Steirische Wirtschaftsförderung

Zusammenfassung Neugeborenennotarztsysteme sichern das Überleben von Früh- und Neugeborenen, die außerhalb einer Geburtseinrichtung mit angeschlossener neonatologischer Versorgung geboren werden. Vielfach fehlt es an einer Definition, einer Klarstellung der Organisation sowie einer eindeutigen Zuordnung der Finanzierung dieser Systeme. Neugeborenennotarztsysteme werden ortsabhängig von den Kinderkliniken, teilweise von den Kostenträgern oder, falls überhaupt, nur durch Spendengelder finanziert. Eine Umfrage des Verbands Leitender Kinder- und Jugendärzte und Kinderchirurgen Deutschlands e. V. (VLKKD), Landesverband Baden-Württemberg zeigt die aktuellen Probleme in Baden-Württemberg in der Vorhaltung und Logistik auf, die mitunter zu einer wesentlichen Verzögerung der Einsatzzeiten führen. Sie beruhen auf unzureichenden gesetzlichen Vorgaben und einer Fehlinterpretation der Richtlinie des Gemeinsamen Bundesausschusses über Maßnahmen zur Qualitätssicherung der Versorgung von Früh- und Reifgeborenen (QFR-RL). Die Situation in Baden-Württemberg steht dabei stellvertretend für die rettungsdienstliche Versorgung früh- und reifgeborener Patienten in Deutschland.

BackgroundIn rural states, paediatric capacities and competencies are concentrated in urban centres due to demographic change and economical pressure. This results in greater distances, longer waiting times and multiple examinations for rural-dwelling children seeking healthcare. A regional tele-paediatric network (RTP-Net) was implemented to improve the access of children to paediatric care by providing videoconferencing and digital health information exchange between paediatricians from hospitals with different sizes and degrees of specialization.ObjectiveEvaluation of the user acceptance as well as implementation barriers and facilitators.MethodsBetween January 2021 and March 2024, mixed-methods were carried out including participant observation and a survey of the RTP-Net users. Descriptive analysis based on the Technology Acceptance Model according to Davis. The study report follows ‘A comprehenSive tool to Support rEporting and critical appraiSal of qualitative, quantitative and mixed methods implementation reSearch outcomes’ (ASSESS).ResultsA total of 507 tele-consultations were conducted. 907 questionnaires were analysed. The respondents were satisfied with 92.1% of the tele-consultations. The respondents found most of the tele-consultations (95.8%) adequate for solving their questions. Technical issues were the most mentioned reason (59.3%) why tele-consultation were inadequate; 184 project diary entries were analysed; 42 times (61%), the participants highlighted positive usability aspects of the RTP-Net (e.g., improved availability of patient health data) and 27 times (39%) negative aspects (e.g., interoperability issues).ConclusionsA regional tele-paediatric healthcare network is feasible and acceptable in order to improve paediatric care in rural regions. However, technical improvements and policy adjustments are needed to enhance telemedicine adoption.Trial registration: This study was registered under the title ‘Implementation und Evaluation of a Regional Tele-paediatric Network in Mecklenburg-Vorpommern and Brandenburg' (registration no. DRKS00024002, https://drks.de/search/de/trial/DRKS00024002) at the German Registry for Clinical Trials.