Ökonomische Evaluation von Telematik-Anwendungen im Gesundheitswesen und Schlußfolgerungen für ihre Implementierung

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Digital Health : die Zukunft des Schweizer Gesundheitswesens

Digital Health ist in aller Munde. Egal ob nun von eHealth, mHealth, Big Data, Gesundheit 4.0 oder eben Digital Health gesprochen wird, die Chancen und Gefahren der digitalen Möglichkeiten beschäftigen die meisten Akteure unseres Gesundheitssystems. Aber wofür stehen eigentlich die zahlreichen neuen Begriffe? Wird Digital Health wirklich das Gesundheitswesen revolutionieren oder handelt es sich nur um einen weiteren Hype, der schon bald wieder vergessen sein wird? Der vorliegende Report schafft ein einheitliches Verständnis, beschreibt den aktuellen Stand aus der Managementperspektive und geht auf zukünftige Entwicklungen ein

Einsatz telekonsiliarischer Infrastruktur im Rahmen fachärztlicher Dienstleistungen: Ansatzpunkte einer empirischen Untersuchung

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The effects of the Covid-19 pandemic on the transition towards digital health solutions : evidence from telemedicine use in Germany

Since the outbreak of the COVID-19 pandemic, the way digital health services are perceived and valued has changed. To minimize the risk of virus transmission, digital health services have come to the fore in place of traditional health services. A prominent example of digital health is telemedicine as it is convenient, time saving, and meets the needs of social distancing. The purpose of this thesis is to examine the effects of the COVID-19 pandemic on telemedicine and the acceptance and use of this service by physicians in Germany. Country-specific characteristics of the German healthcare system are described, and physicians’ perceptions of the benefits and limitations of telemedicine are elaborated. The research consists of several expert interviews and an online survey among physicians in Germany. The results indicate that both, the acceptance and use of telemedicine among German physicians have increased in the wake of the COVID-19 pandemic. Nevertheless, it is evident that telemedicine is only used in specific cases and that the service is currently merely a complement to traditional healthcare. The main benefits of telemedicine are the savings in travel time for physicians and patients as well as improved interactions between physicians, while the main limitations are technical difficulties and the lack of physical patient examinations. Physicians from university hospitals, who are young and have strong technological know-how are the main users of telemedicine in Germany. Although telemedicine has not yet reached mass adoption, the outlook on telemedicine is promising, as the view on digital healthcare has shifted.Desde o surto da pandemia COVID-19, a forma como os serviços de saúde digitais são compreendidos e valorizados mudou. Para minimizar o risco de transmissão do vírus, os serviços de saúde digitais têm vindo a ocupar o lugar dos serviços de saúde tradicionais. Um exemplo proeminente de serviços de saúde digitais é a telemedicina, pois é conveniente, economiza tempo e satisfaz as necessidades de distanciamento social. O objetivo desta tese é examinar os efeitos da pandemia COVID-19 na telemedicina e a aceitação e utilização deste serviço por médicos na Alemanha. São descritas as características específicas do sistema de saúde alemão e são elaboradas as perceções dos médicos sobre os benefícios e limitações da telemedicina. A investigação consiste em várias entrevistas feitas a especialistas e numa pesquisa quantitativa, um inquérito online, realizada entre médicos na Alemanha. Os resultados indicam que tanto a aceitação, como a utilização da telemedicina entre os médicos alemães aumentaram como consequência da pandemia COVID-19. No entanto, é evidente que a telemedicina só é utilizada em casos específicos e este serviço é atualmente, apenas um complemento aos cuidados de saúde tradicionais. Os principais benefícios da telemedicina são a poupança de tempo de viagem para médicos e pacientes, bem como a melhoria das interações entre médicos, enquanto as principais limitações são as dificuldades técnicas e a falta de exames físicos dos pacientes. Os médicos dos hospitais universitários, que são jovens e possuem um forte know-how tecnológico, são os principais utilizadores da telemedicina na Alemanha

Telemedicine - a scientometric and density equalizing analysis

Background As a result of the various telemedicine projects in the past years a large number of studies were recently published in this field. However, a precise bibliometric analysis of telemedicine publications does not exist so far. Methods The present study was conducted to establish a data base of the existing approaches. Density-equalizing algorithms were used and data was retrieved from the Thomson Reuters database Web of Science. Results During the period from 1900 to 2006 a number of 3290 filed items were connected to telemedicine, with the first being published in 1964. The studies originate from 101 countries, with the USA, Great Britain and Canada being the most productive suppliers participating in 56.08 % of all published items. Analyzing the average citation per item for countries with more than 10 publications, Ireland ranked first (10.19/item), New Zealand ranked second (9.5/item) followed by Finland (9.04/item). The citation rate can be assumed as an indicator for research quality. The ten most productive journals include three journals with the main focus telemedicine and another five with the main focus “Information/Informatics”. In all subject categories examined for published items related to telemedicine, “Health Care Sciences & Services” ranked first by far. More than 36 % of all publications are assigned to this category, followed by “Medical Informatics” with 9.72 % and “Medicine, General & Internal” with 8.84 % of all publications. Conclusion In summary it can be concluded that the data shows clearly a strong increase in research productivity. Using science citation analysis it can be assumed that there is a large rise in the interest in telemedicine studies

Effectiveness of Telemedicine and Teledentistry after the COVID-19 Pandemic.

