[Development and piloting of a nurse-led telemedicine care model in rural areas: a feasibility study]

Development and piloting of a nurse-led telemedicine care model in rural areas: a feasibility study Abstract: Background: Older residents in rural long-term care facilities often face unmet needs for primary and specialist medical care. Expanded nursing roles and telemedicine may help to address these gaps. Aim: The aim was to develop and test a nurse-led, telemedicine-supported care model to strengthen primary care delivery in long-term care facilities. Methods: A feasibility study described the structures and technical requirements of the living lab approach as well as the interprofessional collaboration between doctors, wound care specialists and nursing professionals (PFP). The iterative, user-centered development of the intervention was assessed using a mixed-methods design, integrated into further development and piloted over six months. Focus groups, interviews, workshops, and usability feedback enabled the participatory involvement of all stakeholders. Results: Users rated the developed work processes and structures positively. Interprofessional communication was improved and patient care benefited from the new procedures. A total of 32 residents participated in 46 teleconsultations. The scope of expanded nursing activities also included tasks according to the German Federal Joint Committee (Gemeinsamer Bundesausschuss [G-BA], 2011), although their independent execution was limited by regulatory restrictions. Conclusion: The application of expanded nursing activities within the care model is feasible. However, full implementation and sustainable interprofessional integration will require regulatory adjustments and secure long-term financing.