Telemedicine in Germany During the COVID-19 Pandemic: Multi-Professional National Survey

Background: In an effort to contain the effects of the coronavirus disease (COVID-19) pandemic, health care systems worldwide implemented telemedical solutions to overcome staffing, technical, and infrastructural limitations. In Germany, a multitude of telemedical systems are already being used, while new approaches are rapidly being developed in response to the crisis. However, the extent of the current implementation within different health care settings, the user's acceptance and perception, as well as the hindering technical and regulatory obstacles remain unclear. Objective: The aim of this paper is to assess the current status quo of the availability and routine use of telemedical solutions, user acceptance, and the subjectively perceived burdens on telemedical approaches. Furthermore, we seek to assess the perception of public information quality among professional groups and their preferred communication channels. Methods: A national online survey was conducted on 14 consecutive days in March and April 2020, and distributed to doctors, nurses, and other medical professionals in the German language. Results: A total of 2827 medical professionals participated in the study. Doctors accounted for 65.6% (n=1855) of the professionals, 29.5% (n=833) were nursing staff, and 4.9% (n=139) were identified as others such as therapeutic staff. A majority of participants rated the significance of telemedicine within the crisis as high (1065/2730, 39%) or neutral (n=720, 26.4%); however, there were significant differences between doctors and nurses (P=.01) as well as between the stationary sector compared to the ambulatory sector (P<.001). Telemedicine was already in routine use for 19.6% (532/2711) of German health care providers and in partial use for 40.2% (n=1090). Participants working in private practices (239/594, 40.2%) or private clinics (23/59, 39.0%) experienced less regulatory or technical obstacles compared to university hospitals (586/1190, 49.2%). A majority of doctors rated the public information quality on COVID-19 as good (942/1855, 50.8%) or very good (213/1855, 11.5%); nurses rated the quality of public information significantly lower (P<.001). Participant's age negatively correlated with the perception of telemedicine's significance (p=-0.23; P<.001). Conclusions: Telemedicine has a broad acceptance among German medical professionals. However, to establish telemedical structures within routine care, technical and regulatory burdens must be overcome

Two-stage visual speech recognition for intensive care patients

Abstract In this work, we propose a framework to enhance the communication abilities of speech-impaired patients in an intensive care setting via reading lips. Medical procedure, such as a tracheotomy, causes the patient to lose the ability to utter speech with little to no impact on the habitual lip movement. Consequently, we developed a framework to predict the silently spoken text by performing visual speech recognition, i.e., lip-reading. In a two-stage architecture, frames of the patient’s face are used to infer audio features as an intermediate prediction target, which are then used to predict the uttered text. To the best of our knowledge, this is the first approach to bring visual speech recognition into an intensive care setting. For this purpose, we recorded an audio-visual dataset in the University Hospital of Aachen’s intensive care unit (ICU) with a language corpus hand-picked by experienced clinicians to be representative of their day-to-day routine. With a word error rate of 6.3%, the trained system reaches a sufficient overall performance to significantly increase the quality of communication between patient and clinician or relatives

Impact of the COVID-19 Pandemic on Urologists in Germany

Background: In order to contain the coronavirus disease 2019 (COVID-19) pandemic, Germany has implemented drastic restrictions on public or social life, while health institutions are invoked to postpone elective procedures. Although urologists are less involved in the direct treatment of COVID-19 patients, the current situation strongly affects the urological work routine. Objective: To analyze the impact of the COVID-19 pandemic on various aspects of work and personal life among urologists in Germany. Design, setting, and participants; A total of 589 urologists in Germany participated in an online survey between March 27 and April 11, 2020. Outcome measurements and statistical analysis: Participants were stratified into subgroups according to professional characteristics. Results and limitations: Most urologists rated Germany as well prepared and the increasing restrictions of social life as very positive. Routine operation was more restricted in hospitals than in the outpatient sector (p = 0.046). Moreover, urologists from the outpatient sector felt significantly less prepared for the COVID-19 pandemic (p = 0.001), reported a higher shortage of protective medical equipment (p < 0.001), and described a tendency toward a higher level of threat (p = 0.054). Although restrictions regarding telemedicine approaches were reported by 60% of participants, the outpatient sector used telehealth more frequently than hospitals (25.5% vs 17.0%, p < 0.001). Limitations include the national design and the restricted survey period. Conclusions: This survey systematically evaluates the impact of the COVID-19 pandemic on personal and professional aspects of German urologists. We identified several issues, such as a higher shortage of medical protective equipment in the outpatient sector that could trigger specific measures to further improve the quality of urological care in Germany. Patient summary: We evaluated a potential impact of the coronavirus disease 2019 (COVID-19) pandemic on professional and personal aspects of the urologists in Germany. Our results suggest that the outpatient sector should receive specific attention as, for example, shortage of protective equipment was more common. (C) 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved