Current State of Interoperability in German Practice Management Systems: Insights from the TeleDerm Project

Bertram, Oliver; Dorflinger, Sven; Clin, Lucien; Polanc, Andreas; Koch, Roland; Joos, Stefanie; Thies, Christian

doi:10.1109/cbms.2018.00045

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…18,19 Most of the Patient Data Management Systems (PDMS) in Germanys GP practices lack the support of modern health data exchange standards. 20 In 2017, the professional code of conduct for physicians (MBO-Ä) and the professional legislation were changed to open a way for the implementation of telemedical care services in Germany, roughly 20 years later than other European countries. 21,22 The primary objective of this cluster randomized controlled trial was to evaluate whether referrals to dermatologists could be reduced by implementing a store-andforward teleconsultation (TC) system in GP practices.…”

Section: Introductionmentioning

confidence: 99%

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TELEDerm: Implementing store-and-forward teledermatology consultations in general practice: Results of a cluster randomized trial

Koch,

Rösel,

Polanc

et al. 2022

J Telemed Telecare

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Background Although teledermatology has been proven internationally to be an effective and safe addition to the care of patients in primary care, there are few pilot projects implementing teledermatology in routine outpatient care in Germany. The aim of this cluster randomized controlled trial was to evaluate whether referrals to dermatologists are reduced by implementing a store-and-forward teleconsultation system in general practitioner practices. Methods Eight counties were cluster randomized to the intervention and control conditions. During the 1-year intervention period between July 2018 and June 2019, 46 general practitioner practices in the 4 intervention counties implemented a store-and-forward teledermatology system with Patient Data Management System interoperability. It allowed practice teams to initiate teleconsultations for patients with dermatologic complaints. In the four control counties, treatment as usual was performed. As primary outcome, number of referrals was calculated from routine health care data. Poisson regression was used to compare referral rates between the intervention practices and 342 control practices. Results The primary analysis revealed no significant difference in referral rates (relative risk = 1.02; 95% confidence interval = 0.911–1.141; p = .74). Secondary analyses accounting for sociodemographic and practice characteristics but omitting county pairing resulted in significant differences of referral rates between intervention practices and control practices. Matched county pair, general practitioner age, patient age, and patient sex distribution in the practices were significantly related to referral rates. Conclusions While a store-and-forward teleconsultation system was successfully implemented in the German primary health care setting, the intervention's effect was superimposed by regional factors. Such regional factors should be considered in future teledermatology research.

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Section: Introductionmentioning

confidence: 99%

“…18,19 Most of the Patient Data Management Systems (PDMS) in Germanys GP practices lack the support of modern health data exchange standards. 20…”

Section: Introductionmentioning

confidence: 99%

TELEDerm: Implementing store-and-forward teledermatology consultations in general practice: Results of a cluster randomized trial

Koch,

Rösel,

Polanc

et al. 2022

J Telemed Telecare

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Requirements analysis for an AI-based clinical decision support system for general practitioners: a user-centered design process

Schütze,

Holtz,

Neff

et al. 2023

BMC Med Inform Decis Mak

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Background As the first point of contact for patients with health issues, general practitioners (GPs) are frequently confronted with patients presenting with non-specific symptoms of unclear origin. This can result in delayed, prolonged or false diagnoses. To accelerate and improve the diagnosis of diseases, clinical decision support systems would appear to be an appropriate tool. The objective of the project ‘Smart physician portal for patients with unclear disease’ (SATURN) is to employ a user-centered design process based on the requirements analysis presented in this paper to develop an artificial Intelligence (AI)-based diagnosis support system that specifically addresses the needs of German GPs. Methods Requirements analysis for a GP-specific diagnosis support system was conducted in an iterative process with five GPs. First, interviews were conducted to analyze current workflows and the use of digital applications in cases of diagnostic uncertainty (as-is situation). Second, we focused on collecting and prioritizing tasks to be performed by an ideal smart physician portal (to-be situation) in a workshop. We then developed a task model with corresponding user requirements. Results Numerous GP-specific user requirements were identified concerning the tasks and subtasks: performing data entry (open system, enter patient data), reviewing results (receiving and evaluating results), discussing results (with patients and colleagues), scheduling further diagnostic procedures, referring to specialists (select, contact, make appointments), and case closure. Suggested features particularly concerned the process of screening and assessing results: e.g., the system should focus more on atypical patterns of common diseases than on rare diseases only, display probabilities of differential diagnoses, ensure sources and results are transparent, and mark diagnoses that have already been ruled out. Moreover, establishing a means of using the platform to communicate with colleagues and transferring patient data directly from electronic patient records to the system was strongly recommended. Conclusions Essential user requirements to be considered in the development and design of a diagnosis system for primary care could be derived from the analysis. They form the basis for mockup-development and system engineering.

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Current State of Interoperability in German Practice Management Systems: Insights from the TeleDerm Project

Cited by 2 publications

References 5 publications

TELEDerm: Implementing store-and-forward teledermatology consultations in general practice: Results of a cluster randomized trial

TELEDerm: Implementing store-and-forward teledermatology consultations in general practice: Results of a cluster randomized trial

Requirements analysis for an AI-based clinical decision support system for general practitioners: a user-centered design process

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