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CC BY-NC-ND 4.0 · Klin Padiatr 2024; 236(01): 16-23
DOI: 10.1055/a-2154-6659
Original Article

The Congenital Cardiology Cloud – optimizing long-term care by connecting ambulatory and hospital medical attendance via telemedicine

Eine Cloud für die Kinderkardiologie – Optimierung der Langzeitversorgung durch die Kopplung von ambulanter und klinischer Versorgung via Telemedizin
Kathrin Rottermann 
1   Department of Pediatric Cardiology, FAU, Erlangen, Germany
,
Ulrike Doll
1   Department of Pediatric Cardiology, FAU, Erlangen, Germany
,
Simon Pfenning
2   Department of Computer Science, Chair for Computer Architecture, FAU, Erlangen, Germany
,
Marc Reichenbach
2   Department of Computer Science, Chair for Computer Architecture, FAU, Erlangen, Germany
,
Dietmar Fey
2   Department of Computer Science, Chair for Computer Architecture, FAU, Erlangen, Germany
,
Alexander Dobler
3   Telepaxx Medical Data GmbH, Telepaxx, Buechenbach, Germany
,
Céline Siauw
4   Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
,
Fabian Reif
5   Practice for Pediatric Cardiology, Ambulatory Practice, Nuremberg, Germany
,
Julia Gnibl
6   Chair of Education with a Focus on Organizational Education, FAU, Erlangen, Germany
,
Robert Cesnjevar 
7   Department of Pediatric Heart Surgery, University of Zurich, Zurich, Switzerland
,
Sven Dittrich
1   Department of Pediatric Cardiology, FAU, Erlangen, Germany
› Author Affiliations Funding Information Bayern Innovativ — http://dx.doi.org/10.13039/100019627; PBN-MED-1609-0004
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Abstract

Background Patients with complex congenital heart disease frequently undergo a life-long ambulatory therapy with the need for repeated hospital interventions. To optimize this manifold interplay, we designed and implemented a tele-medical service, the Congenital Cardiology Cloud (CCC). This study aims to analyse the requirements for its implementation through the comprehensive assessment of design, installation and impact on patient´s care.

Methods CCC’s development comprised the analysis of historically raised admission and discharge management and the definition of technical and organizational requirements. Elaboration of procedural flow charts, description of data formats and technical processes as well as distribution of patient structure formed part of this process.

Results Analysis of existing workflows uncovered a need for the rebuilding of admission and discharge process and decision making for further treatment. The CCC reduces conference-meetings in general and repetitive meetings up to less than a third. Real-time dispatch of discharge documents guarantees an instantaneous access to patient-related data. Comparative analyses show a more complex patient group to be involved in tele-medical services.

Conclusions The CCC enables the sharing of complex clinical information by overcoming sectoral barriers and improves mutual patient advice. Implementation of a tele-medical network requires willingness, perseverance and professional engagement. Future application analysis and possible introduction of refinancing concepts will show its long-term feasibility.

Zusammenfassung

Hintergrund Patienten mit komplexen angeborenen Herzfehlern benötigen vielmals eine lebenslange ambulante Betreuung, gepaart mit wiederholten Klinikaufenthalten. Für eine Optimierung dieses vielschichtigen Zusammenspiels haben wir einen telemedizinischen Service konzipiert und eingeführt, die Congenital Cardiology Cloud (CCC). Diese Studie zielt darauf ab, die Voraussetzungen für die Implementierung durch die Einflussgrößen Entwicklung, Einrichtung und Impact auf die Patientenversorgung zu analysieren.

Methoden Die Entwicklung der CCC beinhaltete die Analyse von bestehendem Aufnahme- und Entlassmanagement sowie die Definition von technischen und organisatorischen Anforderungen. Die Erarbeitung von prozeduralen Ablaufprogrammen, die Beschreibung von Datenformaten und technischen Prozessen formten ebenso Teil dieses Prozesses wie die Verteilung der Patientenstruktur.

Ergebnisse Die Analyse bestehender Workflows ergab Bedarf für die Umstrukturierung des Aufnahme- und Entlassmanagements und der Entscheidungsprozesse in Bezug auf zukünftige Behandlungen. Die CCC reduziert die generelle Anzahl an Konferenztreffen sowie die Zahl erneuter Treffen auf weniger als ein Drittel. Der Versand von Entlassdokumenten in Echtzeit garantiert einen sofortigen Zugang zu patientenbezogenen Daten. Vergleichende Analysen zeigen eine komplexere Patientengruppe unter Beteiligung telemedizinischer Services.

Zusammenfassung Die CCC ermöglicht das Teilen komplexer klinischer Informationen durch das Überwinden von Sektorgrenzen und verbessert die gemeinsame Patientenversorgung. Die Implementierung eines telemedizinischen Netzwerks erfordert Einsatzbereitschaft, Durchhaltevermögen und professionelles Engagement. Zukünftige Anwendungsanalysen und die mögliche Einführung von Refinanzierungskonzepten werden die langfristige Realisierbarkeit zeigen.

Key words

telemedicine - telecardiology - congenital heart disease - cloud - data security - pediatric cardiology

Schlüsselwörter

Telemedizin - Telekardiologie - Angeborene Herzfehler - Cloud - Datenschutz - Kinderkardiologiepublished online 2023

Supplementary Material



Publication History

Article published online:
08 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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