Digitale Transformation von Dienstleistungen im Gesundheitswesen I

Pfannstiel, Mario A.; Krammer, Sandra; Swoboda, Walter

doi:10.1007/978-3-658-12258-4

Cited by 1 publication

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“…While the basic technical requirements for telemedicine have been in place for years [10], most people today also have their own computer or smartphone with video conferencing capability [10]. This feasibility study explores how video consultation can be designed and implemented in the context of history taking and physical examination in knee joint complaints.…”

Section: Introductionmentioning

confidence: 99%

“…Ein höheres Alter verlängerte die Dauer der Videountersuchung (p = 0,032; r = 0,47). Im Mittel wurden 9,32 (± 0,4) von 10 Bisherige telemedizinische Einsatzgebiete lagen vor allem im Bereich der radiologischen Befundung, der Nachsorge und des Monitorings psychiatrischer und internistischer Erkrankungen sowie geriatrischer Patientenbetreuung [3 -8]. Auch in ländlichen Gebieten, z.…”

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“…Während grundlegende technische Voraussetzungen zur Durchführung der Telemedizin bereits seit vielen Jahren bestehen [10], besitzen die meisten Menschen heutzutage zudem einen eigenen Computer oder ein Smartphone, das videotelefoniefähig ist [10]. Wie sich der Einsatz einer Videosprechstunde in der speziellen Anwendung für die Anamnese und Untersuchung bei Beschwerden des Kniegelenks konzipieren und umsetzen lässt, soll im Rahmen dieser Machbarkeitsstudie erarbeitet werden.…”

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A Feasibility Pilot Study on the Use of Telemedicine for the Examination of the Knee Joint

Sebastian¹,

Kehrer²,

Jaenisch³

et al. 2020

Z Orthop Unfall

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Background In times of a pandemic threat, such as COVID-19, and the need for reduced direct doctor-patient contact, internet-based telemedicine has attracted more and more attention as a surrogate service. Suspending the diagnosis and treatment of non-virus related diseases for longer periods of time is not a viable option since this would only exacerbate problems on the patient and national level. The need for alternative treatment modalities increased rather quickly. So far, telemedical applications have mainly focused on teleradiological diagnosis, follow-up and monitoring of psychiatric and internal diseases, as well as geriatric patient care. As far as these authors are aware, orthopaedic physical examination of the knee joint, including trauma work-up, has not been the subject of any studies to date. This feasibility study explores how video consultation can be designed and implemented in the context of history taking and physical examination in knee joint complaints. Material and Method 21 patient actors (PA) with simulated complaints of the knee joint were examined individually for each diagnosis, first via video consultation and then directly by a specialist (SP). One PA group has a medical background, the other was made up of laypersons. The time was measured for both types of consultation. The physician documented the detected symptoms, the quality of implementation of the self-examination steps, and the derived diagnosis on an assessment form. After completion of both consultation sessions, the PAs were handed a questionnaire on the respective examination modality. Results With the video consultation the examination lasted 8.63 (± 2.5) minutes on average and with the regular consultation in person 5.63 (± 1.7) minutes (p < 0.001). For the group with medical background the examination lasted 7.67 (± 1.4) minutes on average, while for the lay group the video consultation took 9.7 (± 3.1) minutes (p = 0.049). With increased age, the video consultation was prolonged (p = 0.032; r = 0.47). The mean value for self-examination of leg axis, gait pattern and degrees of freedom was 9.32 (± 0.4) of 10 points. The following functional tests resulted in lower mean values (points): Payr 7.2 (± 2.3), Merke 5.9 (± 2.8), no-touch Lachmann 6.4 (± 2.7), gravity sign-recurvatum 6.7 (± 2.4). The mean grade by the PAs for the feasibility of self-examination was 2.43 (± 0.98) out of 5 points. Conclusion The video consultation for musculoskeletal complaints of the knee joint allows exploratory remote examination and helps to minimise the number of patients in hospitals and practices. It takes longer for the physician to perform and does not permit functional testing for ligament injuries of the knee joint. In its present form, telemedical examination is not able to fully replace personal consultation.

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Section: Introductionmentioning

confidence: 99%

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