Optimized Acute Care for Geriatric Patients Using an Intersectoral Telemedical Cooperation Network - Around the Clock

Days spent at hospital

• Resuscitation during teleconsultation
• Unexpected death during teleconsultation
• Unexpected death within 24 hours after teleconsultation
• Unexpected hospitalisation within 24 hours of teleconsultation
• Unexpected death while wearing a biosensor (if available)

Days spent at nursing home

Number of medical contacts

Time to doctor contact

Admission to hospital in general and to specific diagnosis

Use of medical services

Number of ambulatory sensitive hospital cases

Cost effects via HCRU

Transport units used

Quality of life assessed using Quality of Life-Alzheimer's Disease (QoL-AD). The total score ranges from 13 to 52, with a higher number indicating better quality of life

Quality of life assessed using Veterans Rand 12 Item Health Survey (VR-12). The outcome includes a physical and mental health component score (PCS and MCS, respectively). Each component score (PCS and MCS) has a range of 0-100, with a higher score on the PCS and MCS indicating better outcome, or better physical or mental health-related quality of life, respectively.

Assessment procedures of daily living skills assessed via Barthel Index. Score of the Barthel Index ranging from 0 to 100 were collected when 0 is the minimum (worst outcome) and 100 is the maximum (best outcome).

Identification of people with dementia syndromes in inpatient care for the elderly using Dementia Screening Scale (DSS). Score of the DSS ranging from 0 to 14. When 0 is the minimum (no impairment) and 14 is the maximum (maximum impairment).

Number of double prescriptions (drug therapy safety)

Number of hospitalizations due to medication (drug therapy safety)

Number of adverse events due to medication (drug therapy safety)

Time-to-event concerning medication and hospitalization (drug therapy safety)

Need for additional staff in case of telemedical call

Amount of ambulance service calls

hospital referrals and use of primary care physicians and physicians of the GP emergency service before and after the implementation of telemedicine in nursing homes

Response times in doctor-patient contact before and after the implementation of telemedicine in nursing homes

• Number of most diagnosed diseases with correct/incorrect suspected diagnoses

• Concordance rate of suspected and confirmed diagnoses related to specific diseases

• Causes of inaccurate suspected diagnoses

Reasons for deviations (lack of knowledge, individual knowledge about patient, allergies, living will, local conditions/treatment resources, patient wishes)

• Number of operations

• Number of a new teleconsultation during or after a NÄPÄ (Z) operation

• Need for hospitalization

• Misadmissions

Number of deviations between initially defined catalogue of requirements and acutal requirements

• Point of time of the operations

• Duration of the operations

• Number of request by primary care physician, primary care emergency service, tele physician

Questionnaire about the acceptance of nursing home staff

• Number of false alarms

• Number of measurements with the spot-check monitor

• rate of accuracy in detecting a deterioration in health condition

• Rate of different parameters leading to an diagnosis

• frequency of diagnosis derived from the early warning system

Questionnaire or interview to survey acceptance by caregivers and residents

Questionnaire or interview to survey the usability

Incidence of parameters leading to alarm/decisive parameters

Incidence of correct recognition of deteriorating medical conditions

• tracer-diagnoses: fever, urinary-tract infection, pneumonia, cardiac decompensation, cardiac arrhythmia, reduced vigilance, hypertension, hypo-/hyperglycaemia, pain

Gender differences

Questionnaires to survey satisfaction about the intervention in the project

Interviews to survey satisfaction about the intervention in the project

Questionnaires to clarify whether the intervention is seen as ethically appropriate

Interviews to clarify whether the intervention is seen as ethically appropriate

Questionnaires to survey acceptance about the intervention in the project

Interviews to survey acceptance about the intervention in the project