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Zöllner JP, Rosenow F, Schubert-Bast S, Roth C, Knake S, Eickhoff C, Scheuble P, Martin J, Bollensen E, Teepker M, Singer O, Schirmer S, Dietz A, Henn KH, Stolz E, Schüttler-Gahin K, Fischer M, Noda A, Mann C, Strzelczyk A. Consultation Requests and Satisfaction with a Telehealth Network for Epilepsy: Longitudinal Analysis of the Epilepsy Network Hessen Evaluation. Telemed J E Health 2024; 30:e2013-e2023. [PMID: 38683593 DOI: 10.1089/tmj.2023.0659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Background: Telemedicine improves access to specialized medical expertise, as required for paroxysmal disorders. The Epilepsy Network Hessen Evaluation (ENHE) is a pilot cross-sectoral teleconsultation network connecting primary neurologists and pediatricians with epilepsy centers in Hessen, a federal German state. Methods: We prospectively and longitudinally evaluated telehealthcare in the ENHE. Participating physicians rated each consultation for satisfaction and impact on further management. The survey was administered at each consultation and 3 months later. Results: We analyzed 129 consultations involving 114 adult and pediatric patients. Their mean age was 34 years (standard deviation: 26, range: 0.1-91 years), 48% were female, and 34% were children and adolescents. The most common consultation requests were co-evaluation of an electroencephalogram (electroencephalogram [EEG]; 76%) and therapeutic (33%) and differential diagnosis (24%) concerns. Physicians transmitted one paraclinical examination on average (range: 1-4), predominantly EEG (85%), followed by magnetic resonance imaging (17%) and written records (9%). Response rates were 72% for the initial and 67% for the follow-up survey. Across respondents, 99% (n = 92) were satisfied with the ENHE. Overall, 80% of the consultations contributed to the diagnosis, and 90% were considered helpful for treatment, influencing it in 71% of cases. Seizure frequency had decreased more often (96%) than increased (4%) at 3 months. The initial diagnosis was confirmed in 78% of patients. Discussion: In this pilot teleconsultation network for paroxysmal disorders, diagnostic and therapeutic advice was perceived as helpful. Clinical outcomes were largely positive, suggesting tele-epileptology is viable for paroxysmal (seizure) disorders.
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Affiliation(s)
- Johann Philipp Zöllner
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, University Hospital, Goethe University, Frankfurt am Main, Germany
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, University Hospital, Goethe University, Frankfurt am Main, Germany
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt am Main, Germany
| | - Susanne Schubert-Bast
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, University Hospital, Goethe University, Frankfurt am Main, Germany
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt am Main, Germany
- Department of Neuropediatrics, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Christian Roth
- Department of Neurology, DRK Kliniken Kassel, Kassel, Germany
- Department of Neurology, Gesundheit Nordhessen-Klinikum Kassel, Kassel, Germany
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Susanne Knake
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | | | - Pascal Scheuble
- Department of Pediatrics, St. Vincenz Krankenhaus, Limburg, Germany
| | | | - Edgar Bollensen
- Neurological Practice, Neurozentrum Eschwege, Eschwege, Germany
| | - Michael Teepker
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
- Neurological Practice, MVZ Hardtwaldklinik I, Bad Zwesten, Germany
| | | | - Svenja Schirmer
- Neuropediatric Practice, Sozialpädiatrisches Zentrum, Offenbach, Germany
| | - Andreas Dietz
- Department of Neurology, Hochtaunus-Kliniken, Bad Homburg, Germany
| | | | - Erwin Stolz
- Neurological Practice, Frankfurt am Main, Germany
| | | | - Michaela Fischer
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, University Hospital, Goethe University, Frankfurt am Main, Germany
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt am Main, Germany
| | - Anna Noda
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, University Hospital, Goethe University, Frankfurt am Main, Germany
- Medical Center for Adults with Disabilities (MZEB), Varisano Klinikum Frankfurt-Höchst, Frankfurt am Main, Germany
| | - Catrin Mann
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, University Hospital, Goethe University, Frankfurt am Main, Germany
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt am Main, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, University Hospital, Goethe University, Frankfurt am Main, Germany
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt am Main, Germany
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Stoumpos AI, Kitsios F, Talias MA. Digital Transformation in Healthcare: Technology Acceptance and Its Applications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3407. [PMID: 36834105 PMCID: PMC9963556 DOI: 10.3390/ijerph20043407] [Citation(s) in RCA: 46] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 05/27/2023]
Abstract
Technological innovation has become an integral aspect of our daily life, such as wearable and information technology, virtual reality and the Internet of Things which have contributed to transforming healthcare business and operations. Patients will now have a broader range and more mindful healthcare choices and experience a new era of healthcare with a patient-centric culture. Digital transformation determines personal and institutional health care. This paper aims to analyse the changes taking place in the field of healthcare due to digital transformation. For this purpose, a systematic bibliographic review is performed, utilising Scopus, Science Direct and PubMed databases from 2008 to 2021. Our methodology is based on the approach by Wester and Watson, which classify the related articles based on a concept-centric method and an ad hoc classification system which identify the categories used to describe areas of literature. The search was made during August 2022 and identified 5847 papers, of which 321 fulfilled the inclusion criteria for further process. Finally, by removing and adding additional studies, we ended with 287 articles grouped into five themes: information technology in health, the educational impact of e-health, the acceptance of e-health, telemedicine and security issues.
