A trend toward digital innovations has been emerging for some time now. In the context of the COVID-19 pandemic, the use of telemedicine applications in particular has gained currency. In addition to many digital solutions that have already been successfully implemented, however, there is still considerable need for action, among other things with regard to the legal and remuneration framework.
The importance of telemedicine services in healthcare is steadily increasing, with the COVID 19 pandemic providing an additional boost to this trend (overview 1) . Issues surrounding digital health innovations are highly topical on the healthcare policy agenda. In this context, the FMH offers a platform for telemedicine services to transparently communicate the respective services on the basis of a self-declaration. An up-to-date overview of telemedicine providers can be found on the homepage: www.fmh.ch.
Telemedicine offerings grow in popularity amid COVID-19 crisis
On the occasion of the virtual ZDFT annual congress, Christian Greis, MD, senior physician at the Dermatology Clinic of the University Hospital Zurich, and Prof. Dr. med. Dr. sc. nat. Alexander Navarini, Chief of Dermatology, University Hospital Basel, gave an up-to-date overview of experiences and trends in the field of telemedicine [1]. The fact that more and more spatially dislocated consultations are in demand from patients is clearly noticeable, according to Prof. Navarini – they receive requests for telemedicine consultations on a daily basis. The offer for online consultations of the dermatological outpatient clinic of the Waid and Triemli City Hospital (www.triemli.ch/derma2go), which has been available since April, is also enjoying great popularity, and its use has increased exponentially in the course of the past few months, says Dr. Greis, explaining with regard to cost absorption: “Video consultations can be billed via telephone consultations, which is relatively problem-free”. Patient contacts via e-mail can also be billed via TARMED (box) . However, the billing for the use of “store and forward” technology, i.e. the time-delayed assessment of patient images and data, is still insufficiently solved. But there is a lot going on. The SGDV advocates the expansion of telemedical examinations and flat rates for charging for the corresponding services and is conducting a dialog on this with the FMH.
Interesting results of the “Digital Trends Survey 2019
There are still one or two hurdles to overcome before digitization has fully taken hold in practices. However, a majority has a positive attitude towards digital innovations, according to a position paper published by the FMH on the “Digital Trends Survey 2019”, a survey in which a total of 494 outpatient physicians and 2432 members of the public participated [1]. 85% of physicians surveyed said that using digital options was important to them, with the greatest interest in online reference tools. Not only doctors, but also patients have a great interest in digitization. For example, it was found that the choice of doctor’s office is definitely also made depending on the offer of an online appointment. Overall, the public’s interest in digital offerings is greater than that of the medical profession, with automatic notifications of doctor’s appointments or waiting times being among the most frequently expressed patient wishes. The latter has been successfully implemented at the dermatology department of the University Hospital Basel, reports Prof. Navarini. This way, patients receive a notification via sms a few minutes before it is their turn and do not have to stay in the waiting room. According to the “Digital Trends Survey 2019,” the most common telemedicine service offered is sending photos to the medical professional using a smartphone. “That plays a critical role for dermatology,” Dr. Greis said. In summary, it can be stated that digital offerings can bring great benefits to practice if technical, legal and remuneration-related obstacles can be removed.
Interim results of the eHealth Switzerland 2.0 strategy are available
One of the goals of the federal government and the cantons is to increase the promotion of digitization in healthcare [2,3]. A key element is the introduction and dissemination of the electronic patient record. In the future, healthcare facilities and healthcare professionals will be digitally networked, will be able to exchange information electronically along the treatment chain, and will be able to use data multiple times. The current version of the “Strategy eHealth Switzerland 2.0” is still valid until 2022 [2,3]. As of the end of June 2020, a report on the current status of implementation has been summarized:
Electronic Patient Dossier (EPD): All measures concerning the introduction of the EPD are in progress (e.g. communication, empowerment, exchange formats, self-declaration of health apps).
Promoting digitization in general: Concrete projects in this regard are being implemented by the federal government and the cantons on an ongoing basis. What has already been implemented, for example: Creation of a new “Digital Transformation” department at the FOPH or recommendations from the federal government and cantons on interoperable EPD supplementary services.
Cybersecurity: Minimum standards for primary systems or strengthening cyber and data security are among the topics that have not yet been sufficiently addressed due to scarce resources.
Interoperability: A need for more interoperability and thus multiple uses of data and infrastructure has been identified. There is room for improvement with regard to the coordination of players in the healthcare system and the use of existing infrastructures, as well as for the setting of recognized standards. The processing of the interoperability strategy planned for the second half of 2020 can contribute to this.
Source: ZDFT 2020
Literature:
- Greis C, Navarini A: Digital dermatology. Christian Greis, MD, Prof. Dr. sc. nat. Alexander Navarini, Zurich Dermatology Training Days (ZDFT), May 14-15, 2020.
- FMH: “Digital Trends Survey 2019”, www.fmh.ch/files/pdf23/fmh-digital-trends-survey-2019-de.pdf, last accessed 05.11.2020
- Strategy eHealth Switzerland 2.0: www.e-health-suisse.ch/politik-recht/strategische-grundlagen/strategie-ehealth-schweiz.html, last accessed 05.11.2020
- Elsner P: Teledermatology in the era of COVID-19 – a systematic review. JDDG 2020, https://doi.org/10.1111/ddg.14180_g
- FMH: Fact Sheet: Billing of Medical Services Related to COVID-19 (New Corona Virus), Version 8.0, October 28, 2020, www.fmh.ch/files/pdf23/faq-abrechnung-covid-19.pdf, last accessed Nov. 05, 2020.
DERMATOLOGIE PRAXIS 2020; 30(6): 4-5 (published 12/2/20, ahead of print).
InFo NEUROLOGY & PSYCHIATRY 2021; 19(1): 39-40.
