Patientus: Online doctor now also in Germany

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The Lübeck start-up Patientus offers an online ehealth consultation for doctors and patients. But what can the platform do, which has been available to all resident doctors in Germany since October 2014?

The country doctor becomes a web doctor

Patients in major German cities are well looked after medically. In addition to general practitioners, numerous specialists have also settled here. But in many rural regions there is a shortage of doctors. Even with minor complaints such as a cold, a kilometer-long journey has to be accepted – specialists are even more difficult to reach. Patientus can clarify in advance whether a long journey and long waiting times are worthwhile: The Lübeck start-up brings the doctor and patient together via ehealth chat on its online platform.

Online doctor may only advise

The founders Jonathan von Gratkowski, Christo Stoyanov and Nicolas Schulwitz expressly emphasize that their aim is not to replace the physical visit to the doctor, but to supplement it in a meaningful way. In Germany, according to the (model) professional code of practice, doctors are not allowed to make a diagnosis exclusively via print or communication media. It is different if you have examined and diagnosed the patient at least once in your practice in the event of a disease. Further treatment of such existing patients, even with modified therapeutic measures, is only possible then. This means that patients do not have to come into practice for aftercare.

Getting to know each other via webcam

In the so-called “information consultation hour”, patients have the opportunity to obtain information in advance from the doctor of their choice. The doctor can inform the patient about the possible consequences of any treatment that may be necessary (length of outpatient or inpatient stay, possible pain and side effects, etc.). The patient can thus avoid unnecessary loss of time when traveling to the doctor and can be sure that the doctor's visit is really necessary and useful. In addition, Patientus offers the “patient consultation hour” for follow-up and a “second opinion consultation hour” for the assessment of a second specialist. The dashboard offers the option of uploading documents and images so that X-ray images and other findings can be discussed with one another.

Who pays what at Patientus?

Mediation is free of charge for patients. Doctors have to register with an account on the online platform. The fees vary depending on the range of functions. If you only want to speak to your existing patients, e.g. for follow-up treatment, you pay 59 euros per month. Doctors who also want to advise new patients via the ehealth chat function appear in the search list and pay 99 euros a month. The doctors set the price for the consultations. Doctors usually offer initial information talks free of charge. Follow-up appointments usually cost between 20 and 50 euros for 30 minutes – depending on the effort and subject. The health insurance companies are not yet covering the costs, as the online doctor's consultation is not listed in the health insurance benefits catalog. However, this should be possible in the future. The planned eHealth law should create the conditions for this.

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How secure is the patient data?

The development trio began designing and developing four years ago. The aim was to enable a ehealth conference between doctor and patient that is easy to integrate into everyday life, is based on a secure connection and can be used from all end devices without additional software. When it comes to sensitive patient data, data protection comes first in Germany. For this reason, the decision was made to use a browser-based solution. All you need is an internet-enabled PC and a webcam. Since the program runs via the browser, no additional software is required. The conversation participants make an appointment and then communicate via ehealth chat via a separately opened browser window. The direct connection between the two computers (Peer-to-peer connection) is more secure because the data is not first stored and forwarded on a server. In addition, the data is transmitted in encrypted form, similar to online banking.

This secure connection also enables the exchange of X-ray images or other findings. Patient data is only stored at a German data center after the user's express consent. And Patientus does not store the information required for the payment process at all, since the company works with a service provider that specializes in online payment. There is an iOS and an Android app for mobile users.

Doctor 2.0 is not a new phenomenon

In the press release on the new online portal, the Lübeck-based patientus boasts: "What Google is still testing in the USA is already on the market in Germany: the online ehealth consultation hour" – a reference to the extension the Google platform helpouts to the medical field. However, the comparison lags because Google will never get past the beta phase: Helpouts will end on April 20, 2015,

However, the ehealth portal is not a groundbreaking novelty. In other European countries such as Switzerland or England, telemedicine has long been an integral part of medical care. However, doctors can also make diagnoses there online, prescribe medication and bill the services through the health insurance companies. Patientus shows how the virtual visit to the doctor can complement the real one without replacing it. It is important to start here and to advance the digitalization of medicine in Germany as well.

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