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Telemedical, Intersectoral Network as New Digital Health Structure to Measurably Improve the Local Health Care (TELnet@NRW)

1 czerwca 2020 zaktualizowane przez: RWTH Aachen University
Telemedicine allows providing expert know-ledge from specialized health centers to regional hospitals and practices. In this multicenter, prospective, non-interventional study hospitals and practices in NRW are supplied via a telematics platform with expertise from the university hospitals RWTH Aachen and Münster. The communication occurs via highly encrypted audio/video conference systems and a certified data exchange platform "Fallakte+". In total 40.000 outpatient and stationary patients with infectious diseases or need for intensive care should be treated with telemedical support. The participating hospitals and practices are randomly distributed into four clusters. The clusters are supplied with telemedicine at different time points but all clusters start at the same time collecting data from patient cohorts of infectiology and intensive care (e.g. symptom, therapeutic progress and outcome). The collected data is later compared to data obtained in the same way from patients treated with telemedical support and evaluated regarding differences in the quality of treatment, therapeutic process and the satisfaction of the patients with telemedicine. The aim is to improve the treatment quality in regional hospitals and practices of patients with serious and complex diseases and bring forward the application of telemedicine.

Przegląd badań

Status

Zakończony

Interwencja / Leczenie

Szczegółowy opis

In future time the number of old people will significantly increase in Germany because of the demographic change taking place. The health care of the large number of old people will probably lead to a lack of physicians and an inefficient health care system. One strategy to tackle the problem could be telemedicine. Telemedicine makes it possible to provide know-ledge from experts to local hospitals and practices which otherwise need to send patients with serious and complex diseases to specialized trans-regional health centers. In this multicenter, prospective, non-interventional study hospitals and practices in NRW are supplied via a telematics platform with expert know-ledge from the university hospitals RWTH Aachen and Münster. The communication occurs via highly encrypted audio/video conference systems and a certified data exchange platform "Fallakte+".

In total 40.000 outpatient and stationary patients should be treated with telemedical support. Registered doctors will be involved in already existing practice networks to evaluate the potential for transfer and to ensure the sharing of know-ledge beyond the borders of individual sectors. The aim of the study is to improve the treatment quality of regional hospitals and practices and to increase the efficiency of the care of relevant patient cohort in the field of infectiology and intensive care with the main focus sepsis as those patient groups especially often require professional expertise for a successful therapy.

In the beginning of the study participating hospitals and practices are randomly distributed into four clusters (cluster randomization). The different clusters all start with the control phase but enter into the intervention phase at different times (stepped-wedge design). During the control phase data of patients with infection and intensive care patients routinely treated without the support of telemedicine are documented and the patients are asked to complete a questionnaire regarding health-related quality of life (SF36) directly after treatment and at two time points in the follow-up. The collected data will be later compared to data obtained in the same way from patients treated with telemedical support and evaluated regarding differences in the quality of treatment, therapeutic process and the satisfaction of the patients with telemedicine.

If the study shows that the treatment quality and therapeutic process of patients with infectious diseases or need for intensive care is improved by telemedicine, the telematics platform can be expanded and used by other specialized fields and users in future time.

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

159065

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

      • Münster, Niemcy
        • University Hospital Münster
    • NRW
      • Aachen, NRW, Niemcy, 52074
        • University Hospital RWTH Aachen

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat i starsze (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

  • majority
  • written informed consent
  • infectiological and/or intensive care treatment

Exclusion Criteria:

  • minority
  • absence of written informed consent in the case of non-acute life-threatening disease
  • persons who have a dependency or employment relationship with the sponsor or investigator
  • persons who are sheltered in an institution upon court or administrative order

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Diagnostyczny
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Brak interwencji: Control
Patients of this group are routinely treated without telemedical support.
Aktywny komparator: Telemedical support
Patients of this group are routinely treated with telemedical support.
Participating sites will be advised by telemedicine support.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Improvement of treatment quality
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year
The level of implementation of the 10 recommendations of the German Society of Infectious Diseases (Deutsche Gesellschaft für Infektiologie, DGI) within the framework of the Initiative "Decide wisely" ("Klug entscheiden").
through study completion, an average of 30 days up to a maximum of 1 year