Telemedicine has become increasingly important worldwide over the last two decades. As a new field, it became known especially during the COVID-19 pandemic; this review presents fields of activity with special attention to opportunities and risks. Numerous areas of application offer the possibility for broad use in the medical and dental care landscape in diagnostics, therapy, rehabilitation, and decision advice across a spatial distance. Technical and semantic standards are required, and profiles and guidelines are increasingly defined and organized. Medical/dental consultations have been established in various regions around the world as a response to pandemic challenges and have made video and online emergency consultations possible. Telemedicine applications are already regularly used in medical/dental emergencies, regardless of the pandemic situation, both for transport by train and by plane, from which patients benefit. However, legal hurdles are often still unresolved, but infrastructure challenges both for provider, user hard- and software also complicate deployment. Problems are particularly prevalent in the absence of necessary internet coverage or among socially disadvantaged and vulnerable groups who cannot afford expensive equipment or do not know how to use the technology. Broad access must be enabled, and hardware and software interfaces and updates must be regularly checked and updated. Telemedicine might also improve access to and delivery of oral and general health care support both for rural and urban areas with low costs. Even though dentistry and many medical specialties are still performed clinically by means of practical/manual examination, there are areas of diagnostics where telemedicine applications can provide good support. Therefore, as conclusions, access, and delivery of telemedicine applications in dentistry and medicine should be expanded and improved to provide access to all population groups

Gesundheitsökonomische Aspekte in der telemedizinischen Schlaganfall-Akutversorgung - eine qualitative Analyse

Spezialisierte Stroke Units bieten Schlaganfallpatienten die bestmögliche Behandlung – ihrer flächendeckenden Einrichtung steht allerdings akuter Mangel an erfahrenen Neurologen sowie die geringe Schlaganfallinzidenz in dünnbesiedelten, ländlichen Gebieten entgegen. Hier werden zunehmend telemedizinische Lösungen eingesetzt, um neurologische Expertise in Krankenhäusern der Grund- und Regelversorgung verfügbar zu machen. Nationale und internationale telemedizinische Pilotprojekte haben gezeigt, dass eine fundierte und schnelle Entscheidung über die Thrombolyse als wichtigste Akuttherapie, aber auch über weitere Interventionen telemedizinisch getroffen werden kann. Dabei evaluieren bisherige Studien zwar die Verbesserung der Versorgungsqualität durch die Netzwerke, nicht aber ihre für eine nachhaltige Umsetzung grundlegende Wirtschaftlichkeit. Komplementär zu der medizinischen Evaluation zeigt die hier vorgestellte qualitative ökonomische Bewertung deutscher und amerikanischer telemedizinischer Versorgungskonzepte bezüglich ihrer Geschäfts- und Finanzierungsmodelle klare Unterschiede in der Effizienz und dem langfristig möglichen Erfolg der einzelnen Netzwerkkonzepte. Auffällig ist die konträre Schwerpunktsetzung zwischen zwei großen amerikanischen und den deutschen Netzwerken: Während in den amerikanischen Netzen gezielt Nutzungsanreize geschaffen wurden, die über den immanenten Wunsch der beteiligten Ärzte zur Versorgungsverbesserung hinausgehen, ist dies in den deutschen von sekundärer Bedeutung. Weiterhin sind die deutschen Telemedizinnetzwerke im Unterschied zu einigen amerikanischen tendenziell nicht auf Wachstum angelegt. Aus wirtschaftlicher Sicht bieten dezentral organisierte Netzwerke ein höheres Effizienzpotential als rein lokale, und die Integration von Anreizen in das Geschäftsmodelldesign ist für das langfristige Bestehen vor allem in einem wettbewerbsintensiven Markt ein grundlegender Erfolgsfaktor.Telemedizin, Netzwerkkonzepte, ökonomische Evaluation, Schlaganfall

Wie bewerten Bürger/innen die Telemedizin? Ergebnisse einer Repräsentativbefragung

