NEPHRO-DIGITAL
The nephrology eHealth system of the Hannover Region for the digitalization of care, establishment of decision support systems and analysis of the reality of care
Background
Patients with chronic renal failure generate large amounts of disease-related data. Progress data from renal replacement therapy or transplantation can be added to this. There are often complex drug treatment requirements and inpatient stays are frequent. As a rule, these patients are treated on an outpatient basis by (pediatric) nephrologists and/or other service providers, while concomitant or other illnesses are treated by the family physician or pediatrician.
The associated patient records are kept in separate IT systems and are only linked across sectors via paper-based physician's letters or telephone exchanges, which can lead to a loss of information and data.
Objectives
The overarching goal is to develop a digital case file (eFA) that replaces the paper physician's letter and is linked to the hospital and practice software system. As an eHealth system in the Hanover region, it should enable cross-sector data exchange including teleconsultations between outpatient nephrology practitioners, primary care GPs and pediatricians and nephrology Clinical Departments. In addition, a clinical decision support system will be established for the early identification of patients with concomitant cardiovascular diseases and progression of renal insufficiency. By involving patients in the data collection, an improvement in prognosis, patient satisfaction and quality of life should be achieved.
Methods
The research project is divided into 3 work phases:
- In the preparation and development phase, the need for information and data exchange between general practitioners or pediatricians and practicing nephrologists as well as inpatient facilities or Institutions is recorded. At the same time, the nephrological data to be exchanged is defined and standardized, the digital case file is developed and the interface programming between the digital case file and the IT systems of outpatient and inpatient care is carried out.
- In the implementation phase, the digital case file will initially be used in the Hanover region and adapted to the needs of the individual user groups. In the next step, the case file will be implemented in another region in order to test its transferability.
- The evaluation phase includes an evaluation of the acceptance and practicability of the eFA in practice as well as the measurement of patients' quality of care and quality of life.
In the sub-project, for which the Institute ofGeneral Medicine and Palliative Medicine is responsible, interviews will initially be conducted with GPs and pediatricians in order to ascertain their perceptions of the content and functional scope of an eFA and to obtain information on beneficial factors and possible barriers to future use.
Publications
Pape L, Schneider N, Schleef T et al. 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. BMC Med Inform Decis Mak. 2019; 19(1):176 (pubmed)
A current poster on the project, which was presented at the digital 19th German Congress for Health Services Research, can be viewed here as a PDF.
Cooperation partner
NEPHRO-DIGITAL is a collaborative project led by Prof. Dr. Lars Pape from the Clinical Department of Pediatric Kidney, Liver and Metabolic Diseases at the MHH.
Further cooperation partners are: Clinical Department of Nephrology and Hypertension - MHH, Peter L. Reichertz Institute of Medical Informatics - MHH/Braunschweig, Clinic for Nephrology and Hypertensiology - University Hospital Erlangen, KRH Klinikum Region Hannover.
Funding
The project is funded by the Ministry of Science and Culture of Lower Saxony and the Volkswagen Foundation ("Niedersächsisches Vorab"). The funding period runs from 01.01.2020 to 31.12.2022.
