Institute of Family Medicine, University Medical Center Lübeck, Lübeck 23562, Schleswig-Holstein, Germany.
Regional Medical Support Command Kiel, Bundeswehr Medical Service, Kiel 24106, Schleswig-Holstein, Germany.
Mil Med. 2022 May 3;187(5-6):e726-e734. doi: 10.1093/milmed/usab080.
The history of the use of telemedicine in maritime medicine dates back to the 1930s. In the early 2000s, the German Navy built up a telemedicine network which today is installed in all ships and provides a connection to the medical infrastructure ashore. The objective of this study was to optimize the implementation of telemedicine based on the experience gained in the German Navy. For this purpose, qualitative and quantitative methods were used to identify determinants which affect the use of telemedicine in order to determine whether there is any need for optimization.
The study was conducted using a mixed methods design. First, guideline-based interviews were conducted with Navy medical officers who had been recruited via various email distribution lists. The interviews were then transcribed and coded. In an analysis, deductive and inductive categories were derived from the codes. Hypotheses were deduced from the interviews, too, and used to develop a questionnaire.Besides the medical officers, other Navy medical personnel with experience in the field of telemedicine took part in the survey. The study was concluded by a descriptive analysis of the quantitative data.
The analysis of the interviews revealed that a regular use of telemedicine workstations increased the users' confidence and, in their opinion, improved medical treatment. Technical and organizational problems posed obstacles, which increased the use of partly insecure alternatives. A proper technical support was regarded as a precondition for effectively using telemedicine.The results of the quantitative analysis showed that consultation was mainly sought for dermatological (46%), surgical (24%), and internal (22%) conditions.
The study revealed determinants for the use of telemedicine in the German Navy. Factors improving the motivation of the users should be strengthened in order to optimize the use of telemedicine. Furthermore, it can be assumed that a successful implementation will be supported by reducing or eliminating obstacles. The findings on the main reasons for seeking medical advice could be taken into account in the further planning of specific training.
远程医疗在航海医学中的应用历史可以追溯到 20 世纪 30 年代。在 21 世纪初，德国海军建立了一个远程医疗网络，该网络目前已安装在所有船只上，并与岸上的医疗基础设施建立了连接。本研究的目的是根据德国海军的经验优化远程医疗的实施。为此，使用定性和定量方法来确定影响远程医疗使用的决定因素，以确定是否需要进行优化。
本研究采用混合方法设计。首先，通过各种电子邮件分发列表招募了海军医务人员，并对他们进行了基于指南的访谈。访谈记录被转录并进行编码。在分析中，从代码中推导出演绎和归纳类别。访谈中还推导出了假设，并用于开发问卷。除了医务人员外，其他有远程医疗经验的海军医务人员也参与了调查。通过对定量数据的描述性分析来总结研究结果。
访谈分析表明，定期使用远程医疗工作站会增加用户的信心，并在他们看来，改善医疗服务。技术和组织问题构成了障碍，增加了使用部分不安全替代方案的情况。适当的技术支持被认为是有效使用远程医疗的前提条件。定量分析的结果表明，咨询主要是针对皮肤科（46%）、外科（24%）和内科（22%）的情况。
本研究揭示了德国海军使用远程医疗的决定因素。应加强激励用户的因素，以优化远程医疗的使用。此外，可以假设成功实施将通过减少或消除障碍得到支持。寻求医疗建议的主要原因的发现可以在进一步规划特定培训时考虑在内。
