The need for fast and safe diagnoses is posing new challenges to the healthcare systems, which are already facing an increasing number of financial strains. However, the digital age also opens the door to new opportunities. The magic word of the day is telemedicine.
The healthcare industry is the most important single sector in North Rhine-Westphalia. More than 1.1 million people work in this sector and achieve an annual turnover of almost 60 billion euros. Approximately every sixth employee in the state is indirectly or directly active in healthcare provision. This framework data underscores why North Rhine-Westphalia supports the development of the healthcare sector in many different ways. For example, through a state-run NRW Centre for Health, which is located on the newly developed healthcare campus in Bochum between the Hochschule für Gesundheit (a state-funded university for healthcare professions) and the Cancer Registry NRW.
As part of the state’s “eGesundheit.nrw” initiative, the Ministry of Health, Equalities, Care and Aging (MGEPA) bundles multiple projects which test information and communication technologies with the aim of further developing the healthcare sector in NRW. North Rhine-Westphalia has institutionalised the telematics and telemedicine sectors by establishing the Kompetenzzentrum ZTG (Zentrum für Telematik und Telemedizin GmbH – centre for telematics and telemedicine) in 1999. The aim of the ZTG is to develop, implement and disseminate state-of-the-art information and communications technologies for the healthcare sector, in order to improve the quality of healthcare provision while keeping costs down. An autonomous telemedicine department, the Centre for Telemedicine (Zentrum für Telemedizin – ZfT), has been established at the ZTG since 2012. The department is responsible for turning the state’s goals into reality – the establishment of corresponding framework conditions for a culture of telemedicine-friendly health care provision and increasing the acceptance of telemedicine applications such as telemonitoring, teleconsultation, teleradiology and teletherapy. ZfT is also the starting point for the further development of telematics and telemedicine. According to Mathias Redders, head of the healthcare industry and telematics department at the MGEPA in North Rhine-Westphalia, the state is currently supporting 30 projects with budgets totalling 25 million euros. There are 14 promotion measures that focus on telemedicine and involve almost 60 projects in the state alone.
Additional research focal points are the electronic case and patient files, which are developed and processed in nine projects. A pioneer in this field is the electronic medical record (EFA) developed at the University Hospital in Aachen. Under the common brand of Gesundheitswirtschaft.NRW (healthcare industry in NRW), the six healthcare business regions in North Rhine-Westphalia represent state-wide coordinated key topics and topic sponsorships.
The key topics of the six healthcare business regions in North Rhine-Westphalia:
Aachen region: Medical technology/life science
Cologne/Bonn region: Health for generations
Münsterland region: Preventive medicine
Ostwestfalen-Lippe region: Networked healthcare
Ruhr Metropolis region: Hospital care industry
South Westphalia region: Materials and technologies for the healthcare industry
Along with EFA and telemedical projects in the Ostwestfalen model region, a project drawing on teleradiological communication has been successfully initiated. TeBiKom.Ruhr is a telemedical project network launched in 2012 that is supported by NRW and the EU with a total volume of approx. 2.5 million euros and is scheduled to run through to 2015.
The overall coordination of the project lies in the hands of the largest regional network for the healthcare industry in NRW (MedEcon Ruhr). VISUS GmbH in Bochum, a market leader in image management solutions for medical applications, is also an established partner in the technical development platform, which, on the one hand, boasts many years of extensive experience in the area of image data communication and, on the other hand, is also able to support and implement further developments. A segment in this project is the quality assurance in elective teleradiology designed to counter the effects of demographic change and the increasing shortage of doctors, which results in healthcare bottlenecks, particularly in rural areas. Thus, elective teleradiology could represent a considerable contribution to ensuring local, stationary healthcare. An additional field is the interventional treatment of stroke patients where quite often patients need to be quickly transferred to a suitably specialised centre. An additional TeBiKom.Ruhr field is the teleradiological networking of almost 30 cooperating neurological clinics, including eight centres with a focus on interventional medicine, and the clarification of the required information and communications technologies and medical requirements.
What is remarkable about this project is that it builds on already established and market-tested structures, specifically the Westdeutschen Teleradiologieverbund (West German teleradiological network). This network includes about 200 affiliated clinics, rehab facilities and radiological practices which currently transfers, 100,000 examinations a year among them, by means of a default-based, independent and open solution. This network, unique in Germany, has not only managed to improve the cooperation between clinics, but has also succeeded in creating a lively network community. Practical further developments in telemedical applications are being discussed and development orders for the industry are being formulated at regularly held events. So it fits well that both the bridge between this application and EFA has been completed and a project for the integration of KV-Connect standard used by registered physicians for electronic physician letters has been initiated.
The fact that new and advanced developments are to build on an accepted and established system in the market is unique to a funded project. One of the objectives is to prevent new projects with positive results from becoming isolated applications, which are either not compatible with other solutions, or where compatibility can only be established with considerable additional effort. This shows that the significance of interoperability and standards in telemedical applications and developments has been identified at virtually all levels and is also adequately considered in specific measures.
And it is exactly this aspect that is the subject of intense and multifaceted exchange by the various market players, beginning with the state government, which specifies framework conditions and provides funding options, to the healthcare regions in NRW, trade associations, clinics, cost units as well as service providers and the industry, which is strongly represented by companies including CompuGroup Medical AG (Hattingen), i-SOLUTIONS Health GmbH (Bochum), März Network Services GmbH (Essen) or VISUS Technology Transfer GmbH (Bochum). This documents that North Rhine-Westphalia takes advantage of its size and its population, economic and healthcare market structure to become a leader in driving the developments in the areas of telematics and telemedicine.
The author is 45 years old and holds a business degree from the University of Cologne. During his professional career, Marcus Kremers worked several years as press spokesman for the Vereinigung der Unternehmerverbände für Mecklenburg-Vorpommern (enterprise trade association in the state of Mecklenburg-Western Pomerania). He has been managing director of MedEcon Telemedizin GmbH with its main office in Bochum since 2012..