Telemedicine: Technology alone does not make patients healthier
Wednesday, the 02.11.16 , written by Anja Schlicht Telemedicine enables the exchange between doctor and patient despite spatial separation. From a distance diseases can be treated and therapies used. In rural areas, telemedicine can be an answer to the shortage of doctors. But it still lacks the appropriate legislation, say critics. Not at all, replies the health expert dr. Achim Hein.
Telemedicine could replace visit to the doctor by remote treatment
There are critics who think that Germany is lagging behind in telemedicine. In particular, in the area of legislation, a lot of work should be done so that patients benefit better from the opportunity to be treated or treated at home. This not only saves them the way to the doctor. Telemedical treatment can also improve the care of citizens in areas with few medical professionals. But what good are the good prospects if the legal framework for telemedicine is insufficient ?
Dr. Achim Hein, CEO of EvoCare Telemedicine ECT eG, believes that there are no laws required . On the contrary, they could even be harmful. In an interview with finanzen.de he explains that patients already benefit from telemedical treatment. But only those who understand telemedicine correctly can develop telemedical methods that are similar to traditional treatments, paid by the pension fund or health insurance fund and benefit patients.
Dr. Hein, why is the legislation of telemedicine not lagging behind the times?
Dr. Achim Hein: The existing success stories of the implementation of telemedicine treatment in today’s standard care show that the often- awaited new legislation for the settlement of telemedicine treatment is not required. It is possible that softening the current regulatory framework to provide quality of care services, as well as its overall funding, is more damaging .
The key to the success of telemedicine treatments is the understanding of the word telemedicine itself – TeleMEDIZIN is a medical treatment service and therefore an effective supply within the social system. Treating a patient means prescribing, “taking care of” and supervising on an individual basis. Telemedicine is therefore more than just providing technology to the patient. I always say: “Technology does not make the grandma happy and not healthier” – it is the treatment and care that bring success.
If telemedicine treatment is understood as a novel interaction between therapist and patient that complies with the contents of the guidelines and existing guidelines, it fulfills the very well-proven requirements for existing treatment methods and can be applied by service providers and reimbursed by payers in the same way as conventional methods. To strive for new legislation is unnecessary.
Exempting from my criticism I would like to create regulations for the use of uniform platforms such as EPA (Electronic Patient Record) or Health Card. If the legislature so wishes, it is required to create the conditions for it.
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In your experience, how much does a reimbursement by health insurance funds or pension insurers most often fail?
Dr. Achim Hein: If the providers of treatment services comply with the existing guidelines, the compensation channels are well defined and usable. However, if payers are expected to pay for the technology of the industry or other vendors, thereby potentially opening up the available budgets in an uncontrollable manner, then this will have to go nowhere.
Hundreds of pilot projects show the same patterns over and over again. There is talk about technology, not about treatment. Technology is offered, not treatment. Such projects are not aware of the answer to the question of how telemedical treatment services can be precisely defined for the healthcare system and which criteria must be met in the German health and social system. From our experience, this is not easy and requires great expertise.
From practice: With TEMPSIS / STENO, physicians in patients with stroke from the region of South-East Bavaria can still call experts in the emergency recording by videoconference. Not only can he interview the patient directly, he can also neurologically examine it together with the local physician. This provides patients in rural areas with effective stroke care.
What further hurdles do you see in the expansion of telemedicine services on the part of both patients and doctors?
Dr. Achim Hein: Imagine that you are a patient. They expect a high quality treatment. You do not expect to be fobbed off by app . However, when a patient is properly hired by the practitioner for telemedicine treatment, studies reveal no barriers to acceptance, satisfaction and adherence (compliance).
There are already numerous lifestyle apps in the area of monitoring, with nice gimmicks as an encore. Such apps can certainly stimulate behavioral changes, but in no way replace a medical treatment. Lifestyle apps are very different from professional telemedicine treatments. These obey the prescription principle, the supervision principle, are based on evidence-based medicine and have been “heart and kidney” checked by doctors and payers. In this case, medical therapeutic services are not replaced, but supplemented.
If a telemedicine treatment offer is perceived by doctors as a therapeutic , the application hurdles fall. It is medically controlled and can be ordered within existing budgets. This removes the main hurdle – that of financing.
In practice: Telemedical EvoCare treatment is used in a variety of areas, such as physiotherapy. Patients can thus flexibly perform the prescribed treatment at home. This is subject to the personal supervision of the doctor or therapist. For this purpose, patients receive a loan device, with which they get in touch with their therapist and their individual treatment plan with specific feedback interactions such as image, sound and video is specifically pursued.
How many telemedical treatment procedures have made it to standard care so far?
Dr. Achim Hein: From our point of view, there are currently two noteworthy procedures. In the field of stroke (stroke treatment) TEMPIS / STENO has made a name for itself. In home care, remedies and rehabilitation, EvoCare treatment is a pioneer and most experienced player in the application of digitization in healthcare. The two procedures have proven for more than a decade that treatment is as effective as traditional methods , that treatments offer tangible benefits in terms of quality , efficacy and cost, create jobs and support the elimination of skills shortages . Realized in this way, digitization really helped everyone.
Service providers, clinics, practices, doctors undoubtedly bring digitalisation opportunities. However, the technical solutions are unmanageable and often not suitable for the purpose of patient treatment. Practitioners need tailor-made treatment offers for their patients – especially with digitization. In 2013, the first telemedicine cooperative was founded in Germany. As a cooperative self-help organization, the EvoCare Telemedicine ECT eG has a need, as well as a statutory task, to sustainably anchor telemedicine opportunities as a community of values.
- Thank you very much for the interview, Dr. Hein!
- Anja Schlicht
- editorial staff
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