Procedure for automatic allocation and display of responsibilities in telemedical procedures and overall system

Abstract

Method for the automatic allocation and display of responsibilities in telemedical procedures with at least one medical device, in which procedures at least two medical personnel are involved, of which at least one first person is located in the immediate vicinity of the device (“local”) and at least one second person is located away from the device (“remote”), comprising the following steps: • Planning and / or retrieving a sequence of procedural steps to carry out the telemedical procedure, • querying or retrieving an information profile for at least the first and the second person, wherein the information profile contains information about the respective person relevant for carrying out the procedure, • Determination of a competency classification of at least the first and second person for each procedural step of the telemedical procedure based on the information profiles, in particular taking into account a weighting of the information, and • Display of a division of responsibilities determined from the specific competency classifications for at least the first person and the second person in relation to one another for at least one currently executed or upcoming procedural step, wherein the determination takes into account a mutual influence of information at least about the first person and information about the second person and / or a correlation of information at least about the first person and information about the second person.

Description

[0001] The invention relates to a method for automatically allocating and displaying responsibilities in telemedical procedures with at least one medical device, in which procedures at least two medical personnel are involved, according to patent claim 1, and to an overall system for carrying out such a method according to patent claim 12.

[0002] In modern medical technology, minimally invasive interventions are used to perform therapies (e.g., placement of stents) or diagnoses (e.g., detection of stenosis) using objects (instruments, guidewires, stents, devices) inserted into hollow organs of the body. Navigation into the individual vascular branches is achieved by rotating and advancing a guidewire or catheter, which is inserted at a puncture point in the patient's groin.

[0003] If such procedures are supported by a robotic system (e.g. the Corindus CorPath GRX ® Vascular Robot, see https: / / www.corindus.com / corpath-grx / how-it-works), the robot handles the manipulation of the objects semi-automatically or automatically, with an operator (e.g. a doctor) controlling the movement remotely using a control unit. Depending on the application, the operator can be located in the immediate vicinity of the robot, e.g. in the same room (“local”), or remotely from the robot, e.g. in a corresponding room in a distant hospital (“remote”). In the latter case, two people or even teams located in different locations must work together: one person or team locally with the patient and one person or team remotely to control the robot. For this to happen, responsibilities must be clearly allocated, e.g. through prior agreement and definition.

[0004] In such a setting, it can happen that the individuals or teams are not working together, for example, they don't know each other or don't even speak the same language. If misunderstandings, errors, or even conflicts arise between individuals or teams, the smooth flow of the procedure is jeopardized, and serious consequences for the patient can arise. If safety mechanisms are implemented to synchronize responsibilities between individuals or teams, this can also endanger the procedure or the patient due to long delays in time-critical steps.

[0005] Publication US 2020 / 0 160 063 A1 discloses a monitoring system for surgical procedures that collects and evaluates a variety of status data for safety purposes. Publication DE 10 2009 022 681 A1 discloses a method for transmitting a communication request relating to a medical DICOM image.

[0006] The object of the present invention is to provide a method which enables rapid and error-free execution of telemedical procedures carried out by persons or teams located at different locations; furthermore, the object of the invention is to provide an overall system suitable for carrying out the method.

[0007] The object is achieved according to the invention by a method for the automatic allocation and display of responsibilities in telemedical procedures with at least one medical device, in which procedures at least two medical personnel are involved, according to patent claim 1 and by an overall system according to patent claim 12. Advantageous embodiments of the invention are each the subject of the associated subclaims.

[0008] The inventive method for automatically allocating and displaying responsibilities in telemedical procedures with at least one medical device, in which procedures at least two medical personnel are involved, of which at least a first person is located in the immediate vicinity of the device (“local”) and at least a second person is located away from the device (“remote”), comprises the following steps: Planning and / or retrieving a sequence of procedural steps for carrying out the telemedical procedure, Querying or retrieving an information profile for at least the first and second person, wherein the information profile contains information relevant to the respective person for carrying out the procedure, Determining a competency classification of the at least first and second person for each procedural step of the telemedical procedure based on the information profiles,in particular taking into account a weighting of the information, and displaying a division of responsibilities for at least one currently executed or upcoming procedural step, determined from the specific competency classifications for at least the first person and the second person in relation to each other, wherein the determination takes into account a mutual influence of information at least on the first person and information on the second person and / or a correlation of information at least on the first person and information on the second person. It can also be provided that more than two people are involved, for example, two teams with two or more people each, however, there is always at least one first person on site and at least one second person remotely. The information, information profiles,Competency classifications and allocations of responsibilities can therefore also refer to teams, or the corresponding terms can refer to more than two people. The procedure can be performed entirely or partially during the telemedicine procedure, or even before the telemedicine procedure begins.

