REMOTE TREATMENT: NEW DEPARTURES IN THE SOUTH WEST
Doctors in Baden-Württemberg are able to provide remote treatment without an initial contact. A start-up company and two private health insurance firms are the first to put the model into action.
COLOGNE. It all begins on 1st December. This is when doctors in Baden-Württemberg will be able to treat their first patients by telephone, video conference or app, even if they have never had contact with them before. This remote treatment has been made possible by the professional code of the Baden-Württemberg Medical Association and a model project it has approved from the digital healthcare platform TeleClinic.
By the end of 2019, the Munich start-up firm wants to find out, in conjunction with private healthcare insurance providers, whether remote medical treatment is a practicable alternative to attending a doctor's surgery for patients, doctors and insurance companies. Also involved are the Barmenia health insurance company and another provider. By all accounts, this is the private health insurance market leader Debeka, however the contracts have not yet been finalised. Debeka is involved with the digital health insurance provider Ottonova, which offers clients video consultations with doctors from Switzerland.
Provider arranges first case
The pilot project does not need to remain with just two insurance providers. "The project is open to other private health insurance companies", TeleClinic Managing Director Katharina Jünger tells "Ärzte Zeitung".
Since only the professional code in Baden-Württemberg allows doctors to treat unknown patients remotely, only doctors from this region are able to participate in the pilot project. At least initially, the insurance providers are keen to limit the service to clients in the region too.
TeleClinic has a pool of around 200 doctors involved with the scheme. "At the moment we are recruiting specifically in Baden-Württemberg in order to attract more doctors", reports Jünger. Doctors from all disciplines are able to participate in the pilot project, provided they have at least seven years of practical experience. They do not need to have any special technical equipment. An Internet-enabled PC with camera and sound, as well as an adequate Internet speed, are all that is required.
Insured clients who wish to have a remote consultation contact TeleClinic. There, medical assistance personnel initially triage the case. If it is an emergency, the emergency service is alerted. If the caller needs advice urgently, they are called back within 15 minutes. For all other enquiries, TeleClinic sends a message to all of the doctors in the discipline required.
The first doctor to respond treats the patient
"The first doctor wishing to take on the case is assigned the patient", explains Jünger. If the doctor feels that a remote consultation is not possible or sufficient, then he refers the patient to a colleague locally. Doctors are able to charge their service via the Medical Fee Schedule (GOÄ). The GOÄ code here is 3 (incoming consultation, including by telephone), which can be quoted at a rate of 3.5 x the normal rate. "We pay the fees", she says.
Each treatment step is documented. "The documents are stored for ten years." Medical remote treatment from TeleClinic meets strict data protection standards, and highly sensitive healthcare data is stored exclusively on German servers, stresses Jünger.
Barmenia has already tried out consultations with TeleClinic doctors, although no diagnoses were made. "The feedback from our insured clients was positive", reports Chairman Dr Andreas Eurich. Although some patients were a little uncertain and worried about contact, the majority appreciated the benefits of the service. These include, for example, being able to access a doctor outside normal surgery hours.
According to Eurich, remote treatment can be a valuable addition to practice-based treatment, especially in rural areas. The digital service can save patients from having to make long and in some cases unnecessary journeys. It also has a number of advantages for doctors, he opines. "Every doctor is able to decide for themselves when they will be available."
Saving not on doctors, but with them
The hope expressed by Barmenia's boss: "As an insurance provider, remote treatment can help to keep costs under control more effectively." He believes that there are potential savings to be made in the gatekeeper function performed by medical assistants at TeleClinic. "For us, it's not about saving on doctors, but rather it's about implementing efficient pathways and processes", he stresses. The model deliberately did not use its own pool of doctors. "We are involving doctors from the region."
Barmenia will provide the new service to all of its fully insured clients in Baden-Württemberg. "It is not premium-related." Eurich believes that two years is a good period in order to gain valid results from the remote treatment project. If the positive experiences from Switzerland are confirmed, then the remote treatment model will hopefully also be rolled out to other federal states.
