The Southern German state of Bavaria has announced the setup of a new major hospital telemedicine network that aims to improve the care for children with inborn cardiac defects.

Within the next few months, nine regional hospitals in Bavaria and one in Austria will be connected electronically to the German Heart Centre in Munich, one of the largest cardiology centres in Germany.

Doctors from the hospitals involved will be able to use a variety of teleconsultation solutions in order to capitalise on the expertise of the highly specialised paediatric cardiologists at the Munich cardiology centre.

The spectrum of systems ranges from simple electronic transfers of written patient documents and DICOM-pictures to a live video consultation system which makes it possible for the experts to assist their colleagues in tricky echocardiography examinations. Paediatric echocardiography is the standard ultrasound procedure used to evaluate cardiac defects in children. It is vital for deciding whether a possible cardiac operation or catheter intervention is required.

“The system makes it possible for the referring paediatric departments to present their patients to the specialists online, without the need of a physical transport”, says Christa Stewens, the Bavarian social minister. “It will even be possible to treat the little patients on distance because the necessary monitoring can be done via the network.”

Stewens’ ministry is the main driver behind the project, which is part of the much wider Bavarian telemedicine activities nicknamed TempoBy (with “Tempo” being the German word for “speed” and “By” the short form for Bavaria). TempoBy is essentially a web portal that can be accessed by doctors via a virtual private network (VPN) in order to upload and download medical information including radiographs and moving pictures. It has been developed by Siemens, with the state of Bavaria giving Euros nine million of start-up financing.

The new hospital network is thought to be the largest hospital-based telemedicine network in Germany so far to use “smartcards plus password plus VPN” for the identification of the communicating doctors.

The technology is very similar to the one which will be used for the German national health-IT infrastructure. This means, that it should be easy to migrate the system into the new world once doctors are equipped with their ‘official’ health professional cards to be issued by the German Medical Association (Bundesaerztekammer) in the near future.

Finnacing of the new paediatric cardiology network is likely to be modelled on the TEMPiS stroke network. TEMPiS is another Bavarian hospital-network of roughly the same size as the new one. It uses video-based teleconsultation to improve the care of stroke patients in rural areas, and is widely considered to be the most successful German telemedicine project so far.

TEMPiS has resulted in a scientifically demonstrated improvement in stroke patient outcome. And it runs completely without state money for about two years now, mainly because health insurance companies have realised that it is cost-effective.

The new paediatric cardiology network could well lead to a similar scheme once the pilot phase is over. By making sure that children with cardiac defects are treated early and at the same time avoiding unnecessary transport, health insurance companies can probably be convinced to pay more per case to the regional hospitals than they normally would. “Of course the scope of the project can easily be extended to other paediatric disciplines once it is running smoothly”, says Christa Stewens.


TempoBy telemedicine portal

TEMPiS stroke network