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@ARTICLE{Weber:153427,
      author       = {Weber, J. E. and Angermaier, A. and Bollweg, K. and Erdur,
                      H. and Ernst, S. and Flöel, A. and Gorski, C. and Kandil,
                      F. I. and Kinze, S. and Kleinsteuber, K. and Kurth, T. and
                      Schmehl, I. and Theen, S. and Endres, M. and Audebert, H.
                      J.},
      title        = {{A}cute neurological care in north-east {G}ermany with
                      telemedicine support ({ANNOT}e{M}): protocol of a
                      multi-center, controlled, open-label, two-arm intervention
                      study},
      journal      = {BMC health services research},
      volume       = {20},
      number       = {1},
      issn         = {1472-6963},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DZNE-2020-01424},
      pages        = {755},
      year         = {2020},
      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.},
      keywords     = {Acute Disease / Adult / Critical Care: organization $\&$
                      administration / Female / Germany / Health Services Research
                      / Hospitals, Rural: organization $\&$ administration /
                      Humans / Male / Nervous System Diseases: therapy / Research
                      Design / Stroke: therapy / Telemedicine: organization $\&$
                      administration},
      cin          = {AG Grabe / AG Endres},
      ddc          = {610},
      cid          = {I:(DE-2719)5000001 / I:(DE-2719)1811005},
      pnm          = {344 - Clinical and Health Care Research (POF3-344)},
      pid          = {G:(DE-HGF)POF3-344},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32807159},
      pmc          = {pmc:PMC7430113},
      doi          = {10.1186/s12913-020-05576-w},
      url          = {https://pub.dzne.de/record/153427},
}