How to Evaluate a Regional Telemedical Care Network Focusing on Critically Ill Children? Results from the Consensus-Based Development of an Evaluation Design.

Abstract

Background: The medical care of critically ill children requires special expertise in pediatric emergency and intensive care medicine. In Germany, this expertise is mainly available in specialized centers at maximum-care hospitals due to the small number of cases of critically ill children. Telemedical care networks, such as the Pediatric-Tele-Intensive-Care Network Saxony, offer a solution for networking these centers with regional hospitals providing basic or standard care. However, the evaluation of these networks represents a major challenge, especially because it involves a heterogeneous target group of patients with various diseases. This article reports on the evaluation design development process for such a network, under equal participation of all relevant stakeholders, and presents the resulting evaluation design. Methods: The methods used were a literature review, two workshops, and a survey of all relevant stakeholders (representatives of 17 partner clinics, 4 external experts in pediatric intensive care, and 2 patient representatives). Results: The evaluation design contained proposals for a care objective, outcomes, and the corresponding databases (project database, clinic database, and survey database) to investigate these. Conclusions: Our study can offer other researchers and stakeholders a methodological approach and template for their evaluation design. It is the first published, consented evaluation design for a telemedical care network in pediatric intensive care. When developing and realizing an evaluation design for (tele)medical interventions, including the perspectives of relevant stakeholders, from the outset, it is essential to achieve a high level of commitment to the implementation of the evaluation.