The Futures of Telemedicine: Knowledge, Policy, Regulation

Digital health cards, electronic health records, medical telematics infrastructure – these are the terms dominating the public and political debates on the digitalization of the health care system in Germany. At EU level, electronic health services (eHealth) are also seen as a great opportunity. As part of its digital health and care strategy, the European Commission expects to improve public health by facilitating greater cross-border healthcare access, enabling citizens to access their health data and researchers to share patient data and medical expertise across the EU. Digital tools are expected to provide efficient, user-friendly and widely accepted electronic health services.

At the same time, eHealth applications and services have become an important market within the digital economy, with an estimated global turnover of around 18 billion euros in 2018. Well-known applications range from medical patient counseling and consultations or self- monitoring devices to virtual expert networks. Technological paradigms such as the “Internet of Things”, “Artificial Intelligence” or “Smart Devices” are increasingly integrated into research and development goals of eHealth applications, also promoting medical (self-)surveillance and control.

The diagnostic or therapeutic use of digital technologies has a strong effect on doctor-patient relationships and therefore affects the level of acceptance of these new technological solutions. In addition, eHealth applications and practices produce, store and evaluate highly sensitive data on individuals, resulting in a particular need for legal and regulatory frameworks.

In this context, the project “The Futures of Telemedicine: Knowledge, Policy, Regulation” focused on two closely interwoven research perspectives:

1. Social norms, standards and acceptance

The project looked at how and to what extent political institutions or companies define the development targets in the field of telemedicine and eHealth. It focused on country-specific cultural and social differences in order to gain insight into which practices of medical surveillance are considered either acceptable or a violation of personal privacy. With eHealth applications, a comprehensive knowledge of individuals was produced that extended beyond medical contexts and allowed for far-reaching conclusions about behavioral patterns, personality traits or psychological dispositions. Therefore, it was necessary to critically assess the data that has been collected and the extent to which individuals were subjected to evaluative and normative processes.