AcuteCare Telemedicine Blog


Telemedicine In Europe: Another Euro Disney Experience?

It seemed like a “no-brainer. Take the most successful family entertainment experience (Disney World), clone an exact copy, pack it all up, and implant it to the center of European culture and voila, another mega Disney entertainment success story!  Well, not exactly. It seems as though the European culture frowns on fast food, long lines and many other conveniences and inconveniences that Americans have become accustomed to enjoying and enduring.  The initial Disney experience required many millions of dollars and years of tweaking and modification to the American Disney World model before it became anything nearly as successful. It forever set-forth another example as to how Europeans differ in their perceptions and customs relative to other world societies.  So where does entertainment and telemedicine have commonality?

Decade’s after Disney’s surprising experience significant advances in telecommunications technologies have brought about vast improvements to societies all around the world, across all industries, commerce, media, personal communication and even to the well-established healthcare delivery model.  And while some resistance to changes in healthcare delivery, brought on by the telemedicine and telehealth revolution, have been experienced the vast majority of cultures around the world are envisioning and welcoming significant benefits to the quality and availability of medical services derived from the revolution.  Even deeply traditional governmental regulation and policy barriers are falling aside, albeit slowly in some cases, giving way to a new era of medical care delivery.  But in Old Europe, as telemedicine revolutionizes medical care around the rest of the world, Germans are happier paying a visit to the doctor, and those who could benefit most from the technology will just have to wait.

By international standards, Germans have plenty of doctors: 3.84 for every 1,000 patients. In the US, the number is 2.46. But such statistics shed little light on how doctors are distributed throughout a country. “In some rural regions, we have a situation where a consultation might require a day’s travel for the patient,” says Wolfgang Loos, chairman of the German Society for Telemedicine. One of the solutions, he says, is that a doctor could consult patients via live video streams to the patient’s home. Digital medicine is taking hold in the field of stroke prevention and care, small hospitals and care clinics are networked and can consult specialists through video conferencing whenever they have questions. Patients with chronic heart issues can access a different form of telemedicine: some measuring instruments are connected to centralized medical networks, and if a patient’s value suddenly worsens, a nearby doctor is alerted. But telemedicine faces a number of particularly German hurdles.

Doctors in Germany, as stipulated in the “prohibition of remote treatment” (a German physician’s code of conduct), doctors are not allowed to diagnose a patient remotely without having dealt with that patient before, at least once in person.

Beyond code of conduct restrictions, patients in Germany are accustomed to, and expect, a direct line of personal contact with their general practitioner and specialist. And while most German physicians recognize huge potential in the field of telemedicine, they continue to view “direct contact between doctor and patient as indispensable.” A custom many early detractors of telemedicine in America promoted, only to be rebuffed by patients once the convenience of virtual consultations was experienced.

There are also technical barriers that inhibit telemedicine in Germany. In many regions, high-speed Internet access is lagging, making video conferencing or the transmission of large patient data files nearly impossible. The areas lacking broadband access are often the same rural regions, say its advocates, which would benefit most from telemedicine.

It appears that cloning even the most advantageous of instruments and practices of technology will need some tweaking and modification in order to be universally accepted and successful.



Growth of Telemedicine is Global and Becoming Common Place

Though the United States has been dominating the global telemedicine market, Europe and developing nations are rapidly catching up. The global telemedicine market is expected to grow at a compound annual growth rate of 19 percent, driven mainly by growth opportunities in Europe, but the enthusiastic growth may be tempered by the lack of standardized classifications. However, the increase in remote monitoring of patients is expected to keep driving the market, which is also boosted by the increase in telesurgery. The shift is occurring mainly because of the increase in the number of patients with chronic diseases and the increasing availability of online healthcare services.

The remote delivery of healthcare services over the telecommunications infrastructure, or telemedicine, is a topic of interest to the vast majority of Italian general practitioners (GPs), with 73 percent stating that they are prepared to use the technology according to a study conducted by the Italian Family Doctor’s Association FIMMG. Over half of the doctors surveyed, 52 percent, are in favor of using these new technologies if they help to develop organizational aspects of the profession, while 30 percent state that telemedicine could even improve the doctor-patient relationship.

Global virtual doctor visits could become as common as face-to-face appointments because health insurers, hospital systems and employers view it as a way to clamp down on rising medical costs. They hope that by giving patients easy access to a primary care physician, it will discourage them from visiting a costly emergency room when they get sick. The trend in the US is expected to escalate as an influx of new patients, caused by the implementation of the Affordable Care Act (ACA), promises to put a strain on some doctors’ offices for treatment of routine illnesses.  Health giants UPMC and Highmark Inc. are rolling out new services that allow patients to video-conference with doctors through computers, tablets and smartphones.  “We think more and more people, as they become more familiar with telemedicine, will see this as something that is just going to be commonplace,” said Natasa Sokolovich, executive director of telemedicine at UPMC.  Convenience is the big selling point of telemedicine services to patients.  Rather than having to wait days or weeks to schedule an appointment at a doctor’s office, a video conference could be scheduled within minutes or hours, and the patient wouldn’t have to leave their home.

While such convenience is enticing to an increasingly busy society, some doctors and medical care providers are warning that an E-visit can’t entirely replace face-to-face consultations in a physician’s office environment. Nonverbal cues can be very important in accurately diagnosing patients, said Dr. Bruce MacLeod, president of the Pennsylvania Medical Society. “Some details could be missed in a video conference.”

But as the availability and quality of telemedicine advances globally, a increasing majority of patients are willing and eager to invite the technology into their relationship with their health care providers.  The desire to make medical care more accessible and less-costly is global. Whether E-visits replace face to face medical care completely or just become some relative portion of interaction between patients and physicians, the medical services delivery model is going to be altered dramatically for the future.  The rate of acceptance of communication technology in the medical care process will be driven more by necessary changes to the well-established regulations, licensing requirements, and cost reimbursement policies from within the health care community.