[0009] The method according to the invention can ensure conflict-free and simple coordination between individuals or teams, even those located at different locations, during a telemedical procedure by utilizing information profiles, determining competency classifications for the procedural steps, and automatically determining responsibilities. This ensures that the procedure is carried out quickly and safely for the patient. By evaluating the information profiles, responsibilities can be assigned automatically and based on evidence, with particular consideration given to correlations and synergy effects. The display ensures that each individual or team knows exactly what they are responsible for. Overall, the method leads to better treatment and care for patients and also to higher patient throughput.The automated implementation of the procedure avoids the misunderstandings and delays that occur when voting is carried out manually.

[0010] According to one embodiment of the invention, a first display unit is assigned to the first person and a second display unit is assigned to the second person, and a display of the specific division of responsibilities is provided on both the first and the second display unit. In this way, an individual display is provided for at least the first and the second person, which is advantageous if the people are in different locations. Furthermore, it is also possible for each person to receive a display that is specifically tailored to them, independently of one another. In particular, these displays can differ depending on the person assigned to them. In addition to the people's individual preferences with regard to choice of color, image sharpness, etc., each person can also be shown exactly what their responsibilities are, for example.The elements relating to the other person can also be omitted entirely or displayed in a way that makes it clear they are not relevant to that person (e.g., reduced in size, grayed out, etc.). This way, each person can clearly see what they are and are not responsible for, thus avoiding misunderstandings and errors.

[0011] In particular, the first person is assigned a first control unit, and the second person a second control unit, similar to the display units. This allows the people to operate the operating functions of the overall system, the medical device, or other devices independently of one another and according to their responsibilities for steps of the medical procedure. Other manual actions that cannot be controlled by the control unit (inserting / changing catheters, measuring the patient's vital signs, emergency measures, etc.) can also be performed, particularly by the person on site.

[0012] According to a further embodiment of the invention, during the telemedical procedure, a blocking of the corresponding operating functions, e.g. of the medical device or other devices, is triggered if the respective person has secondary responsibility, and / or an enabling of the corresponding operating functions, e.g. of the medical device or other devices, is triggered if the respective person has primary responsibility. In this way, it is automatically guaranteed that there will be no accidental or intentional incorrect operations, since an automatic blocking takes place if a person is not responsible for an operating function. The control takes place during the corresponding steps of the telemedical procedure. For example,In a telemedicine procedure involving X-ray-monitored navigation of an object within a patient's body, where the second person (remote) is responsible for the navigation, operation of the robotic system may be blocked for the first person (local). Conversely, monitoring of a patient monitor may be blocked for the second person and enabled for the first person at the same time or during the entire procedure.

[0013] To provide a better overview of the people, the corresponding blocking and / or release are indicated on the respective display units. This can be achieved, for example, by a color code (red for blocked).

[0014] According to a further embodiment of the invention, the information profile of the persons comprises information on their whereabouts and / or their training and / or their specialization and / or their language and / or their level of experience and / or the number of similar procedures already performed. Such information has a significant influence on the execution of individual steps of the procedure and on the operation of device functions of the medical device or other devices and is used accordingly to determine the competency classification. For example, a remote person cannot perform a puncture in the patient to insert the guidewire because they are not on site. For many procedural steps, it can also be important how often a person has already performed these steps or the corresponding device operations and how much experience they have.Different languages ​​can complicate communication between people and thus easily lead to misunderstandings. In principle, the training or specialization of the person is relevant to the procedure. For example, a surgeon may be better suited for a surgical procedure than an internist and will be classified accordingly.

