Acute neurological care in north-east Germany with telemedicine support (ANNOTeM): protocol of a multi-center, controlled, open-label, two-arm intervention study
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| Název: | Acute neurological care in north-east Germany with telemedicine support (ANNOTeM): protocol of a multi-center, controlled, open-label, two-arm intervention study |
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| Autoři: | Weber, Joachim E., Angermaier, Anselm, Bollweg, Kerstin, Erdur, Hebun, Ernst, Stefanie, Flöel, Agnes, Gorski, Claudia, Kandil, Farid I., Kinze, Stephan, Kleinsteuber, Katharina, Kurth, Tobias, Schmehl, Ingo, Theen, Sarah, Endres, Matthias, Audebert, Heinrich J., ANNOTeM-consortium |
| Zdroj: | BMC Health Serv Res BMC Health Services Research, Vol 20, Iss 1, Pp 1-8 (2020) BMC health services research 20(1), 755 (2020). doi:10.1186/s12913-020-05576-w |
| Informace o vydavateli: | Springer Science and Business Media LLC, 2020. |
| Rok vydání: | 2020 |
| Témata: | therapy [Stroke], Adult, Male, Health care research, Critical Care, Hospitals, Rural, organization & administration [Telemedicine], Study Protocol, 03 medical and health sciences, 0302 clinical medicine, ANNOTeM, therapy [Nervous System Diseases], Germany, Humans, ddc:610, Quality management, 9. Industry and infrastructure, Telemedicine, Stroke / Neurological disease, 3. Good health, Stroke, organization & administration [Hospitals, Rural], Research Design, Acute Disease, Emergency medicine, Female, organization & administration [Critical Care], Health Services Research, Neuro acute units, Public aspects of medicine, RA1-1270, Nervous System Diseases, Female [MeSH], Stroke/therapy [MeSH], Adult [MeSH], Humans [MeSH], Nervous System Diseases/therapy [MeSH], Research Design [MeSH], Critical Care/organization, Hospitals, Rural/organization, Acute Disease [MeSH], Health Services Research [MeSH], Male [MeSH], Telemedicine/organization, Germany [MeSH], Quality, performance, safety and outcomes, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit |
| Popis: | Background Both diagnosis and treatment of neurological emergencies require neurological expertise and are time-sensitive. The lack of fast neurological expertise in regions with underserved infrastructure poses a major barrier for state-of-the-art care of patients with acute neurological diseases and leads to disparity in provision of health care. The main purpose of ANNOTeM (acute neurological care in North East Germany with telemedicine support) is to establish effective and sustainable support structures for evidence based treatments for stroke and other neurological emergencies and to improve outcome for acute neurological diseases in these rural regions. Methods A “hub-and-spoke” network structure was implemented connecting three academic neurological centres (“hubs”) and rural hospitals (“spokes”) caring for neurological emergencies. The network structure includes (1) the establishment of a 24/7 telemedicine consultation service, (2) the implementation of standardized operating procedures (SOPs) in the network hospitals, (3) a multiprofessional training scheme, and (4) a quality management program. Data from three major health insurance companies as well as data from the quality management program are being collected and evaluated. Primary outcome is the composite of first time of receiving paid outpatient nursing care, first time of receiving care in a nursing home, or death within 90 days after hospital admission. Discussion Beyond stroke only few studies have assessed the effects of telemedically supported networks on diagnosis and outcome of neurological emergencies. ANNOTeM will provide information whether this approach leads to improved outcome. In addition, a health economic analysis will be performed. Study registration German Clinical Trials Register DRKS00013067, date of registration: November 16 th, 2017, URL: http://www.drks.de/DRKS00013068 |
| Druh dokumentu: | Article Conference object Other literature type |
| Jazyk: | English |
| ISSN: | 1472-6963 |
| DOI: | 10.1186/s12913-020-05576-w |
| DOI: | 10.17169/refubium-34723 |
| Přístupová URL adresa: | https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-020-05576-w https://pubmed.ncbi.nlm.nih.gov/32807159 https://doaj.org/article/8946429af8594f07ab2a047059e7a5ba https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430113 https://pubmed.ncbi.nlm.nih.gov/32807159/ https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05576-w https://link.springer.com/content/pdf/10.1186/s12913-020-05576-w.pdf https://www.ncbi.nlm.nih.gov/pubmed/32807159 https://link.springer.com/article/10.1186/s12913-020-05576-w https://repository.publisso.de/resource/frl:6464183 |
| Rights: | CC BY |
| Přístupové číslo: | edsair.doi.dedup.....283f1f9bed04d5b5d7fd8532ad8c6bba |
| Databáze: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Background Both diagnosis and treatment of neurological emergencies require neurological expertise and are time-sensitive. The lack of fast neurological expertise in regions with underserved infrastructure poses a major barrier for state-of-the-art care of patients with acute neurological diseases and leads to disparity in provision of health care. The main purpose of ANNOTeM (acute neurological care in North East Germany with telemedicine support) is to establish effective and sustainable support structures for evidence based treatments for stroke and other neurological emergencies and to improve outcome for acute neurological diseases in these rural regions. Methods A “hub-and-spoke” network structure was implemented connecting three academic neurological centres (“hubs”) and rural hospitals (“spokes”) caring for neurological emergencies. The network structure includes (1) the establishment of a 24/7 telemedicine consultation service, (2) the implementation of standardized operating procedures (SOPs) in the network hospitals, (3) a multiprofessional training scheme, and (4) a quality management program. Data from three major health insurance companies as well as data from the quality management program are being collected and evaluated. Primary outcome is the composite of first time of receiving paid outpatient nursing care, first time of receiving care in a nursing home, or death within 90 days after hospital admission. Discussion Beyond stroke only few studies have assessed the effects of telemedically supported networks on diagnosis and outcome of neurological emergencies. ANNOTeM will provide information whether this approach leads to improved outcome. In addition, a health economic analysis will be performed. Study registration German Clinical Trials Register DRKS00013067, date of registration: November 16 th, 2017, URL: http://www.drks.de/DRKS00013068 |
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| ISSN: | 14726963 |
| DOI: | 10.1186/s12913-020-05576-w |