Employment of Telemedicine in Nursing Homes: Clinical Requirement Analysis, System Development and First Test Results.
Identifieur interne : 000348 ( Main/Corpus ); précédent : 000347; suivant : 000349Employment of Telemedicine in Nursing Homes: Clinical Requirement Analysis, System Development and First Test Results.
Auteurs : Marian Ohligs ; Stephanie Stocklassa ; Rolf Rossaint ; Michael Czaplik ; Andreas FollmannSource :
- Clinical interventions in aging [ 1178-1998 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (prevention & control), Female (MeSH), General Practice (methods), Germany (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Male (MeSH), Nursing Homes (MeSH), Pandemics (prevention & control), Pneumonia, Viral (prevention & control), Remote Consultation (instrumentation), Remote Consultation (methods), Remote Consultation (organization & administration), Software (MeSH), Surveys and Questionnaires (MeSH).
- MESH :
- geographic : Germany.
- instrumentation : Remote Consultation.
- methods : General Practice, Remote Consultation.
- organization & administration : Remote Consultation.
- prevention & control : Coronavirus Infections, Pandemics, Pneumonia, Viral.
- statistics & numerical data : Hospitalization.
- Aged, Betacoronavirus, Female, Humans, Male, Nursing Homes, Software, Surveys and Questionnaires.
Abstract
Purpose
Demographic change and lack of specialized workforces are challenging. Likewise, home visits by general practitioners (GPs) become rarer. If a nursing home resident develops acute symptoms, nurses are often inclined to call the rescue service. Besides patient-related consequences, this might lead to unnecessary hospitalization and far-reaching health economic costs. Due to legal restrictions of remote treatment in Germany, which were recently loosened, telemedicine is still in the early stages. The aim of this study was to employ a holistic telemedical system for nursing homes which facilitates the connection to a GP and thus avoids unnecessary hospitalizations in the case of ambulatory-sensitive illnesses.
Materials and Methods
After an inter-professional requirement analysis, the iterative development was started. In addition to an audio-video connection, several point of care measurements were integrated. Finally, first field tests were performed in a nursing home in a rural area in Germany.
Results
One nursing home was equipped with telemedical system based on the results of the requirement analysis and tele-medically connected to a GP. Over a period of seven months, 56 routine and emergency teleconsultations took place. Only one of those required a hospital admission. In addition to video telephony, electrocardiography and assessment of vitals such as pulse, blood pressure, oxygen saturation and auscultation of heart and lungs were applied frequently.
Conclusion
A telemedical system including integrated medical devices was successfully developed and has turned out to be helpful and even necessary for careful and reliable decision-making by the GP. First test results show high acceptance for elderly care. Involved patients, nurses, and the GP itemize various specific benefits, including economic, personal, and altruistic issues. Another issue that the current COVID-19 crisis brought to light is lowering the risk of contagion; GPs can replace their home visits by using telepresence combined with point of care measures.
