One example of a trend that will and is already changing the health care system in the medium term is telemedicine. Connecting doctor and patient or physicians to each other offers many, by now well-known advantages: it facilitates a faster diagnosis, for example, improves outpatient care and the quality of care for chronically ill patients at home, supports care coordination and communication among physicians, relieves medical practices by using teleconsultations and therefore reduces health care system costs overall.
This is why there are good reasons for the use of telemedicine and in essence, it benefits all medical specialties and occupational groups in medical practices and hospitals. And still, telemedicine, telematics, and eHealth only sporadically appear in German medical education: the almost 89,000 registered continuing education options offered nationwide through the German Medical Association only list 15 (telemedicine), two (telematics) and one (eHealth) events (as of April 7th 2016). The subject of "telemedicine" therefore appears to be more the stuff for self-taught learners among physicians. But why is that?
Is a less tech-savvy and skeptical medical community that shies away from initial investments subsequently the reason there are hardly any continuing education options on this subject? What Beckers has to say about this, only outlines a partial aspect: "Based on our experience, interest in courses we were involved in is limited to physicians who are already interested." This consequently rules out physicians as a target audience who want to look at the subject "just for fun". This is actually understandable since professional development costs time and money. However, just blaming physicians for this would mean oversimplifying things.
When it comes to eHealth, primarily data protection and security issues often still elicit skepticism among users: how can you be sure that patient data does not fall into the wrong hands during a cyberattack? What happens to data that is not stored on the server of a hospital or medical practice for processing but on an external server of a service or equipment provider? This is the case with many medical apps for example that are in part not even tested for security prior to coming on the market. They are not labeled as a "medical device", whereby they do not require an approval process.
Rainer Beckers illustrates another obstacle of a very practical nature. "A big challenge for the health care system is still the current lack of interoperability. There are far too many interfaces between the different systems that are difficult to bypass." Telemedicine can therefore only become interesting to a great number of physicians if the systems are also truly able to communicate with each other and if they are secure - after all, who wants to install something in their medical practice that ultimately requires more work?
When these types of obstacles are removed, perhaps the subject will also become more interesting for continuing education organizers and a majority of the medical community. Having said that, interested parties and those who want to check things out are able to obtain a hands-on experience prior to that - at the "Telemedicine User Laboratory" of the ZTG. "Our user laboratory gives people the chance to enjoy a true up-close eHealth experience. By now, our premises house 26 systems by leading manufacturing companies. Visitors can test the usability of the systems live," explains Beckers. The ZTG aims to demonstrate the systems regardless of their manufacturer, to allow extended insights and also facilitate a critical analysis.
The user laboratory wants to provide a better understanding of interoperability by offering a practical experience or by presenting an electronic case file that enables medical data exchange among physicians for example. "We want to reach those who want to utilize telemedicine. We show potential users what is possible today and how telemedicine fits into everyday life - whether that pertains to the patient, physician or the hospital," says Beckers.
Although the ZTG user laboratory is not an exclusive educational facility for physicians, it actually represents a great first step for them. And maybe facilities where new technologies can be tried out without any obligations and bias, might generally be the right approach to plant subjects into the world of continuing education and pique the interest of the target audience. From there, it is only a small step towards accredited continuing medical education. Inevitably, eHealth will enter everyday medical practice, but new technologies in the areas of imaging, diagnostic devices, and surgery are also going to modernize the work in medical offices and hospitals over the next few years.
Needless to say, new acquisitions initially always translate into costs, required training, and more work. However, easily accessible options such as a user laboratory, for example, assist future users in learning to better assess the use, benefits and drawbacks of these technologies for their own respective field. Laboratory visitors might actually also become "early adopters", who take advantage of the new options before the majority of the professional community does. However, as long as eHealth does not become a full-fledged subject in certified continuing medical education, it will primarily be the self-taught learners among physicians who will continue to get involved in this specialty.