Skip to main content

Advertisement

SpringerLink
Log in

Versorgungsforschung zu telemedizinischen Anwendungen

Health service research of telemedicine applications

  • Leitthema: Telemedizin
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Vor dem Hintergrund der zunehmenden, aber auch zögerlichen Einführung telematischer/telemedizinischer Medien in das Gesundheitswesen wurde eine deskriptive Analyse der Literatur (Review) zur Versorgungsforschung über ausgewählte diesbezügliche Anwendungen durchgeführt. Die Ergebnisse dieses Überblicks werden unter den Gesichtspunkten der Nutzungscharakteristika, der Prozess- und der Outcomeforschung an den Beispielen elektronischer Entscheidungssysteme, elektronischer Patientenakten (EPA) und elektronischer Verschreibungen (CPOE) referiert. Als Ergebnis zeigt sich, dass es sehr wenige empirische Versorgungsforschungsstudien zur Gesundheitstelematik gibt und dass nur ein kleiner Anteil der Ärzte, die z. B. elektronische Patientenakten eingeführt haben, komplexere Funktionen dieser Systeme nutzt. Derzeit gibt es kaum Evidenz dafür, dass die Implementation telematischer/telemedizinischer Systeme einen Einfluss auf Ergebniskriterien der Versorgung (z. B. Reduktion von Behandlungsfehlern) besitzt, mit Ausnahme einiger Studien zu elektronischen Entscheidungssystemen.

Abstract

The current descriptive review summarizes health service research in the area of telemedicine and health telematics with respect to the increasing, but slow implementation of health telematics in medical care. Findings of the review are summarized under three areas: the prevalence and use of three selected applications (computerized physician prescriptions, electronic health records, and electronic decision support). Findings of the review show that there is only very limited research on the impact of telemedicine on routine care in the selected study areas. In general, only a small percentage of physicians actively use the more comprehensive functions of electronic health records or electronic prescribing and there is almost no evidence showing a relationship between outcomes of health care and the implementation of electronic health records on a broad level despite some evidence concerning the impact of clinical decision support.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Schmidt S, Schuchert A, Oeff M (2009) Hat Telemonitoring wirklich einen Einfluss auf objektive Befunde und subjektives Befinden? (im Druck)

  2. Clark RA, et al. (2007) Telemonitoring or structured telephone support programmes for patients with chronic heart failure: systematic review and metaanalysis. BMJ 334:942–953

    Article  PubMed  Google Scholar 

  3. Chaudhry S, et al. (2007) Telemonitoring for patients with chronic heart failure: a systematic review. J Card Fail (35):56–62

  4. Schmidt S (2009) Health service research into telemonitoring, in European hospital care management. Campden Media (im Druck)

  5. Grigsby J, Brega AG, Devore PA (2005) The evaluation of telemedicine and health service research. Telemedicine e-health 11(3):317–328

    Article  Google Scholar 

  6. Hersh W (2006) Evidence report telemedicine. US Health Serv Agency

  7. Linder JA, Bates DW (2007) Electronic health record use and the quality of ambulatory care in the United States. Arch Intern Med 167(13):1400–1405

    Article  PubMed  Google Scholar 

  8. Chaudhry B, Wang J, Wu S, et al. (2006) Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med 144:742–752

    PubMed  Google Scholar 

  9. Hing ES, Burt CW, Woowwell DA (2006) Electronic medical record use by office-based physicians and their practices: United States, 2006. Advance data from vital and health statistics. 393:1–7

    Google Scholar 

  10. Hollingworth W, Devine E-B, et al. (2007) The impact of e-prescribing on prescriber and staff time in ambulatory care clinics: a time-motion study. J Am Med Inform Assoc 14:722–730

    Article  PubMed  Google Scholar 

  11. McInnes DK, Saltman DC, Kidd MR (2006) General practitioners' use of computers for prescribing and electronic health records: results from a national survey. Medical J Australia 185(2):88–91

    Google Scholar 

  12. Skrepnek GH, et al. (2006) Workload and availability of technology in metropolitan community pharmacies. J Am Pharmacists Assoc 46(2):154–160

    Article  Google Scholar 

  13. Barton PL, Brega AG, Devore P, et al. (2007) Specialist physicians' knowledge and beliefs about telemedicine: a comparison of users and nonusers of the technology. Telemedicine e-health 13(5):487–499

    Article  Google Scholar 

  14. Schmidt S (2005) Ak-Tel. Akzeptanz der Telematik in der medizinischen Versorgung der Freien und Hansestadt Hamburg. Gutachten und Projektbericht. http://www.hamburgergesundheit.de

  15. Schmidt S, Koch U (2003) Telemedizin aus medizinpsychologischer Perspektive – Der Einfluss von Telematikanwendungen auf die Arzt-Patienten-Beziehung. Z Med Psychol 12(3):105–118

