Telemedicine as part of Hospital@Home

Healthcare is facing enormous challenges worldwide. An ageing population, the rising incidence of chronic diseases and the lack of resources make it necessary to find innovative solutions. Traditional inpatient treatments are often not only costly but also impractical for many patients, especially the elderly or those with mobility impairments. H@H is a concept that aims to care for patients in their own homes, which improves both the comfort and quality of life of patients. It can also help to avoid common complications, such as delirium, by providing a familiar home environment. A key component of this model is telemedicine, which makes it possible to offer medical services via digital means of communication. Telemedicine refers to medical treatments in which the interaction between medical staff and patients, as well as between several doctors, takes place without direct physical contact and communication takes place via information and communication technologies [1].

One example of successful telemedicine in the outpatient care sector is Medgate. Medgate has been offering telemedical services in Switzerland for over 20 years and has established itself as a leading provider in this field. With around 150 doctors, Medgate looks after an average of 1,500 patients with medical concerns every day and gives them quick and uncomplicated access to high-quality medical advice and treatment. This covers a wide range of medical issues - from acute health problems to questions about health behaviour [2]. In this way, costly hospital and doctor visits can be avoided [3] and patients with increased health risks can be identified in good time [2].

Communication poses a particular challenge here: As doctors cannot always see their patients (telephone, chat), they have to ask specifically about symptoms and correlations that are not visually accessible to them. The challenge here lies in focussing on the medical question on the one hand and understanding the patient's complexity on the other [4]. Targeted anamnesis and symptom-oriented questioning can be used to classify health problems, recognise urgency and make recommendations for further action. Patients can also provide Medgate doctors with additional information such as images, videos or voice messages to better assess their state of health [4]. In around 50% of cases, Medgate doctors can complete consultations entirely by telephone - provided that no additional examinations or laboratory values are required [4].

However, patients without prior experience of telemedicine may feel unsure - and may, for example, question whether they are receiving the same quality of care as they would in a physical consultation with a healthcare professional. Technical barriers such as access to the internet and digital devices also pose challenges. The question of where telemedicine actually offers an improvement in patient care is therefore of central importance. It is important to understand the potential benefits and challenges of telehealth in order to make informed decisions about its implementation within H@H.

It is also necessary to consider the perspectives of different stakeholders - including patients and healthcare professionals - to gain a comprehensive picture of the impact of telehealth on healthcare and ensure seamless implementation. Only a well-founded analysis can ensure that telemedicine is not just a temporary solution, but a sustainable component of future patient care.