1. Quality is measurable — also
in telemedicine! As the first
and up to now only telemedi-
cal centre in Germany, the Vitaphone
GmbH Telemedical Service Center
fulfils not only the requirements of
the standard DIN EN ISO 9001:2000,
but also the “VDE Recommendations
of Application for Telemonitoring”.
The VDE Testing and Certification
Institute confirmed this after a suc-
cessful certification audit with an ap-
propriate certificate. Amongst other
things, it was said that Vitaphone in-
troduced a quality management sy-
stem for the field “Implementation
of Services as a Telemedical Centre”
(comprises patient monitoring, inclu-
ding coordination of emergency mea-
sures and reporting/evaluation to the
client) and also applies this.
“We are very proud and with our cu-
stomers and partners we are pleased
that we have successfully produced
this important quality certificate. In
addition to the ongoing operation with
Dr. Carmen Ehrenstein, our represen-
tative for quality management, the
team from our Telemedical Service
Center under the leadership of Matthi-
as Murin outstandingly managed a
great challenge in the preparation
of the audit. Particularly against the
background of the current discussion
surrounding the protection of and de-
aling with sensitive patient data in the
healthcare industry, the certification
according to ISO and the “VDE Re-
commendations of Application for Te-
lemonitoring” gains a special signifi-
cance”, states Dipl.-Kaufmann Matthi-
as Quinger, CEO of Vitaphone GmbH.
The Quality Management project
group, which was active on behalf of
the VDE-IMM [Initiative Micromedici-
ne] Working Committee on Telemedi-
cine/Disease Management in the VDE/
DGBMT under the leadership of Prof.
Dr. med. Harald Korb, implemented
for the first time the standards DIN
EN ISO 9000:2000, DIN EN ISO 9001
as well as DIN EN ISO 13485 and other
pertinent regulations in view of their
application to telemonitoring systems
and a quality management system
for telemedical centres. A practically
oriented fundamental work of higher
quality was created with the “VDE
Recommendations of Application for
Telemonitoring”, which was published
in the autumn of last year.
In addition to the comprehensive defi-
nition of terms and detailed descripti-
onoftelemedicalresources,structures
and processes, it offers an overview of
the relevant legal norms. It provides
cost carriers and decision-makers in
the healthcare industry with valuable
references for appraisal of the quality
of providers in the growth market te-
lemedicine.
TELEMEDICINE
Networked thinking – joint action
today
Imprint
Publisher
Benjamin Homberg
Medizin - Service
Institut für Strategisches Marketing & Kommunikation
Karl-Straube-Straße 56, 46483 Wesel
Telephone: +49 (0)281 963014
E-Mail: Medizin_Service@t-online.de
Editorial Department:
Prof. Dr. med. Harald Korb (V.i.S.d.P.),
Carolin Baumann, Benjamin Homberg
On behalf of
Vitaphone GmbH
Markircher Straße 22, DE 68229 Mannheim
Telephone +49 (0)621-178918-100
Fax: +49 (0)621-178918-101
E-Mail: info@vitaphone.de
www.vitaphone.de
CEO: Dipl.-Kaufmann Matthias Quinger
HRB 9388, USt-ID-NR. DE812913633
Telemedicine trade fairs & congresses
1TELEMEDICINE today Issue 3 2008
Issue 3 2008
...with strong partners
Ambient Assisted Living (AAL) and
diabetes – an alliance for life
In the near future we will be present at these events and would be very pleased with your
visit. For detailed information, visit our website at www.vitaphone.de
MEDICA 2008
40th “World
Forum of
Medicine”
19 – 22 Nov. 2008
Düsseldorf Exhibition Centre
Hall 9 / C54
ARAB HEALTH 2009
26 – 29 Jan. 2009
Dubai International Convention &
Exhibition Centre
German Pavilion, Zabeel Hall
Stand ZC79
...and for modern therapy management...
Despite many eHealth concepts –
telemedicine in Europe still has not
arrived at medical reality
Page 3
Telemedical solutions for diagnostics…
Dr. Jos Widdershoven: “The Vitaphone
Tele-ECG-Card 100 IR has become an
indispensable device for our rhythm
patients.”
