Telemedicine

Data flow

Telemedicine plays an important role in the digitalization of the healthcare sector. The use of video consultations and other telemedical applications has now become second nature for many people.

This is why continuous further development of telemedical procedures is essential. The MEDUCORE Standard² product from WEINMANN Emergency contributes to the fostering of telemedicine.

Definition: What is telemedicine?

Telemedicine uses audiovisual information and communication technologies (ICT) for healthcare and for medical consultation despite being at a distance from the patient. Aids such as apps, remote second opinion platforms and video technologies allow remote treatment in the form of diagnosis, consultation, monitoring, and emergency medical services.

The aim of telemedicine is to improve medical care, especially in rural areas. According to the German Department of Health, the aim is that by 2026, at least 60 percent of regions currently with inadequate provision will have a contact point for assisted telemedicine.1

Telemedical applications in the healthcare sector

Potential applications in telemedicine are extremely varied, ranging from the optimization of organizational processes, for example using electronic patient folders or electronic health insurance cards, to improved diagnosis and treatment. In numerous scenarios, remote treatments such as those below prove to be a meaningful complement to conventional medical care:

  • Teleconsultation (physician <> patient): During a teleconsultation, patients obtain medical recommendations from a physician via online video consultations. Data such as vital signs can be transmitted beforehand so that they are available to the physician. Such consultations are used to discuss test results, to obtain a medical history, and to give advice.
  • Remote second opinion (physician <> physician): A remote second opinion is an exchange (of information) between colleagues. Physicians support one another in assessing findings, during surgery and in teleneurology - in the diagnosis and treatment of strokes, for example.
  • Telemonitoring in cardiac insufficiency: Telemedicine is also used in cardiology, for telemonitoring in cardiac insufficiency. In the event of cardiac insufficiency, the data from a defibrillator are recorded online and assessed by medical personnel. This makes it unnecessary to visit a clinic regularly and ensures long-term care.
  • Telediagnosis: Telediagnosis includes the transmission of medical data such as X-rays, CT scans, MRIs, vital signs or information from a cardiac pacemaker or defibrillator to a specialist. Medical personnel can competently assess the results of tests without needing to be physically present.

Benefits of telemedicine

Just like its applications, the benefits of telemedicine are far-reaching. They primarily benefit patients, but medical personnel can also benefit from the expansion of telemedicine. We would like to highlight the following advantages in particular:

  • Preventing the risk of infection: Telemedicine allows medical care without physical contact, thus reducing the risk of infection for both patients and healthcare staff.
  • Relieving the load on medical centers: The integration of telemedical treatments reduces numbers in medical centers and thus takes the load off reception areas, waiting rooms, and car parks.
  • Shorter waits for consultant appointments: By efficiently transmitting and passing on health data, telemedicine makes consultant appointments smoother. Patients benefit from shorter waits.
  • Improved medical care: Telemedicine can ensure medical care is provided in rural areas and improve/counteract the shortage of physicians. Patients living in rural areas can thus avoid both long journeys to their nearest medical center and waiting times.
  • Alternative for people with restricted mobility: Teleconsultation allows chronically ill people and those with restricted mobility to get medical care conveniently from home.
  • Continuous monitoring: Telemedicine can be used to monitor patients so that irregularities or life-threatening changes are picked up early.
  • Patient data in real time: Patient data such as weight, blood pressure, and heart rate can be recorded and analyzed by medical personnel in real time, facilitating more accurate diagnosis and treatment.
  • International exchange of specialist knowledge: Telemedicine facilitates the international exchange of specialist medical knowledge and allows global access to expert knowledge.
Woman in accident receives invasive ventilation

The challenges of telemedicine

Before everyone can benefit from the treatment opportunities delivered by telemedicine, it will be necessary for it to be easy and clear to use and for a legal framework to be established. The challenges to be overcome include:

