Journal Article

DZNE-2020-01424

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Acute neurological care in north-east Germany with telemedicine support (ANNOTeM): protocol of a multi-center, controlled, open-label, two-arm intervention study

Weber, J. E. (Corresponding author) ; Angermaier, A. ; Bollweg, K. ; Erdur, H. ; Ernst, S. ; Flöel, A.DZNE* ; Gorski, C. ; Kandil, F. I. ; Kinze, S. ; Kleinsteuber, K. ; Kurth, T. ; Schmehl, I. ; Theen, S. ; Endres, M.DZNE* ; Audebert, H. J.

2020
BioMed Central London

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Please use a persistent id in citations: doi:10.1186/s12913-020-05576-w

Abstract: BackgroundBoth 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.MethodsA “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.DiscussionBeyond 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.

Keyword(s): Acute Disease (MeSH) ; Adult (MeSH) ; Critical Care: organization & administration (MeSH) ; Female (MeSH) ; Germany (MeSH) ; Health Services Research (MeSH) ; Hospitals, Rural: organization & administration (MeSH) ; Humans (MeSH) ; Male (MeSH) ; Nervous System Diseases: therapy (MeSH) ; Research Design (MeSH) ; Stroke: therapy (MeSH) ; Telemedicine: organization & administration (MeSH)

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Contributing Institute(s):

1. Biomarkers of Dementia in the General Population (AG Grabe)
2. Interdisciplinary Dementia Research (AG Endres)

Research Program(s):

1. 344 - Clinical and Health Care Research (POF3-344) (POF3-344)

Appears in the scientific report 2020

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