title: Is telemonitoring an option against shortage of physicians in rural regions? Attitude towards telemedical devices in the North Rhine-Westphalian health survey, Germany.
abstract: BACKGROUND
  General practitioners (GP) in rural areas of Germany are struggling to find successors for their private practices. Telemonitoring at home offers an option to support remaining GPs and specialists in ambulatory care.
  
  
  METHODS
  We assessed the knowledge and attitude towards telemedicine in the population of North Rhine-Westphalia (NRW), Germany, in a population-based telephone survey.
  
  
  RESULTS
  Out of 2,006 participants, 734 (36.6%) reported an awareness of telemedical devices. Only 37 participants (1.8%) have experience in using them. The majority of participants were in favour of using them in case of illness (72.2%). However, this approval declined with age. These findings were similar in rural and urban areas. Participants who were in favour of telemedicine (n = 1,480) strongly agreed that they would have to see their doctor less often, and that the doctor would recognize earlier relevant changes in their vital status. Participants who disliked to be monitored by telemedical devices preferred to receive immediate feedback from their physician. Especially, the elderly fear the loss of personal contact with their physician. They need the direct patient-physician communication.
  
  
  CONCLUSIONS
  The fear of being left alone with the technique needs to be compensated for today's elderly patients to enhance acceptance of home telemonitoring as support for remaining doctors either in the rural areas or cities.
authors.affiliation: NRW Centre for Health, Bielefeld 33611, Germany. claudia.terschueren@lzg.gc.nrw.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Terschüren
authors.forename: Monika
authors.initials: M
authors.lastname: Mensing
authors.forename: Odile C L
authors.initials: OC
authors.lastname: Mekel
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001292:Attitude to Computers; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D004522:Educational Status; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000600:supply & distribution*; D019114:Remote Consultation; D019035:Rural Health Services; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000295:instrumentation* / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D000078329:Workforce