One winner in the corona crisis is already apparent: telemedicine. Patients avoid visiting a doctor and the risk of infection in the waiting room. And those who have to remain in domestic quarantine need a good connection to the doctor all the more urgently – especially chronically ill people are then particularly dependent on it. This is pushing the use of telemedicine.
Video chat in the doctor’s office: What was previously a rather shadowy existence in many countries will become a lifeline for many people in the Covid 19 pandemic. Internet connection, PC, tablet or smartphone with camera, microphone and loudspeaker – and remote treatment can begin. Patients use various digital platforms to virtually consult their doctor’s office. In Germany, the restrictions previously in place were relaxed in the wake of the corona pandemic and doctors are now allowed to treat an unlimited number of patients in digital sessions. Providers of telemedicine platforms, in turn, must be certified by the German National Association of Statutory Health Insurance Physicians (KBV). Due to the current situation, the Health Innovation Hub, the expert committee for the digitalization of medicine under the responsibility of the Federal Ministry of Health, has published the list “Corona digital, Covid-19: Telemedicine as an opportunity” with certified providers.
More comfort for patients
Especially patients in rural areas benefit from the video consultation: Long journeys and waiting times are eliminated. Especially for young families with small children or for older people this is a great advantage. Whether at the weekend, at night, on vacation or on business trips – the doctor of confidence can be reached from every corner of the world via telemedicine. He advises on necessary vaccinations when travelling or can give a second opinion on a diagnosis. Even simple questions can be answered quickly in the virtual consultation hour: Do I only have a banal cold or am I seriously ill? Can I treat the wound myself or do I have to go to hospital? This also relieves the burden on emergency rooms and emergency clinics.
Chronically ill patients benefit especially
Chronically ill long-term patients benefit particularly. One of the most impressive examples of this is the TIM-HF2 or FONTANE study with patients suffering from heart failure, i.e. chronic heart failure: The overall mortality of the group monitored by telemonitoring was 30 percent lower than that of the control group. The basis was a once-daily transmission of blood pressure, ECG, weight, oxygen saturation and a clinical short questionnaire as well as close monitoring of the patients by a telemedical service center. In addition, the Telemed5000 project aims to develop a system with the aid of artificial intelligence that will enable the care of even larger numbers of patients.
The virtual hospital
A further step in digital care digital care is the “virtual hospital”: Ultimately, such a facility without beds and a fixed location is nothing more than a digital platform that aims to bundle specialist medical expertise and medical knowledge from centres of excellence on a supra-regional basis and make it more accessible. The virtual hospital could then enable, among other things, the electronic exchange of patient data and video consultation hours and make uniform quality available anywhere in the world. In this way, the available expert knowledge can serve patients and physician colleagues everywhere – even in rural areas where hospitals and specialists are lacking. By pooling the expertise of specialized centers, for example, the diagnosis and treatment of rare diseases in particular could be significantly improved.
The digital health network “TELnet@NRW” is already a reality. The aim is to improve intensive and emergency medicine, particularly in the field of serious infections. In the university hospitals of Aachen and Münster, teams of experienced specialists and senior physicians as well as intensive care nurses are ready to advise their colleagues in practices or hospitals on questions via audio-video conference. The experiences are positive throughout. In the corona pandemic, teleconsultations especially for COVID-19 patients requiring intensive care are also possible for NRW clinics.
Digital health: global differences
Not only in Israel and Canada are remote diagnosis and remote treatment via video a natural part of health care. European countries such as Estonia, Denmark and Sweden are also well advanced in implementing a digitization strategy in the healthcare sector, according to a study by the Bertelsmann Stiftung. For example, the availability of electronic patient records or e-prescription. In Israel, even simpler examinations of the ears, eyes, skin or throat can be carried out at home using a portable examination kit and results can be transmitted live to a telemedicine doctor via an app.
In Germany, little has been achieved so far by the digital possibilities in everyday health care and they are not yet available nationwide and for all patients. Although the legal basis for the introduction of the e-prescription has been created, a secure digital infrastructure is still being tested in pilot projects. The ePA, the electronic patient file, is to be available to all insured persons by 2021. Furthermore, the availability of high-quality data networks in rural areas must be guaranteed for a nationwide telemedicine offering, as must binding framework conditions for data security and medical quality assurance.
Competence Center for Telemedicine and E-Health Hessen
In order to drive forward the digitization of health care in Hesse, the “Competence Center for Telemedicine and E-Health Hessen” was founded in 2018 as part of the “E-Health Initiative Hesse” and is based in Gießen. In partnership with the Technical University of Central Hesse (THM), the Justus Liebig University (JLU) in Giessen and the Hessian Ministry of Social Affairs and Integration (HMSI), the center advises and supports healthcare players throughout the state in projects relating to telemedical applications and e-health infrastructures. “We want to make digitization in the healthcare system a reality,” explains Armin Häuser, Managing Director of the Competence Center for Telemedicine and E-Health Hessen. There are already many innovative approaches in the region that we want to help make a success of. “Digitization, for example, can relieve our medical staff of bureaucratic work – and thus give them more time for their patients again. Digitalization should be perceived as helpful – and not scare the citizens. Our primary concern is not to save costs but to improve patient care,” says Häuser. His vision: “In five years’ time, possibilities that are perhaps not yet conceivable today should be taken for granted.
Ultimately, telemedicine and the other digital health services are all about one goal: to use all aspects of digitization for the best possible, patient-centered healthcare and to integrate them into standard care as a complementary service.
In 2020, Hesse will present an eHealth Award in the healthcare sector for the first time. Innovative projects or project ideas to improve health care in Hessen with the help of electronic applications are to be honored. The call for entries and application documents can be found here.