[Cross-regional telemedicine services as a supplement to rural primary care: a mixed-methods analysis]

Family doctor care in rural areas is facing upheaval. On the one hand, demographic change is increasing patient demand, but on the other hand, it is also reducing physician density. In this context, telemedicine opens up new potentials for care. This study explores the possibilities of digitalization in family care with diverse stakeholders. The most important element of this work is to explore the attitudes towards telemedical supplementary options in primary care. In doing so, the chances and concerns of both general practitioners and citizens will be analyzed. The aim is to find out possibilities which can relieve GPs and support the health care provision in rural regions in the long term.

A mixed-methods design combines findings from qualitative semi-structured guided interviews with general practitioners (N=8) with a quantitative citizen survey (N=1,276) in a rural region.

Concern about future health care provision is high among physicians and citizens. Although physicians see a need for action and opportunities through telemedicine measures, they also raise clear concerns about the doctor-patient relationship. The citizens are principally open to various telemedical options and can imagine using simple services such as e-prescription and e-appointment booking.

These results can serve as a basis for the further development of digital offerings of family doctors' offices as well as other model projects in rural regions, if they guarantee low-threshold access, are implemented in cooperation with doctors and patients and do not endanger the established doctor-patient relationship.

There are major concerns about the future of family physician care, especially in rural areas. The COVID-19 pandemic opens up opportunities for digitization across age boundaries. Initially, however, telemedicine care can only have a supplementary role. Low-threshold offerings in close cooperation with the family doctor are particularly promising here.