Telemedicine online diagnoses against medical shortage

Telemedicine: online diagnostics via video chat are still prohibited in Germany

13/11/2013

Videochat treatment via online diagnosis is prohibited in Germany. In other countries, such as Switzerland, so-called telemedicine is already an integral part of the healthcare system. In Germany, most doctors and health insurance companies are critical of online diagnoses. It requires an individual view of each patient and not a global diagnosis based on some facts, they argue. Advocates of telemedicine, however, see this as a great opportunity to counter the impending lack of doctors, especially in rural areas.

Advocates of telemedicine see advantages, especially for rural areas, through online diagnostics
A man with chest pains that radiate to his arm, and respiratory distress is taken to a hospital. To diagnose a specialist is connected by video chat in the treatment room. The cardiologist comes quickly to the diagnosis heart attack. All medical procedures are quickly initiated by the on-site assisting physician necessary for a heart attack. The specialist will continue to receive the blood and ECG data by email to quickly provide further instructions if a change occurs.

Remote diagnostics are already part of everyday life in other countries. In Germany, however, this is prohibited. According to the model occupational code for doctors, no diagnosis may be made if the doctor has not already treated the patient directly. Advocates of telemedicine, however, argue that the model could help bring specialist medical knowledge to rural areas affected by the shortage of doctors. „We can thereby bring medical expertise to where it does not exist, but is needed, "explains Wolfgang Loos of the German Society for Telemedicine to the news agency „dpa“.

In Switzerland, Medgate offers a medical service where professional doctors give medical advice over the phone. You can also issue recipes. „We believe that will eventually prevail in Germany, "said Loos.

Roland Stahl, spokesman for the National Association of Statutory Health Insurance Physicians (KBV), does not see any alternative to a doctor's visit in online diagnostics. „Every patient is different. I can not do that remotely, "Stahl told the news agency, and Franz Bartmann, chairman of the Telematics Committee of the German Medical Association, told the news agency that „where a doctor with his five senses has to come into contact with a patient“, this is not replaceable by telemedicine.

In order to enforce telemedicine in Germany, secure, digital infrastructures must be created
Currently, telemedicine in Germany is also being hampered by a technical problem. Especially in rural areas, the Internet is too slow to enable remote diagnostics consistently and reliably. Often not even the minimum speeds are available. „There is no reasonable broadband in the country, "said Robert Wieland, managing director of Infratest, to the news agency, who said he believes medical care will be more computerized in the future. „That's what's needed in the healthcare system to even finance the system. "

According to Loos, the technical prerequisites for image and data transmission have already been created. „The cardiologist or the surgeon comes to the nursing home via videoconference - that's technically possible. "

Before it is even possible to authorize remote diagnostics via video chat in Germany, studies must prove the benefits of telemedicine. Such a study is currently taking place in heart failure patients in Berlin and Brandenburg. Before 2016, however, the first results can not be expected.

Telemedicine network for heart patients to improve health status monitoring
In October 2011, Germany's first nationwide telemedicine network was launched. Since then, 500 patients with chronic heart failure have been remotely medically supervised and looked after remotely around the clock using state-of-the-art information and communication technologies (ICT). In this way, patients with a high health risk should be allowed to have their medical data checked at any time from home, at work or on vacation, without having to consult a doctor. The project is funded by the federal and state government with 1.53 million euros.

A further step in the direction of telemedicine went to a number of health insurance associations by offering a telephone service in emergency service, explained Bartmann. If the clinical picture was clearly assessed, treatment recommendations would also be given by telephone. „Since the distance treatment ban is already relativized a bit. "Bartmann can not imagine, however, a service as the company Medgate offers him to establish in Germany. „The term 'I'll go to the doctor quickly' is taken literally by many here. "

When and to what extent further steps will be taken towards digital medicine in Germany is still uncertain. „One thing is certain, "says Bartmann. „We can no longer maintain a complete doctor's home in every 800-person primary care location. "Thus physicians in solid real estate are not the only solution for the future.