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Rate of sepsis diagnosis
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year
Rate of sepsis diagnosis
through study completion, an average of 30 days up to a maximum of 1 year
Rate of ARDS Diagnosis
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year
Rate of ARDS Diagnosis
through study completion, an average of 30 days up to a maximum of 1 year
Sepsis therapy in compliance with guidelines
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year
Sepsis therapy in compliance with guidelines through for instance timely administration of antibiotics within 3 h and reduction of sepsis mortality.
through study completion, an average of 30 days up to a maximum of 1 year
Rate of ARDS therapy according to guidelines
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year

Measured against the evident ventilation targets, Ventilation with low ventilation volumes and low peak pressures: with controlled ventilation:

Breath volume of 6 ml/kg calculated Body ideal weight, PEEP setting in proportion with the necessary FiO2, plateau pressure < 30 cm H2O

through study completion, an average of 30 days up to a maximum of 1 year
Rate of inadequate antibiotic therapies
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year
Measured by the Percentage of postoperatively continued perioperative Antibiotic prophylaxis
through study completion, an average of 30 days up to a maximum of 1 year
Rate of patients with dialysis
Ramy czasowe: At discharge from Intensive Care Unit (study completion); after an average of 30 days up to a maximum of 1 year
Rate of patients with dialysis requiring Kidney insufficiency in discharge from the Intensive care
At discharge from Intensive Care Unit (study completion); after an average of 30 days up to a maximum of 1 year
Rate of transfer transport
Ramy czasowe: At discharge from Intensive Care Unit (study completion); after an average of 30 days up to a maximum of 1 year
Rate of transfer transport
At discharge from Intensive Care Unit (study completion); after an average of 30 days up to a maximum of 1 year
Health-related quality of life (SF36-Questionnaire)
Ramy czasowe: At discharge from Intensive Care Unit (through study completion; an average of 30 days up to a maximum of 1 year), through study completion, an average of 12 months and 24 months after discharge of ICU
Clinical studies 36-item Medical Outcomes Study Short-Form General Health Survey An instrument used to assess multidimensional health-related QOL, which measures 8 health related parameters: physical function, social function, physical role, emotional role, mental health, energy, pain, general health perceptions; each parameter is scored from 0 to 100 Managed care 36-Item Short-Form Functional and Perceived Health Status Survey A questionnaire which measures health status; the SF-36 also includes a list of 18 self-reported chronic conditions
At discharge from Intensive Care Unit (through study completion; an average of 30 days up to a maximum of 1 year), through study completion, an average of 12 months and 24 months after discharge of ICU
Rate of non-diagnosed sepsis
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year
Defined as no filled out sepsis bundle despite presence of sepsis symptoms
through study completion, an average of 30 days up to a maximum of 1 year
Sepsis mortality rate
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year
Sepsis mortality rate
through study completion, an average of 30 days up to a maximum of 1 year
Hospital mortality rate
Ramy czasowe: through study completion, an average of 30 days up to a maximum of 1 year
Hospital mortality rate
through study completion, an average of 30 days up to a maximum of 1 year
Length of stay in intensive care unit
Ramy czasowe: At discharge from Intensive Care Unit (study completion); after an average of 30 days up to a maximum of 1 year
Length of stay in intensive care unit measured in hours
At discharge from Intensive Care Unit (study completion); after an average of 30 days up to a maximum of 1 year
Hospital stay
Ramy czasowe: At discharge from Hospital; after an average of 30 days up to a maximum of 1 year
Hospital stay measured in days
At discharge from Hospital; after an average of 30 days up to a maximum of 1 year

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Śledczy

  • Główny śledczy: Gernot Marx, Univ.-Prof. Dr. med., Clinic for Operative Intensive Care and Intermediate Care, University Hospital RWTH Aachen

Publikacje i pomocne linki

Osoba odpowiedzialna za wprowadzenie informacji o badaniu dobrowolnie udostępnia te publikacje. Mogą one dotyczyć wszystkiego, co jest związane z badaniem.

Publikacje ogólne

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

1 maja 2017

Zakończenie podstawowe (Rzeczywisty)

31 października 2019

Ukończenie studiów (Rzeczywisty)

31 stycznia 2020

Daty rejestracji na studia

Pierwszy przesłany

28 kwietnia 2017

Pierwszy przesłany, który spełnia kryteria kontroli jakości

28 kwietnia 2017

Pierwszy wysłany (Rzeczywisty)

3 maja 2017

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

2 czerwca 2020

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

1 czerwca 2020

Ostatnia weryfikacja

1 stycznia 2020

Więcej informacji

Terminy związane z tym badaniem

Słowa kluczowe

Inne numery identyfikacyjne badania

  • 16-162

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

Badania kliniczne na Telemedical support

3
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