Telemedicine: online diagnoses against a shortage of doctors

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Telemedicine: Online diagnoses via video chat are still prohibited in Germany

Treatment via video chat using online diagnosis is prohibited in Germany. In other countries such as Switzerland, telemedicine is already an integral part of the health system. In this country, most doctors and health insurance companies are critical of online diagnoses. They argue that each patient needs to be considered individually and not a general diagnosis via the Internet based on a few facts. Proponents of telemedicine see this as a great opportunity to counter the impending shortage of doctors, especially in rural areas.

Proponents of telemedicine see benefits for online diagnoses, especially in rural areas. A man with chest pain that extends to the arm and shortness of breath is brought to a hospital. For diagnosis, a specialist is switched to the treatment room via video chat. The cardiologist quickly comes to the diagnosis of heart attack. All medical measures that are necessary in the event of a heart attack are quickly initiated by the assistant doctor on site. The specialist receives the data from the blood test and the ECG continuously via email, so that further instructions can be given quickly in the event of a change.

Remote diagnostics are already part of everyday life in other countries. In Germany, however, this is prohibited. According to the model professional code for doctors, no diagnosis may be made if the doctor has not already treated the patient directly. Proponents of telemedicine argue, however, that the model could help bring specialist knowledge to rural areas affected by the shortage of doctors. "This enables us to bring medical expertise to places where it is not available but is required," explains Wolfgang Loos from 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 at some point this will also prevail in Germany," said Loos.

Roland Stahl, spokesman for the National Association of Statutory Health Insurance Physicians (KBV), does not see online diagnoses as an alternative to visiting a doctor. “Every patient is different. I can't do that by remote diagnosis, "Stahl told the news agency. Franz Bartmann, chairman of the telematics committee of the German Medical Association, agrees with him. He told the news agency that" where a doctor uses his five senses to treat a patient Contact must be ", this can not be replaced by telemedicine.

In order to implement telemedicine in Germany, secure, digital infrastructures must be created. Telemedicine is currently being slowed down by a technical problem in Germany. Especially in rural areas, the internet is too slow to enable remote diagnostics consistently and reliably. Often the minimum speeds are not even available. "There is no reasonable broadband in the country," Robert Wieland, Managing Director at Infratest, told the news agency. In his view, medical care will still be provided more on the computer in the future. "This is necessary in the health system in order to fund the system at all to be able to. "

According to Loos, the technical requirements for image and data transmission have already been created. "The cardiologist or the surgeon comes to the nursing home via video conference - everything is technically possible."

Before thinking about approving remote diagnoses via video chat in Germany, studies must prove the benefits of telemedicine. Such an examination is currently taking place in heart failure patients in Berlin and Brandenburg. However, the first results are not expected before 2016.

Telemedicine network for cardiac 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 monitored and cared for around the clock using modern information and communication technologies (ICT technology). This is intended to enable patients at high health risk to have their medical data checked at any time from home, at work or on vacation without having to see a doctor. The project is funded by the federal and state governments with 1.53 million euros.

A further step towards telemedicine was taken by some statutory health insurance associations by offering a telephone service in the emergency service, explained Bartmann. If the clinical picture is clearly assessed, treatment recommendations would also be made by telephone. "The ban on remote treatment is put into perspective a little." However, Bartmann could not imagine establishing a service like that offered by the company Medgate in Germany. "The term 'I'm going to the doctor quickly' is taken literally by many here . "

When and to what extent further steps towards digital medicine will be taken in Germany is still uncertain. "But one thing is certain," said Bartmann. "We can no longer keep a full doctor's office in every 800-person location for basic medical care." Thus, doctors in fixed real estate are not the only solution for the future. (ag)

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