[0015] According to a further embodiment of the invention, updates to the respective information profile of the persons or the procedural steps are used to determine and / or display updated competency classifications and / or responsibility allocations in real time. This allows for real-time responses to changes during the procedure or during specific procedural steps, thus optimizing the execution of the procedure.

[0016] According to a further embodiment of the invention, at least one pre-trained machine-learning algorithm is used to determine the competency classification and / or the allocation of responsibilities.

[0017] Advantageously, communications and interactions between individuals are monitored or regulated on the basis of competency classifications and / or information profiles.

[0018] The invention further comprises an overall system for carrying out a corresponding method, designed to carry out a telemedical procedure, in which procedure at least two medical personnel are involved, of which at least a first person is located in the immediate vicinity of a medical device (“local”) and at least a second person is located away from the device (“remote”), with at least two procedural steps, comprising at least one medical device, a control unit for controlling the overall system, a retrieval unit for retrieving information profiles of the persons, a determination unit for determining a competency classification of the at least two persons for the respective procedural steps based on the information profiles, in particular taking into account a weighting of the properties, a calculation unit for creating a division of responsibilities for each procedural step,wherein a mutual influence of properties and / or a correlation of properties is taken into account, at least two display units, wherein a first display unit is assigned to a first person and a second display unit to a second person, and at least two operating units, wherein a first operating unit is assigned to a first person and a second operating unit to a second person.,

[0019] According to one embodiment of the invention, the control unit is provided for blocking operating functions of the medical device or other devices when the respective person has secondary responsibility and / or for enabling operating functions of the medical device or other devices when the respective person has primary responsibility. Advantageously, the overall system can also include a planning unit for planning the telemedical procedure.

[0020] The invention and further advantageous embodiments according to the features of the dependent claims are explained in more detail below with reference to schematically illustrated embodiments in the drawings, without thereby limiting the invention to these embodiments. They show: Fig. 1 a sequence of steps of the method according to the invention; Fig. 2 shows a further sequence of steps of the method according to the invention; Fig. 3 shows a further sequence of steps of the method according to the invention; Fig. 4 a view of an overall system for carrying out the method according to the invention; and Fig. 5 a view of a first and a second operating unit during the process.

[0021] In the Fig. 1 shows a sequence of steps of the method. The method optimizes collaboration in telemedical procedures with at least one medical device, in which procedures at least two people are involved, of which at least a first person is located in the immediate vicinity of the device (“local”) and at least a second person is located away from the device (“remote”). The method can avoid communication problems between the people and other conflicts, thus ensuring that the procedure is carried out quickly, in an orderly manner and safely for the patient. More than two people can also be involved in the procedure and the people can also be divided into two teams, for example, with a first team located locally and a second team located remotely.In such a case, the information, information profiles, competency classifications and allocations of responsibilities may also refer to the teams or the corresponding terms may refer to more than two people or may be available for more than two people.

[0022] A typical telemedical procedure is generally carried out by integrating a remote control of at least one of the devices involved. The telemedical procedure can, for example, be formed by a remotely executed robot-assisted navigation of a medical object (e.g., guidewire, catheter, stent, device, instrument, etc.) through a hollow organ of a patient under X-ray monitoring (controlled locally or remotely), for which an overall system with a robot system for navigation and an X-ray device for X-ray monitoring can be used. Other devices, in particular a plurality of devices, can also be involved. However, it also includes any other telemedical procedure in which medical personnel are located at different locations (locally and remotely). Fig. 4 shows an exemplary overall system 1 for carrying out the method.

[0023] In a first step 20, a sequence of procedural steps for carrying out the telemedical procedure is planned or a previously planned procedure is retrieved from a storage unit or a database. The planning can be planned using a planning unit and on the basis of prior information, e.g., existing image data sets, patient data, etc. The telemedical procedure comprises at least two consecutive procedural steps, but can also comprise a large number of procedural steps with more or less detail. In addition to the basic sequence of procedural steps, the probability of emergency measures, continuous patient monitoring, processes extending over several steps or rare events can also be recorded or planned. A procedural step can also be divided into two or more sub-steps.

