Medical consultations via video chat instead of in the practice, digital monitoring of heart patients from a distance, and apps on prescription: the spread of coronavirus is becoming a driver for digitalized medicine. Change is coming and will be here to stay.
Mrs Lichtberg sits in front of the laptop and holds her son's arm in front of the camera. The four-year-old has had a strange rash for days that just won't go away. On the screen they see their pediatrician. Dr. Blume takes a close look at the rash on the camera and makes the diagnosis. Tom's mother can pick up a prescription at the surgery in the afternoon. Thanks to a video consultation, and without having to wait in the waiting room.
No technical innovation has so far succeeded in accelerating the digitalization of the healthcare system in Germany to the extent that coronavirus has: For fear of the risk of infection, many patients are suddenly shying away from the usual trip to the doctor's surgery. What's more, the Federal Joint Committee (G-BA) came up with the option of enabling patients with mild respiratory tract disorders to obtain sick notes by telephone for several weeks. Many doctors were also under pressure, because the number of patients in practices was continuing to drop. Due to this pressure, the time of a long known application finally came: telemedicine.
Only recently, the health insurance companies and the National Association of Statutory Health Insurance Physicians agreed on important updates, which are now taking effect. In the past, doctors and psychotherapists were allowed to bill a maximum of 20 percent of their medical treatment as video consultation hours, but this restriction now no longer applies. For doctors, in March the time had come to invest in the required technology. Currently, many providers of video consultation software are even offering their products free of charge and are looking forward to a significant increase in growth throughout Europe. There is talk of a 250 percent increase in such medical treatment, or an increase to 50,000 visitors per month. A representative survey by Bitkom Research shows how open Germans have suddenly become to video consultations: More than 90 percent of those surveyed in April and May 2020 are in favor of expanding digital healthcare. Two thirds would like to see more medical advice via chat apps, and the same number would like video consultations become standard in medical practices.
A virtual hospital opened at the end of March in North Rhine-Westphalia – somewhat earlier than planned because of the coronavirus outbreak. In this project, the University Hospitals of Aachen and Münster offer their expertise in the treatment of Covid-19 patients to other hospitals via teleconsultations. The figures for the virtual hospital in NRW show there is significant demand: In the first week after the start, almost 200 Covid-19 patients received telemedical support from the university hospitals of Aachen and Münster. Teleconsultations have seen sporadic use for some time now; one of the first in Germany was the Carus Consilium Telehealth Ostsachsen (CCS), a subsidiary of Dresden University Hospital. Since 2015, hospital doctors have been remotely monitoring their patients with heart failure (cardiac insufficiency) or strokes via a technically open platform. What's more, the attending doctors exchange information digitally via the platform, are available to their patients for consultations even at short notice, and can obtain second opinions from specialists in real time. Thanks to CCS Telehealth Ostsachsen, patients from rural areas also receive better medical care. And they can stay in familiar surroundings longer.
The topic of healthcare apps also moved up on Germany's agenda thanks to coronavirus. Cycle calendars, diabetic diaries or blood pressure monitors for the smartphone, these applications have been living in the shadows for some time now. But knowing who has had contact with a person suffering from coronavirus and at what time is currently essential for many people. The tracing app from Telekom and SAP, which records precisely this information via Bluetooth, was developed under a great deal of pressure and in the public eye, which was of course critical but also curious about this technology for the first time. And according to the Robert Koch Institute (RKI), it had been downloaded 16.1 million times by mid-July. Assuming that everyone actually uses the app after downloading it, that would be around 20 percent of the population. In June the first app users experienced the fact that it works: they received a message informing them that they had been in the vicinity of a person infected with Covid-19.
In order to promote digital care in Germany, Federal Health Minister Jens Spahn set the legal course for the "App auf Rezept" (app on prescription) in December 2019. With the Digital Care Act, doctors and psychotherapists can prescribe digital applications to their patients at the expense of the statutory health insurance. These apps help to identify, monitor, treat, and alleviate illnesses. The applications must successfully pass an approval procedure at the Federal Institute for Drugs and Medical Devices (BfArM). In doing so, the ministry checks the manufacturer's information regarding the required product characteristics, from data protection to user-friendliness. What's more, the manufacturer must demonstrate a positive supply effect. Because digital medicine is not a lofty prestige project of the federal government: above all, it should help to reduce costs in view of the increasing number of older and chronically ill people and increasingly expensive medical innovations.
E-health applications have become part of the everyday life of many patients. Experts assume that telemedicine will firmly establish itself in German practices. And the Corona app will probably accompany users for many months to come. At the same time, Jens Spahn is rapidly advancing the digital transformation of the health system. He is driving forward the rollout of a telematics infrastructure as a data highway nationwide, in order to network all those involved, from doctors to pharmacists to hospitals. In future, every German citizen will be able to maintain an electronic patient file (ePA), in which all of their documents are stored: findings, diagnoses, therapy measures, treatment reports, vaccinations, electronic medication plans, digital doctor's letters, and emergency data records. Soon prescriptions too will no longer be available on paper; they will be replaced by a digital version for smartphones. The corona warning app will probably be the first e-health application to run on the majority of smartphones in Germany. Perhaps it will be the long-awaited forerunner for digital medicine, if the benefits are clearly visible.
