Chatting with the doctor: First (surprising) experience with the TI messenger

On July 1, the time had finally come for many policyholders: the first health insurance companies activated the TI Messenger (TIM) for their policyholders – heise online started typing straight away and discovered that policyholders can also start a chat with doctors. Only doctors and pharmacies are actually allowed to initiate the first chat – but due to a misconfiguration, insured individuals were also able to simply spam doctors. Otherwise, it is rare to get into conversation with doctors so quickly. Gematik commented on the whole thing in its usual relaxed manner: "It is not unusual that minor optimizations have to be made during an introductory phase." No problem, we are happy to test as long as there are no TI faults.

Meanwhile, the problem has apparently been fixed: When we recently tried to start a conversation with another doctor via TIM, we got an error message that resulted in an empty chat. We were able to get one of the doctors we contacted by chance to talk to us about his initial experiences with TIM. Volker Thielmann has been a general practitioner since 1995, works in a group practice and is involved in the Rhineland-Palatinate Association of General Practitioners, among other things.

How long have you been using the TI Messenger?

We have been using TIM since the end of last year. The trigger was the need for secure communication. The previous practice was to send images via Siilo. This was no longer an option for us and was no longer tenable under data protection law. We therefore looked for an alternative to communicate securely with a care home, pharmacy and other colleagues, for example.

We are also one of seven practices in the pilot project "Rhineland-Palatinate becomes HÄPPI" (short for "Hausärztliches Primärversorgungszentrum – Patientenversorgung Interprofessionell"). The aim is to optimize GP care in rural regions – also through digital solutions. The TI Messenger is one component of this. We are testing how communication with care facilities, pharmacies and also internally in the practice can be improved using digital tools.

How many inquiries have you received via TIM so far?

There have only been four with you so far. One of them came from a colleague I knew from a medical forum, which was more of a test. Overall, use is still very limited. I regularly use the chat with a colleague from a neighboring town who uses the same practice software and the same messenger service.

What functions do you use in your practice with TIM?

Internally, we use TIM extensively: for group and individual chats, for sending pictures, and even occasionally for video calls. Our nursing assistant can send pictures or videos directly to the practice during a home visit. We are also currently testing communication with pharmacies via TIM. We primarily use TIM internally and with selected partners. We mainly use KIM for specialist reports.

What do you think would be important for the acceptance of TIM?

Integration into existing practice management systems such as Tomedo is crucial so that no information is lost. We have various channels, such as KIM, and it is becoming increasingly difficult to keep track of everything. If TIM is better integrated and runs stably, it can be a useful addition – for appointment requests or follow-up prescriptions, for example. But it must be clearly regulated who is allowed to contact us. I would rather not be contacted directly by patients – that would go beyond the overview.

Do you also use the electronic patient file?

We haven't used the ePA yet, but it's coming soon. I'm still unsure how much the EPR will help young patients in particular. There is also whether the storage of certain data – for example, about serious illnesses – could have long-term disadvantages and lead to people no longer being able to get insurance. For older patients, on the other hand, the ePA can be very helpful, for example, for collecting hospital discharge reports. This is where we see the greatest benefit, as this important information is often left behind for patients' further treatment.

(mack)