Implementing telehealth interventions between medical care and nursing homes in rural areas of Germany to enable regular medical support in everyday care procedures – a qualitative pre-post study

Abstract Background Currently, there is a shortage of general practitioners and specialists in rural areas in Germany. In particular, people who are not mobile are at risk of not being provided adequately with medical care. This development is expected to increase in the coming years. One approach to counteracting this problem is the use of telemedicine. In two rural areas in Brandenburg/Germany, a telemedical intervention (video consultation and data exchange) is therefore to be tested in the general practitioner care of people living in nursing homes. The aim of this study is to investigate the expectations, experiences, barriers and motivation for the use from the perspective of the professional groups involved (physicians, nurses, software developers, legal supervisors). Methods The duration of the telemedicine intervention was six months. Following a qualitative pre-post design, interviews with the professionals were conducted at two time points, before the implementation of telemedicine interventions (t0) and after the implementation (t1). For the analysis of the interviews, the inductive-deductive approach according to Kuckartz was followed. Results In total 20 interviews were conducted. At t0 a positive influence on time savings, more efficient cooperation between nursing and medical care, an improved image of the institution and higher satisfaction of nursing home residents was expected. At t1, an improved quality of care, more efficient work, as well as an attractive image for the institution were positively emphasized. Enormous obstacles resulted from the fact that the technical interfaces of the different documentation systems were not compatible or technically unattainable. Video consultation and data exchange worked particularly well in cases where: 1. where patients/residents changed settings (e.g., from hospital back to nursing home) 2. frequent physician visits were required (e.g., wound checks) 3. routine appointments between physician and nurses with little or no contact with patients. Conclusions Telemedicine interventions such as video consultation and shared documentation systems can relieve the existing care structures and supplement them with additional elements, provided that the technical and legal framework conditions allow this. However, the use of telemedical interventions cannot replace the personal visit but is to be understood as an additional option.