  • Technical barriers and accessibility: In order to use teleconsultations, access to a mobile terminal device and a basic understanding of how to use it are required. Older people in particular may be at a disadvantage here, as they generally have less experience of dealing with digital media.
  • Technical difficulties: Technical difficulties may occur, especially in areas with slow or unstable internet connections; this may make it harder to use telemedical services.
  • Data protection and patient data security: Another important concern is around data protection and patient data security. Telemedical applications have to comply with data protection and security standards in order to ensure that sensitive health information remains confidential and to ensure that patient data are protected.
  • The limitations of telemedicine: Some diseases still require physical examinations in order for them to be diagnosed, so personal contact with physicians remains essential.

The legal principles for telemedicine in Germany

There is currently no dedicated law governing telemedicine. Instead, the legal regulations for handling health data and for integrating telemedical procedures are rooted in various existing laws. These include in particular:

  • General Data Protection Regulations (GDPR): According to § 9 of the GDPR , health data come under the special category of personal data, which essentially prohibits their being processed. Such data may only be transmitted if the person involved has given their express consent.
  • Electronic health law: The electronic health law which came into force on December 29, 2015, is intended to promote digitalization in the healthcare sector and to make it easier for patients to access medical applications. It is intended to provide the context for incentives to introduce telemedical applications.
  • (Sample) professional regulations for German physicians (MBO-Ä)
    § 7 Section 4 of MBO-Ä stipulates that medical treatment may not be delivered exclusively via print and communication media. Telemedical processes also require direct medical care. Essentially, remote treatment is permitted as long as physicians supervising treatment have had contact with the patient previously through a personal examination.

Telemedicine in prehospital emergency medicine

Germany has a dual emergency services system: Whilst non-medical EMS field providers act independently in around half of all emergencies, an emergency physician is called in for the remaining cases. In life-threatening situations, it is usual for an emergency physician’s vehicle to be called in parallel with the emergency services vehicle.

In Germany, the emergency services vehicle is often on site sooner than the emergency physician’s because its coverage is greater. This leads to challenges in rural areas, in particular, as the waiting time for an emergency physician can be much longer, potentially putting the patient at risk.

Telemedicine is a meaningful addition to the existing structure of the emergency medical services. The American Heart Association, too, recommends telemedicine in the emergency medical services.2 The use of the latest technologies facilitates efficient, reliable communication between EMS field providers and an emergency physician in real time. We would particularly highlight the option of transmitting ECGs remotely in cases where a heart attack is suspected. 

Telemedicine at WEINMANN Emergency

MEDUCORE Standard² is the monitor/defibrillator from WEINMANN Emergency for mobile use in the healthcare sector. The device allows EMS field providers to send 12 lead ECGs they have recorded straight to a hospital by e-mail. This allows diagnosis of the ECG to be brought forward, reducing door-to-balloon time.3

MEDUCORE Standard² also provides the option of teleconsultation. This allows the recorded ECG to be sent to an expert of your choice to obtain a second opinion and get support in making a diagnosis as well as in selecting the right target hospital.

All the patient measurements recorded can be archived with the aid of WEINMANN Connect, guaranteeing seamless follow-up.

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1https://www.bundesgesundheitsministerium.de/service/begriffe-von-a-z/t/telemedizin.html

2Leitlinien der Telemedizin in der prähospitalen Notfallmedizin: https://register.awmf.org/assets/guidelines/001-037l_S1_Telemedizin_praehospitale_Notfallmedizin_2016-11-abgelaufen.pdf

3 Kardiologe 2014 DOI 10.1007/s12181-013-0540-1 © Deutsche Gesellschaft für Kardiologie - Herz- und Kreislaufforschung e.V. Published by Springer-Verlag Berlin Heidelberg - all rightsreserved 2014; S. 3: leitlinien.dgk.org/files/2014_Empfehlungen_zur_Organisation_von_Herzinfarktnetzwerken.pdf