An Empirical Analysis of the Current Need for Teleneuromedical Care in German Hospitals without Neurology Departments

Abstract

Indroduction. At present, modern telemedicine methods are being introduced, that may contribute to reducing lack of qualified stroke patient care, particularly in less populated regions. With the help of video conferencing systems, a so-called neuromedical teleconsultation is carried out. Methods. The study included a multicentered, completely standardized survey of physicians in hospitals by means of a computerized on-line questionnaire. Descriptive statistical methods were used for data analysis. Results. 119 acute hospitals without neurology departments were included in the study. The most important reasons for participating in a teleneuromedical network is seen as the improvement in the quality of treatment (82%), the ability to avoid unnecessary patient transport (76%), easier and faster access to stroke expertise (72%) as well as better competitiveness among medical services (67%). The most significant problem areas are the financing system of teleneuromedicine with regard to the acquisition costs of the technical equipment (43%) and the compensation for the stroke-unit center with the specialists' consultation service (31%) as well as legal aspects of teleneuromedicine (27%). Conclusions. This investigation showed that there is a high acceptance for teleneuromedicine among co-operating hospitals. However these facilities have goals in addition to improved quality in stroke treatment. Therefore the use of teleneuromedicine must be also associated with long term incentives for the overall health care system, particularly since the implementation of a teleneuromedicine network system is time consuming and associated with high implementation costs.

Sustainable Community Health

“…European Union initiatives include implementation of telehealth such as the teleneuromedicine network for quicker access to neuromedical expertise in Germany, which networked comprehensive stroke unit centers and mostly was supported by the state system (Ickenstein et al, 2010). The federal Medicare Benefits Scheme (MBS) of the Department of Health of Australia includes a range of incentives to providers for delivering specialists telehealth services to Australians in remote, regional, and outer metropolitan areas, with higher reimbursements for videobased telehealth services, compared to face-to-face consultations (Bursell, Zang, Keech, & Jenkins, 2016).…”

“…It is a fast-emerging form of telehealth solutions for all types of healthcare needs (White, Thomas, Ezeanochie, and Bull 2016). mHealth or tele-video conference telehealth service delivery models have been implemented with efficacy around the globe (Campbell et al, 2017;Dorstyn, Mathias, & Denson, 2013;Ettinger, Pharaoh, Buckman, Conradie, & Karlen, 2016;Hall, Fottrell, Wilkinson, & Byass, 2014;Ickenstein et al, 2010;Zakus et al, 2019), although the benefits were not consistent [see Discussion Box 11.1]. One explanation for mixed research support outcomes could be from differences in infrastructure and health policy capabilities for mHealth in some countries limiting access to services and resources.…”

A Framework for Telestroke Network Design

“…In these networks, various pilot studies have demonstrated that valid decisions on thrombolytic therapy, the most important and time-critical therapy for the majority of acute stroke patients, and on a variety of further special interventions can be made accurately with the aid of telemedical expert support (Audebert et al, 2006;. Since telemedicine has proven to be a valid supplemental procedure in the treatment of acute stroke patients, primary care hospitals, especially in less populated regions, increasingly show interest in complementing their range of care by teleconsultations (Ickenstein et al, 2010). Those primary care hospitals may have totally different characteristics, some are e.g.…”