[0024] In a second step 21, an information profile is queried or retrieved for at least the first person and the second person, wherein the information profile contains information or characteristics of the respective person relevant for carrying out the procedure. In the simplest version, an information profile with relevant information for the respective person is already available in a storage unit or a database and only needs to be queried. However, further information can also be added, e.g. manually or automatically. Alternatively or additionally, information can be queried as part of the procedure, e.g. by asking the person to enter the relevant information into an input unit. For example, a certain set of information can be relevant for each procedure, e.g. depending on the type of procedure and the individual procedural steps.The totality of the information forms the respective information profile, e.g. in an ordered or processed form.

[0025] The information can, for example, contain details about the person's medical training and / or professional specialization, e.g. also in varying levels of detail. For example, it is relevant whether the person is a doctor, a technician or a nurse and whether the person specializes in certain medical disciplines or device operations. The information can also include information on the level of experience (e.g. clinical expertise with regard to different devices or steps or patient monitoring) and / or the number of procedures already performed by the person. It can also include information on the person's location (e.g. local or remote); this can be updated, for example, at the start of the procedure. It can also include information on the person's language.Some of the information is particularly relevant in relation to the information about the other person(s) (located at a different location) (e.g., language, level of education, experience, etc.). The information may also include details about which other person(s) the respective person has already worked with, how often, and within which procedure. A query unit 5, for example, may be provided to retrieve information.

[0026] The first step 20 and the second step 21 can also be carried out in reverse order or simultaneously.

[0027] In a third step 22, competency classifications are determined at least for the first person and for the second person for each procedural step of the telemedical procedure based on the information profiles. The competency classifications can be implemented, for example, as a type of suitability assessment for the corresponding procedural steps, e.g. by evaluating the information profiles with regard to the procedural steps. This can be carried out in various ways, e.g. by means of scoring, a (graded) assessment or the awarding of points or grades with regard to the implementation of the corresponding procedural step. The competency classification can be implemented in various levels of detail, from very coarse (e.g. 3 levels: "very suitable", "somewhat suitable" and "not suitable") to very fine (e.g. > 100 levels).

[0028] The information contained in the information profiles is incorporated into the competency classification. In particular, information can be given greater or lesser weighting depending on the procedural step. For example, the information that a person is assigned remotely can lead to a competency classification of “not suitable” for a procedural step that is to be carried out on site (which requires direct patient contact, such as inserting a needle, resuscitation measures, etc.). In such a case, the weighting of this fact is very high, e.g., 100%. The competency classification can be carried out, for example, using a determination unit 6 of the overall system 1, e.g., using a machine learning (machine learning, deep learning, GAN, etc.) algorithm. By using machine learning algorithms, the classification can be carried out particularly accurately, reliably, and quickly.Machine learning algorithms can be trained using a variety of examples.

[0029] In a fourth step 23, a division of responsibilities for the procedural steps is then determined for at least the first and second person, for example for the next currently planned procedural step or for several or all planned procedural steps. This specifies exactly what each person is responsible for with regard to the respective procedural step and its details, e.g. in the form of a distributed workflow. For example, in the case of a robot-assisted navigation procedure under X-ray monitoring, the following can be provided for the remotely assigned (second) person (or team): if clinical expertise on the procedure is available, the second person is responsible for the general control of the robot system, general control of the X-ray system, the selection of the objects to be navigated and the instructions regarding the objects to be inserted.In return, the (first) person (or team) on site is responsible for on-site control and handling of the robot system and the X-ray system, provided they have sufficient expertise in patient care / monitoring and have a basic understanding of the objects to be navigated (e.g., for correct selection and insertion / change according to instructions).

[0030] When determining the allocation of responsibilities, any mutual influence between information about the first person and information about the second person and / or a correlation between information about the first person and information about the second person can also be taken into account. For example, if the remotely assigned second person has no prior knowledge of the X-ray system, the person on site with sufficient experience in the field can take over control of the X-ray system; a remotely assigned second person with a lot of experience would also be responsible for controlling the X-ray system. Different weightings of information can also be taken into account when determining responsibilities. For example, different languages ​​can be given less weight than a large number of similar procedures already carried out together.

