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Telemedicine is on the rise in Austria

Telemedicine has been a topic in Austria for quite some time now, but it has gained a lot of importance due to coronavirus and the accompanying distance rules. The Swiss Business Hub Austria met with the expert in telemedicine, Dr. Andrea Vincenzo Braga, for an interview and talked to him about the current situation in telemedicine in Austria.

telemedicine

Why has telemedicine experienced such a surge in recent years?

The reasons for this boom in telemedicine are primarily the savings in time and money regarding travel costs, no waiting times, and also the elimination of a risk of infection. Another important issue is a changing care system, as primary medical care is tapering out massively and a shortage of general practitioners is expected in the coming years. This phenomenon can be observed not only in Austria, but also in Switzerland and Germany.

When and what has changed due to coronavirus?

The boom in telemedicine started at the beginning of the coronavirus pandemic, i.e. in spring 2020. There was a lot of uncertainty during the first lockdown regarding the general medical situation. What's more, many therapists were unsettled by the government announcements. At the same time, acceptance on the insurance side increased. Sick notes via telephone, electronic sending of prescriptions and general medical consultations via electronic channels were made possible. Furthermore, billing for such telemedicine consultations now worked. Issues that have been politically stalled for 10 years have suddenly started moving again. People realized that you don't necessarily have to sit somewhere and wait if you need a sick note or have a quick question.

What is the current situation in the telemedicine sector?

Currently, the run on electronic medical consultations has decreased again. What has also decreased are the many "unnecessary" visits to doctors and outpatient clinics. During the lockdown, over 90% of therapeutic conversations took place online - this has now leveled off again at 25%. Video consultations have played a minor role during the pandemic due to low rates. In general, the regulatory environment has not yet reached a point where it can meaningfully reflect telemedicine issues; there is a great deal of uncertainty and room for improvement. 

What is the Telemed Austria Association responsible for?

In Austria, interests in telemedicine are represented by the Telemed Austria Association. The biggest goals and raison d'être of this non-profit association are to demystify the entire telemedicine industry, on the one hand, and to ensure quality, on the other. In addition, Telemed Austria is working together with Quality Austria on a concept for the certification of telemedical platforms and also of the people who operate telemedicine solutions. 

Is the so-called "Telemedicine Seal of Approval" of Telemed Austria in any way state-controlled, or purely private?

The Telemedicine Seal of Approval is 100% a private-sector seal, but it was created in close contact with government-related stakeholders. To get this certificate, you have to go through two phases. The first part is the self-declaration (process description, GDPR compliance, data structure, technical cornerstones), followed by an audit by Quality Austria to weed out any weaknesses.

In principle, can any general practitioner perform video consultations?

Basically, a general practitioner does not need an additional qualification for this, so any doctor can carry them out. One very important point here is communication, because not every doctor is also a good communicator. It is even more important to be able to communicate well via video, because for this you have to collect and send more information. 

Is ELGA (electronic health record) suitable as an infrastructure for telemedicine?

ELGA is not suitable for the communication that would be needed in telemedicine. This is because it would make sense to have access to any preliminary findings as well as the patient history. Exchanging documents via ELGA would be possible, but as an electronic medical record it would not really be of much use. 

Are there government guidelines in Austria that regulate telemedicine?

In Austria, there are no generally applicable standards in this regard. However, a great many of the technical aspects have been documented (data protection, communication, etc.). It has been widely reported that telemedicine was and is prohibited in Austria, but this is not true. Telemedicine is, and always has been, allowed as per the Medical Act (Ärztegesetzt), which states that the work must be done directly on the patient and for the patient, but by what means this should be done has not been defined.

Where are the greatest benefits of telemedicine over traditional treatment?

For chronic illnesses (cardiovascular diseases, diabetes, etc.), but also with emergency medical aid and sudden medical complaints. With the prevalence of chronic illnesses due to our demographic situation, how we keep ourselves healthier and make better and more careful use of the system's resources is a major factor. On the eedoctors platform, for example, 90% of the inquiries can be clarified via telemedicine. Other areas of application of telemedicine are dermatology, pediatric problems, integrated care (virtual + real medical care). Telemedicine can also be used when preparing for surgery (explanatory talks), with psychotherapy, wound management in part, and everything concerning aftercare. In cancer surgery, for example, there is a system called eSMART. This is oncological aftercare, which is used to detect changes in the patient quickly enough, and thus prevent possible hospitalization. 

What marketing measures would you personally carry out to advance telemedicine?

One of the most important measures would be to write a children's book. This would describe the scenario whereby a child is injured and does not go to straight to the outpatient clinic, but a passer-by calls a doctor instead and clarifies whether it is necessary for the child to be taken to the hospital. These habits change with society. The younger generation is more aware of the time they have and more tech-savvy. Within a 15-year time horizon, a significant portion of primary medical care services will also be provided telemedically. Many studies highlight this and the acceptance is already there.  

What does the future of telemedicine look like in Austria?

A key factor here is the regulatory situation, i.e. that telemedicine is put on an equal footing with real medicine and that reasonable payment systems are created so that everyone is motivated to use it, doctors and patients alike. Switzerland is living the example that you can save on health insurance if you use telemedicine. The second major factor will simply appear once the "inconvenience factor of visiting a real doctor becomes evident". When access to real medicine becomes more difficult and there is simply no one there, or you have to drive three hours somewhere, it's time to think about how the allocation of your resources, and those of the patient, can be improved. Behavior will change, as medicine is very much shaped by culture and habits.

If you have any questions or are interested in the medtech or telemedicine industry in Austria, please feel free to contact us at any time at wien.sbhaustria@eda.admin.ch.

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