Die Telemedizin im Sinne einer medizinischen Versorgung von Patient/innen aus der Distanz unter Einsatz von Informations- und Kommunikationstechnologien (IKT) prägt zunehmend das Gesundheitswesen. Spätestens seit der Coronapandemie werden telemedizinische Angebote verstärkt ausgebaut und nachgefragt, um Kontakte zu reduzieren und Wege in die Arztpraxen oder Krankenhäuser zu vermeiden sowie gleichzeitig die medizinische Versorgung über die Distanz hinweg zu erhalten. Die Nutzenbetrachtung von Telemedizin kann aus verschiedenen Perspektiven erfolgen: Neben Aspekten der medizinischen Versorgungsqualität und -effizienz ist die Sichtweise der Patient/innen bzw. Bürger/innen wesentlich, um Fragen der zukünftigen Akzeptanz und Relevanz telemedizinischer Angebote sinnvoll adressieren zu können. Der TAB-Sensor rückt entsprechend Fragen zur Nutzung und zu den Nutzenpotenzialen von telemedizinischen Angeboten in den Mittelpunkt. Daneben wird auch auf Fragen zum Einfluss der Telemedizin auf die Beziehung zwischen Arzt/Ärztin und Patient/in fokussiert sowie auf mögliche Vor- und Nachteile von Videosprechstunden als zunehmend genutzter Form der Telemedizin. Die bundesweite Repräsentativbefragung stellt eine Ergänzung der Untersuchung des TAB zum Thema „Stand und Perspektiven der Telemedizin“ dar, die aktuell als TA-Projekt in Arbeit ist. Der Fokus des Projekts liegt auf telemedizinischen Ansätzen in der medizinischen Versorgung und den jeweiligen Arzt-Patienten-Kontakten sowie den fachlichen und administrativen Beziehungen zwischen beteiligten medizinischen Fachkräften und Einrichtungen

Digital transformation in the german healthcare industry : an analysis of the video consultation (teledoctor) and how it can shape the german healthcare industry

The healthcare industry is currently undergoing a digital transformation. Thereby, efficiency and accessibility between physicians and patients shall be improved by innovative care and treatment concepts. One of these innovative concepts is the telemedicine and in particular the video consultation which enables a location independent treatment of patients through information and communication technology. However, this kind of digital medical treatment is currently not properly available in Germany. Therefore, this exploratory study deals with the current status and potential of video consultation in Germany, the challenges and derives potential impacts of the video consultation. The findings reveal that the legal framework of the video consultation, inappropriate reimbursement, acceptance within patients and physicians and no adequate expanded telematic infrastructure are the main challenges that hinder the further development of the video consultation. At the same time, an educated guess showed that a potential size of video consultation based on physicians and patient’s acceptance exists. The video consultation and its connected features will shift the physical based healthcare system to a more online focused and patient centered system which in return will affect all involved stakeholder. Patients will have better access to medical care and physicians will have more efficient practice processes and more flexible working models. In order to adapt to the digital change of society, physicians should provide VC and healthcare insurance companies should support it.A indústria da saúde está, atualmente, a passar por uma transformação digital. Deste modo, a eficiência e a acessibilidade entre médicos e pacientes serão melhoradas através de conceitos inovadores de cuidados e tratamentos. Um destes conceitos inovadores é a telemedicina e, em particular, a videoconferência, que permite um tratamento independente da localização dos doentes através das tecnologias da informação e da comunicação. No entanto, este tipo de tratamento médico digital não está actualmente disponível de forma adequada na Alemanha. Portanto, este estudo exploratório lida com a situação atual e o potencial da consulta por vídeo na Alemanha, os desafios e os potenciais impactos da consulta por vídeo. Os resultados revelam que a estrutura legal da consulta em vídeo, o reembolso inadequado, a aceitação pelos pacientes e médicos e a falta de infraestrutura telemática expandida adequada são os principais desafios que dificultam o desenvolvimento futuro da consulta em vídeo. Ao mesmo tempo, uma suposição esclarecida mostrou que existe um tamanho potencial de consulta por vídeo baseado na aceitação dos médicos e pacientes. A consulta em vídeo e os recursos conectados mudam o sistema de saúde com base física para um sistema mais focado online e centrado no paciente, o que afetará todas as partes interessadas envolvidas. Os pacientes terão melhor acesso aos cuidados médicos e os médicos terão processos práticos mais eficientes e modelos de trabalho mais flexíveis. A fim de se adaptar à mudança digital da sociedade, os médicos devem fornecer VC e as companhias de seguros de saúde devem apoiá-la

project report Promise2007

Das Projekt Promise2007 befasste sich mit der Erstellung und Auswertung einer Statistik zur Mitgliedersituation im Berufsverband Medizinischer Informatiker e.V.. Mit dem Ziel mehr über die Mitglieder und ihre derzeitige Situation zu erfahren wurde das Projekt an der Fachhochschule Hannover initiiert. Statistisch erfasst wurden Fragen zum Beschäftigungsverhältnis, zu Aus- und Weiterbildung, der beruflichen Situation und persönliche Angaben. Die Ergebnisse wurden ausgewertet und daraus wichtige Erkenntnisse für den BVMI e.V. abgeleitet, welche auf die weitere Verbandsarbeit Einfluss nehmen