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Affiliation(s)
- Angelos I. Stoumpos
- Healthcare Management Postgraduate Program, Open University Cyprus, P.O. Box 12794, Nicosia 2252, Cyprus
| | - Fotis Kitsios
- Department of Applied Informatics, University of Macedonia, 156 Egnatia Street, GR54636 Thessaloniki, Greece
| | - Michael A. Talias
- Healthcare Management Postgraduate Program, Open University Cyprus, P.O. Box 12794, Nicosia 2252, Cyprus
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Zöllner JP, Noda AH, McCoy J, Schulz J, Tsalouchidou PE, Langenbruch L, Kovac S, Knake S, von Podewils F, Hamacher M, Mann C, Leyer AC, van Alphen N, Schubert-Bast S, Rosenow F, Strzelczyk A. Use of Health-Related Apps and Telehealth in Adults with Epilepsy in Germany: A Multicenter Cohort Study. Telemed J E Health 2022; 29:540-550. [PMID: 35984859 DOI: 10.1089/tmj.2022.0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Telehealth can improve the treatment of chronic disorders, such as epilepsy. Telehealth prevalence and use increased during the coronavirus disease 2019 (COVID-19) pandemic. However, familiarity with and use of telehealth and health-related mobile applications (apps) by persons with epilepsy remain unknown. Methods: We investigated telehealth use, demographics, and clinical variables within the multicenter Epi2020 cross-sectional study. Between October and December 2020, adults with epilepsy completed a validated questionnaire, including individual questions regarding knowledge and use of apps and telehealth. Results: Of 476 included individuals (58.2% women; mean age 40.2 ± 15.4 years), 41.6% reported using health-related apps. Health apps were used more frequently (pedometer 32.1%, exercise app 17.6%) than medical apps (health insurance 15.1%, menstrual apps 12.2%) or apps designed for epilepsy (medication reminders 10.3%, seizure calendars 4.6%). Few used seizure detectors (i.e., apps as medical devices 1.9%) or mobile health devices (fitness bracelet 11.3%). A majority (60.9%) had heard the term telehealth, 78.6% of whom had a positive view. However, only 28.6% had a concrete idea of telehealth, and only 16.6% reported personal experience with telehealth. A majority (55%) would attend a teleconsultation follow-up, and 41.2% would in a medical emergency. Data privacy and availability were considered equally important by 50.8%, 21.8% considered data privacy more important, and 20.2% considered data availability more important. Current health-related app use was independently associated with younger age (p = 0.003), higher education (p < 0.001), and subjective COVID-19-related challenges (p = 0.002). Persistent seizure occurrence (vs. seizure freedom ≥12 months) did not affect willingness to use teleconsultations on multivariable logistic regression analysis. Conclusions: Despite positive telehealth views, few persons with epilepsy in Germany are familiar with specific apps or services. Socioeconomic factors influence telehealth use more than baseline epilepsy characteristics. Telehealth education and services should target socioeconomically disadvantaged individuals to reduce the digital care gap. German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).
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Affiliation(s)
- Johann Philipp Zöllner
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany
| | - Anna H Noda
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany
| | - Jeannie McCoy
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany
| | - Juliane Schulz
- Department of Neurology, University Hospital Greifswald, Greifswald, Germany
| | - Panagiota-Eleni Tsalouchidou
- Epilepsy Center Hessen, Department of Neurology, University Hospital Marburg-Philipps-University, Marburg (Lahn), Germany
| | - Lisa Langenbruch
- Epilepsy Center Münster-Osnabrück, Department of Neurology with Institute of Translational Neurology, University Hospital Münster-Westfälische Wilhelms-University, Münster, Germany.,Department of Neurology, Osnabrück Hospital, Osnabrück, Germany
| | - Stjepana Kovac
- Epilepsy Center Münster-Osnabrück, Department of Neurology with Institute of Translational Neurology, University Hospital Münster-Westfälische Wilhelms-University, Münster, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Department of Neurology, University Hospital Marburg-Philipps-University, Marburg (Lahn), Germany
| | - Felix von Podewils
- Department of Neurology, University Hospital Greifswald, Greifswald, Germany
| | - Mario Hamacher
- Department of Neurology, University Hospital Greifswald, Greifswald, Germany
| | - Catrin Mann
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany
| | - Anne-Christine Leyer
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany.,Department of Pediatrics and Neuropediatrics, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany
| | - Natascha van Alphen
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany
| | - Susanne Schubert-Bast
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany.,Department of Pediatrics and Neuropediatrics, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany
