Telemedicine Congress: "Create structures before we urgently need them"

Contents

In view of the shortage of skilled workers and demographic change, the question is increasingly arising as to how comprehensive care of consistent quality can be ensured in the future. Without telemedicine, this will not succeed, is Gernot Marx, Chairman of the Board of DGTelemed, sure. It makes it possible to make expertise available regardless of location and is therefore relevant for access to specialized competencies as well as for emergency care. This is to be achieved with the establishment of telecooperations, which are intended to support hospitals and indeed “not only in the form of teleconsultations, but also as fundamental co-treatment”.

For implementation, DGTelmed recommends (PDF) in its statement on hospital reform, centralizing and scaling corresponding offers around teleconsultations. Information about patients, such as laboratory results, should be available to all caregivers promptly, for example in the electronic patient record (ePA). In addition, DGTelmed calls for a critical re-examination of the principle of presence for doctors employed in clinics with a view to the upcoming reforms, especially the emergency reform. Doctors who are active in telemedicine do not necessarily have to be on-site in clinics.

Preparation for major incidents

Marx named “preparedness”, i.e. the preparation of care for major damage events and exceptional burdens, as another topic. Without telemedicine structures, the existing capacities could not be controlled efficiently – patients would first be admitted to the large hospitals, but would then have to be redistributed. “Telemedicine is the backbone of modern crisis management. We will not be able to cope with a scenario with 100 additional patients without a nationwide telemedicine structure, as only then can the existing capacities be used adequately and efficiently,” says Marx. Reliable cooperation between medical-scientific institutions and between regions and care sectors would be necessary. Resilience can be shaped: “Create structures before we urgently need them,” he appeals.

Marx also advocated for the modernization of the Kleeblatt system, which was established during the Corona pandemic for the supra-regional transfer of intensive care patients within Germany. Likewise, there needs to be a real-time query of capacities; the DIVI intensive care register has shown what is possible. Telemedicine structures must therefore be established in every federal state, otherwise neither the reform nor the crisis will be manageable.

“Don't save on digitalization, but with digitalization”

Subsequently, Philipp Müller, Head of Department 5 “Digitalization and Innovation” at the Federal Ministry of Health (BMG), made it clear that the ministry does not want to “save on digitalization”, “but with digitalization” – in the medium and long term, efficiencies should also be increased. This idea runs through the ministry's roadmap.

Müller referred, as already at the Future Health Day of Telekom and also at DMEA, to the new digitalization strategy adopted last year, which was supplemented by the topic of AI after he took office. The ministry wants to be measured by goals such as 20 million active users of the electronic patient record and 300 research projects by 2030. In addition, AI is to play a larger role. “We are not starting from scratch,” Müller emphasized. So far, around 30 million documents have been uploaded, and the volume for e-prescriptions is 1.3 billion prescriptions.

The criticism that the ePA is not used by patients is taken seriously: “We are working on it,” says Müller. At the same time, he admitted the well-known problems surrounding the telematics infrastructure (TI). The aim is to “significantly strengthen” TI and reduce complexity. This will “not work entirely without side effects”, which is why gematik should also be given more enforcement powers.

Research Data Center and EHDS

In October, the Research Data Center Health (FDZ) celebrates its first anniversary. Müller emphasized the goal of further expanding the FDZ; the implementation of the EHDS regulation is considered by him to be the central foundation of a networked European health data space. Structured data from the ePA should flow into the FDZ, and work will continue on usability and interoperability. “Data is the new oil,” Müller quoted an often-used comparison to illustrate the value of data. A culture of data sharing is enshrined in the coalition agreement, and the BMG is working on its implementation.

Primary Care and Emergency Reform

According to Müller, a central project of the legislative period is primary care, also with a view to contribution stability, which Health Minister Nina Warken had promised at DMEA. The goal is better management and more efficient patient care. There should be a strong focus on digital elements. With the current draft law, the Federal Ministry of Health wants to do preparatory work and pursue a triad of digital initial assessment, appointment scheduling, and referral. It is not about “trial and error,” Müller emphasized. Adjustment screws should be set in such a way that fine-tuning is possible. The ministry gladly accepts constructive suggestions – also digitally.

On the subject of cybersecurity, Müller emphasized that the health sector in Europe is one of the most frequently attacked sectors. “Nobody wants to see pictures of closed emergency rooms,” he said. The BMG plans a billion-euro immediate program in the course of NIS2 implementation, which includes not only hospitals but also pharmacies and other facilities.

Digitalization as a joint task

The originally two planned laws on digitalization and data use have become one. The minister decided to merge both projects – but not everyone in the ministry shared this from the start, Müller admitted with a wink. Much has already been written down; stakeholders can then comment on the draft, which has so far been leaked, in the hearing procedure. With the law, they want to further develop the ePA and strengthen the telematics infrastructure, among other things.

In conclusion, Müller emphasized that the project is a joint task: “We don't want to do all of this alone, we can't do it alone either.” With DGTelemed, they are well-positioned for this. It's not just about saving money, but also about efficiency and better care with the available resources if done correctly together. “We can get better, provide better care [...] if we do it right.”

(mack)