Challenges and conditions for successfully implementing and adopting the telematics infrastructure in German outpatient healthcare: A qualitative study applying the NASSS framework.

Background: Germany's healthcare system provides high-quality, universal health coverage to almost all residents. However, a major challenge lies in the strong separation of healthcare structures, which hinders efficient interprofessional and intersectoral communication and collaboration. The mandatory nationwide implementation of the telematics infrastructure may offer a solution to enhance healthcare professionals' communication and collaboration. Objective: Our study aims to elicit participants' perceptions of and attitudes towards the implementation and usage of the telematics infrastructure in fostering interprofessional communication and collaboration between home-care nursing services and general practitioner practices. Methods: We conducted interviews with seven members of general practitioner practices and 10 in home-care nursing services. Using thematic content analysis, we identified five themes, of which four along with 10 subthemes were integrated into Greenhalgh et al.'s 'nonadoption, abandonment, scale-up, spread and sustainability' framework. Results: Participants recognised the potential of digital technology to enhance interprofessional communication and collaboration. However, this potential largely depended on individual healthcare actors' willingness to seek information, invest and adapt. Attitudes towards the telematics infrastructure varied widely from hopeful confidence to outright rejection. Home-care nursing services generally viewed the telematics infrastructure with optimism, while general practitioners expressed reservations, particularly due to technological disruptions, lack of user-friendliness, and organisational structures. Conclusion: Our findings highlight the potential of digital technology to enhance interprofessional communication. Successful implementation of technological innovations, however, goes beyond technological aspects and involves social, political and organisational processes. Future implementation strategies for such innovations in healthcare should involve users early and ensure clear communication.

[Analysing the Need for Long-Term Care: Potential of Data from Long-Term Care Assessments of the Bavarian Medical Service for Public Health Research and Practice]. / Pflegebedürftigkeit analysieren ­ Potential der Daten aus Pflegebegutachtungen des Medizinischen Dienstes Bayern für Public Health-Forschung und -Praxis.

BACKGROUND: Despite demographic changes, there is still no systematic and comparable differentiation of nursing care reporting on a small-scale level in Germany, where outpatient long-term care is depicted. This article presents findings of care assessment data of the Medical Service of Bavaria and draws conclusions for future reporting on nursing. METHODS: For the analysis, anonymised initial long-term care assessments of the Bavarian Medical Service of 2019 were evaluated exemplarily using descriptive methods. The study describes the characteristics of persons with a care level recommendation, the distribution of care level categories, medical diagnoses and degree of independence in the areas of life. RESULTS: The persons assessed were on average 80 years old. At the time of the initial assessment, the largest proportion of persons with an assigned care level lived in an outpatient setting. Care level (PG) 1 (slight impairment of independence or abilities) was assigned to 35.1% of the insured, PG 2 (considerable impairment) to 43.1%, PG 3 (severe impairment) to 16.6%, PG 4 and 5 (most severe impairment) were each rarely assigned at the time of the initial assessment (3.9% and 1.4%, respectively). Medical diagnoses were dominated by gait and mobility disorders, unspecified dementia, heart failure and senility. In particular, there were impairments in the areas of 'mobility' and 'organisation of everyday life and social contacts'. CONCLUSIONS: The data available from the German Medical Service may be highly relevant to health research and policy and may provide a basis for planning interventions in long-term care.

[Implementation of fall sensors in long-term care : An interview study to identify promoting and inhibiting factors from the perspective of professional caregivers]. / Implementation einer Sturzsensorik in der Langzeitpflege : Eine Interviewstudie zur Betrachtung fördernder und hemmender Faktoren aus Sicht professionell Pflegender.

BACKGROUND AND OBJECTIVE: Digital support systems are becoming increasingly more important in long-term inpatient care facilities. Welfare technologies have the potential to make a valuable contribution to maintaining independence in advanced age. At the same time the technologies can support professional caregivers. The aim of the study was to describe the expectations and experiences with a new technology, using the example of a fall sensor system, from the perspective of professional caregivers. METHOD: We used a qualitative design with semistructured interviews in two long-term inpatient care facilities. In one facility, three individual interviews took place, while in the other long-term care facility, a group interview with three nursing professionals was conducted. Additionally, one individual interview was conducted with a person in a leadership role in each facility. The time from implementation of the fall sensors to the interviews was between 1 and 3 months. Data were analyzed using qualitative content analysis in MAXQDA. RESULTS AND DISCUSSION: The study demonstrated that there was a correspondence between expectations of and retrospective experiences with the new technology among professional nurses. The main facilitating factors of the implementation that were identified were timely information about the risk of falling or a fall that has occurred, maintenance of residents' autonomy and freedom of movement as well as the enhancement of the sense of security among nursing professionals and the associated psychological relief effect. The inhibiting factors of the implementation were compulsory presetting, false alarms and faulty handling of the technology due to missing knowledge.

Conceptualizing Interprofessional Digital Communication and Collaboration in Health Care: Protocol for a Scoping Review.

BACKGROUND: Effective communication and collaboration among health professionals are essential prerequisites for patient-centered care. However, interprofessional teams require suitable structures and tools to efficiently use their professional competencies in the service of high-quality care appropriate to the patient's life situation. In this context, digital tools potentially enhance interprofessional communication and collaboration and lead to an organizationally, socially, and ecologically sustainable health care system. However, there is a lack of studies systematically assessing the critical factors for successfully implementing tools for digitally supported interprofessional communication and collaboration in the health care setting. Furthermore, an operationalization of this concept is missing. OBJECTIVE: The aim of the proposed scoping review is to (1) identify factors influencing the development, implementation, and adoption processes of digital tools for interprofessional communication in the health care sector and (2) analyze and synthesize the (implicit) definition, dimensions, and concepts of digitally supported communication and collaboration among health care professionals in the health care setting. Studies focusing on digital communication and collaboration practices among health care professionals, including medical doctors and qualified medical assistants, in any health care setting will be included in this review. METHODS: To address these objectives, an in-depth analysis of heterogeneous studies is needed, which is best achieved through a scoping review. Within this proposed scoping review, which adheres to the Joanna Briggs Institute methodology, 5 databases (SCOPUS, CINAHL, PubMed, Embase, and PsycInfo) will be searched for studies assessing digital communication and collaboration among various health care professionals in different health care settings. Studies focusing on health care providers or patient interaction through digital tools and non-peer-reviewed studies will be excluded. RESULTS: Key characteristics of the studies included will be summarized through descriptive analysis, using diagrams and tables. We will synthesize and map the data and conduct a qualitative in-depth thematic analysis of definitions and dimensions of interprofessional digital communication and collaboration among health care and nursing professionals. CONCLUSIONS: Results from this scoping review may help in establishing digitally supported collaborations between various stakeholders in the health care setting and successfully implementing new forms of interprofessional communication and collaboration. This could facilitate the transition to better coordinated care and encourage the development of digital frameworks. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/45179.