[Telematics services and telemedicine under ophthalmological legal aspects]

Telemedical solutions are increasing with respect to diversity, frequency and scope. It should be part of medical practice to remind again and again that telemedicine does not represent a special medical field or even a subspecialty. The concept of telemedicine is more used as a superior term for different medical care concepts, provided across distance and time barriers. Telematic solutions implemented as a new field of service in ophthalmological practice or in hospitals must fulfill the following obligatory requirements in conformity with the law: patients must be informed about the range of telemedical solutions, operators must ensure medical specialist qualifications and all care responsibilities combined with the telemedical services must be guaranteed. The legal assessment standard is always the direct comparison between telemedical measures and the individual patient result of medical treatment in a face to face situation in an ophthalmologists practice as the gold standard. The court makes a targeted examination on whether the individual damage to health of a patient under telemedical care would also have normally occurred under medical treatment within the framework of regular care by a medical specialist in a practice or clinic. If the court has a well-founded doubt, the operator must be able to justify either constraints in individual cases or a better prognosis and success rate (reversal of burden of proof). Especially due to the latter aspect it is important for the operator that the standards for telemedical services of the specific medical fields are predefined by the specialist societies or that corresponding results from healthcare research projects are available.