Implementation of a tele-paediatric network in hospitals in a rural region: A mixed methods implementation study

In rural states, paediatric capacities and competencies are concentrated in urban centres due to demographic change and economical pressure. This results in greater distances, longer waiting times and multiple examinations for rural-dwelling children seeking healthcare. A regional tele-paediatric network (RTP-Net) was implemented to improve the access of children to paediatric care by providing videoconferencing and digital health information exchange between paediatricians from hospitals with different sizes and degrees of specialization.

Evaluation of the user acceptance as well as implementation barriers and facilitators.

Between January 2021 and March 2024, mixed-methods were carried out including participant observation and a survey of the RTP-Net users. Descriptive analysis based on the Technology Acceptance Model according to Davis. The study report follows 'A comprehenSive tool to Support rEporting and critical appraiSal of qualitative, quantitative and mixed methods implementation reSearch outcomes' (ASSESS).

A total of 507 tele-consultations were conducted. 907 questionnaires were analysed. The respondents were satisfied with 92.1% of the tele-consultations. The respondents found most of the tele-consultations (95.8%) adequate for solving their questions. Technical issues were the most mentioned reason (59.3%) why tele-consultation were inadequate; 184 project diary entries were analysed; 42 times (61%), the participants highlighted positive usability aspects of the RTP-Net (e.g., improved availability of patient health data) and 27 times (39%) negative aspects (e.g., interoperability issues).

A regional tele-paediatric healthcare network is feasible and acceptable in order to improve paediatric care in rural regions. However, technical improvements and policy adjustments are needed to enhance telemedicine adoption.Trial registration: This study was registered under the title 'Implementation und Evaluation of a Regional Tele-paediatric Network in Mecklenburg-Vorpommern and Brandenburg' (registration no. DRKS00024002, https://drks.de/search/de/trial/DRKS00024002) at the German Registry for Clinical Trials.