[What is needed to improve telemedicine in rural areas? Action required and research gaps from the perspective of experts].

Abstract

Background: Telemedicine is considered to have a great potential for maintaining or improving healthcare provision in rural areas of Germany. However, there are often significant obstacles to the effective and efficient implementation of digital solutions. Beyond project-specific evaluations, knowledge about the opportunities and challenges posed by telemedicine in rural regions of Germany is still thin and scattered across different disciplinary discourses.

Methods: The aim of the present study was to reconstruct and to relate the perspectives of experts working at the interface between research and practice and to identify the necessary practical improvements and new pathways of research to better use the potential of telemedicine in rural areas.

Results: A total of 27 interviews with 33 individuals were conducted and potential for improvement at various levels was articulated as follows: Operational improvements were needed in specific treatment situations and work processes. Organisational and professional needs were found to be related to broader organisational and knowledge-related prerequisites for certain groups of doctors that would enable them to use telemedicine solutions effectively and efficiently. Structural and systemic requirements addressed the cooperative healthcare system and the regional diversity of Germany as a whole, as well as the level of fundamentally negotiable norms and values.

Discussion: Key conclusions aim to embed needs-based telemedicine approaches into larger, integrated healthcare concepts, develop digital solutions together with users, and not lose sight of the limitations of digitalisation.