Page 2
ContentsQuality is measurable
Telemedical Service Center successfully certified
according to “VDE Recommendations of
Application for Telemonitoring” by VDE Testing
and Certification Institute
TeleHealth 2009
International congress & trade
fair for ICT solutions in the
health market
3 – 8 March 2009
Hanover Exhibition Centre
Hall 9
75th
Annual
Conference of
the German
Cardiac Society
(DGK)
16 – 18 April 2009
Congress Center Rosengarten,
Mannheim Symposium on
16 April 2009
Growth market Ambient Assisted Living
Vitaphone live in ZDF “morgen magazin”
Vitaphone CEO Dipl.-Kaufmann
Matthias Quinger had to get
up early: ZDF (German
television network) had invited
him as an expert on the topic of te-
lemedical geriatric healthcare. The
occasion was the thematic focal point
“Living and Residing in Old Age” from
theZDFprogramme“morgenmagazin”
[“Morning Magazine”]. Several reports
were broadcast live from the model
dwellings of the project “SmarterWoh-
nenNRW” [“Living Smarter in North-
Rhine Westphalia”] in Hattingen du-
ring the Berlin-produced programme.
Rental dwellings in a model project
there were reconfigured so that on re-
quest they offer their occupants a gre-
at deal of comfort: climate control at
the touch of a button, securing alarm
system, central disconnection of all
electrical appliances when leaving the
dwelling, motion detector, connection
to various service providers via TV and
Internet as well as telemedical care in
the event of a chronic illness.
In the discussion with ZDF moderator
Frank Bethmann, Matthias Quinger
explained not only the perspectives
for medium-sized enterprises in this
growth market, but also presented
practical telemedical applications and
services. ZDF had additionally filmed
a video segment in the Vitaphone
Telemedical Service Center for this
purpose.
A congress of the BMBF [Federal Mi-
nistry of Education and Research] and
the VDE will also deal with the topic
“Ambient Assisted Living” (AAL) in
the coming year (see Page 4 for more
on this).
Page 4

2. With the Vitaphone Tele-ECG-Card 100
IRtheclinicexpandstheirmonitoring
arsenal for cardiac arrhythmias. This
card allows patients to record an ECG - where-
ver and whenever - at the touch of a button. Up
to three ECGs can be saved on the card, which
is not larger than a credit card. After recording
the ECG the patient transmits the data per te-
lephone to the Vitaphone Telemedical Service
Center. Thence the ECGs are sent per email, as a
PDF file, to the Department of Cardiology of the
TweeSteden hospital where the medical staff on
duty analyses the ECGs and, if necessary, initia-
tes the necessary therapeutic procedures.
Cardiologist Dr. Jos Widdershoven,
MD, PhD, explains:
„We want to be at the forefront of healthcare and
therefore are always eager to evaluate new de-
velopments. When Vitaphone presented its solu-
tions for the first time we were quite curious but
wanted to convince ourselves true to the motto
“believing after seeing”. Believe us, we actually
did and the results were astonishing!
We decided for the Tele-ECG-Card because we
believe that this device closes a diagnostic gap
in the line of already existing (continuous) ECG
monitoring devices. After the first evaluation
we were absolutely impressed by the quality of
the transmitted ECGs. Besides, our patients de-
clared that the use of the card was amazingly
simple and – what is even more important – they
feel save with the card. The certainty to always
and wherever be able to record and send an ECG,
if the patient feels like it, gives our patients a fee-
ling of safety. In the end, the card improves the
quality of life of our patients. Therefore, it did
not take us long to decide to use the Vitaphone
Tele-ECG-Card in daily clinical practice routine-
ly, and I must admit that very soon it became an
indispensable diagnostic instrument in our ar-
rhythmic patients.
Using the card, patients are able to record ECGs
at any time, something that is practically im-
possible with traditional rhythm monitoring
devices, due to their limited memory capacity.
