Unit Health Services Research and Telemedicine in Primary Care
Head of the Unit:
Assoc. Prof. PD. Dr. Kathryn Hoffmann, MD, MPH
… 2002 doctorate in medicine, 2007 General Practitioner, ÖÄK (Austrian Medical Association) - diplomas for psychosocial and psychosomatic medicine, since 2010 Master of Public Health and working at the Medical University of Vienna, 2017 Habilitation/Venia docendi in General Practice and Family Medicine. Kathryn Hoffmann is an associate professor at the Medical University of Vienna and a leading researcher in health services research in the Austrian primary care sector. Research stays at Duke University in the USA and at Ghent University in Belgium. Author of numerous publications in international journals and of book chapters, she directed large EU-funded studies on primary care and health services and system research in Europe. Hoffmann is the Austrian representative at the European General Practice Research Network, former advisory board member at the European Forum for Primary Care and a founding member of the Austrian Forum for Primary Care in Health Care.
From October 2016 until October 2018 Kathryn Hoffmann was interim head of the department of General Practice and Family Medicine and since 2020, she is head of the Unit “Health Services Research and Telemedicine in Primary Care” at the Department for Social- and Preventive Medicine, Centre for Public Health, Medical University of Vienna as well as Senior Health Expert at the Austrian Public Health Institute.
Research focus of the Unit:
Unit members
Maria de la Cruz Gomez Pellin, Univ.-Assistent, M.D. is a researcher and lecturer at the Unit Health Services Research in Primary Care of the Department of Social- a
nd Preventive Medicine, Medical University of Vienna. Additionally, she is a general practitioner and emergency physician with specialisations in Geriatrics and Palliative Medicine, School Health and Addiction Medicine. Alongside her duties, she is pursuing an MSc and PhD in Public Health.
She has conducted several research projects on topics concerning the quality of postgraduate general practice training, telemedicine and potentially inadequate medications in the elderly. Dr Gomez´s research and teaching focuses are on primary health care, family medicine, evidence-based medicine as well as public health.
The other members and cooperation partners are described under the respective research points of the unit.
Research focus Health Services Research in Primary Care
The research focus health services research in primary care emerged in 2011 from the participation in the international “Quality and Costs in Primary Care (QUALICOPC)” study, in which 34 countries including Austria (under the coordination of assoc. Prof. PD Dr. Kathryn Hoffmann, MPH took part .
Within the framework of this research focus, Prof. Hoffmann collaborates with international colleagues, especially at Ghent University, Department of Family Medicine and Primary Health Care, at the Netherlands Institute for Health Services Research (NIVEL) and at the Duke University, Department of Family and Community Medicine as well as with colleagues from the Department for Social and Preventive Medicine such as Prof. Thomas Dorner, Prof. Ruth Kutalek and Dr. Elena Jirovsky.
The active participation in the following scientific and expert societies is also due to this research focus:
- European General Research Network (EGPRN): Austria representative and member of the Research Committee
- European Forum for Primary Care (EFPC): former Advisory Board Member
- Österreichisches Forum Primärversorgung: founding member
- Open Medical Institute’s Duke Family Medicine Seminar in collaboration with the American Austrian Foundation (AAF) and Duke University, NC, USA: collaboration as co-course director
This has yielded several (top) publications, mainly focused on the uptake and performance of the Austrian health care system at the level of primary care.
You can find a selection of projects and publications related to this research focus here:
Publications:
Hoffmann K, Ristl R., George A, Maier M, Pichlhöfer O. The ecology of medical care: Access points to the health care system in Austria and other developed countries. Scand J Primary Health Care. 2019 Sep 12:1-9. DOI: 10.1080/02813432.2019.1663593. [Epub ahead of print]. Link: https://www.tandfonline.com/doi/full/10.1080/02813432.2019.1663593
Hoffmann K, George A, Van Loenen T, De Maeseneer J, Maier M. The influence of general practitioners on access points to healthcare in a system without gatekeeping: a cross-sectional study in the context of the QUALICOPC project in Austria. Croatian Medical Journal. 2019 Aug 31;60(4):316-324. DOI: 10.3325/cmj.2019.60.316 Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734571/
Hoffmann K, George A, Jirovsky E, Dorner TE. Re-examining access points to the different level of health care. A cross-sectional series in Austria. Eur J Public Health. 2019 Dec; 29(6):1005–1010. DOI: https://doi.org/10.1093/eurpub/ckz050
Further publications you can access here.
