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. 2023 Nov 9;10:1251915. doi: 10.3389/fmed.2023.1251915

Table 1.

Network characteristics.

Competence network Long COVID Rhein-Neckar Long COVID network Ludwigsburg
Start

  • - May 22, 2021

  • - January 01, 2022
Funding

  • - Realization MWK1: Personnel costs in the university setting and compensation for participation in self-help.

  • - Evaluation MWK1: Reimbursement of expenses for participation in the SWOT analysis

  • - Realization: none

  • - Evaluation MWK1: Reimbursement of expenses for participation in the SWOT analysis
Structure

  • - Trigger: Appointment requests at the University’s Long COVID Outpatient Clinic that cannot be accommodated due to capacity constraints.

  • - Continuation of an intersectoral cooperation between the Department of General Practice & Health Services Research and the Department of Internal Medicine IV/Long COVID Outpatient Clinic of Heidelberg University Hospital, which was established during the COVID-19 pandemic.2

  • - Identification of stakeholders and interested parties in a snowball system

  • - Trigger: Perceived needs in the ambulatory sector and response to closure of the Long COVID Outpatient Clinic at the nearby hospital.

  • - Informal association of general practitioners, ambulatory specialists, and therapists as well as two rehabilitative institutions

  • - Integrated into the regional “Quality in Ambulatory Medicine Working Group” (initiative of the ambulatory medical profession)
Coordination

  • - General Practitioner from the Department of General Practice & Health Services Research (SS) and Specialist in Gastroenterology from the Department of Internal Medicine IV/Long COVID Outpatient Clinic of Heidelberg University Hospital (UM)

  • - General practitioner (JK)
Consensus goals

  • - Provide long-term medical care services with sufficient capacity and based on current knowledge.

  • - Share knowledge

  • - Identify and communicate contacts

  • - Coordinate patient pathways

  • - Communicate information

→Improve skills
→Making the most of existing outpatient resources
→Increase acceptance of the disease
→Reduce uncertainties in treatment
→Avoid both underuse and overuse

  • - Identification of patients in need of advanced or specialized diagnostic/therapeutic services

  • - Provide specialized medical diagnostic and treatment services in an interdisciplinary network

  • - Application of treatment methods according to indication and need, avoiding underuse, overuse or misuse

  • - Fostering personal resources and resilience factors of patients to increase the ability to cope with everyday life and professional resilience.

  • - Counteracting uncertainty, dysfunctional coping and chronification of symptoms

  • - Network-wide incorporation of new knowledge and experience in diagnostics and therapy, and adaptation of network structures as required.
Network definition

  • - Participation = Listing as network partner on the web site and/or participation in the advisory board.

  • - Requirements for listing: 1. involvement in Long COVID medical care; 2. active participation in knowledge transfer or on the advisory board; and/or 3. certificate of participation in Long COVID continuing education.

  • - Statement: Basic medical care is provided by any general practitioner, therefore no listing of general practitioners on the web site.

  • - Orientation of care toward the consented care concept (general practitioners based medical care and coordination; stepped concept).

  • - Advisory board: Multidisciplinary (medicine: general practice, gastroenterology, pediatrics, psychiatry, psychosomatics, rheumatology, sports medicine), multispecialty (occupational therapy, physiotherapy, psychotherapy), intersectoral (ambulatory and university hospital) providers; medical profession/medical association, association of statutory health insurance physicians, local authorities, health insurance funds, self-help groups of those affected.

  • - Participation = Listing as network partner on the web site

  • - The network is defined by its aims

  • - The coordination of diagnosis and treatment is carried out by the respective general practitioner or Long COVID specialized general practices based on of written treatment pathways and interface agreements between different medical groups and service providers. Each referral for co-treatment by a specialist must contain the complete results of the basic diagnostics, the current therapy and anamnestic information (“interface agreements”). The referral for medical or therapeutic co-treatment is made by the coordinating practice, stating the problem and the urgency (time frame).
Activity status May 2023

  • - Project end date December 31, 2022

  • - Follow-up project with focus on supra-regional network ongoing with work package participatory regional network development in pilot regions

  • - Web site is maintained by the Department of General Practice and Health Services Research Heidelberg, 34 network partners listed (26 ambulatory, 7 inpatient/university hospital), 11 specialties/professions

  • - 36 participating practices/facilities (ambulatory), 11 specialties/professions, 52 mailing list individuals

1Project funded by the Ministry of Science, Research and Art Baden-Wuerttemberg (MWK) “Prevention of sequelae and chronification in Long COVID by developing a regional network with a stepped care concept and piloting a general practice based case management with app (PrELongCOV).” Network development and the SWOT analysis are work packages of the project. The realization was done in cooperation with the Competence Network Preventive Medicine. 2Stengel et al. (28).