Furthermore, we are able to receive the ECGs
within minutes after recording and thus are able
to offer our patients a more effective and effici-
ent treatment. We use the Vitaphone Tele-ECG-
Card 100 IR for patients with infrequent cardiac
arrhythmias of unknown origin. Frequently, the
conventional 24-hour Holter monitoring does not
capture the arrhythmic episodes, but the card
enlarges the monitoring period more or less in-
finite. Generally, we leave the card with our pa-
tients for three weeks, including the option for
a prolongation. By using the card we spare our
patients the visits to the hospital when they feel
any complaints.
The card does not only support us to further
improve the treatment of patients with cardiac
arrhythmias but also helps us to calm those pati-
ents down where a cardiac background for their
troubles can be excluded. The introduction of
the card in our clinic was that successful that by
now we even have a waiting list. It is needless to
say that we hope to increase our stock of devices
as soon as possible.”
“Allow me to give you an example of how the
Vitaphone Tele-ECG-Card 100 IR helps us and
our patients in daily clinical practice,” Dr. Wid-
dershoven continues. “A typical situation was the
case of a 41 year old woman who presented her-
self at our outpatient clinic for the first time in
2004 with complaints of palpitations and no fur-
ther known risk factors for a heart disease. Du-
ring the episodes she felt unwell and had a heart
rate of 150 BPM. She explained that she already
experienced these episodes of a fast heartbeat
for several years. Complaints started most of the
time during the morning. She was not short of
breath or dizzy, and never fainted. What worried
her most about her disease was the fact that she
was planning to become pregnant, and therefore
was not willing to take medication.
Upon physical examination we saw a young wo-
man with a normal blood pressure, and a regular
pulse of 61 BPM. No abnormal heart and lung
sounds were heard. Physical examination was
normal. The resting ECG (see ECG 1) showed a
normal sinus rhythm of 73 BPM with a vertical
axis, a normal PR and QRS duration, and nor-
mal ST segments. No abnormalities were found
in echocardiographic examination. An exercise
test was not performed.
First we sent her home with a cardiomemo de-
vice. But during the 3 weeks monitoring period
she experienced no palpitations. Later she was
seen at the outpatient clinic again with palpita-
tions but no therapy was started because at that
time she had become pregnant.
In 2006 she gave birth to a healthy daughter. Du-
ring the following year the palpitations – possib-
ly due to stress – appeared again. During these
episodes she was lightheaded and experienced
diminished exercise capacity. We were never
able to record an ECG when she had complaints.
At this time we expected that the complaints
were based on a AV nodal reentry tachycardia
(AVNRT) but unfortunately the arrhythmia still
was never caught on ECG.
In the beginning of 2007 a cardiomemo device
registered a possible arrhythmia but, unfortu-
nately, due to the low quality of the recording a
definite diagnosis could not be made.
In September 2007 she received a Vitaphone Te-
le-ECG-Card 100 IR. During a period of 6 weeks
she had a severe episode of her well known palpi-
tations and was able to record and send the data
to our center (see ECG 2). The excellent quality
of the ECG in the figure shows there is a narrow
complex tachycardia with a rate of 150 BPM. No
P-waves are seen. Possibly the little hump in the
terminal part of the QRS is a P-wave as we can
see in the case of an AVNRT.
Thus, after all this time we were able to pinpoint
her problem with use of a Vitaphone Tele-ECG-
Card. Needless to say the patient was satisfied
with the benign diagnosis. She did not want to
use any medication, and was not eager for ablati-
on therapy because she is able to let her palpita-
tions distinguish by a prompt response to vagal
manouvres.”
In focus
It was a long and difficult path…
More than two years lie between the
meticulous preparation of binding quality
criteria in the quality handbook “VDE
Recommendations of Application for Tele-
monitoring”* and the crowning conclusion:
the certification of a telemedical centre!
But it was also a path without alternative!
We telemedical professionals can only be
successful in the long run if we engender
confidence in our services on a broad level
amongst patients, medical partners and cost
carriers.Andconfidencemeans:confidencein
the quality of our work! But this presupposes
the willingness to allow one’s own quality to
be measured neutrally and independently —
according to a clear standard and unequivocal
guidelines!