[0031] The allocation of responsibilities can be determined, for example, using a determination unit 7, e.g., also using a machine learning algorithm (machine learning, deep learning, GAN, etc.). By using machine learning algorithms, the classification can be performed particularly accurately, reliably, and quickly. Machine learning algorithms can be trained using a large number of examples.

[0032] In a fifth step 24, the allocation of responsibilities for at least the first and second person is displayed, for example, on display units. For example, a first display unit 8 can be assigned to the first person and a second display unit 9 to the second person. This is particularly advantageous since the people are located at different locations. Each person is now shown the assigned responsibility on their display unit; in particular, the display differs depending on the person. The first person sees, for example, on the first display unit 8 - see Fig. 4 - what they themselves are responsible for, the second person can see what they are responsible for on the second display unit 9. The display can be for the procedural step currently being carried out / to be carried out, for the following procedural step or for all procedural steps. It can be provided that each person can only see their own responsibility on their display. Alternatively, the respective person can also see the responsibilities of the other person(s), but this will be visually different from their own responsibility, for example. The elements relating to the other person can, for example, be displayed in such a way that it is clear that they are not relevant to the person (e.g. reduced in size, grayed out, etc.). In this way, each person can clearly see what they are and are not responsible for, and misunderstandings and errors can be avoided.In addition, it is also possible for each person to have individual preferences regarding color choice, image sharpness, etc. on their display.

[0033] If during the procedure changes (updates) of the information regarding one or more persons occur or are initiated - see the seventh step 26 in Fig. 3 - It can be provided that the respective information profile of the persons is updated and, depending on this, the competency classifications and / or the distribution of responsibilities are also updated and / or displayed. This can be done, for example, live or in real time. Changes in the procedural steps (resulting, for example, from the progress or emergencies, etc.) can also be used for updates. Furthermore, it can also be provided that the distribution of responsibilities for the subsequent procedural step is only determined and / or displayed during the execution of a procedural step.

[0034] Analogous to the display units, control units can also be assigned to the persons, e.g., a first control unit 10 for the first person and a second control unit 11 for the second person. The control units can be designed to operate and / or control the operating functions of the device(s) involved and / or for inputs. In this way, the persons can independently control the operating functions of the overall system, the medical device, or other devices according to their responsibilities. The control units 10, 11 can, for example, be touchpads, computer keyboards, control bars, joysticks, control buttons, switches, or a combination of these.

[0035] The process is automatically controlled and monitored by a control unit 4 of the overall system. The control unit 4 has access to the various components of the overall system, for example, to the detection unit 7 and the determination unit 6, to the first and second display units 8, 9, and to the first and second operating units 10, 11. The control unit can have wireless or wired communication connections 18 and / or interfaces to all components.

[0036] In a sixth step 25 - shown in Fig. 2 - In addition to displaying the allocation of responsibilities, an operating control for the persons can also be controlled during the procedure, e.g., via the control units. This can be used to block or lock the operating functions of the medical device or other devices if the respective person has secondary responsibility, e.g., by locking or disabling the corresponding functions on the control units. This can also be controlled and / or regulated automatically via control unit 4.

[0037] For example, in the context of a robotic intervention when manually changing an object (e.g. catheter) by the first person 2, it can be provided that the second person 3 should not be able to interact with the robot and accordingly the corresponding operating function is blocked, for example on the second operating unit 11 (or, for example, generally). If, for example, in a critical situation for the patient, emergency measures must be taken by the first person 2 (e.g. resuscitation), the operation of any operating function on the second operating unit can be completely blocked for the second person until, for example, an input or release has been made by the first person 2. Operating functions for one person at a time can also be blocked or released by the other person, provided this is generally provided for. This can be the case, for example, if one of the people has a significantly higher competency classification (e.g.(through extensive experience) than the other person. Furthermore, if, for example, the people have already performed many procedures together and trust each other, the responsible person can unblock the non-responsible, blocked person and allow them to operate the system. On the other hand, a responsible person can also block a non-responsible person by making an input, for example, if the responsible person has a much higher competency classification.

