eHealth: just for self-taught learners?

Every technology we take for granted today was new and unfamiliar at first and needed to be learned: this applies to smartphones, new operating systems or VCRs alike. It is even more important to keep up with the latest technologies in your job since know-how also presents a financial advantage. Physicians fare no differently here than other occupational groups.


Photo: Physicians videochatting

eHealth, like a video conference between two physicians, are well on the way to change the health care system; © Andrey Popov

Quite the opposite is true: physicians are not only able to continue their professional development to remain up-to-date in their field and expand their expertise, they are actually obligated to do this; at least in Germany. Here, the medical associations require physicians to earn a certain number of credits each year by participating in certified medical training. Yet even in areas where they are not legally obligated to continue their professional development, physicians still need to keep up-to-date with the latest research and technology to ensure the best possible care for their patients. Not only is this great to guarantee treatment success, but physicians who know and are able to offer more examination procedures and treatment methods also enjoy a better image and competitive edge over their colleagues since the use of modern procedures makes their medical practice more attractive and sought-after.

New technology pays off for patients and physicians

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?

Photo: Female physician with a laptop

Until now, eHealth seems to be a relevant topic only for physicians who are anyway interested in the topic; © danr13

"The impression we get is that younger physicians tend to be more open-minded towards this subject. This might also be because physicians who will only continue their medical practice for perhaps another two to three years, no longer want to invest in the necessary infrastructure but rather leave this to their respective successor," explains Rainer Beckers, Managing Director of the ZTG Center for Telematics and Telemedicine GmbH in Bochum. In the past, the ZTG, whose goal is to "develop, introduce and advance modern information and communication technologies for the healthcare sector to improve the quality of healthcare at affordable prices," has developed continuing education options pertaining to telemedicine and eHealth. It serves as the coordinator and manager of projects by the state initiative and is funded by the North Rhine-Westphalian state government.

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.

eHealth: status uncertain

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.

Photo: Physician and patient are looking at ultrasound images

New technology in the physician's office pays off in the long run, both for patients and physicians. This is not only true for eHealth but also imaging and diagnostics; © SimpleFoto

Easily accessible options pave the way for new technologies

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.

Photo: Timo Roth; Copyright: B. Frommann

© B. Frommann

The article was conducted by Timo Roth and translated from German by Elena O'Meara.