Vitaphone has met this challenge as the first
telemedical service centre in Germany and
brilliantly mastered the testing procedure!
But at the same time a new national and
international standard has been set —
optimally suitable to separate the wheat from
the chaff!
Quality in telemonitoring has a new name:
we stand for this!
In this spirit I remain
Yours truly,
Prof. Dr. med. Harald Korb
Medical Director
*VDE Recommendations of Application
for Telemonitoring
Quality Management DIN EN ISO 9001:2000.
Structure – process – case studies.
Publisher: VDE Initiative Micromedicine,
Frankfurt, 2007
As a globally nominated, international leading supplier of innovative telemonitoring technologies, since a couple
of years Vitaphone also implants their telemedical services in the Netherlands. The Department of Cardiology of
the TweeSteden Hospital in Tilburg was amongst the first to profit from the benefits of telemedicine.
2
Te le me dica l S o lut io ns fo r Diagnos tic s …
Growing acceptance of
telemedicine in the Netherlands
record
transmissionreceiving
analysis
wear
attending
doctor
Recording and transmission of an ECG with
the Vitaphone Tele-ECG-Card 100 IR
Dr. Jos Widdershoven: „The Vitaphone
Tele-ECG-Card 100 IR has become an
indispensable diagnostic device for our
arrhythmic patients.”
ECG 1: Resting ECG of the patient without
pathological findings
ECG 2: ECG of the patient with paroxysmal
supraventricular tachycardia typically for a
AVNRT

3. Experts agree: great challenges are in store for the healthcare
systems of the western industrialised nations. The number of
chronically ill will increase explosively. The reason for this is
on the one hand increasingly more efficient medicine and on
the other hand the demographic development. Compared with
this, neither the financial nor the personnel resources on the
part of medical service providers and cost carriers are able to
be optionally augmented. “We need intelligent solutions in or-
der to be able to meet future challenges. Telemedicine in con-
junction with a continuous health telematics infrastructure in
the European association is one of them”, said Dr. med. Micha-
el Nerlich, President of the International Society for Telemedi-
cine and eHealth (ISfTeH), as he summarised the result of the
Vitaphone symposium “Telemonitoring with chronic illnesses
— collective strategies for a global problem?” on the occasion
of the 74th Annual Conference of the German Cardiac Society
in Mannheim on 27 March 2008.
Despite many eHealth concepts — telemedicine in Europe still has
not arrived at medical reality
International panel of experts at cardiology congress:
…a nd fo r mo de r n t he ra py management …
TELEMEDICINE today Issue 3 2008 3
„L
ike all European states, Switzerland
has also politically adopted an eHealth
strategy”, explained Dr. med. Mar-
tin Denz, President of the Swiss Association of
Telemedicine and eHealth (SGTMeH). But this
has arrived neither in Switzerland nor in other
European states in the clinical reality of life.
In order to develop lasting effects, clinical tele-
medicine must be perceived and established as
part of national eHealth activities and infra-
structures.
„I
n Austria, integrated regionally over-
lapping telemedical care of the increa-
singly mobile 8 million inhabitants and
approx. 21 million annual guests plays an increa-
singly important role”, says OA Dr. med. Peter
Sögner MSc., President of the Austrian Scientific
Society for Telemedicine and eHealth (ASSTeH).
This particularly applies to the fields of tele-
radiology and telecardiology. However, compre-
hensive care and a consistent implementation of
telemedical care concepts are also still far off in
the ordinary clinical reality.
N
ow about 10 percent of the population in
Germany is already chronically ill. In the
future, these illnesses will reach a disse-
mination degree of epidemic proportion. Serious
secondary diseases – the consequence of bela-
ted diagnosis and treatment, for instance with
diabetes mellitus – additionally aggravate the
situation. Consequence: an enormous burden
on the healthcare budget. Even today about
80 percent of all healthcare expenditures
in the amount of 250 billion euros annually
will be expended for the treatment of chronic ill-
nesses — alone 25 to 30 billion for the therapy of
diabetes mellitus and its secondary diseases.