[0038] Other aspects, such as how well communication between people works, can also be taken into account, for example, whether functions are blocked for one person or not. For example, if two people (or teams) are working together for the first time, the same function can be blocked for the first person if the second person is responsible. However, if people are well-versed and have already performed numerous similar procedures together, both people can access the functions, since it can be assumed that the non-responsible person will ask first before activating functions.

[0039] The overall system 1 for carrying out the procedure ( Fig.4) comprises, in addition to the control unit 4, medical devices in the form of an X-ray system 14 and a robot system 13. The robot system 13 is designed for the semi- or fully automatic navigation of an object, e.g. guide wire, catheter, instrument or stent, in a hollow organ of a patient 12, the X-ray system 14 for X-ray monitoring of such navigation or generally for taking X-ray images of the patient. The overall system 1 is designed to carry out a telemedical procedure in which a first person 2 (or a team of two or more people as shown) is located on site with the patient and a second person 3 (or a team of several people) is located away from the patient, for example in another hospital, another city or even another country.The first person is assigned a first display unit 8 and a first operating unit 10 for operating and controlling operating functions of the robot system 14 and the X-ray system 13 and other associated devices. The second person 3 is assigned a remotely arranged second display unit 9 and a remotely arranged second operating unit 11 for operating and controlling operating functions of the robot system 14 and the X-ray system 13 and other devices. The control unit 4 for controlling the method has wireless and / or wired communication connections 18 and interfaces to the components of the overall system. The control unit 4 has access to the various components of the overall system, for example, the detection unit 7 and the determination unit 6.Other devices necessary to perform the medical procedure may be assigned, for example, a patient monitoring system for monitoring the patient's vital signs, an ECG, an ultrasound device, etc. More than one display unit per person and more than one control unit (keyboard, smart device, foot switch, etc.) may also be assigned.

[0040] The medical procedure is performed to examine or treat patient 12.

[0041] With regard to the use of the information or the information profile within the process, various scenarios are also conceivable. For example, it may be provided that the control unit 4 accesses exclusively the allocation of responsibilities to initiate appropriate display or interaction measures. It may also be provided to use additional differentiations based on the competency classification to implement more specific measures. Alternatively, the information or the information profile can also be accessed, for example, as a weighting factor for selecting appropriate measures.

[0042] Furthermore, the process can also take into account significant differences between individuals or teams regarding competency classification. Individuals can be shown significantly different information on the display units, with the overall workflow being managed by Control Unit 4 and maintained by it. The following examples are conceivable: • A highly experienced (e.g., >100 procedures) second person (remote) with extensive knowledge of the equipment used and the procedure itself may, for example, receive a suggestion from the control unit regarding the level of detail displayed. In addition, such a second person may be given more freedom in setting the settings or, in an extreme example, even be granted complete control (within certain parameters). • A very inexperienced (e.g., less than 10 procedures) first person (local) with basic knowledge of the equipment used and the procedure might be suggested or even prescribed a certain (lower) level of detail to ensure adequate information, but also to influence the procedure as little as possible or to present it in a way that reflects the current level of knowledge. In this case, the first person's options for alternatives or even adjustments would be severely limited.

[0043] For example, the overall system 1 can further be configured to provide or, if necessary, block interaction mechanisms. For example, other suitable acoustic or visual indicators can also be provided.

[0044] The overall system 1 is designed to record and evaluate general communication requirements and to implement them into appropriate presentation and interaction measures.

[0045] The invention can be briefly summarized as follows: For a particularly error-proof implementation of telemedical procedures, a method is provided for the automatic determination and display of competence in telemedical procedures with at least one medical device, in which procedures at least two medical personnel are involved, of which at least a first person is located in the immediate vicinity of the device (“local”) and at least a second person is located away from the device (“remote”), with the following steps: Planning and / or retrieving a sequence of procedural steps for implementing the telemedical procedure, querying or retrieving an information profile for at least the first and second person, wherein the information profile contains information about the respective person relevant for implementing the procedure,Determining a competency classification of at least the first and second person for each procedural step of the telemedical procedure based on the information profiles, in particular taking into account a weighting of the information, and displaying a division of responsibilities determined from the determined competency classifications for at least the first person and second person in relation to one another for at least one currently executed or upcoming procedural step, wherein the determination takes into account a mutual influence of information at least about the first person and information about the second person and / or a correlation of information at least about the first person and information about the second person.

