20.500.12556/DKUM-78457 Analiza uporabe telekardiologije na primarni zdravstveni ravni Analysing the performance of telecardiology on primary level in healt care Namen: Pri obravnavi bolnika s sumom na motnjo ritma v ambulanti družinske medicine se kljub velikemu napredku medicine na tem področju, velikokrat bolnika napoti h kardiologu. V času digitalne dobe so se pojavile nove tehnologije, ki ponujajo storitve na daljavo, kar se je izkazalo za zelo pomembno v času izrednih razmer kot trenutna pandemija virusa Covid-19. Na Inštitutu Jožefa Štefana so v sodelovanju z zdravniki razvili osebni prenosni merilnik EKG Savvy, ki deluje v kombinaciji s pametnim telefonom in ga lahko uporabljamo pri bolnikih, ki tožijo za motnjami srčnega ritma. Študije so pokazale, da lahko z uporabo podobnih merilnikov pomembno vplivamo na kakovost obravnave bolnika na primarni ravni. Cilji: Cilj naloge je bil analizirati uporabnost telekardiologije v ambulanti zdravnika družinske medicine. S pomočjo bolnikove anamneze o motnji ritma in opravljenega EKG posnetka z uporabo EKG senzorja smo želeli oceniti uporabnost novega orodja in zadovoljstvo bolnikov in njihovih zdravnikov z uporabo pripomočka EKG senzorja pri taki obravnavi na primarni ravni. Prav tako smo želeli narediti okvirno stroškovno analizo uporabe tega orodja na primarni ravni in predlagati klinično pot obravnave bolnikov z motnjami ritma v ambulanti zdravnika družinske medicine. Metode: Izvedli smo intervencijsko randomizirano kontrolirano raziskavo, uporabili smo kvantitativno znanstveno metodologijo. Vključili smo bolnike (n=400) in njihove lečeče zdravnike (n=30), ki so v časovnem obdobju od oktobra 2016 do januarja 2018 obiskali ambulanto družinske medicine in so tožili zaradi motenj srčnega ritma; bolnike smo naključno razdelili v testno skupino, kjer so bolniki dobili EKG merilnik Savvy, in kontrolno skupino, kjer merilnik ni bil nameščen. Bolniki so nato opravili kontrolo čez 5–10 dni ter čez 3 mesece. Na podlagi opravljenih testov in pregledov smo lahko postavili ali ovrgli sum na motnjo srčnega ritma in pregledali intervencije, ki so bile potrebne; predvsem nas je zanimalo število napotenih bolnikov h kardiologu in zadovoljstvo bolnikov ter zdravnikov z uporabljeno metodo. Rezultati: Vključeni bolniki so bili povprečno stari 49,7 let, tri čertitne je bilo žensk. Razlik med skupinama v odkritih motnjah ritma ni bilo (26,0 proti 32,0 %, p=0,186), medtem ko je bilo ob uporabi merilnika EKG napotitev h kardiologu statistično značilno manj kot v kontrolni skupini (11,5 proti 34,0 %, p Purpose: When treating a patient with a suspected arrhythmia at family medicine office, despite the great advances in medicine in this field, the patient is often referred to a cardiologist. In the times of the digital age, new technologies have emerged that offer remote services, which has proven to be very important in times of emergency as the current Covid-19 pandemic. The Jožef Štefan Institute, in collaboration with doctors, has developed a personal portable ECG sensor Savvy that works in combination with a smartphone and can be used in patients who complain about heart rhythm disorders. The studies showed that the use of similar sensors can significantly influence the quality of treatment of the patient at the primary level. Goals: The goal was to analyse the usefulness of telecardiology in the primary health care level. With the help of a patient's history of rhythm disturbance and an ECG scan using an ECG personal sensor (ECG PS), we wanted to evaluate the satisfaction of patients and their physicians with the use of an ECG sensor treatment at the primary level. We also wanted to evaluate the cost-effectiveness of this tool at the primary level and propose a clinical pathway for treating patients with rhythm disorders at the primary health care level. Methods: We have conducted an intervention randomized controlled trial, using a quantitative scientific methodology. We included patients (n=400) and their treating physicians (n=30) who visited a family medicine clinic in the period from October 2016 to January 2018 and compalined about for cardiac arrhythmias; patients were randomly divided in a test and control group. In the test group, the patient received a Savvy ECG sensor, and in the control group, an ECG sensor was not installed. After a check-up at the doctor in 5 to 10 days and in three months, we were able to raise or disprove the suspicion of a heart rhythm disorder, review the interventions that were necessary; we were mainly interested in the number of patients referred to a cardiologist and the satisfaction of patients and doctors with the method used. Results: The patients included were on average 49,7 years old, three-quarters were women. There were no differences between the groups in the detected arrhythmias (26,0 vs. 32,0%, p=0,186), while when using the ECG meter, referrals to a cardiologist were statistically significantly less than in the control group (11,5 vs. 34,0 %, p telekardiologija primarna zdravstvena oskrba motnje srčnega ritma stroškovna učinkovitost telecardiology primary health care cardiac rhythm disorders cost-effectiveness true true false Slovenski jezik Angleški jezik Doktorsko delo/naloga 2021-01-06 12:38:26 2021-07-20 14:07:12 2022-08-09 19:10:39 2021-01-07 03:24:39 2021 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 70867715 URN:SI:UM:DK:1FROTXYV DOK_Vodicka_Stasa_2021.pdf DOK_Vodicka_Stasa_2021.pdf 1 9A1A73D0478BBA6704922783C6BFF38C 0ae9846dd8054d2df164720656c2566e2ef5f1cd137a2688536ae78aea8a70e1 afbf7731-d7d3-11eb-8812-00155d581298 20.500.12556/dkum/b9e05db4-db89-49af-aeed-085f5b0d8495 https://dk.um.si/Dokument.php?lang=slv&id=150963 Medicinska fakulteta 0 0 0