Digitalisierung in der Medizin während der COVID-19-Pandemie – Möglichkeiten und Grenzen der Teledermatologie

[E-learning via webinars in orthopedics and trauma surgery : Increase in supply and demand during the COVID-19 pandemic]

BACKGROUND

Contact teaching was prohibited by nationwide lockdowns during the COVID-19 pandemic. The scientific literature contains no concrete figures concerning e‑learning via webinars in the subject of orthopedics and trauma surgery in the context of the COVID-19 pandemic.

OBJECTIVE

This research study was established to collect facts and figures about webinars as a representative part of e‑learning in the subject of orthopedics and trauma surgery in the context of the COVID-19 pandemic.

MATERIAL AND METHODS

German-speaking non-commercial and edited webinars, produced by suppliers from Germany were identified using common search engines. Structured interviews with questionnaires about provider, format, and number of participants in the webinars over time, were offered to the operating companies.

RESULTS

The study included four suppliers of webinars (AO Online Campus, BVOU Study Club, OU TO GO and WebDGU). There was approval of all operating companies to participate in the interviews and to disclose facts and figures about their webinars. All suppliers showed an increased supply and demand for webinars during the COVID-19 pandemic.

DISCUSSION

OU TO GO and BVOU Study Club already offered webinars prior to the COVID-19 pandemic. AO online Campus was designed in addition to the existing portfolio. The supply of WebDGU was newly established. Limitations of this study are the exclusion of commercial suppliers, non-German operating companies and all other types of e‑learning except webinars. The increased supply and demand for webinars during the COVID-19 pandemic gives hope for further improvement of e‑learning in the subject of orthopedics and trauma surgery.

Diagnostic spectrum and therapeutic efficiency in teledermatology-Results of the largest cohort study to date

Timely and comprehensive dermatological care is a major challenge. Digitized medical consultation offers a possibility to overcome this problem. Here, we studied the diagnostic spectrum and treatment success in teledermatology in the largest cohort to date. Over 12 months, 21 725 individuals received a diagnosis and therapeutic advice using the asynchronous image-text method. In the context of quality management, 1802 individuals (~10%) of both sexes with a mean age of 33.7 years (SD 15.36) received a follow-up 3 months after the initial consultation to assess the treatment outcome. Of these, 81.2% did not require a face-to-face consultation. Therapeutic efficiency could be ascertained in 83.3% of the patients, whereas 10.9% did not improve, and 5.8% did not provide an information on the course of therapy. Teledermatology is a useful tool in digitalized medicine and complements the classical in-person dermatological examination, as shown by the high degree of treatment efficacy in this study. Although face-to-face consultations can not and should not be completely substituted by teledermatology it reflects a significant contribution to patient care and justifies the further expansion of digital structures in dermatological care.

Considering medical students' perception, concerns and needs for e-exam during COVID-19: a promising approach to improve subject specific e-exams

The COVID-19 pandemic forced a rapid shift to digital strategies including e-exams in medical schools. However, there are significant concerns, predominately from student perspectives, and further data is required to successfully establish e-assessment in the medical curricula. The objective of the study was to examine medical students' perceptions, concerns, and needs regarding e-assessment to establish a comprehensive e-exam based on these and previous findings and to evaluate its effectiveness in terms of examinee perceptions and further needs. During the 2021 summer term, a cross-sectional study using qualitative and quantitative methods was conducted among all 1077 students at the School of Medicine, Technical University of Munich. They were asked to provide information regarding their characteristics, preferred exam format, e-assessment perception, concerns, and needs in an online questionnaire. Based on these findings, a pilot e-exam including an e-exam preparation for the students were established and subsequently evaluated among 125 pilot e-exam examinees under study consideration via an online-questionnaire. Of the 317 pre-exam participants (73.2% female), 70.3% preferred in-person exams and showed concerns about the technological framework, privacy, and examination requirements. Qualitative analysis showed that these concerns lead to additional exam stress and fear of failure. The 34 (79.4% female) participants who participated in the evaluation survey showed a significantly more positive e-exam perception. The fairness of the platform, the independence from an internet connection, the organization including the e-exam preparation, and the consideration of participant needs were discussed as particularly positive in the open-ended comments. In both surveys, participants requested uniform platforms and processes for all subjects. This study provides evidence for a positive, complementary role of student participation in a successful e-exam implementation. Furthermore, when establishing an e-exam format in the medical curricula, e-exam training, equal accessibility, availability offline, and all-round fairness should be considered.

Praktischer Leitfaden zum Einsatz telemedizinischer Anwendungen bei der Betreuung von Allergiepatienten

Seit Frühjahr 2020 führten die weitreichenden Maßnahmen zur Kontaktbeschränkung im Rahmen der SARS-CoV-2-Pandemie auch zu einer Reduktion der Arzt-Patienten-Kontakte im ambulanten Versorgungsbereich. Telemedizinische Anwendungen werden zunehmend eine Möglichkeit darstellen, die Patientenversorgung unter Infektionsschutzmaßnahmen effizient zu gewährleisten. Auch in der Allergologie können telemedizinische wie digitale Anwendungen den klinischen Alltag deutlich erleichtern. Die mit der Implementierung digitaler Strategien verbundenen technischen und rechtlichen Hürden müssen hierfür jedoch generell überwunden werden.

Telemedicine in allergology: practical aspects: A position paper of the Association of German Allergists (AeDA)

Since spring 2020, the wide-ranging contact restriction measures in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have also led to a reduction in physician–patient contacts in the ambulatory care setting. Telemedicine applications will increasingly provide a way to efficiently deliver patient care under infection control measures. In allergology, telemedical as well as digital applications can also significantly facilitate everyday clinical practice. However, the technical and legal hurdles associated with the implementation of digital strategies must be overcome for this to happen. The aim of this article is to provide an intuitive overview of the aspects to be considered in the implementation of telemedicine consultations and to highlight the current state of the framework as well as optimization possibilities and perspectives in allergology. If a structured use is guaranteed, digital and telemedical applications can improve patient care—also in allergology. There is potential to be exploited in many areas, from the remote collection of clinical history, and video consultations, to the discussion of diagnostic findings, disease monitoring, and therapy support. The use of telemedical applications, especially video consultations, has experienced a remarkable acceleration in the context of the coronavirus disease 2019 (COVID-19) pandemic. The present overview of the legal, technical and professional framework is intended to support the anchoring of digital and telemedical technologies in everyday allergology. However, in order to consolidate these in the future, an agreement is needed regarding professional standards of action as well as a remuneration structure that is permanently defined beyond the current pandemic.