Abstract
Objective As neurosurgery is a 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 for medical images and cases plays an increasing
role in neurosurgical services. However, no standards and demands have been established
for its execution in the subfield of neurosurgery, so far. Therefore, as a first step,
we performed a survey about the current state of teleconsultation in neurosurgery
in Germany.
Methods A standardized questionnaire consisting of 20 items was used to investigate the frequency
of use and the operating conditions of teleconsultation in the field of neurosurgery.
The survey was performed during the annual national German Society of Neurosurgery
conference in 2017. Participation in the written survey was on voluntary and anonymous
basis.
Results In total, 296 individuals took part in the survey (140 specialists in neurosurgery,
77 residents). Among them, 71% were male and 121 worked at a university medical center.
In total, 87.5% of all participants indicated that teleconsultation was used in their
institutions (n = 113 in university medical centers and n = 76 in hospitals), and a vast majority stated to have had personal experience with
it (88.6% of specialists, 85.5% of residents). The most frequent initial request for
a consultation was done by phone call (80.3%). Images or data were then primarily
transmitted via an electronic system (77.3%), followed by transmissions via CD or
by post. The reply to a consultation was also mainly done by phone call (91.3%), followed
by fax, or by e-mail. No standard protocol was followed by 78.6% of the respondents,
and they stated not to know about the statutory and legal rules. However, it was stated
that the protection of patient data was not endangered by using teleconsultation.
The usefulness of teleconsultation and its future relevance were 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 teleconsultation for medical images and
cases is a frequently used and well-accepted tool in neurosurgical health care. However,
a standardized neurosurgical procedure is still lacking and the statutory rules for
this field of digital medicine are generally not known in our community. Potential
misinterpretation and resulting misjudgment seem to be realistic drawbacks. Thus,
we see a necessity for elaboration of guidelines for teleconsultation in neurosurgery
on national and European basis.
Keywords
telemedicine - teleconsultation - e-health - neurosurgery
