Possibilities of telemedical cooperation within the framework of outpatient specialist care (ASV)
ASV covers diseases with special disease progressions (e.g. oncological diseases, rheumatological diseases, multiple sclerosis or epilepsy) as well as rare diseases with low case numbers (e.g. tuberculosis, serious immunological diseases) and highly specialized services (such as CT/MRI-supported interventional pain therapy or brachytherapy). For the care of patients with oncological diseases, the Federal Joint Committee (G-BA) has to make regulations for cooperation agreements; for the care of diseases with special disease progressions, agreements on cooperation between the participating service providers can be made if this serves the requirements of the care area.
Section 5 (4) of the ASV Ordinance also regulates the possibilities of telemedical care within the framework of ASV. This means that consultations and treatments can be carried out via telecommunication channels, including the use of digital applications of the telematics infrastructure, provided that the ASV beneficiary meets the relevant technical requirements. This also includes video consultations, which are defined as synchronous communication between a doctor working in ASV and a patient. It can be offered via the equipment available to the patient, possibly with assistance, e.g. by a caregiver, in the form of an online video consultation in real time with doctors working in ASV. Medical case conferences or case discussions for communication between doctors working in ASV can also be held as video conferences. However, the exclusive treatment and care of ASV patients via video consultation is prohibited, as is the exclusive participation of an ASV team member in ASV via video consultation. Telemedical methods are intended to supplement, but not completely replace, care within the framework of ASV. By integrating digital communication channels, diagnostics and therapy can be made more flexible and often more efficient, but without replacing the need for personal contact and direct cooperation.
ASV is an area of care in which interdisciplinary teams of doctors work together to care for seriously ill patients. The telemedical possibilities within ASV also expand the scope for the treatment of complex and difficult-to-treat diseases. It can be assumed that the possibilities of ASV will become even more important in the context of outpatient treatment, also because this will enable outpatient and inpatient service providers to work together across sectors.