PDF(Pubmed)
Abstract：
BACKGROUND: Increasing numbers of ambulance calls, vacant positions and growing workloads in Emergency Medicine (EM) are increasing the pressure to find adequate solutions. With telemedicine providing health-care services by bridging large distances, connecting remote providers and even patients while using modern communication technologies, such a technology seems beneficial. As the process of developing an optimal solution is challenging, a need to quantify involved processes could improve implementation. Existing models are based on qualitative studies although standardised questionnaires for factors such as Usability, Acceptability and Effectiveness exist.
METHODS: A survey was provided to participants within a German county. It was based on telemedical surveys, the System Usabilty Scale (SUS) and earlier works describing Usability, Acceptability and Effectiveness. Meanwhile a telemedical system was introduced in the investigated county. A comparison between user-groups aswell as an exploratory factor analysis (EFA) was performed.
RESULTS: Of n = 91 included participants n = 73 (80,2%) were qualified as emergency medical staff (including paramedics n = 36 (39,56%), EMTs n = 28 (30,77%), call handlers n = 9 (9,89%)) and n = 18 (19,8%) as emergency physicians. Most participants approved that telemedicine positively impacts EM and improved treatment options with an overall Usabilty Score of 68,68. EFA provided a 3-factor solution involving Usability, Acceptability and Effectiveness.
CONCLUSIONS: With our results being comparable to earlier studies but telemedicine only having being sparsely introduced, a positive attitude could still be attested. While our model describes 51,28% of the underlying factors, more research is needed to identify further influences. We showed that Usability is correlated with Acceptability (strong effect), Usability and Effectiveness with a medium effect, likewise Acceptability and Effectiveness. Therefore available systems need to improve. Our approach can be a guide for decision makers and developers, that a focus during implementation must be on improving usability and on a valid data driven implementation process.
METHODS: A survey was provided to participants within a German county. It was based on telemedical surveys, the System Usabilty Scale (SUS) and earlier works describing Usability, Acceptability and Effectiveness. Meanwhile a telemedical system was introduced in the investigated county. A comparison between user-groups aswell as an exploratory factor analysis (EFA) was performed.
RESULTS: Of n = 91 included participants n = 73 (80,2%) were qualified as emergency medical staff (including paramedics n = 36 (39,56%), EMTs n = 28 (30,77%), call handlers n = 9 (9,89%)) and n = 18 (19,8%) as emergency physicians. Most participants approved that telemedicine positively impacts EM and improved treatment options with an overall Usabilty Score of 68,68. EFA provided a 3-factor solution involving Usability, Acceptability and Effectiveness.
CONCLUSIONS: With our results being comparable to earlier studies but telemedicine only having being sparsely introduced, a positive attitude could still be attested. While our model describes 51,28% of the underlying factors, more research is needed to identify further influences. We showed that Usability is correlated with Acceptability (strong effect), Usability and Effectiveness with a medium effect, likewise Acceptability and Effectiveness. Therefore available systems need to improve. Our approach can be a guide for decision makers and developers, that a focus during implementation must be on improving usability and on a valid data driven implementation process.
摘要：
背景：越来越多的救护车呼叫，急诊医学（EM）的空缺职位和不断增加的工作量正在增加寻找适当解决方案的压力。随着远程医疗通过桥接远距离提供医疗保健服务，在使用现代通信技术的同时连接远程提供者甚至患者，这样的技术似乎是有益的。由于开发最佳解决方案的过程具有挑战性，需要量化所涉及的过程可以改进实施。现有的模型是基于定性研究的，尽管对可用性、存在可接受性和有效性。
方法：向德国一个县的参与者提供了一项调查。它是基于远程医疗调查，系统可用性量表(SUS)和早期描述可用性的作品，可接受性和有效性。同时，在被调查的县引入了远程医疗系统。进行了用户组之间的比较以及探索性因素分析（EFA）。
结果：在n=91的参与者中，n=73（80,2%）符合急救医务人员的资格（包括护理人员n=36（39,56%），急救人员n=28(30,77%)，呼叫处理人员n=9(9,89%))和n=18(19,8%)作为急诊医生。大多数参与者批准，远程医疗对EM产生了积极影响，并改善了治疗方案，总体Usabilty评分为68,68。EFA提供了一个涉及可用性的三因素解决方案，可接受性和有效性。
结论：我们的研究结果与早期的研究相当，但远程医疗只被稀疏地引入，积极的态度仍然可以证明。虽然我们的模型描述了51.28%的潜在因素，需要更多的研究来确定进一步的影响。我们表明可用性与可接受性(强效应)相关，具有中等效果的可用性和有效性，同样是可接受性和有效性。因此,可用的系统需要改进。我们的方法可以为决策者和开发人员提供指导，实施过程中的重点必须是提高可用性和有效的数据驱动实施过程。
方法：向德国一个县的参与者提供了一项调查。它是基于远程医疗调查，系统可用性量表(SUS)和早期描述可用性的作品，可接受性和有效性。同时，在被调查的县引入了远程医疗系统。进行了用户组之间的比较以及探索性因素分析（EFA）。
结果：在n=91的参与者中，n=73（80,2%）符合急救医务人员的资格（包括护理人员n=36（39,56%），急救人员n=28(30,77%)，呼叫处理人员n=9(9,89%))和n=18(19,8%)作为急诊医生。大多数参与者批准，远程医疗对EM产生了积极影响，并改善了治疗方案，总体Usabilty评分为68,68。EFA提供了一个涉及可用性的三因素解决方案，可接受性和有效性。
结论：我们的研究结果与早期的研究相当，但远程医疗只被稀疏地引入，积极的态度仍然可以证明。虽然我们的模型描述了51.28%的潜在因素，需要更多的研究来确定进一步的影响。我们表明可用性与可接受性(强效应)相关，具有中等效果的可用性和有效性，同样是可接受性和有效性。因此,可用的系统需要改进。我们的方法可以为决策者和开发人员提供指导，实施过程中的重点必须是提高可用性和有效的数据驱动实施过程。
