. With this innovation, the medical profession will in future bear the responsibility of deciding on a case-by-case basis whether purely remote treatment is permissible. Despite relaxations of the paragraph, telemedicine is still not in widespread use. Many physicians complain about the high costs associated with the technical implementation of these concepts. Health insurance companies, meanwhile, are going their own way. In Switzerland, the health insurance company Swica wants its policyholders to examine themselves in the future using a diagnostic device designed for this purpose. The data collected in this way will first be sent to the insurance company’s specialist staff via an app. If there is a medical need, the experts will then initiate an online consultation. Critics of the new concept complain that patients can only perform such examinations in an amateurish manner and also point to data protection concerns. Nevertheless, German health insurers are now moving in similar directions to Swica.
Doctor-patient communication remains irreplaceable
Despite the numerous possibilities offered by telemedicine, corresponding measures will probably not completely replace direct doctor-patient communication in Germany in the future. Rather, according to experts, they will be used as a supplement to enable communication even where it would otherwise be omitted. In this way, doctors will be able to care for a larger number of patients in the future and save money and effort at the same time. In addition to better care, patients can expect improvements in their quality of life, particularly through convenient consultation and monitoring in their own homes. The increase in demand for consultation and care caused by demographic change will at least be better managed by telemedicine in the future. In addition, telemedicine offers new opportunities for specialized areas such as space travel. The ISS, for example, has long used telemedical diagnostic and treatment procedures for astronauts. In the event of medical emergencies in space, this can reduce the risk of serious complications. Especially if the astronauts have received training in advance. In the future, such training will play a role not only in the space sector: So that patients can soon enjoy all the benefits of telemedicine options, they too will benefit from basic medical knowledge. As a result, they could leave the role of layperson in the future and would themselves be more involved in their diagnosis and treatment. The better the individual knows medical contexts, the more appropriate the decision for remote treatment. This could ease the situation for overburdened physicians. Only when there is a real need would they still have to invest their precious time in one-on-one consultations.