Projects (ongoing)
VOICE study – giving patients a voice: wishes and needs of the Austrian population with regard to general practitioner care provision in Austria
This project is funded by the medical-scientific fund of the Mayor of Vienna.
Project head: assoc. Prof. Priv.-Doz. Dr. Kathryn Hoffmann, MPH
Project staff member: Nicole Rumpler, MSc.
General Practice is the key medical field in the primary care sector and, in terms of its relevance to the care of the population, the most important and demanding medical field. Under ideal conditions, it can terminatory handle up to 70%-80% of all consultations. In Austria, general practice, and the primary care sector in general, were structurally neglected in the past decades, until a comprehensive health care reform was decided in 2012 to strengthen primary care. But in such circumstances it is especially important to obtain the population’s views on this subject, as it will be the user of the future general practice and other primary care services. The aim of this study was to survey the needs and wishes of the Austrian population with regard to their notion of an ideal general practice, and to convey the results to those in charge.
Projects (completed)
Landarzt (Country Doctor) 2.0
This project was funded by the federal state of Styria and was a collaborative project between FH Joanneum Graz, the Medical University of Vienna and the Medical University of Graz, under the leadership of FH Joanneum Graz. See also: www.fh-joanneum.at/projekt/landarzt-2-0/
Project director for the Medical University of Vienna: assoc. Prof. Priv.-Doz. Dr. Kathryn Hoffmann, MPH
The aim of this project was to identify potential areas of friction between patients and health providers in Styria in the context of the paradigm shift in health care provision.
EUR-HUMAN: European Refugees - Human Movement and Advisory Network (3rd Health Program of the European Union, project ‘717319 / EUR-HUMAN’ (2014-2020); Partner)
Project leadership and coordination for Austria: Assoc.-Prof. PD Dr. Kathryn Hoffmann, MPH
Project collaborators: Mag. Dr. Elena Jirovsky, Mag. Elisabeth Sophie Mayrhuber
The EUR-HUMAN project (http://eur-human.uoc.gr/) aimed to improve the capabilities and skills in health care provision to refugees and other migrants across Europe. As part of this project, an online course for doctors, especially general practitioners, was developed to support them in the frequently complex provision of health care to refugees and other migrants. The online course delivers specialist knowledge on the bio-psycho-social health needs of refugees and migrants in Austria, and also provides an overview of the legal situation of the doctors and of the asylum seekers in the primary care system. In addition, the course provides information on the health care offerings, institutions and supporting organizations in Austria.
Quality and Costs of Primary Care in Europe (QUALICOPC): http://www.qualicopc.eu/
The Appropriateness of Prescribing Antibiotics in Primary Health Care in Europe with Respect to Antibiotic Resistance (APRES); (EU FP7-HEALTH-2007; Partner) http://www.nivel.eu/apres/
Research focus Telemedicine in Primary Care
The research focus Telemedicine in primary care is a relatively new, but in the current situation all the more important, research focus of the unit.
Several studies are currently underway in this research focus, while two have already been concluded.
Furthermore, an optional course, “Telemedicine in primary care”, is being developed for medical students. Registration via MedCampus (SoSe).
Projects (ongoing)
Survey on the use of video consultations in general practice and in psychotherapy
Project leadership: Assoc. Prof. PD Dr. Kathryn Hoffmann, MPH
Project staff: Nicole Rumpler, MSC:, Florian Stummer, MPH, MBA, MCHL, PhD student (Edinburgh)
In Austria, the use of video consultations in general practice/primary care hardly existed until 2020 and, until March 2020, it was barely imaginable in the public sector due to a variety of hurdles put in place by the insurance companies and medical associations. However, the increased need to safely provide care to patients in their own homes in the wake of the COVID-19 pandemic to prevent mutual infection resulted in initial steps being taken in this direction.
The successful implementation of a teleconsultation program requires considering the interaction between organizational, technical, regulatory, financial, clinical and social factors as well as how organizations that apply it can steer this interaction through effective processes.
The aim of this study is to collect these factors for the first time for implementation in Austria.
