Article
Applying the RE-AIM framework to neurologic tele-consultations in primary care in rural areas in Germany: protocol for the evaluation of the NeTKoH project’s implementation
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Authors
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Kerstin Wainwright
- Charité – Universitätsmedizin Berlin, Deutschland
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Ricarda Sophia Schulz
- Charité – Universitätsmedizin Berlin, Deutschland
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Hans-Aloys Wischmann
- Charité – Universitätsmedizin Berlin, Deutschland
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Imke Mayer
- Owkin UK Ltd, UK
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Paula Filser
- Charité – Universitätsmedizin Berlin, Deutschland
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Anselm Angermaier
- Universitätsmedizin Greifswald, Deutschland
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Tobias Kurth
- Charité – Universitätsmedizin Berlin, Deutschland
| Published: | September 10, 2024 |
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Outline
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Background: Neurologic diseases represent a major public health burden globally and nationally, especially in rural areas with a scarcity of neurologists. The NeTKoH-project (01NVF19007) targets this by providing tele-consultations with neurologic experts from a university hospital for patients presenting with neurologic symptoms in GP offices in rural areas of Western Pomerania in Germany. A comprehensive evaluation of such tele-neurologic interventions under real-world conditions about their generalizability (internal and external validity) is paramount to inform decision-makers. The RE-AIM framework in implementation research offers a systematic approach to assess external validity of intervention findings.
Objective: We describe the application of the 5 dimensions of RE-AIM to evaluate the implementation of NeTKoH to answer the question: Was NeTKoH implemented as planned?
Methods: NeTKoH is a hybrid effectiveness-implementation cluster randomized controlled trial in a stepped wedge design, involving 33 outpatient GP practices and targeting 1089 of their patients who present with neurologic symptoms. A quantitative approach is employed to assess the implementation of the multi-level NeTKoH initiatives focussing on the 5 dimensions of the RE-AIM framework. We provide insights into how tele-consultations can be evaluated in terms of their reach of the target population (REACH), the intervention outcomes (EFFECTIVENESS), adoption by providers and patients (ADOPTION), implementation fidelity and processes (IMPLEMENTATION) and long-term sustainability (MAINTENANCE). Additionally, we discuss strategies for data collection, analysis, and reporting for all RE-AIM metrics. Challenges will also be addressed.
Results: An outline to apply the RE-AIM framework to evaluate the NeTKoH-tele-consultations will be presented. Results are expected in 2025.
Implication for research and/or (healthcare) practice: By using the RE-AIM framework, this protocol introduces a structured and comprehensive way of investigating the implementation of tele-neurologic consultations in primary care in rural areas in Germany and informs researchers, healthcare providers, and policymakers seeking to plan, evaluate and optimize tele-consultation services in other areas, ultimately improving access to quality healthcare for patients.
Funding: Innovationsfonds/Versorgungsforschung; Project name: NeTKoH; Grant number: 01NVF19007