Networked thinking, collective action and
intelligent telemedical solutions for the fields
of prevention, diagnostics, therapy and disease
management as well as promotion of compliance
are the compelling priority, said Prof. Dr. med.
Harald Korb, Deputy Chairman of the German
Society for Health Telematics (DGG) and Medi-
cal Director of telemedicine provider Vitaphone.
Prof. Korb: “It is a matter of breaking open han-
ded down structures, breaking up sectoral limits
and overcoming thought blockades in the minds
of service providers and cost carriers if one in-
tends to successfully handle the foreseeable
challenges.”
P
rof. Dr. Peter Haas, from the Dortmund
University of Applied Sciences and Arts
(DUASA) and advisory board spokes-
man for the Society for Telematic Health Card
Applications (gematik mbH), pointed out that
a common “process language” as well as intero-
perability interfaces in the primary systems for
documentation of medical treatment sequen-
ces are an indispensable prerequisite for com-
prehensive implementation of telemedical care
concepts. Topical and up-to-date data exchange
between all medical service providers, including
telemedical service centres, can only be ensured
via an electronic patient file for the benefit of
patients.
This also has a positive effect on the quality
of therapy and thus on the treatment results.
“The physician as user is frequently forgotten
during the development of software in the me-
dical field. The result: lacking acceptance, un-
necessary workload, deficient transparency in
the processes and a high degree of frustration.
Here there is a very concrete call for action and
pent-up demand if eHealth concepts are to be
accepted in the clinical reality”, stated Prof. Dr.
Peter Haas.
Dr. med. Martin Denz Professor Dr. Peter HaasOA Dr. med. Peter Sögner
Know what is going on:
Now there is a new
patient brochure for
patients of “CorBene”
— the largest compre-
hensive integrated care programme for patients
with heart failure. Generally understandable, it con-
veys fundamental and important information per-
taining to the illness heart failure. Moreover, it ex-
plains the sequence and benefit of telemonitoring,
which is an obligatory component of therapy in the
CorBene programme. Information pertaining to the
CorBene hotline (0800 - 2 67 23 63) staffed round
the clock with physicians in the Telemedical Service
Center rounds off the extensive information offer.
With the new brochure Vitaphone actively supports
the medical practices and clinics participating in the
CorBene programme in North-Rhine Westphalia
and Saarland with their commitment to comprehen-
sively enlighten and inform their patients. After all:
only the informed patient can independently sup-
port his/her therapy.
A sample of the new patient brochure can be re-
quested free of charge with the info coupon on
Page 4.
Information for
CorBene patients
Informationen für telemedizinisch betreutePatienten mit Herzinsuffizienz

4. Not only in Germany, but around the glo-
be, experts from the most varying fields
of study are thinking about how challen-
ges approaching as a result of the demographic
change on the healthcare systems are to be over-
come. Telemonitoring and telemedical functional
diagnostics can provide an essential contribution
for this purpose — considerable worldwide agree-
ment prevails about this topic. However, national
solutions which can be smoothly integrated
in the most varying structures of healthcare
systems are called for. Together with national
partners in the respective countries Vitaphone
offers exactly these tailor-made solutions.
Vitaphone technologies shall be comprehensively
utilised in South Africa by the Football World
Cup in 2010. This is the ambitious goal of Allerco
Ltd., a marketing company for medical technolo-
gy with headquarters in Johannesburg.
There is also great interest in telemedical solu-
tions in Serbia. HAPEL Medical Systems with
headquarters in Belgrade is one of the leading
Serbian companies in the field of marketing me-
dical technology. This year they adopted the
Vitaphone range of products in their marketing
portfolio.
In the Czech Republic and Slovakia, 550
clinics trust the services of the MDT (Medical
Data Transfer, with headquarters in Prague)
service centres. Effective immediately, they
offer Vitaphone products and services in the
Czech Republic.
IMC (Interaktivt MedieCenter) with headquar-
ters in Farum/Denmark develops and accompa-
nies projects in the Danish healthcare industry.