Survey among medical students in Austria regarding medical care and counselling via telemedicine
Project head: Donau Universität Krems, Research Lab Society in Transition, Schwerpunkt Gesundheit und Gesellschaft, Mag. Dr. Christina Hainzl MSc, Isabella Juen, MA
Project board members: Medizinische Universität Innsbruck (Vizerektor Univ .Prof. Dr. Peter Loidl), Medizinische Universität Graz (Univ. Prof. Dr. med. Siebenhofer-Kroitzsch), Medizinische Universität Wien (Assoc. Prof. Priv.-Doz. Dr. Kathryn Hoffmann, MPH), Medizinische Fakultät der Johannes Kepler Universität Linz (Florian Stummer, MPH, MBA, MCHL)
Explorative survey to evaluate the experience, chances and barriers of video consultations in care homes in Upper Austria.
This study is being implemented in collaboration with Florian Stummer, MPH, MBA, MCHL, PhD student, who is the main project leader in the framework of his PhD.
In a first in the German-speaking world, this study aims to evaluate to what extent the use of video consultations in care homes is meaningful to support patients, doctors and care staff, and for what consultation and treatment events.
Projects (concluded)
Latido – Telemedicine
This project was funded by Latido Health Tech GmbH
Project head for the Medical University of Vienna: Assoc. Prof. PD Dr. Kathryn Hoffmann, MPH
The result of this project was a systematic literature review on the subject: telemedicine video consultations in general medicine care provision (in the private practitioner sector).
The report can be accessed here: hier
The intelligent software for practices (LATIDO)
This project was funded by Latido Health Tech GmbH
Project head for the Medical University of Vienna: Assoc. Prof. PD Dr. Kathryn Hoffmann, MPH
The aim was to advise on a novel organization of the patient file (structured data collection, rules for data structure, coding, medical episodes, usability, cross-patient search functions etc.).
COVID-19 and Primary Care
Health care provision by primary care / GP organizations (single practices, group practices, primary health care units) is fundamental in providing primary care to patients during an epidemic/pandemic and was able to prevent many possible collateral health damages. The primary care provided by general practitioners is the key medical field in terms of its relevance to the care of the population. Under ideal conditions, it can terminatory handle up to 70%-80% of all consultations. Good primary care can prevent hospital stays, especially related to chronic diseases, and can generally reduce the mortality from chronic diseases.
However, the COVID-19 pandemic has shown that despite its enormous significance for the health of the population, pre-existing structural deficits and a continued invisibility of the primary care sector in Austria (“hidden” in the out-patient sector) meant that there was no coordinated planning management that could quickly and effectively support the primary care professions. The challenging reorganization of the primary care organizations with regard to appointment management, regulation of access to the practices, time/spatial separation of infectious and non-infectious patients, adequate and sufficient protective equipment, and requirements for telemedicine depended on the assessments and resources as well as on the creativity of the individual actors.
Formulated positively, the past months witnessed an innovation spurt, especially with regard to infection prevention and telemedicine, which was also supported by the insurance companies and which will hopefully continue to be developed with the appropriate quality assurances for the wellbeing of the population.
Information and current activities
In August 2020, Gesundheit Österreich GmbH (GÖG) founded an interdisciplinary working group to develop official recommendations for the continued planning certainty of primary care organizations by the end of October 2020. Assoc. Prof. PD Dr. Kathryn Hoffmann is a member of this working group.
The recommendations can be found here: https://goeg.at/Empfehlung_PV_Pandemie
The Austrian Society for General Medicine (Österreichische Gesellschaft für Allgemeinmedizin, ÖGAM) has created a homepage together with the Karl Landsteiner University of Health Sciences in Krems: COVID-19 und Umgang in der Primärversorgung. On this site, up-to-date knowledge on SARS-CoV-2 and COVID-19 is collected, prepared and presented in a manner that is practically relevant. It also provides a link to a helpdesk on the subject for general practitioners.
Example of a current contribution: COVID-19 und Thrombosen: Was tun in der hausärztlichen Versorgung? (COVID-19 and thrombosis: what to do as a general practitioner?)
