Koch Roland, Polanc Andreas, Haumann Hannah, Kirtschig Gudula, Martus Peter, Thies Christian, Sundmacher Leonie, Gaa Carmen, Witkamp Leonard, Joos Stefanie
University Hospital Tübingen, Institute for General Practice and Interprofessional Care, Osianderstraße 5, 72076, Tübingen, Germany.
AOK Baden-Württemberg Hauptverwaltung, Fachbereich Integriertes Leistungsmanagement, Presselstraße 19, 70191, Stuttgart, Germany.
Trials. 2018 Oct 24;19(1):583. doi: 10.1186/s13063-018-2955-2.
Internationally, teledermatology has proven to be a viable alternative to conventional physical referrals. Travel cost and referral times are reduced while patient safety is preserved. Especially patients from rural areas benefit from this healthcare innovation. Despite these established facts and positive experiences from EU neighboring countries like the Netherlands or the United Kingdom, Germany has not yet implemented store-and-forward teledermatology in routine care.
The TeleDerm study will implement and evaluate store-and-forward teledermatology in 50 general practitioner (GP) practices as an alternative to conventional referrals. TeleDerm aims to confirm that the possibility of store-and-forward teledermatology in GP practices is going to lead to a 15% (n = 260) reduction in referrals in the intervention arm. The study uses a cluster-randomized controlled trial design. Randomization is planned for the cluster "county". The main observational unit is the GP practice. Poisson distribution of referrals is assumed. The evaluation of secondary outcomes like acceptance, enablers and barriers uses a mixed-methods design with questionnaires and interviews.
Due to the heterogeneity of GP practice organization, patient management software, information technology service providers, GP personal technical affinity and training, we expect several challenges in implementing teledermatology in German GP routine care. Therefore, we plan to recruit 30% more GPs than required by the power calculation. The implementation design and accompanying evaluation is expected to deliver vital insights into the specifics of implementing telemedicine in German routine care.
German Clinical Trials Register, DRKS00012944 . Registered prospectively on 31 August 2017.
在国际上，远程皮肤病学已被证明是传统现场转诊的一种可行替代方案。它降低了差旅费和转诊时间，同时保障了患者安全。特别是农村地区的患者受益于这一医疗创新。尽管有这些既定事实以及来自荷兰或英国等欧盟邻国的积极经验，但德国尚未在常规医疗中实施存储转发式远程皮肤病学。
TeleDerm研究将在50家全科医生（GP）诊所实施并评估存储转发式远程皮肤病学，作为传统转诊的替代方案。TeleDerm旨在确认在全科医生诊所开展存储转发式远程皮肤病学的可能性将使干预组的转诊减少15%（n = 260）。该研究采用整群随机对照试验设计。计划按“县”进行整群随机分组。主要观察单位是全科医生诊所。假设转诊呈泊松分布。对接受度、促进因素和障碍等次要结果的评估采用问卷调查和访谈相结合的混合方法设计。
由于全科医生诊所组织、患者管理软件、信息技术服务提供商、全科医生个人技术亲和力和培训的异质性，我们预计在德国全科医生常规医疗中实施远程皮肤病学将面临若干挑战。因此，我们计划招募比功效计算所需多30%的全科医生。实施设计及配套评估预计将为德国常规医疗中实施远程医疗的具体情况提供重要见解。
德国临床试验注册中心，DRKS00012944。于2017年8月31日前瞻性注册。
