Brauns H-J, Loos Wolfgang
Vorstandsvorsitzender, Deutsche Gesellschaft für Telemedizin, Berlin, Deutschland.
Geschäftsführendes Vorstandsmitglied DGTelemed, Rhinstraße 84, 12681, Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2015 Oct;58(10):1068-73. doi: 10.1007/s00103-015-2223-5.
Telemedicine as a subject has reached politics, doctors and patients, but it has still not been able to make the leap from research, development, and testing into real practice. This is generally because of the great barriers to implementation, mainly the lack of telematics infrastructure and of payment regulations in Germany. Telemedicine projects are mainly isolated applications and it has not been possible to integrate them in to nationwide regular health services. Other challenges along the path to standard care include that research-based small-medium enterprise (SME) companies usually face high barriers hindering access to this market, because it is imposible for them to finance all the required evidence-based studies to verify the medical benefits and the econimic efficiency. Additionally, a high market nontransparency is noted. However, the signs of progress are visible, e.g., the E-health initiative of the German government or recent legislative initiatives. However, long processes are observed that do not facilitate the use of telemedicine. Although some federal states, e.g., North Rhine Westphalia, Bavaria, Mecklenburg-Western Pomerania, and Saxony, show exemplary activities, there are still many white areas on the telemedicine map of Germany. The road to standard care will be long, but is not unattainable. The reasons for supporting telemedicine are still strong. The future development of telemedicine applications will contribute to sustainable and high-quality patient care in Germany.
远程医疗作为一个主题已涉及政治、医生和患者，但它仍未能从研究、开发和测试阶段跃升至实际应用阶段。这通常是由于实施过程中存在巨大障碍，主要是德国缺乏远程信息处理基础设施和支付法规。远程医疗项目主要是孤立的应用，无法将它们整合到全国性的常规医疗服务中。通向标准医疗的道路上的其他挑战包括，以研究为基础的中小企业通常面临进入这个市场的高壁垒，因为它们无法资助所有所需的循证研究来验证医疗效益和经济效益。此外，还存在市场透明度低的问题。然而，进步的迹象是明显的，例如德国政府的电子健康倡议或近期的立法举措。然而，也观察到存在一些不利于远程医疗使用的漫长流程。尽管一些联邦州，如北莱茵-威斯特法伦州、巴伐利亚州、梅克伦堡-前波美拉尼亚州和萨克森州，展现了示范活动，但在德国远程医疗地图上仍有许多空白区域。通向标准医疗的道路将漫长，但并非无法实现。支持远程医疗的理由依然充分。远程医疗应用的未来发展将有助于德国实现可持续和高质量的患者护理。