There are also COVID19 info talks organized by ÖGAM, which are short impulse contributions on relevant topics relating to COVID19. Here you can find e.g. the info talk on the subject of "diagnostic tests for COVID-19 in general practice - an overview"
Projects (ongoing)
PRICOV-19: Quality and Patient Safety in Primary Care in Times of a Pandemic - An Exploratory Cross-Country Study
Project lead: Prof. Dr. Sara Willems, Department of Public Health and Primary Care, Ghent University, Belgium
Project coordinator Austria: Assoc. Prof. PD Dr. Kathryn Hoffmann, MPH
Project staff Austria: appl.Prof. PD Dr. Ruth Kutalek, Dr. Susanne Rabady, Dr. Maria Wendler, Dr. Franz Mayrhofer
PRICOV-19 is an online questionnaire study in more than 35 European countries, in which the effects of the COVID-19 pandemic on the organization of primary care organizations (single practices, group practices and primary care centers), the efforts to ensure access to care for all patients and the effects on the various dimensions of quality of care are examined.
COVID-19 in primary care: Assessment of initial symptoms, risk factors and predictors for severe courses - a prospective observational study in General Practice in Austria (PrimeRisk II)
Project lead: Karl-Landsteiner Universität Krems (Frau Dr. Susanne Rabady)
Project consortium: Assoc. Prof. PD Dr. K. Hoffmann, MPH, Dr. G. Kamenski, Dr. M. Brose, Dr. O. Lammel, Dr. S. Poggenburg, Dr. M. Wendler, Dr. C. Auer, assoc. Prof. Dr. S. Zehetmayer
The aim of the study is to gain knowledge of the distribution and course of symptoms in primary care for COVID19 patients as well as the identification of risk factors and predictors for a complicated course (post-COVID, long-COVID, hospital stay, death) as a prerequisite for optimized monitoring and care.
Aufruf zur Beteiligung für Hausärztinnen und Hausärzte:
CoV-FIT: eine qualitative Studie zu Infektionsschutz, Infrastruktur, Rahmenbedingungen sowie zur Behandlung von Menschen mit und ohne infektiöse Erkrankungen in der COVID-19 Pandemie in der hausärztlichen Primärversorgung in Österreich
Projektleitung: assoc. Prof. PD Dr. Kathryn Hoffmann, MPH
Projektmitarbeiterinnen: Dr. Mira Mayrhofer, Nathalie, Szabo
Diese Studie wird gefödert aus Mitteln des medizinische-wissenschaftlichen Fonds des Bürgermeisters der Bundeshauptstadt Wien.
Die Studie ist eine Nachfolgestudie der europäischen online-Fragebogen-Studie Pricov19, an welcher sich dankenswerterweise viele von Ihnen bereits beteiligt haben! Als Rückmeldung auf den Fragebogen der Pricov19-Studie wurde des Öfteren genannt, dass er für die spezielle österreichische Situation mit vielen Einzelordinationen nicht ganz passend wäre.
Darauf möchten wir nun Rücksicht nehmen und mittels einer zusätzlichen qualitativen Studie ganz spezifisch erheben: Welche Hürden und Herausforderungen durch COVID-19 im hausärztlichen Bereich in Österreich entstanden sind, inwiefern diese bewältigt werden konnten und wo es Unterstützung gegeben oder diese gefehlt hat. Grob werden die Interviews fünf Themenblöcke umfassen: 1. Infektionsschutz: Praxisorganisation (Terminmanagement, Wartezimmermanagement), Infrastruktur der Praxis, Empfehlungen und Selbstfürsorge; 2. Remote Konsultation (Telemedizin, PatientInnen-Software, Videokonsultation); 3. Diagnostik, Testung, Meldung, Krankschreibung, Monitoring und Behandlung von COVID-19 Erkrankten sowie Behandlung von PatientInnen mit chronischen und anderen Erkrankungen; 4. Kommunikation mit Behörden, Gesundheitsämtern, Ärztekammern, KollegInnen, Kassen, 1450 etc.; 5. Erfahrungen zu Long-COVID.
Dafür suchen wir österreichweit insgesamt 30 InhaberInnen einer hausärztlichen Ordination (10-12x Einzelordinationen, 6x kleine Gruppenpraxen, 6x große Gruppenpraxen und 6x Primärversorgungszentren), welche an so einem wissenschaftlichen Interview über die Onlineplattform ‚Webex‘ teilnehmen möchten, um ihre Erfahrungen und Erlebnisse des letzten Jahres mit uns zu teilen.
Bei Interesse schreiben Sie bitte ein kurzes Mail an Nathalie Szabo: nathalie.szabo@meduniwien.ac.at. Diese wird Sie dann kontaktieren und alle weiteren Details besprechen und den Interviewtermin vereinbaren.
Wir würden uns sehr über Ihre Teilnahme an der CovFIT-Studie freuen!
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