Telemedicine has been assumed to have considerable potential for many years already. The remote medical care of patients using information and communication technologies (ICT) should help to better monitor the health condition of patients as well as the compliance with therapy and medical aftercare. Telemedicine should also help to better inform patients and involve them more actively in their treatment (improved self-management). The travelling and waiting times of patients could be decreased and hospitalisation reduced. From the perspective of the healthcare system as a whole, professional expertise could be made available more comprehensively in terms of time and space. Medical specialists and facilities could be networking more closely and also across various sectors. Treatment guidelines could be better adhered to and the quality of medical care could be improved or medical services provided more efficiently. Thus, health-related or economic benefits could be achieved with regard to medical care. From a health policy perspective and due to this assumed potential, telemedical applications also raise the hope of being able to meet different structural challenges of the national health system: In sparsely populated or structurally weak regions, telemedicine could help to maintain high-quality medical care. The efficiency gains attributed to telemedicine could relieve the pressure on social security systems caused by demographic change.

Different monitoring reports and innovation analyses show that telemedicine is only slowly finding its way into medical care – even, but not only, in Germany. This indicates either that technology diffusion is limited by technical, normative, personnel, organisational or social barriers or that the potential of telemedicine might be overestimated.

Objectives and approach

The project focuses on telemedical approaches in medical care and the respective contacts between doctor and patient as well as on the professional and administrative relationships between medical professionals and institutions involved.

The following priority areas should be considered in the project:

• Teleanamnesis and diagnosis: contacts (e. g. also by means of anamnesis chatbots), video consultations, findings and diagnostic findings (e. g. also using teleradiology, medical teleconsultations, medical assistance or expert systems) up to patient information systems (e. g. with regard to specific disease situations and treatment options).
• Medical treatment: medical or therapeutic apps (e. g. for tinnitus treatment), surgical robots, telemonitoring of vital signs partly with automated drug delivery (so-called closed-loop systems), e. g. in diabetes treatment, functional checks of aggregates, including communication between the actors involved during treatment (in Germany services provided by health insurance companies).
• Rehabilitation and medical aftercare: from ICT-supported individual services to more comprehensive service portals or platforms, including communication between the actors involved, also across various sectors (in Germany [follow-up] services provided by other third-party payers).

The project will not consider digital services that support healthy lifestyles (e. g. health apps) or independent life in one's own home (e. g. ambient assisted living, smart home solutions).

The current status and the foreseeable technology development and diffusion will be presented for the telemedical priority areas mentioned above. For this purpose, structural and regulatory aspects of data protection, performance and benefit assessment, quality assurance, expenditure components and financing, emerging business models as well as liability and acceptance issues will be addressed. The project will discuss existing diffusion and application barriers as well as possibilities for funding and support. Moreover, options for action for the German Bundestag will be derived.

Two expert reports shall provide a professionally sound basis for the situation of telemedicine in selected pioneering countries on the one hand and in Germany on the other hand. Finally, in a comparison, structural differences as well as possibilities and limits of transferability with regard to the use of telemedical applications will be worked out.

Project progress

Following the evaluation of external expert reports on telemedicine applications in selected pioneer countries and in Germany, as well as its own research, the final report was submitted to the responsible TA rapporteur group of the parliamentary groups for approval in autumn 2024.