The nephrology eHealth-system of the metropolitan region of Hannover for digitalization of care, establishment of decision support systems and analysis of health care quality.

Clinical decision support system Graft survival Interoperability Kidney transplantation Patient survival Quality of life eHealth

Journal

BMC medical informatics and decision making
ISSN: 1472-6947
Titre abrégé: BMC Med Inform Decis Mak
Pays: England
ID NLM: 101088682

Informations de publication

Date de publication:
02 09 2019
Historique:
received: 19 07 2019
accepted: 22 08 2019
entrez: 4 9 2019
pubmed: 4 9 2019
medline: 20 2 2020
Statut: epublish

Résumé

Even though a high demand for sector spanning communication exists, so far no eHealth platform for nephrology is established within Germany. This leads to insufficient communication between medical providers and therefore suboptimal nephrologic care. In addition, Clinical Decision Support Systems have not been used in Nephrology until now. The aim of NEPHRO-DIGITAL is to create a eHealth platform in the Hannover region that facilitates integrated, cross-sectoral data exchange and includes teleconsultation between outpatient nephrology, primary care, pediatricians and nephrology clinics to reduce communication deficits and prevent data loss, and to enable the creation and implementation of an interoperable clinical decision support system. This system will be based on input data from multiple sources for early identification of patients with cardiovascular comorbidity and progression of renal insufficiency. Especially patients will be able to enter and access their own data. A transfer to a second nephrology center (metropolitan region of Erlangen-Nuremburg) is included in the study to prove feasibility and scalability of the approach. A decision support system should lead to earlier therapeutic interventions and thereby improve the prognosis of patients as well as their treatment satisfaction and quality of life. The system will be integrated in the data integration centres of two large German university medicine consortia (HiGHmed ( highmed.org ) and MIRACUM ( miracum.org )). ISRCTN16755335 (09.07.2019).

Sections du résumé

BACKGROUND
Even though a high demand for sector spanning communication exists, so far no eHealth platform for nephrology is established within Germany. This leads to insufficient communication between medical providers and therefore suboptimal nephrologic care. In addition, Clinical Decision Support Systems have not been used in Nephrology until now.
METHODS
The aim of NEPHRO-DIGITAL is to create a eHealth platform in the Hannover region that facilitates integrated, cross-sectoral data exchange and includes teleconsultation between outpatient nephrology, primary care, pediatricians and nephrology clinics to reduce communication deficits and prevent data loss, and to enable the creation and implementation of an interoperable clinical decision support system. This system will be based on input data from multiple sources for early identification of patients with cardiovascular comorbidity and progression of renal insufficiency. Especially patients will be able to enter and access their own data. A transfer to a second nephrology center (metropolitan region of Erlangen-Nuremburg) is included in the study to prove feasibility and scalability of the approach.
DISCUSSION
A decision support system should lead to earlier therapeutic interventions and thereby improve the prognosis of patients as well as their treatment satisfaction and quality of life. The system will be integrated in the data integration centres of two large German university medicine consortia (HiGHmed ( highmed.org ) and MIRACUM ( miracum.org )).
TRIAL REGISTRATION
ISRCTN16755335 (09.07.2019).

Identifiants

pubmed: 31477119
doi: 10.1186/s12911-019-0902-0
pii: 10.1186/s12911-019-0902-0
pmc: PMC6720092
doi:

Banques de données

ISRCTN
['ISRCTN16755335']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

176

Références

Methods Inf Med. 2018 Jul;57(S 01):e50-e56
pubmed: 30016818
BMC Health Serv Res. 2017 Aug 23;17(1):587
pubmed: 28830408
PLoS Med. 2018 Mar 13;15(3):e1002528
pubmed: 29534063
Nat Genet. 2016 Apr;48(4):343
pubmed: 27023771
Stud Health Technol Inform. 2018;248:196-203
pubmed: 29726437
Methods Inf Med. 2018 Jul;57(S 01):e66-e81
pubmed: 30016813
J Biomed Inform. 2016 Oct;63:277-294
pubmed: 27507090
Methods Inf Med. 2018 Jul;57(S 01):e82-e91
pubmed: 30016814
Nephrol Dial Transplant. 2013 Apr;28(4):972-81
pubmed: 23243040
Am J Nephrol. 2018;47(3):200-207
pubmed: 29558745
Artif Intell Med. 2018 Jul;89:10-23
pubmed: 29753616
Kidney Int. 2017 Dec;92(6):1328-1333
pubmed: 28893419

Auteurs

L Pape (L)

Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany. Pape.Lars@mh-hannover.de.

N Schneider (N)

Institute for General Practice, Hannover Medical School, Hannover, Germany.

T Schleef (T)

Institute for General Practice, Hannover Medical School, Hannover, Germany.

U Junius-Walker (U)

Institute for General Practice, Hannover Medical School, Hannover, Germany.

H Haller (H)

Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.

R Brunkhorst (R)

Department of Nephrology, Angiology and Rheumatology, KRH Regional Hospital Hannover Siloah, Hannover, Germany.

N Hellrung (N)

Symeda GmbH, Braunschweig, Germany.

H U Prokosch (HU)

Department of Medical Informatics, Biometrics and Epidemiology, Chair for Medical Informatics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.

B Haarbrandt (B)

Peter L. Reichertz Institute for Medical Informatics University of Braunschweig - Institute of Technology and Hannover Medical School, Hannover, Germany.

M Marschollek (M)

Peter L. Reichertz Institute for Medical Informatics University of Braunschweig - Institute of Technology and Hannover Medical School, Hannover, Germany.

M Schiffer (M)

Department of Nephrology, University Hospital Erlangen, Erlangen, Germany.

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Classifications MeSH