With the distribution of Vitaphone products IMC
is consistently expanding its service offer for
clinics and physicians.
The French healthcare system is also very in-
terested in telemedical concepts and solutions
in the fields of functional diagnostics and patient
monitoring. Jean-Michel Dutois attends to this
growth market as an experienced manager on
behalf of Vitaphone.
The broad exchange of views is the focus of
attention at the Vitaphone International Partner
Meeting 2008, which will be held immediately
before the MEDICA in Mannheim. Experts from
numerous countries within and beyond Europe
will report on different strategies in their natio-
nal markets. The programme will be rounded off
through medical specialised lectures, which will
be held amongst others by high-calibre speakers
from German clinics.
…wit h st r o ng pa r t ners !
4 TELEMEDICINE today Issue 3 2008
Statement
Reinhart Hoffmann, Executive
Board Representative of the
German Diabetes Foundation (DDS),
Munich
Over 7 million people in Germany are currently undergoing dia-
betes treatment, tendency increasing. About another 3.5 million
know nothing of their illness. Diabetes develops virtually pandemic,
also so defined per UN resolution at the end of 2006 as the only non-
infectious disease. I am firmly convinced that people with diabetes
can be more optimally cared for and treated with the help of modern
IT & communications technology. At the same time, prevention me-
ans quite a lot to me! Because particularly with diabetes it is of ut-
most importance to avoid or at least to delay long-term side effects
or secondary damages. This would be successful if diabetics were to
be diagnosed earlier. Training courses in dealing with the illness and
reminders of necessary special examinations would also be helpful.
In the VDE project group “Diabetes” we have worked out what can
be particularly achieved in the preventive field with more innovative
technology and also recently published a position paper*.
Today it is especially important that we theorise less, but focus much
more on practical experience: How can the person with diabetes very
specifically utilise AAL technologies? The symposium at the 2nd
German AAL Congress presents the typical developmental scenario
of a diabetic in an understandable and practically-oriented manner,
and also presents suitable technical solution possibilities for this pur-
pose. There it is outstandingly suitable for making the public sensi-
tive to the problems.
* VDE position paper [English title]: Telemonitoring for prevention
of diabetes illnesses. Microsystems in medicine. Application,
technology, economy.
Publisher: VDE Initiative Micromedicine, Frankfurt, 2008.
We asked ourselves, ‘why not’, and conceived an AAL sym-
posium that will not even follow the customary pattern —
but a story. More precisely said: a storyboard!
We all know it: in the past decades diabetes has developed into a
national disease with epidemic proportion and enormous health-eco-
nomic implications. Highly relevant in this connection are long-term
side effects as a consequence of cardiovascular complications: every
19 minutes an amputation, every 90 minutes a loss of sight, every 60
minutes a new dialysis treatment, and every seven to eight minutes a
cardiovascular incident. And everyone also knows the typical deve-
lopmental phases of a diabetic, from the incipient metabolic imbalan-
ce to chronically ill people with classic belated complications.
But all also know how intervention can be meaningfully ac-
complished with the help of modern information and communications
technologies in every phase of the typical “diabetic career” — for
prevention, risk identification, diagnostics and for improved therapy
and emergency management? Precisely these will be the chapters of
the story: Internet TV for transfer of knowledge, animated training
programmes for sport in the living room, health management and
risk assessment from the laptop, dietary plans from the mobile phone
and ultramodern sensors in the T-shirt… And if it becomes serious:
telemedically supported care in the monitored household environ-
ment and more and more safety at home through conclusive residen-
tial concepts for the chronically ill.
Even today, Ambient Assisted Living can offer all that in the best
intended sense: close to people with a plus in quality of life and safety
of life!
You will find more information on the congress programme at
www.aal-kongress.de and at www.vitaphone.de
AAL and diabetes — an alliance for life!
Preview: excited session at the 2nd
German Ambient Assisted Living
Congress in Berlin on 28 January 2009
Vitaphone technologies for Football World Cup 2010
in South Africa
Tailor-made telemedical solutions in
association with national partners
around the globe
Moskau
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Web: www.vitaphone.de
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