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Harder JL, Linden P, Jahn L, Aslan M, Schmücker V. [Cross-regional telemedicine services as a supplement to rural primary care: a mixed-methods analysis]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 169:67-74. [PMID: 35183473 DOI: 10.1016/j.zefq.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Family doctor care in rural areas is facing upheaval. On the one hand, demographic change is increasing patient demand, but on the other hand, it is also reducing physician density. In this context, telemedicine opens up new potentials for care. This study explores the possibilities of digitalization in family care with diverse stakeholders. The most important element of this work is to explore the attitudes towards telemedical supplementary options in primary care. In doing so, the chances and concerns of both general practitioners and citizens will be analyzed. The aim is to find out possibilities which can relieve GPs and support the health care provision in rural regions in the long term. METHODOLOGY AND MATERIAL A mixed-methods design combines findings from qualitative semi-structured guided interviews with general practitioners (N=8) with a quantitative citizen survey (N=1,276) in a rural region. RESULTS Concern about future health care provision is high among physicians and citizens. Although physicians see a need for action and opportunities through telemedicine measures, they also raise clear concerns about the doctor-patient relationship. The citizens are principally open to various telemedical options and can imagine using simple services such as e-prescription and e-appointment booking. DISCUSSION These results can serve as a basis for the further development of digital offerings of family doctors' offices as well as other model projects in rural regions, if they guarantee low-threshold access, are implemented in cooperation with doctors and patients and do not endanger the established doctor-patient relationship. CONCLUSION There are major concerns about the future of family physician care, especially in rural areas. The COVID-19 pandemic opens up opportunities for digitization across age boundaries. Initially, however, telemedicine care can only have a supplementary role. Low-threshold offerings in close cooperation with the family doctor are particularly promising here.
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Affiliation(s)
- Jamie Lee Harder
- Seminar für Sozialwissenschaften, Universität Siegen, Siegen, Deutschland.
| | - Philipp Linden
- Seminar für Sozialwissenschaften, Universität Siegen, Siegen, Deutschland
| | - Leonie Jahn
- Seminar für Sozialwissenschaften, Universität Siegen, Siegen, Deutschland
| | - Meryem Aslan
- Lebenswissenschaftliche Fakultät, Universität Siegen, Siegen, Deutschland
| | - Vanessa Schmücker
- Lebenswissenschaftliche Fakultät, Universität Siegen, Siegen, Deutschland
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Tao D, Zhong T, Wang J. The Influence of Telemedicine and Compassionate Care on the Quality of Life and Mental Health of Patients with Epilepsy in Northeastern China During the COVID-19 Crisis. J Multidiscip Healthc 2021; 14:3359-3368. [PMID: 34887665 PMCID: PMC8653707 DOI: 10.2147/jmdh.s335240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose To understand the influence of telemedicine and compassionate care on the quality of life and mental health of patients with epilepsy (PWE) in northeastern China during the COVID-19 crisis. Patients and Methods Physicians in the epilepsy department conducted a questionnaire survey on PWE on February 2020. The Quality Of Life In Epilepsy-31 (QOLIE-31), Generalized Anxiety Disorder 7-Item Scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used. The intervention (IG) group received compassionate care and follow-up through telemedicine equipment every week, while the nonintervention (NIG) group did not receive. The questionnaire survey was conducted again three month later. Results Ninety patients were recruited: mean age 39.91±15.57 in the IG, 37.39±11.69 in the NIG, 46 (51.1%) were men. Twenty patients had difficulty in purchasing antiepileptic drugs (AEDs). Seven patients reported seizure in the last 1 month. Only 1 patient (2.2%) consulted the emergency department. Up to 84 patients’ lives were affected. Fifteen (33.3%) of the IG and 20 (44.4%) of the NIG patients stated that their family income had decreased, and among them, 13 (28.9%) in the IG group and 10 (22.2%) in the NIG group stated that they were unemployed. 3 months later, the interaction between groups and time of QOLIE-31 was significant, F (1, 88) = 16.996, p<0.001; the interaction between group and time on the PHQ-9 was significant, F (1, 88)= 14.992, p<0.001; the interaction between group and time on the QAD-7 was significant, F (1, 88)= 6.026, p<0.001. Conclusion Our study found that during the COVID-19 outbreak, when patients were in a lockdown, telemedicine and compassionate care were effective and successful in managing PWE in northeastern China. It is a valid method to decrease anxiety and depression and improve the patients’ quality of life. Further research is necessary about compassionate care methods for PWE.
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Affiliation(s)
- Deshuang Tao
- Epilepsy Department of Jiamusi Central Hospital, Jiamusi City, Heilongjiang Province, 154002, People's Republic of China.,Jiamusi University, Jiamusi City, Heilongjiang Province, 154007, People's Republic of China
| | - Tangwu Zhong
- Jiamusi University, Jiamusi City, Heilongjiang Province, 154007, People's Republic of China
| | - Juli Wang
- Epilepsy Department of Jiamusi Central Hospital, Jiamusi City, Heilongjiang Province, 154002, People's Republic of China
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