    Google Scholar 

  16. Miller EA (2001) Telemedicine and doctor-patient communication: an analytical survey of the literature. Journal of Telemedicine and Telecare 7:1–17

    Article  PubMed  CAS  Google Scholar 

  17. Poissant L, Pereira J, et al. (2005) The impact of electronic health records on time efficiency of physicians and nurses: a systematic review. J Am Med Inform Assoc 12:505–516

    Article  PubMed  Google Scholar 

  18. Roukema J, et al. (2006) Paper versus computer: feasibility of an electronic medical record in general pediatrics. Pediatrics 117(1):15–21

    Article  PubMed  Google Scholar 

  19. Patel VL, Arocha JF, Diermeier M, et al. (2001) Cognitive psychological studies of representation and use of clinical practice guidelines. Int J Med Inform 10,63(3):147–167

    Article  Google Scholar 

  20. Mair F, Whitten P (2000) Systematic review of studies of patient satisfaction with telemedicine. Br Med J 320:1517–1520

    Article  CAS  Google Scholar 

  21. Hersh W, et al. (2001) Clinical outcomes resulting from telemedicine interventions: a systematic review. BMC Medical Informatics Decision Making 1(5) URL: http://www.biomedcentral.com/1472-6947/1/5 (Zugriff Januar 2009)

  22. Sood S, Mbarika V, Juggo S, et al. (2007) What is telemedicine? A collection of 104 peer-reviewed. Perspectives and theoretical underpinnings. Telemed J E Health 13(5):573–590

    Article  PubMed  Google Scholar 

  23. van Wyk JT, van Wijk MAM, Sturkenboom MCJM, et al. (2007) Electronic alerts versus on-demand decision support to improve dyslipidemia treatment: a cluster randomized controlled trial. Circulation 117:371–378

    Article  Google Scholar 

  24. Garg AX, Adhikari NK, McDonald H, et al. (2005) Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA 293:1223–1238

    Article  PubMed  CAS  Google Scholar 

  25. Garrido T, et al. (2005) Effect of electronic health records in ambulatory care: retrospective, serial, cross sectional study. BMJ 330:581–584

    Article  PubMed  Google Scholar 

  26. Schmidt S (2007) Telemedizin und Lebensqualität (Telemedicine and quality of life). Dtsch Med Wochenschr 132:442–447

    Article  PubMed  CAS  Google Scholar 

  27. Dehm J, Fischer WJ, et al. (2005) VDE-Thesen zum Anwendungsfeld TeleMonitoring. Arbeitskreis TeleMedizin/Disease Management der VDE Initiative MikroMedizin, Frankfurt/Main, S 47

  28. Delpierre C, et al. (2004) A systematic review of computer-based patient record systems and quality of care: more randomized clinical trials or a broader approach? Intern J Quality Health Care 16(5):407–416

    Article  Google Scholar 

  29. Ory MG, et al. (2002) The behavior change consortium setting the stage for a new century of health behavior-change research. Health Education Res

  30. Ventres W, Kooienga S, Vuckovic N, et al. (2006) Physicians, patients, and the electronic health record: an ethnographic analysis. Annals Family Med 4:124–131

    Article  Google Scholar 

  31. McGrath JM, Arar NH, Pugh AJ (2007) The influence of electronic medical record usage on nonverbal communiction in the medical interview. SAGE Publications 13(2):105–118

    Google Scholar 

  32. Schectman JM, et al. (2005) Determinants of physician use of an ambulatory prescription expert system. Intern J Medical Informatics 74(9):711–717

    Article  Google Scholar 

  33. Makela K, et al. (2005) Electronic patient record system and the general practitioner: an evaluation study. J Telemed Telecare 11(2):66–68

    Article  Google Scholar 

  34. Mitchell ES (2001) Systematic review of published articles on primary care computing 1980–1997. BMJ 322:279–282

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Silke Schmidt & A. Grimm

    Present address: ab 1.1.2009 Universität Greifswald, Greifswald, BRD

Authors and Affiliations

  1. Universitätsklinikum Hamburg-Eppendorf, Hamburg, BRD

    Silke Schmidt & A. Grimm

  2. Universitätsklinikum Hamburg-Eppendorf Arbeitsgruppe Telemedizin und Versorgungsforschung, Institut und Poliklinik für Medizinische Psychologie, S35, Martinistraße 52, 20246, Hamburg, BRD

    Silke Schmidt

  3. Heinz-Nixdorf-Professur Gesundheit und Prävention, Universität Greifswald, Institut für Psychologie, Robert-Blum-Straße 13, 17487, Greifswald, BRD

    Silke Schmidt

Authors
  1. Silke Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Grimm
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Silke Schmidt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schmidt, S., Grimm, A. Versorgungsforschung zu telemedizinischen Anwendungen. Bundesgesundheitsbl. 52, 270–278 (2009). https://doi.org/10.1007/s00103-009-0794-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00103-009-0794-8

Schlüsselwörter

Keywords

Search

Navigation