PEDIATRIC SURGERY AFTERCARE WITH TELEMEDICINE: Mainz University Medical Center starts with 300 young volunteer patients
Samuel is 13 years old and underwent surgery a week ago in pediatric surgery at the University Medical Center. For aftercare, he would now actually take the path to the clinic. Samuel sits tens of kilometers away relaxed in his garden - with his doctor, he talks about a laptop camera. This is made possible by the telemedical consultation of Mainz Pediatric Surgery. Samuel does not miss personal contact with his doctor. "Well, actually it's the same, whether I talk like that or something," he says. Professor Oliver Muensterer, director of the Department of Pediatric Surgery, confirms that. According to a study, the quality of aftercare was just as good among the approximately 300 young patients who voluntarily accepted the offer of video consultation since the beginning of 2015 as were those who came to the clinic in a classic way. But it would stress, time and costs avoided on arrival, says Muensterer. The patients do not miss a lesson, parents do not have to take their time off. This also applies to the stepfather of Samuel, who sits next to him during the telemedicine consultation. He simply put the conversation into his lunch break. "Equally good, but more practical," says Professor Muensterer of the telemedical offer.
Even patients from the Arab world, from China, Russia, Nigeria or Mozambique were already advised by the Mainz doctors after an operation in this way. A young patient, Muensterer tells us, was caught in Azerbaijan - skiing in the Caucasus, at an altitude of over 2500 meters. Patients only need a cell phone or laptop camera for the offer. "Everyone has this hardware at home and access to it," says Muensterer. Even in the clinic, the technology is simple: A large flat screen, camera and microphone, a video telephony software and a "university medicine" markers for the background - nothing more is needed for discussions over thousands of miles. He does not necessarily have to take over the after-care after an operation, says the pediatric surgeon dr. Jan Gödeke, who holds most of the video meeting hours. It is also a kind of success check for the doctors. A large part of the consultations were discussions with patients and parents, says Gödeke. But he also includes parents as a "doctor's substitute" and let them observe or feel symptoms on their child. Some he could by video telephony also examine themselves. "For example, the pupillary reflex - is wonderful," says Gödeke. But there are limits when he actually has to touch the patient. "We need cooperation with the local paediatricians," says Oliver Muensterer.
According to Muensterer, parents of patients or physicians who have been treated for surgery in Mainz, as well as children who have been given aftercare in Mainz, report a second opinion before surgery. Only the exclusive treatment by video consultation is currently not allowed for doctors in Germany. But that too should change. At the beginning of May, the German Medical Association paved the way for exclusive long-distance treatment without prior personal contact. Now, the regional medical associations have to discuss whether they want to adopt the adopted model occupational order. In Rhineland-Palatinate, implementation may take some time. "This year it will certainly not be realized," said the President of the State Medical Association, Günther Matheis. But there is no urgent need for action. Many telemedical models are already possible. "I see in telemedicine new opportunities for health care, especially in rural areas," said Minister of Health Sabine Bätzing-Lichtenthäler (SPD). They welcome the abolition of the long-distance treatment ban by the German Medical Association. However, the personal contact and the direct doctor-patient relationship can not be replaced in the future. "The family doctor around the corner will not be preserved everywhere," said the Association of Statutory Health Insurance Physicians. However, the use of telemedicine services should not lead to international corporations using remote call centers via call centers whose quality can not be controlled. For the pediatric surgeons of Mainz will change little by the decision of the medical day, says clinic chief Muensterer. He hopes, however, that telemedicine will be better recognized. So the video consultation hours of health insurance companies could be recognized and accounted for - currently the project is still funded by research funds from land and foundations. Telemedicine would also pose fewer legal hurdles than technical ones. "We have a great connection abroad," says Muensterer. Even in Mainz-Mombach, it could be difficult, in rural areas, there are always problems in Germany with the Internet connection. "The limiting factor is the broadband connection," says Muensterer.