Need-based care of multi-morbid patients – supporting general practitioners with algorithm-generated recommendations of healthcare services (telemedicine-project ATMoSPHÄRE)

Background The patient-oriented and need-based care of multi-morbid patients with healthcare services and assistive products can be a highly complex task for the general practitioners (GPs). An algorithm-based digital recommendation system (DRS) for healthcare services was developed within the context of the telemedicine research project ATMoSPHÃRE. The plausibility of the DRS was tested and the results used to examine if, and to what degree, the DRS provides useful assistance to GPs. Methods The plausibility of the recommendations of the DRS were tested with the Delphi procedure (n = 8) and Interviews (n = 4) in collaboration with the GPs. They proposed services and assistive products they considered appropriate for two multi-morbid patients. Furthermore, GPs had to report whether, and to what degree they deemed the algorithm-generated recommendations appropriate. Significant quantitative differences between the GPs', and the algorithm-generated, recommendations were evaluated with paired-samples-Wilcoxon-test. Results The first Delphi round revealed a high variability regarding the amount and character of services recommended by the physicians (1 to 10 recommendations, mean = 5.6, sd = 2.8). These professional recommendations converged after consideration of the algorithm-generated recommendations. The number of algorithm-generated recommendations which were judged as appropriate ranged between 7 and 17 of a total of 20 (mean = 11.9, sd = 2.5). The interviews revealed that the additional algorithm-generated recommendations which were judged appropriate contained mainly social care services. Conlusion The DRS provides GPs with additional appropriate recommendations for the need-based care of patients, which may not have been previously considered. It can therefore be assessed as a helpful complement in the primary care of multi-morbid patients. Keywords: Telemedicine, Recommender system, Primary care, Multimorbidity, Decision support system, eHealth