DOI: 10.2147/CIA.S260098
PubMed: 32884251
PubMed Central: PMC7443448
Links to Exploration step
pubmed:32884251Le document en format XML
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last="Rossaint">Rolf Rossaint</name><affiliation><nlm:affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Czaplik, Michael" sort="Czaplik, Michael" uniqKey="Czaplik M" first="Michael" last="Czaplik">Michael Czaplik</name><affiliation><nlm:affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Docs in Clouds GmbH, Aachen, NRW, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Follmann, Andreas" sort="Follmann, Andreas" uniqKey="Follmann A" first="Andreas" last="Follmann">Andreas Follmann</name><affiliation><nlm:affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno 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last="Stocklassa">Stephanie Stocklassa</name><affiliation><nlm:affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Rossaint, Rolf" sort="Rossaint, Rolf" uniqKey="Rossaint R" first="Rolf" last="Rossaint">Rolf Rossaint</name><affiliation><nlm:affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Czaplik, Michael" sort="Czaplik, Michael" uniqKey="Czaplik M" first="Michael" last="Czaplik">Michael Czaplik</name><affiliation><nlm:affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Docs in Clouds GmbH, Aachen, NRW, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Follmann, Andreas" sort="Follmann, Andreas" uniqKey="Follmann A" first="Andreas" last="Follmann">Andreas Follmann</name><affiliation><nlm:affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Clinical interventions in aging</title><idno type="eISSN">1178-1998</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>Coronavirus Infections (prevention & control)</term><term>Female (MeSH)</term><term>General Practice (methods)</term><term>Germany (MeSH)</term><term>Hospitalization (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Nursing Homes (MeSH)</term><term>Pandemics (prevention & control)</term><term>Pneumonia, Viral (prevention & control)</term><term>Remote Consultation (instrumentation)</term><term>Remote Consultation (methods)</term><term>Remote Consultation (organization & administration)</term><term>Software (MeSH)</term><term>Surveys and Questionnaires (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Germany</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Remote Consultation</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>General Practice</term><term>Remote Consultation</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Remote Consultation</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Coronavirus Infections</term><term>Pandemics</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Betacoronavirus</term><term>Female</term><term>Humans</term><term>Male</term><term>Nursing Homes</term><term>Software</term><term>Surveys and Questionnaires</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Purpose</b></p><p>Demographic change and lack of specialized workforces are challenging. Likewise, home visits by general practitioners (GPs) become rarer. If a nursing home resident develops acute symptoms, nurses are often inclined to call the rescue service. Besides patient-related consequences, this might lead to unnecessary hospitalization and far-reaching health economic costs. Due to legal restrictions of remote treatment in Germany, which were recently loosened, telemedicine is still in the early stages. The aim of this study was to employ a holistic telemedical system for nursing homes which facilitates the connection to a GP and thus avoids unnecessary hospitalizations in the case of ambulatory-sensitive illnesses.</p></div><div type="abstract" xml:lang="en"><p><b>Materials and Methods</b></p><p>After an inter-professional requirement analysis, the iterative development was started. In addition to an audio-video connection, several point of care measurements were integrated. Finally, first field tests were performed in a nursing home in a rural area in Germany.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>One nursing home was equipped with telemedical system based on the results of the requirement analysis and tele-medically connected to a GP. Over a period of seven months, 56 routine and emergency teleconsultations took place. Only one of those required a hospital admission. In addition to video telephony, electrocardiography and assessment of vitals such as pulse, blood pressure, oxygen saturation and auscultation of heart and lungs were applied frequently.