Telecare
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Telecare means the use of information and communication technologies to connect caregivers with each other or with other people (such as doctors, people in need of care and relatives) across spatial boundaries. In particular, this should enable increased security of supply in rural regions.
Goals and forms of application
Telecare aims in particular to make a contribution to ensuring the care supply situation continues and to enable simple and location-independent exchange. Similar to telemedicine , telecare should not replace personal contact, for example between caregivers and those in need of care. Rather, the nursing staff's room for maneuver should be expanded. The simplest form of telecare can be the home emergency call . In addition to the transmission of text messages, images (e.g. photos of a wound), signals (e.g. EKG), vital values (e.g. body weight) are increasingly being transmitted in the context of telecare use . Against the background of the expansion of broadband technologies and powerful mobile radio systems , telecare can also be used in a more complex form with a video image. One form of telecare that is currently already established is telemonitoring , for example in the form of. Monitoring of the ECG of pacemaker patients, monitoring of the movement of patients at risk of falling (ibid).
With regard to video-based methods, a distinction can be made between two forms of application, both of which belong to the field of teleconsultation. In this context, several representatives of the health professions come together for the purpose of mutual coordination, advice, supervision or further training. Furthermore, the exchange between professional nurses (e.g. registered nursing staff for wounds and registered nursing staff without this qualification), from the exchange between professional caregivers (e.g. registered nursing staff) and a (caring) layperson (care (specialist) consultations) can be distinguished.
History and distribution in Germany
Tele-care represents a transfer of telemedical approaches to the context of the care sector. In Germany, tele-care has not yet been widely used, even if steps are taken in this direction, for example the ESF-funded tele-care project. One of the central results of the Concerted Care Action in 2019 was to research and implement the area of telecare more intensively than before in Germany.
Potential, international use and research needs
From the point of view of the Federal Ministry of Health, tele care has the potential to make a contribution to networking carers with one another. To this end, the advice for people in need of care and their relatives is to be expanded quickly. The merging of a need for support and the associated expertise can take place in direct exchange or be organized centrally. In the latter case, a (telecare) center organizes the connection between the inquirer and the necessary specialist expertise.
A bundling of international approaches shows that the most common areas of application include patient education, monitoring and case management, which is particularly popular. At the same time, it becomes clear that video telephony is used far less frequently than the telephone. International approaches in the field of telecare and its handling with local health systems can only be transferred to the German health system to a very limited extent. In 2020, the Federal Ministry of Health commissioned the implementation of a study to uncover the potential of telecare in Germany. The results are expected in 2020.
Data protection and data safety
As in telemedicine , high standards with regard to data protection and integrity also apply to the context of telecare . In particular, the transmission of health data and the sensitivity of recordings in a very personal context (care) make this essential. The collection and processing of personal data by public and non-public bodies implies compliance with the Data Protection Act ( BDSG ). Due to the use of telecommunications media, the Telecommunications Act (TKG) and the Telemedia Act (TMG) also apply to telecare , which require the relevance of clearly defined goals to ensure data protection and data security. These include confidentiality, data integrity, data availability, transparency, intervenability, non-chaining of data as well as authenticity and non-repudiation. Encryption and pseudonymization are central aspects to achieve data protection and data security.
Tele care as an opportunity to expand competencies and roles in care
The use of telecare requires the caregivers and those in need of care to accept this form of use and to have basic technical skills. In addition, the use of different forms of telecare results in the need to develop certain social, cognitive and technical skills that nursing staff must bring with them for their everyday work, but may not yet have them because they are not part of the curriculum in their training .; For example, coordination, delegation and / or guidance via video telephony also requires more communicative competence than is necessary in direct face-to-face contact or in telephone conversations.
In the application of the many facets of tele-care, surveys also show the “importance of care as an information hub in the care process. Nursing staff emphasize their role as “knowledge workers” through their increased contact with patients and other stakeholders through tele-care. Viewed in this way, telecare is a continuation of the nursing activities of information management and information forwarding with other means and requires skills to use these means appropriately. "
Telecare thus offers the opportunity to see care even more as a holistic task for which a large number of skills are required. The implementation of tele-care therefore enables new opportunities for qualification and employment opportunities in care (e.g. as a tele-care specialist for older employees), also enhances the professional field and the associated activities and enables the care services to deploy staff more efficiently.
