title: On-call service of neurosurgeons in Germany: organization, use of communication services, and personal acceptance of modern technologies.
abstract: BACKGROUND
  A significant proportion of acute care neurosurgical patients present to hospital outside regular working hours. The objective of our study was to evaluate the structure of neurosurgical on-call services in Germany, the use of modern communication devices and teleradiology services, and the personal acceptance of modern technologies by neurosurgeons.
  
  
  METHODS
  A nationwide survey of all 141 neurosurgical departments in Germany was performed. The questionnaire consisted of two parts: one for neurosurgical departments and one for individual neurosurgeons. The questionnaire, available online and mailed in paper form, included 21 questions about on-call service structure; the availability and use of communication devices, teleradiology services, and other information services; and neurosurgeons' personal acceptance of modern technologies.
  
  
  RESULTS
  The questionnaire return rate from departments was 63.1% (89/141), whereas 187 individual neurosurgeons responded. For 57.3% of departments, teleradiology services were available and were frequently used by 62.2% of neurosurgeons. A further 23.6% of departments described using smartphone screenshots of computed tomography (CT) images transmitted by multimedia messaging service (MMS), and 8.6% of images were described as sent by unencrypted email. Although 47.0% of neurosurgeons reported owning a smartphone, only 1.1% used their phone for on-call image communication.
  
  
  CONCLUSIONS
  Teleradiology services were observed to be widely used by on-call neurosurgeons in Germany. Nevertheless, a significant number of departments appear to use outdated techniques or techniques that leave patient data unprotected. On-call neurosurgeons in Germany report a willingness to adopt more modern approaches, utilizing readily available smartphones or tablet technology.
authors.affiliation: Department of Neurosurgery, University Medical Center Mannheim, Mannheim, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Brenke
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
authors.forename: Elke A
authors.initials: EA
authors.lastname: Lassel
authors.affiliation: Mannheim Institute of Public Health, University Medical Center Mannheim, Mannheim, Germany.
authors.forename: Darcey
authors.initials: D
authors.lastname: Terris
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
authors.forename: Aysel
authors.initials: A
authors.lastname: Kurt
authors.affiliation: Department of Neurosurgery, University Medical Center Mannheim, Mannheim, Germany.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Schmieder
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
authors.forename: Stefan O
authors.initials: SO
authors.lastname: Schoenberg
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Weisser
mesh_terms: D000328:Adult; D020811:Biomedical Technology / Q000706:statistics & numerical data*; D040421:Cell Phone / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D019112:Teleradiology / Q000706:statistics & numerical data*