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>A telemedical system including integrated medical devices was successfully developed and has turned out to be helpful and even necessary for careful and reliable decision-making by the GP. First test results show high acceptance for elderly care. Involved patients, nurses, and the GP itemize various specific benefits, including economic, personal, and altruistic issues. Another issue that the current COVID-19 crisis brought to light is lowering the risk of contagion; GPs can replace their home visits by using telepresence combined with point of care measures.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32884251</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>14</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>14</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1178-1998</ISSN><JournalIssue CitedMedium="Internet"><Volume>15</Volume><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Clinical interventions in aging</Title><ISOAbbreviation>Clin Interv Aging</ISOAbbreviation></Journal><ArticleTitle>Employment of Telemedicine in Nursing Homes: Clinical Requirement Analysis, System Development and First Test Results.</ArticleTitle><Pagination><MedlinePgn>1427-1437</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.2147/CIA.S260098</ELocationID><Abstract><AbstractText Label="Purpose" NlmCategory="UNASSIGNED">Demographic change and lack of specialized workforces are challenging. Likewise, home visits by general practitioners (GPs) become rarer. If a nursing home resident develops acute symptoms, nurses are often inclined to call the rescue service. Besides patient-related consequences, this might lead to unnecessary hospitalization and far-reaching health economic costs. Due to legal restrictions of remote treatment in Germany, which were recently loosened, telemedicine is still in the early stages. The aim of this study was to employ a holistic telemedical system for nursing homes which facilitates the connection to a GP and thus avoids unnecessary hospitalizations in the case of ambulatory-sensitive illnesses.</AbstractText><AbstractText Label="Materials and Methods" NlmCategory="UNASSIGNED">After an inter-professional requirement analysis, the iterative development was started. In addition to an audio-video connection, several point of care measurements were integrated. Finally, first field tests were performed in a nursing home in a rural area in Germany.</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">One nursing home was equipped with telemedical system based on the results of the requirement analysis and tele-medically connected to a GP. Over a period of seven months, 56 routine and emergency teleconsultations took place. Only one of those required a hospital admission. In addition to video telephony, electrocardiography and assessment of vitals such as pulse, blood pressure, oxygen saturation and auscultation of heart and lungs were applied frequently.</AbstractText><AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">A telemedical system including integrated medical devices was successfully developed and has turned out to be helpful and even necessary for careful and reliable decision-making by the GP. First test results show high acceptance for elderly care. Involved patients, nurses, and the GP itemize various specific benefits, including economic, personal, and altruistic issues. Another issue that the current COVID-19 crisis brought to light is lowering the risk of contagion; GPs can replace their home visits by using telepresence combined with point of care measures.</AbstractText><CopyrightInformation>© 2020 Ohligs et al.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ohligs</LastName><ForeName>Marian</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0003-2411-2608</Identifier><AffiliationInfo><Affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Docs in Clouds GmbH, Aachen, NRW, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stocklassa</LastName><ForeName>Stephanie</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rossaint</LastName><ForeName>Rolf</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Czaplik</LastName><ForeName>Michael</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0002-7118-7728</Identifier><AffiliationInfo><Affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Docs in Clouds GmbH, Aachen, NRW, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Follmann</LastName><ForeName>Andreas</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0001-6817-2472</Identifier><AffiliationInfo><Affiliation>Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, NRW, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>New Zealand</Country><MedlineTA>Clin Interv Aging</MedlineTA><NlmUniqueID>101273480</NlmUniqueID><ISSNLinking>1176-9092</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="Y">Coronavirus Infections</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058006" MajorTopicYN="N">General Practice</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N" Type="Geographic">Germany</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009735" MajorTopicYN="Y">Nursing