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000153427 041__ $$aEnglish
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000153427 1001_ $$00000-0002-1666-6021$$aWeber, J. E.$$b0$$eCorresponding author
000153427 245__ $$aAcute neurological care in north-east Germany with telemedicine support (ANNOTeM): protocol of a multi-center, controlled, open-label, two-arm intervention study
000153427 260__ $$aLondon$$bBioMed Central$$c2020
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000153427 520__ $$aBackgroundBoth 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.
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000153427 650_2 $$2MeSH$$aAcute Disease
000153427 650_2 $$2MeSH$$aAdult
000153427 650_2 $$2MeSH$$aCritical Care: organization & administration
000153427 650_2 $$2MeSH$$aFemale
000153427 650_2 $$2MeSH$$aGermany
000153427 650_2 $$2MeSH$$aHealth Services Research
000153427 650_2 $$2MeSH$$aHospitals, Rural: organization & administration
000153427 650_2 $$2MeSH$$aHumans
000153427 650_2 $$2MeSH$$aMale
000153427 650_2 $$2MeSH$$aNervous System Diseases: therapy
000153427 650_2 $$2MeSH$$aResearch Design
000153427 650_2 $$2MeSH$$aStroke: therapy
000153427 650_2 $$2MeSH$$aTelemedicine: organization & administration
000153427 7001_ $$aAngermaier, A.$$b1
000153427 7001_ $$aBollweg, K.$$b2
000153427 7001_ $$aErdur, H.$$b3
000153427 7001_ $$aErnst, S.$$b4
000153427 7001_ $$0P:(DE-2719)2812683$$aFlöel, A.$$b5$$udzne
000153427 7001_ $$aGorski, C.$$b6
000153427 7001_ $$aKandil, F. I.$$b7
000153427 7001_ $$aKinze, S.$$b8
000153427 7001_ $$aKleinsteuber, K.$$b9
000153427 7001_ $$0P:(DE-HGF)0$$aKurth, T.$$b10
000153427 7001_ $$aSchmehl, I.$$b11
000153427 7001_ $$aTheen, S.$$b12
000153427 7001_ $$0P:(DE-2719)2811033$$aEndres, M.$$b13$$udzne
000153427 7001_ $$aAudebert, H. J.$$b14
000153427 773__ $$0PERI:(DE-600)2050434-2$$a10.1186/s12913-020-05576-w$$gVol. 20, no. 1, p. 755$$n1$$p755$$tBMC health services research$$v20$$x1472-6963$$y2020
000153427 8564_ $$uhttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05576-w
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