Digital consulting room? How telemedicine and health apps are changing psychotherapy.

Is the virtual consulting room set to become just as busy as doctor’s offices in the real world? How secure is treatment via smartphone and who protects sensitive patient data? An overview of what is possible and how we can continue to use the digital medical practice in the future without security concerns.

2020 is set to be a decisive year for the digital transformation of Germany’s healthcare system: The German government's Digital Supply Act (DVG) is paving the way for new, digital treatment methods and easier communication between doctor and patient on the Internet. From now on, physicians can prescribe selected health apps. The costs are then borne by the statutory health insurance company – initially for a period of one year. 

This makes Germany the first country in the world to legitimize apps on prescription. This is a concession to patients, many of whom already rely on such software. According to the Digital Health 2019 study by industry association Bitkom (issued in May 2019), two out of three smartphone owners use health apps. Apps that remind patients to take their medication or that facilitate the documentation of symptoms can be prescribed. But there is another area of application in which apps are more than just a reminder. In the case of psychological ailments, they can serve as a virtual consultation room, and play a decisive role in diagnosis and treatment. New providers are already advertising simple therapy sessions via telemedicine. With real therapists – but without the obligatory psychiatrist’s couch in the doctor’s office. 

Even today, people insured with the statutory health insurance company Techniker Krankenkasse who have been diagnosed with an anxiety disorder can have panic attacks treated using a health app and virtual reality glasses. Other providers also advertise apps that can help with psychological ailments. Does this mean that telemedicine will soon replace appointments with a therapist? Such a scenario seems particularly tempting especially in rural areas, where there is sometimes a lack of therapeutic services. That being said, up to now the experts agree that this does seem to be unlikely in the medium term. 

Instead, solutions for smartphones and PCs are seen to be promising, additional programs. For example, after completing therapy, they should help to maintain contact between therapist and patient, helping to ensure that there is no relapse. This has proven to be extremely helpful, for instance, in the treatment of patients with eating disorders. In addition, telemedicine could be useful for people who are looking for help, but who still shy away from a personal visit to a therapist. That is why it is so important to prevent security concerns from standing in the way of digital treatment. 

How to protect patient data in health apps

The issue of data protection is indeed omnipresent in debate on digital health services. That’s because patients worry about security when sensitive personal data is entered and processed. Hacker attacks, in which, for example, information on the user’s state of health could be tapped, are particularly worrying. 

Under the Digital Supply Act, the most important precondition for a doctor to prescribe a health app: The prescription-only health app programs must have been tested by the Federal Institute for Drugs and Medical Devices (BfArM) with a view to data security, privacy and functionality. 

In order to ensure secure exchange between data sender and receiver in telemedicine, a Data Trustee can be used to mediate. The trustee ensures that sensitive health data is passed on in compliance with the GDPR and only after the patient has consented. The trustee gives the patient full control over their data – because only the patient can decide which information is to be transmitted and to whom. 

Another important aspect: Patients must also be able to securely prove their identity online, for instance, when logging into a health app. Digital identification solutions, such as AusweisIDent Online, which enable integration of the online identity function of the German ID card, are a fast, simple and secure option. If both patients and physicians as well as app providers handle user data responsibly, nothing will stand in the way of treatment in the digital consulting room.