https://doi.org/10.1007/s00392-025-02625-4
1Klinikum rechts der Isar der Technischen Universität München Klinik und Poliklinik für Innere Medizin I München, Deutschland; 2TUM School of Medicine and Health Department of Health and Sport Science Chair of Social Determinants of Health München, Deutschland; 3Technische Universität München Klinik für Kardiologie München, Deutschland
Introduction: Digital technologies, such as telemedicine and wearable devices, are transforming healthcare by enhancing cross-sectoral care and targeted health responses. Despite these advancements, challenges like data protection, lack of interoperability, cost coverage, and training needs hinder telemedicine's broader implementation, especially within the German healthcare system. This study explores the use, acceptance, and barriers of telemedicine among in majority cardiologists, but also internists, and general practitioners in practices in Germany.
Methods: A web-based survey was conducted from October 2023 to January 2024, targeting cardiologists, internists, and general practitioners. The survey, distributed through professional associations and the Department of Internal Medicine I at TUM Klinikum rechts der Isar network (German Society for Cardiology and Cardiovascular Research, German Society for Internal Medicine, German Society for General Medicine, Association of Registered Cardiologists), assessed current telemedicine usage, acceptance, and barriers. Data analysis included descriptive statistics and exploratory cluster analysis using SPSS (Version 29.0.1.0).
Results: Out of the 172 interviewed physicians, 76.2% were cardiologists, followed by internists (15,1%) and general practitioners (8,7%). Telemonitoring (45.9%) and wearables (26.2%) were the most used telemedicine applications, while video consultations (11.0%) and apps (19.2%) were less common. Despite high costs (56.4%), insufficient technical expertise (20.3%), and lack of system interoperability (44.8%), 87% of respondents considered telemedicine positively. Cluster analysis identified four user groups: Pioneers, Focused Practitioners, Using Skeptics, and Uninformed Distanced, each with unique needs and challenges.
Overall, the respondents perceive patient acceptance of telemedicine as somewhat neutral. Although this acceptance appears mixed, physicians generally believe that telemedicine provides subjective benefits for patients, such as enhancing daily quality of life or fostering a sense of security. Many respondents also recognize increased patient compliance and adherence, as well as improved health literacy, associated with telemedicine use. However, a significant portion of respondents do not see telemedicine as beneficial for addressing sensitive or stigmatized health topics with patients.
Discussion: The high acceptance of telemedicine among physicians indicates recognition of its benefits for patient care. Only half of the surveyed physicians felt reasonably well informed about telemedicine, mainly through professional associations and specialist journals. The evolving landscape of digital health technologies necessitates that physicians evaluate new products for patient benefit.
However, concerns about misdiagnoses and patient safety must be addressed to achieve full acceptance. High costs and a lack of integration of the systems into practices are understandable and possible obstacles to meaningful integration into everyday practice. Tailored approaches are necessary to meet the diverse needs of different user profiles, and targeted measures are required to improve technical infrastructure and reimbursement models. Future research should include larger, more representative samples and investigate the perspectives of patients and other healthcare professionals.