Claims

[1] A method for the automatic allocation and display of responsibilities in telemedical procedures with at least one medical device, in which procedures at least two medical personnel are involved, of which at least one first person is located in the immediate vicinity of the device (“local”) and at least one second person is located away from the device (“remote”), comprising the following steps: • Planning and / or retrieving a sequence of procedural steps to carry out the telemedical procedure, • querying or retrieving an information profile for at least the first and the second person, wherein the information profile contains information about the respective person relevant for carrying out the procedure, • Determination of a competency classification of at least the first and second person for each procedural step of the telemedical procedure based on the information profiles, in particular taking into account a weighting of the information, and • Display of a division of responsibilities determined from the specific competency classifications for at least the first person and the second person in relation to one another for at least one currently executed or upcoming procedural step, wherein the determination takes into account a mutual influence of information at least about the first person and information about the second person and / or a correlation of information at least about the first person and information about the second person. [2] Method according to claim 1, wherein a first display unit is assigned to the first person and a second display unit is assigned to the second person and a display of the determined allocation of responsibilities is provided on both the first and the second display unit. [3] Method according to claim 2, wherein the display of the determined division of responsibilities on the first display unit and the display on the second display unit differ depending on the assigned persons. [4] Method according to one of the preceding claims, wherein, in the case of subordinate responsibility of the respective person, a blocking of operating functions of the medical device or other devices and / or an enabling of operating functions of the medical device or other devices is triggered in the case of primary responsibility of the respective person. [5] Method according to one of the preceding claims, wherein a first operating unit is assigned to the first person and a second operating unit is assigned to the second person. [6] Method according to claim 4, wherein the blockage and / or the release is displayed on the respective display units. [7] Method according to one of the preceding claims, wherein the information profile of the persons comprises information on their location and / or their education and / or their specialization and / or their language and / or their level of experience and / or the number of similar procedures already performed. [8] Method according to one of the preceding claims, wherein updates of the respective information profile of the persons or of the procedure steps are used to determine and / or display updated competency classifications and / or a distribution of responsibilities in real time. [9] Method according to one of the preceding claims, wherein the procedure comprises at least one robot-assisted navigation of an object in a hollow organ of a patient. [10] Method according to one of the preceding claims, wherein at least one pre-trained machine-learning algorithm is used to determine the competence classification and / or the allocation of responsibilities. [11] Method according to one of the preceding claims, wherein communications and interactions between the persons are monitored or regulated on the basis of the competency classifications and / or the information profiles. [12] Overall system (1) for carrying out a method according to one of claims 1 to 10, designed to carry out a telemedical procedure, in which procedure at least two medical personnel are involved and of these at least a first person (2) is arranged in the close vicinity (“local”) of a medical device and at least a second person (3) is arranged remotely from the device, with at least two procedural steps, comprising • at least one medical device, • a control unit (4) for controlling the entire system (1), • a determination unit (6) for determining a competency classification of the at least two persons for the respective procedural steps based on the information profiles, in particular taking into account a weighting of the information, • a calculation unit (7) for determining a division of responsibilities for each procedural step, taking into account a mutual influence of information and / or a correlation of information, • at least two display units, wherein a first display unit (8) is assigned to the first person (2) and a second display unit (9) is assigned to the second person (3), and • at least two operating units, wherein a first operating unit (10) is assigned to the first person and a second operating unit (11) is assigned to the second person. [13] Overall system according to claim 12, wherein the control unit (4) is provided for blocking operating functions of the medical device or other devices when the respective person has secondary responsibility and / or for enabling operating functions of the medical device or other devices when the respective person has primary responsibility. [14] Overall system according to one of claims 12 or 13, comprising a planning unit for planning the telemedical procedure and / or a retrieval unit (5) for retrieving information profiles of the persons. [15] Overall system according to one of claims 12 to 14, comprising at least one data transmission path (18) for connecting the operating units to the overall system.

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