Brandt Jenny, Albert Michael, Gramminger Steffen, Greim Clemens A, Khaladj Nawid, Kolb Cornelia, Risch Ben Michael, Sander Michael, von Wagner Michael, Zacharowski Kai, Muellenbach Ralf M, Hoffmann Felix
Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland.
Awesome Technologies Innovationslabor GmbH, Würzburg, Deutschland.
Anaesthesiologie. 2023 May;72(5):317-324. doi: 10.1007/s00101-023-01269-1. Epub 2023 Mar 17.
The SARS-CoV‑2 pandemic posed unexpected challenges for hospitals worldwide and in addition to the supply emergency, simultaneously caused a high pressure to innovate. Due to the high number of cases of COVID-19 patients requiring intensive care, structured networking of hospitals gained particular importance. The tele-ICU communication platform TeleCOVID was developed to improve the quality of intensive care both by enabling teleconsultations and by supporting patient transfers.
The present study aimed to survey user experiences with TeleCOVID. The study investigated the extent to which the app is used, the user experiences of the participating hospitals, and the resulting implications for the further development of the telemedicine application.
A user survey was conducted in May 2022 using an online questionnaire. The survey contained both closed and open questions with a free text field. It was sent via the Hessian Ministry of Social Affairs and Integration (HMSI). All 135 hospitals in Hesse were contacted by e‑mail and invited to participate in the study. The results of the closed questions were analyzed using descriptive statistics, and the results of the open questions were clustered and thematically summarized using qualitative content analysis.
The study showed that TeleCOVID was used primarily for transfer requests, followed by the need for a treatment consultation without a transfer request. Most often, ECMO treatment or treatment in a hospital of a higher care level was required. The content analysis showed that users particularly rated the possibility of a data protection-compliant and structured transfer of patient data as advantageous. It is also worth mentioning that in almost 25% of the cases a transfer of patients could be prevented by TeleCOVID. Disadvantages frequently mentioned by respondents were the lack of connection to the electronic hospital information system, the increased time required for the registration process, and the poor primary accessibility of contact persons.
In a further development of the application the connection to the electronic hospital information system should be considered particularly urgent. In addition, the time expenditure should be reduced by a simplified login process. Due to interface barriers, an alternative data infrastructure would also be conceivable to create interoperability. The introduction of a web client could also increase usability. The main beneficiaries of hospital networking are physicians and patients in a context associated with a high workload and specific medical issues. Continuation and expansion of the app to intensive care medicine and beyond are therefore recommended. In further studies on the project, personal interviews with decision makers could be useful to conduct a more targeted needs analysis.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行给全球医院带来了意想不到的挑战，除了供应紧急情况外，同时还造成了巨大的创新压力。由于需要重症监护的2019冠状病毒病（COVID-19）患者数量众多，医院的结构化网络变得尤为重要。为了通过开展远程会诊和支持患者转运来提高重症监护质量，开发了远程重症监护病房（tele-ICU）通信平台TeleCOVID。
本研究旨在调查TeleCOVID的用户体验。该研究调查了该应用程序的使用程度、参与医院的用户体验，以及对远程医疗应用程序进一步开发的影响。
2022年5月使用在线问卷进行了用户调查。该调查包含封闭式和开放式问题以及一个自由文本字段。它是通过黑森州社会事务与融合部（HMSI）发送的。通过电子邮件联系了黑森州的所有135家医院，并邀请它们参与该研究。使用描述性统计分析封闭式问题的结果，使用定性内容分析对开放式问题的结果进行聚类和主题总结。
研究表明，TeleCOVID主要用于转运请求，其次是在无转运请求情况下的治疗咨询需求。最常需要的是体外膜肺氧合（ECMO）治疗或在更高护理水平的医院进行治疗。内容分析表明，用户特别认为符合数据保护要求且结构化的患者数据传输可能性具有优势。还值得一提的是，在近25%的病例中，TeleCOVID可以避免患者的转运。受访者经常提到的缺点包括与电子医院信息系统缺乏连接、注册过程所需时间增加以及联系人的初次可及性差。
在该应用程序的进一步开发中，应特别迫切地考虑与电子医院信息系统的连接。此外，应通过简化登录过程来减少时间消耗。由于接口障碍，也可以设想建立一个替代数据基础设施以实现互操作性。引入网络客户端也可以提高可用性。医院网络的主要受益者是处于高工作量和特定医疗问题背景下的医生和患者。因此，建议将该应用程序继续并扩展到重症监护医学及其他领域。在该项目的进一步研究中，与决策者进行个人访谈可能有助于进行更有针对性的需求分析。