Practicability and meaningfulness
With regard to the implementation of telecare, there are two central points of criticism, on the one hand the technical feasibility, on the other hand the (experienced) usefulness.
In the current situation (2020), sufficient bandwidth via the telephone network or a correspondingly good internet connection is not guaranteed for every region in Germany that needs to be served. In particular, applications that require a comparatively higher volume of data (such as video telephony) are more likely to be implemented in urban regions (implementability).
In addition, an approach such as telecare against the background of the massive shortage of skilled workers in the care industry can at best represent a partial solution. Working with this approach facilitates exchange and cooperation between the actors, but does not help to increase the number of qualified specialists. At most, the use of digital potential through the application of modern technologies encourages (young) people to be enthusiastic about the care profession. Furthermore, acceptance by caregivers and those in need of care should be considered. On the one hand, nursing staff are open to technical innovations in nursing, but these must not damage the nursing self-image. A current study on the use of telecommunication services in the medical field shows that seniors would definitely use these procedures or are interested in not doing so, according to the presumption, due to a lack of knowledge (yet). With a view to the acceptance of technical systems by those in need of care, the personal factors "age", "cognitive skills", "level of education" and "previous technical experience" are decisive as well as "appearance", "size" and "trustworthiness or security of the systems" the technology-related factors. Both aspects should be considered when designing tele-care approaches.
Individual evidence
- ^ Bundesverband Pflegemanagement eV: IT in care - modern communication technologies for area-wide, cross-sector care. Bundesverband Pflegemanagement eV, May 20, 2015, accessed on August 20, 2020 .
- ↑ a b c d Ursula Hübner & Nicole Egbert: Telepflege . In: Peter Bechte, Ingrid Smerdka-Arhelger & Kathrin Lipp (eds.): Shaping Care in Change - A Management Task . Springer Verlag, Berlin 2019, p. 221 .
- ↑ care pioneers: telecare Lower Saxony. Retrieved August 20, 2020 .
- ^ A b c Christian Vaske, Eva Gödde & Melanie Philip: Results of the Telepflege project. 2020, accessed on August 20, 2020 .
- ^ Federal Ministry of Health: Concerted Action Care. Federal Ministry of Health, accessed on August 20, 2020 .
- ↑ Oliver Blatt & Didar Dündar-Gözalan :: Concerted Care Campaign - More than a nursing oath? Vdek Magazin, 4th edition, 2019, accessed on August 20, 2020 .
- ↑ Valutuir Duarte Souza-Junior, Isabel Amelia Mendes, Alessandra Mazzo & Simone Godoy: Application of telenursing in nursing practice: an integrative literature review . Ed .: Applied Nurse Research. tape 29 , 2016, p. 254-260 .
- ↑ Federal Ministry of Health: Study on the potential of tele-care in nursing care. Retrieved August 20, 2020 .
- ↑ Elske Ammenwerth: Shaping the future yourself . Ed .: ProCare 25. No. 1-2 , 2020, p. 6-8 .
- ^ Cathrine McCabe & Fiona Timmis: Embracing healthcare technology - What is the way forward for nurse education . Ed .: Nurse Education Practice. tape 21 , 2016, p. 104-106 .
- ^ Nicole Egbert, Johannes Thye, Jan-David Liebe, Georg Schulte, Werner Hackl, Elske Ammenwerth, Ursula Hübner: An iterative methodology for developing national recommendations for nursing information curricula . Ed .: Studies in Health Technology and Informatics. tape 228 , 2016, p. 660-664 .
- ↑ Ursula Hübner, Toria Shaw, Johannes Thye, Nicole Egbert, Heimar Marin, Marion Ball: Towards an international framework for recommendations of core competencies in nursing and inter-professional informatics: the TIGER competency synthesis project . Ed .: Studies in Health Technology and Informatics. tape 228 , 2016, p. 655-659 .
- ^ Adelheid Kuhlmey, Stefan Blüher, Johanna Nordheim & Jan Zöllick: Technology in care - attitudes of professional caregivers to the opportunities and risks of new technologies and technical assistance systems. 2019, accessed August 20, 2020 .
- ↑ Achim Berg: Seniors in the digital world. 2020, accessed on August 27, 2020 .
- ^ Salifu Yusif, Jeffrey Soar, Abdul Hafeez-Baig: Older people, assistive technologies, and the barriers to adoption: A systematic review. Ed .: International Journal of Medical Informatics. No. 94 , 2016, p. 112-116 .