Video chat instead of waiting room

A preliminary talk about which specialist is the right one, or just briefly checking how the wound is healing. Wouldn't it be practical if this could be done by video call? For physicians, health insurers and many patients probably already. But although video consultations are technically and legally possible, the offer has hardly been used so far. The example of Hesse shows the problems.

"Hopefully, this will become more so in the future," wishes Pavel Khaykin. Frankfurt internist thinks video consultations "definitely make sense," reports dpa. He has been offering this service since the beginning of August, "but so far there hasn't been a single inquiry". Khaykin and a handful of other physicians from various specialties in Hesse offer their video consultations through their own online portals. Sensitive data is involved, so you can't just use programs like Skype or Facetime, explains Dr. Khaykin.

The National Association of Statutory Health Insurance Physicians (KBV) and the central association of statutory health insurers (GKV) had already agreed in 2016 on the technical requirements for practices and video service providers. Doctors must obtain written consent before using video consultations, the conversation must not be recorded and the transmission must be specially encrypted.

KBV spokesman Roland Stahl told dpa that there are no figures yet on how many doctors are using video consultation hours. It's just the beginning. It will become even more widespread. But: "The video consultation is not the digital panacea." It could be used, in particular in the rural area, supportive. And, he added, "Doctors don't block out."

Since the middle of this year, health insurers have been covering the costs of video consultations. How often doctors and patients have used it since then, however, no one knows at present. At the Association of Statutory Health Insurance Physicians of Hesse, the third quarter has not yet been evaluated. KV spokesman Karl Matthias Roth ames that there will not be too many. Video consultation hours are "a useful addition," he says, but "not a solution to the shortage of doctors in rural areas".

The State Medical Association of Hesse also likes video consultation hours, but also emphasizes the limits: "Video consultation hours can be useful, among other things, for monitoring the chronically ill, for wound checks or initial assessments," says Medical Association President Gottfried von Knoblauch zu Hatzbach. The use of electronics is certainly "in accordance with the medical professional code of conduct".

Treating patients exclusively from a distance, on the other hand, is not permitted under the professional code of conduct, the chamber emphasizes. "If, on the other hand, a doctor knows his patients and treats them telemedically for minor illnesses or routine cases, for example, then the convenient, fast and efficient information and communication processes are expressly to be welcomed." The president of the medical association also ames "that these offers will continue to increase.".

Susanne Mauersberg from the Federation of German Consumer Organizations (Verbraucherzentrale Bundesverband) sees the reasons why this has not been the case so far in medicine. "Physicians are slow to implement this," says the healthcare expert. "Yet this is a very innovative, very important story." The consumer center encourages patients to ask specific questions "and to be more offensive to the doctor in the process".

In any case, the desire of patients is there, as a study by the Bertelsmann Foundation shows. According to a representative survey from 2015, 45 percent wanted to use a video consultation with their family doctor or specialist at least occasionally. The authors of the study also see no loss of quality: "Video consultations are just as good as an office visit for many indications and occasions."

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