gms | German Medical Science

Objective: As neurosurgery is a rare and demanding specialty with services in larger medical centers only, consultation over larger distances plays an important role in health care. In times of digitalization, teleconsultation (tc) for medical images and cases plays an increasing role in neurosurgical services. However, no standards and demands have been established for its execution, so far. Therefore, as a first step, we carried out a survey about the current state of tc in neurosurgery in Germany.

Methods: During the annual national DGNC conference in 2017, participants were asked to take part in a written survey with 20 questions on voluntary and anonymous basis.

Results: In total, 296 individuals took part in the survey (165 neurosurgical consultants, 87 residents). 69.5% were male and work at a university medical center (58.3%). In total, 77.7% of all participants indicated that tc is used in their institution (n = 172 in university medical centers and n = 123 in hospitals) and the vast majority stated to have personal experience with it (85.6% of consultants, 81.5% of residents). The most frequent initial request for a consultation is done by phone call (58.4%). Images or data were then primarily transmitted via an electronic system (65.5%), followed by transmissions via CD or by post. The reply to a consultation is also mainly done by phone call (65.2%), followed by fax, or by e-mail. 78.6 % do not use any standardized protocol, and stated not to know about the statutory and legal rules. However it was stated that the protection of patient data by using tc is not endangered. The usefulness of tc and its future relevance was rated highly by the participants. The risk of misinterpretation of image data, especially without having direct access to other patient data, seemed to be a critical and unequivocal challenge .

Conclusion: The results of the survey demonstrate that tc for medical images and cases is a frequently used and well accepted tool in neurosurgical health care. However, a standardized procedure is still lacking and the statutory rules for this filed of digital medicine are mainly not known. Potential misinterpretation and resulting misjudgement seems to be a realistic drawback. Thus, we see a necessity for the elaboration of a national guideline for tc in neurosurgery.