Emergency medicine: how telemedicine strengthens the chain of survival

You have probably heard of the chain of survival. It refers to a series of collaborative actions taken by first responders, emergency response systems, and emergency departments to ensure emergency medical services. However, at times, this chain of survival is too long when emergency vehicles have to travel great distances for example. And although telemedicine is unable to reduce this time, it can make it more productive for emergency medical responders.

In this MEDICA-tradefair.com interview, Armin Häuser explains how telemedicine can support emergency services and effectively strengthen the chain of survival and describes the necessary steps for a comprehensive implementation.

Mr. Häuser, what is the purpose of the Competence Center for Telemedicine and eHealth of the State of Hessen (Kompetenzzentrum für Telemedizin und E-Health des Landes Hessen)?

Armin Häuser: Our primary tasks involve the continuous improvement in telemedicine and eHealth and the further digitization of health care in the State of Hessen. This includes expert and impartial advice on behalf of the Hessian Ministry for Social Affairs and Integration, which we provide free of charge for all stakeholders in the healthcare system. Our consulting service pertains to the development of concepts and solutions centering on the digitization of healthcare.

How can telemedicine support emergency medicine?

Häuser: The State of Hessen features IVENA eHealth, an interdisciplinary care management application. In an emergency, it can be used to quickly assign patients to hospitals that have the required capacity to treat and to send diagnostic information about the patient to the hospital prior to ambulance arrival. Aachen has the so-called Telenotarzt-Dienst (English: tele-emergency medical service) that facilitates a livestream between the ambulance and emergency physician at another location and gives first aid instructions to paramedics until the regular emergency medical physician arrives at the scene of the accident.

How does this benefit emergency care services?

Häuser: On the one hand, you save time when it comes to the transfer of information: thanks to telemedicine systems, rescue teams can quickly find an available hospital with enough room. The already mentioned preliminary information about the patient allows hospitals to prepare and plan operating rooms and staff ahead of time if necessary. In doing so, the ambulance travel time can be used effectively to keep the chain of survival as tight as possible and not waste any precious time. On the other hand, telemedicine allows all emergency medicine stakeholders to stay connected and optimizes team collaboration, which ultimately also benefits the patient.

What requirements must telemedicine systems meet, especially as it relates to emergency medicine?

Häuser: When it comes to using telemedicine systems as part of emergency care operations, data and information should be exchanged in real-time and shared simultaneously with all parties involved.

Most importantly, they need an uninterrupted network connection via a mobile service for example. Meanwhile, this obviously is not always the case, especially in rural areas where it can take longer for ambulance vehicles to get to their destination.

Needless to say, in addition to the reliability of software and technology in the emergency vehicle, it is also crucial to account for the human factor – that means training the emergency response team to safely and competently use all equipment and learn new processes.

What limits the comprehensive use of telemedicine in emergency medicine in your eyes?

Häuser: Needless to say, aside from a mobile network connection and staff training, it is also essential to clarify data protection issues, especially in the wake of the General Data Protection Regulation (DSGVO). There is also a need to set up data exchange standards; so far there are only point solutions. Meanwhile, the different devices and systems must be compatible to facilitate an effective and comprehensive use in the field. That is also one of the areas where we want to offer our support to policy-makers in an advisory capacity.

Speaking of politics: In closing, I would like to know where Germany ranks compared to other countries when it comes to using telemedicine in emergency response settings?

Häuser: Some countries are true trailblazers. Especially the Scandinavian countries are well-developed and very advanced in this area. Of course, this is also due to their comparatively vast areas and lower concentration of hospitals. Austria has also been quite successful in implementing several projects. Compared to other countries, I see Germany ranking in the middle at the moment.