Improving cooperation between general practitioners and dermatologists via telemedicine: study protocol of the cluster-randomized controlled TeleDerm study

Koch, Roland; Polanc, Andreas; Haumann, Hannah; Kirtschig, Gudula; Martus, Peter; Thies, Christian; Sundmacher, Leonie; Gaa, Carmen; Witkamp, Leonard; Joos, Stefanie

doi:10.1186/s13063-018-2955-2

Cited by 16 publications

(17 citation statements)

References 25 publications

(35 reference statements)

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“…German data protection laws guarantee a high degree of data security for patients but leave little room for innovations. 21 Not only electronic systems can provide coordinated care but also a professional coordinator. Coordinated care has been shown to have positive effects.…”

Section: Discussionmentioning

confidence: 99%

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What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study

Bossert

Forstner

Villalobos³

et al. 2020

BMJ Open

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BackgroundPatients with lung cancer with comorbidity often require treatment and care by different health professionals, in different settings and at different points in time during the course of the disease. In order to organise and coordinate healthcare efficiently, effective information exchange and collaboration between all involved care providers are required. The aim of this study was to assess the views of patients with advanced lung cancer with comorbidity regarding coordination of treatment and care across healthcare sectors.MethodsThis qualitative study, as part of the main study, The Heidelberg Milestones Communication Approach, used face-to-face guide-based semistructured interviews with patients with advanced lung cancer and their informal caregivers to explore cross-sectoral information exchange and collaboration in Germany. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA.ResultsIn 15 interviews, participants reported that cross-sectoral collaboration functioned well, if treatments occurred as planned. However, treatment gaps were experienced, especially regarding medication and regimen. As a result, participants felt insecure and obliged to take responsibility for the coordination of healthcare. Patients reported to be in favour of an active patient role but felt that healthcare coordination should still be a responsibility of a care provider. A more intensive information exchange, potentially by using an electronic platform, was expected to strengthen cross-sectoral collaboration.ConclusionPatients with lung cancer are uncertain about their role in the coordination of treatment and care across healthcare sectors. Healthcare providers should be more aware of care recipients’ willingness of taking on a more active role in healthcare coordination.Trial registration numberDRKS00013469.

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Section: Discussionmentioning

confidence: 99%

“…German data protection laws guarantee a high degree of data security for patients but leave little room for innovations. 21 …”

Section: Discussionmentioning

confidence: 99%

What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study

Bossert

Forstner

Villalobos³

et al. 2020

BMJ Open

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“…One of the reasons for the difficulties in implementing telemedicine is the very restrictive data protection laws in Germany. These guarantee a high level of data security for patients but currently offer limited scope for innovation 26 . An additional challenge in implementing e-health across healthcare sectors is the interoperability of the currently existing data systems.…”

Section: Discussionmentioning

confidence: 99%

Lung cancer patients’ comorbidities and attendance of German ambulatory physicians in a 5-year cross-sectional study

Bossert

Ludwig

Wronski

et al. 2021

npj Prim. Care Respir. Med.

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The majority of lung cancer patients are diagnosed with an advanced stage IV, which has short survival time. Many lung cancer patients have comorbidities, which influence treatment and patients’ quality of life. The aim of the study is to describe comorbidities in incident lung cancer patients and explore their attendance of ambulatory care physicians in Germany. In the observed period, 13,111 persons were first diagnosed with lung cancer (1-year incidence of 36.4 per 100,000). The mean number of comorbidities over 4 quarters was 30.77 ± 13.18; mean Charlson Comorbidity Index was 6.66 ± 2.24. In Germany, ambulatory care physicians most attended were general practitioners (2.6 quarters with contact within 4 quarters). Lung cancer was diagnosed by a general practitioner in 38% of the 13,111 incident patients. The average number of ambulatory care physician contacts over 4 quarters was 35.82 ± 27.31. High numbers of comorbidities and contacts in ambulatory care are common in patients with lung cancer. Therefore, a cross-sectoral and interdisciplinary approach is required for effective, patient-centred care. This was a 5-year cross-sectoral study, based on the InGef research database, which covers anonymized health insurance data of 7.2 million individuals in Germany. Incident lung cancer patients in a 5-year period (2013–2017) were identified. Descriptive statistics were calculated for sociodemographic characteristics, comorbidities, and attendance of ambulatory care physicians.

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“…Dennoch konnte die Teledermatologie bisher nicht in ausreichendem Maße Einzug in den Versorgungsalltag halten [ 5 ], wofür es verschiedene Gründe gibt. Zum einen wurden wegen des in Deutschland als staatliches Organisationsprinzip geltenden Föderalismus die neuen Regelungen bezüglich der Telemedizin in den einzelnen Bundesländern zu unterschiedlichen Zeitpunkten ratifiziert.…”

Section: Diskussionunclassified

“…Obwohl die Telemedizin nicht neu ist, ist sie im medizinischen Versorgungsalltag in Deutschland nicht ausreichend etabliert [ 5 ]. Gerade die Dermatologie jedoch bietet auf Basis ihrer primär visuellen Ausrichtung ausgezeichnete Voraussetzungen, um die Möglichkeiten digitaler, multidisziplinärer und sektorenübergreifender Strukturen zu nutzen und auszubauen.…”

Section: Introductionunclassified

Digitalisierung in der Medizin während der COVID-19-Pandemie – Möglichkeiten und Grenzen der Teledermatologie

2020

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Bei Hautkrankheiten handelt es sich initial oft um Blickdiagnosen. Daher bieten sich dermatologische Fragestellungen für telemedizinische Konsultationen an. Die Ergebnisse zahlreicher internationaler Studien weisen darauf hin, dass die Teledermatologie sowohl von den Patienten als auch den Ärzten in zunehmendem Maße angenommen wird. Nach der Lockerung des Verbots der ausschließlichen Fernbehandlung durch den Ärztetag im Jahr 2018 können Ärzte ihre Patienten auch ohne vorherigen persönlichen Erstkontakt ausschließlich telefonisch oder per Internet behandeln. Durch die Zulassung und den Ausbau der telemedizinischen Tätigkeit in verschiedenen deutschen Bundesländern wurde und wird die Teledermatologie insbesondere während der COVID-19-Pandemie erfolgreich eingesetzt.

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Improving cooperation between general practitioners and dermatologists via telemedicine: study protocol of the cluster-randomized controlled TeleDerm study

Cited by 16 publications

References 25 publications

What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study

What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study

Lung cancer patients’ comorbidities and attendance of German ambulatory physicians in a 5-year cross-sectional study

Digitalisierung in der Medizin während der COVID-19-Pandemie – Möglichkeiten und Grenzen der Teledermatologie

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