Telemedicine: remote healthcare services

Telemedicine refers to the use of information and communications technologies to enable medical diagnoses, patient consultations and the analysis of patient data by doctors or other medical professionals. There is no need for patients and doctors to be together in the same location. It is also not always necessary for them to have an appointment to meet each other at the same time.

Telemedicine applications also support exchanges between doctors – for example, the digital exchange of patient test results or consultations with colleagues or with experts from other medical disciplines for the purpose of confirming a correct diagnosis or choice of treatment.

Telemedicine includes, in particular:

• online video appointments
• telemonitoring, i.e., remote monitoring of medical data such as blood pressure or heart rate
• telemedicine house calls, in which a trained healthcare assistant visits the patient in their home and, if necessary, establishes contact with a doctor
• tele-expertise, i.e., the exchange of expertise between doctors

Most medical treatments will, in the future, continue to involve patients being in direct contact with their doctors, therapists or other healthcare professionals. However, telemedicine solutions can make things easier for patients – for example, if they live far away from the care facility or if their mobility is restricted following surgery.

Telemedicine can make processes used by medical practices and health insurance providers more efficient. This is especially true if it is integrated seamlessly with other digital applications. For example, a virtual visit to the doctor can be documented in the electronic patient record (ePA) immediately after the online consultation and medication can be prescribed using an e-prescription.

Another advantage is that remote diagnoses and treatments can prevent people from catching infections when using public transport to get to the doctor’s practice or while sitting in the waiting room.

Another type of telemedicine is telemonitoring, which enables the remote monitoring and analysis of important health parameters to improve medical care. It makes it easier for doctors to track the course of a patient’s treatment and to detect any deterioration in health conditions at an early stage. This gives patients greater peace of mind, in particular if they have a chronic health condition. For example, certain pacemakers for people with heart conditions can send data directly to their doctor or hospital, enabling early intervention if any abnormalities are detected.

Telemedicine can also help to compensate for staff shortages – for example, it can guarantee the provision of emergency care in sparsely populated regions.

It also enables the integration of different areas of care, thereby ensuring high-quality patient treatment. This is the case, for example, when regional hospitals are connected to stroke units in larger hospitals, with specialists in the stroke units providing remote support to their colleagues in terms of diagnosis and treatment. In this way, patients in smaller hospitals can also access high-quality treatment in the event of a stroke.

Many doctors and psychotherapists offer video consultations. They can show their patients on-screen how treatment is going to progress, track the recovery process following surgery or provide patients with a psychotherapy session. This means that patients don’t need to come to the practice for every appointment. This also supports patients who are care recipients.

Various video service providers that have been tested and certified by the German National Association of Statutory Health Insurance Physicians can be used for online consultations. Certification ensures, in particular, that the applications meet the relevant data protection requirements.

Some Associations of Statutory Health Insurance Physicians (Kassenärztliche Vereinigungen) have also established their own offerings – for example, “docdirect” from the Association of Statutory Health Insurance Physicians in Baden-Württemberg (KVBW). In addition, increasing numbers of health insurance providers are offering their own telemedicine solutions.

Telemedicine house calls are a relatively new application of telemedicine. They involve a specially trained healthcare assistant paying a visit to the patient’s home. The healthcare assistant can contact the patient’s doctor by video call during the visit if necessary.

Tele-expertise is the term used when doctors use information and telecommunications technologies to consult with one other.

This makes it possible for medical practitioners to digitally transfer X-ray and CT scan images and discuss them over the phone, for example. This form of telemedicine ensures an efficient exchange of expertise among doctors and helps them reach a diagnosis without additional or repeated patient tests. Patients and doctors benefit equally. If a second opinion is needed or if questions arise in relation to diagnosis or treatment that require expertise from another medical discipline, doctors, dentists, psychotherapists and other healthcare professional can use telemedicine to consult with one another a reach a consensus.

Televisits are increasingly proving to be of benefit in hospital intensive care units (tele-ICU) – by networking experts from various specialties, transfers of seriously ill patients can be avoided and the risk of long-term effects reduced.