Homes</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="Y">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019114" MajorTopicYN="N">Remote Consultation</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012984" MajorTopicYN="N">Software</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">ban on visitors</Keyword><Keyword MajorTopicYN="N">general practitioner care</Keyword><Keyword MajorTopicYN="N">nursing homes</Keyword><Keyword MajorTopicYN="N">teleconsultation</Keyword><Keyword MajorTopicYN="N">telemedicine</Keyword></KeywordList><CoiStatement>Marian Ohligs and Michael Czaplik are employed by Docs in Clouds GmbH (Aachen, Germany), providing telemedical services and consulting. Michael Czaplik and Rolf Rossaint report personal fees from and are shareholders of Docs in Clouds GmbH, Aachen, Germany. The authors report no other conflicts of interest in this work.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32884251</ArticleId><ArticleId IdType="doi">10.2147/CIA.S260098</ArticleId><ArticleId IdType="pii">260098</ArticleId><ArticleId IdType="pmc">PMC7443448</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Methods Inf Med. 2014;53(2):99-107</Citation><ArticleIdList><ArticleId IdType="pubmed">24477815</ArticleId></ArticleIdList></Reference><Reference><Citation>Int J Med Inform. 2001 May;61(2-3):167-73</Citation><ArticleIdList><ArticleId IdType="pubmed">11311671</ArticleId></ArticleIdList></Reference><Reference><Citation>J Telemed Telecare. 2002;8(2):102-6</Citation><ArticleIdList><ArticleId IdType="pubmed">11972945</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2010 Jun 10;362(23):2155-65</Citation><ArticleIdList><ArticleId IdType="pubmed">20558366</ArticleId></ArticleIdList></Reference><Reference><Citation>JMIR Res Protoc. 2016 Jul 18;5(3):e148</Citation><ArticleIdList><ArticleId IdType="pubmed">27430301</ArticleId></ArticleIdList></Reference><Reference><Citation>Eur J Epidemiol. 2012 Oct;27(10):791-7</Citation><ArticleIdList><ArticleId IdType="pubmed">22878939</ArticleId></ArticleIdList></Reference><Reference><Citation>Fam Pract. 2018 Mar 27;35(2):209-215</Citation><ArticleIdList><ArticleId IdType="pubmed">29029048</ArticleId></ArticleIdList></Reference><Reference><Citation>Br J Gen Pract. 2002 Dec;52(485):1004-6</Citation><ArticleIdList><ArticleId IdType="pubmed">12528588</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2011 Sep 29;365(13):1165-7</Citation><ArticleIdList><ArticleId IdType="pubmed">21991889</ArticleId></ArticleIdList></Reference><Reference><Citation>J Eval Clin Pract. 2016 Jun;22(3):378-86</Citation><ArticleIdList><ArticleId IdType="pubmed">26711152</ArticleId></ArticleIdList></Reference><Reference><Citation>J Telemed Telecare. 2002;8(1):11-8</Citation><ArticleIdList><ArticleId IdType="pubmed">11809079</ArticleId></ArticleIdList></Reference><Reference><Citation>Dtsch Arztebl Int. 2014 Mar 28;111(13):215-23</Citation><ArticleIdList><ArticleId IdType="pubmed">24739884</ArticleId></ArticleIdList></Reference><Reference><Citation>J Health Serv Res Policy. 1998 Oct;3(4):207-13</Citation><ArticleIdList><ArticleId IdType="pubmed">10187199</ArticleId></ArticleIdList></Reference><Reference><Citation>PLoS One. 2012;7(5):e36796</Citation><ArticleIdList><ArticleId IdType="pubmed">22629331</ArticleId></ArticleIdList></Reference><Reference><Citation>Dtsch Arztebl Int. 2011 Apr;108(15):255-61</Citation><ArticleIdList><ArticleId IdType="pubmed">21556263</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2017 Oct 12;377(15):1456-1466</Citation><ArticleIdList><ArticleId IdType="pubmed">29020579</ArticleId></ArticleIdList></Reference><Reference><Citation>J Med Internet Res. 2016 Dec 01;18(12):e314</Citation><ArticleIdList><ArticleId IdType="pubmed">27908843</ArticleId></ArticleIdList></Reference><Reference><Citation>Int J Med Inform. 2013 Aug;82(8):684-95</Citation><ArticleIdList><ArticleId IdType="pubmed">23746716</ArticleId></ArticleIdList></Reference><Reference><Citation>Gesundheitswesen. 2016 Mar;78(3):168-74</Citation><ArticleIdList><ArticleId IdType="pubmed">25918929</ArticleId></ArticleIdList></Reference><Reference><Citation>Fam Pract. 2017 Aug 1;34(4):430-436</Citation><ArticleIdList><ArticleId IdType="pubmed">28158576</ArticleId></ArticleIdList></Reference><Reference><Citation>Dtsch Arztebl Int. 2012 Mar;109(9):151-7</Citation><ArticleIdList><ArticleId IdType="pubmed">22461861</ArticleId></ArticleIdList></Reference><Reference><Citation>BMC Fam Pract. 2011 Oct 11;12:112</Citation><ArticleIdList><ArticleId IdType="pubmed">21988900</ArticleId></ArticleIdList></Reference><Reference><Citation>Telemed J E Health. 2018 Apr;24(4):268-276</Citation><ArticleIdList><ArticleId IdType="pubmed">28805545</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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