How telemedicine is revolutionizing the treatment of heart failure – An interview with Prof. Dr. Friedrich Köhler
In this interview with Prof. Dr. Friedrich Köhler, we find out how telemedicine is changing the treatment of heart failure and what developments lie ahead in digital medicine. He also provides exciting insights into his TIM-HF studies, which are further investigating and significantly influencing the impact of telemedicine and artificial intelligence on the treatment of heart failure. Read more in the exclusive interview.
About
Prof. Dr. med. Friedrich Köhler is Head of the Cardiovascular Telemedicine Unit and Senior Consultant in Cardiology at the Charité in Berlin. He is also a Fellow of the European Society of Cardiology (FESC) - an honorary title awarded to doctors who have made a significant contribution to cardiology. Prof. Friedrich is an expert in heart failure, adults with congenital heart disease (EMAH), telemedicine, remote patient management and digital medicine.
SEMDATEX: Prof. Köhler, you led the TIM-HF2 study, which investigated the benefits of telemedical monitoring for heart failure patients in Germany using external sensors. What were the most important findings of this study and what impact did they have on patient care practice?
Prof. Köhler: The TIM-HF2 study showed that telemedicine, particularly through the use of external sensors, has a significant positive effect on life expectancy and the reduction of hospital stays in patients with heart failure. Importantly, it was not the sensors per se, but the comprehensive telemedical care that made the difference. These results led to telemedicine being integrated into standard care within a short period of time, representing a rapid and significant change in patient care.
Can you give us a brief overview of the current status of the TIM-HF3 and TIM-HF4 studies? What new aspects of telemedical care would you like to research with these studies?
The TIM-HF3 study is investigating how artificial intelligence can be integrated into the diagnosis of heart failure patients. We are currently in the evaluation phase of this study. In the TIM-HF4 study, which will start in May 2025, we will investigate the effectiveness of telemedicine in standard care. This study will be conducted at 100 centers across Germany and is intended to document the efficiency of telemedicine in everyday care.
What challenges are doctors currently facing in the nationwide implementation of telecardiology services in Germany? Are there already other European countries where telemedical care in the field of cardiology is more advanced?
The nationwide introduction of telemedicine services in Germany faces challenges such as remuneration, data protection, technical requirements and quality assurance. In addition, new work processes have to be introduced in practices and medical assistants have to be trained, which requires time and adaptation. Nevertheless, there are positive examples from other European countries, such as France, where telemedicine is already firmly integrated into standard care. The first real data are available here, some of which provide even better results than those from clinical studies.
The German Heart Center of the Charité (DHZC)
The DHZC is a leading cardiovascular disease clinic that provides excellent care and comprehensive information for patients. As one of the top centers in Europe and worldwide, the DHZC promotes interdisciplinary collaboration and professional development. Physicians can participate in innovative research projects, develop new therapies and benefit from state-of-the-art laboratories and fellowships. Research and clinical practice are closely linked and benefit patients.
Cardiovascular diseases such as coronary heart disease (CHD) and heart failure often occur together with comorbidities such as diabetes and obesity. In your opinion, how can telemedicine help to better manage these additional risk factors and improve patients' quality of life in the long term?
Telemedicine offers a lot of potential in the area of primary prevention and control of risk factors such as obesity and diabetes. The technology to support weight control and the adaptation of new medications is already well developed. However, there is still a lack of solid, evidence-based data proving the concrete benefits of telemedicine in the treatment of these comorbidities. As a result, the corresponding applications have not yet been sufficiently remunerated, which makes widespread implementation difficult.
Telemonitoring relies on close collaboration between patients, general practitioners, cardiologists and the telemedicine center (TMZ). How important is this interdisciplinary collaboration, what hurdles do doctors and healthcare professionals face and how can these be overcome?
Close cooperation between GPs, cardiologists and telemedicine centers (TMZ) is crucial for the success of telemonitoring. In most cases, the telemedicine centers are cardiology practices, which does not cause any major hurdles. However, difficulties arise when it comes to collaboration between the different medical specialties. Telemedicine should not be seen as a substitute for traditional face-to-face medicine, but as an integral part of the care system.
How do you think patients can be more involved in their treatment in the future, particularly in view of the new ESC guidelines for patients with chronic coronary heart disease?
There are several avenues that can be explored here. Mobile applications such as DiGA (digital health applications), for example, are designed to promote patient self-management and make their everyday lives easier. The aim is not to discover new clinical pictures, but rather to develop individual treatment approaches for each patient. In this way, digital support can be better tailored to the needs of the individual. This is an important step towards involving patients even more closely in their own treatment and improving their quality of life.
Technology plays a key role in telemonitoring. What technical innovations or advances do you expect in the next few years that could further improve the monitoring of heart failure patients?
In the coming years, I expect the currently available wearables to be certified as medical devices and patient monitoring to become even more efficient and scalable through the use of artificial intelligence. The technology we use today is likely to be replaced by even more advanced systems in the next ten years, enabling broader application and more accurate, data-driven care. However, the challenge here is also that technology manufacturers often do not want to take responsibility for medical devices, making integration into clinical practice difficult. Nevertheless, advances in telemedicine and digital healthcare are a promising way to sustainably improve patient care and shape the future of medicine.