Dr. Joachim Weber, coordinator of the Clinical Research Unit at BIH/Charité, leads ANNOTeM (Acute Neurological Care in North-East Germany with Tele-medical Support) to bring expert neurological care to rural Brandenburg and Mecklenburg-Vorpommern via 24/7 telemedicine. Grounded in the “time is brain” principle, the network links regional clinics with central neurologists and rapid, easy-to-use diagnostics such as ANT Neuro’s waveguard™ touch dry EEG and eego™ mylab. This enables fast triage for emergencies like stroke or status epilepticus with minimal local training, even in busy ER/ICU settings. Over three years, ANNOTeM will evaluate outcomes and efficiency to create a scalable model for teleneurology in underserved regions.
Meet the Researcher
Dr. Joachim Weber, coordinator of the Clinical Research Unit at the Berlin Institute of Health and senior physician for Neurology at the Charité – Universitätsmedizin Berlin.
Dr. Joachim Weber is the coordinator of the Clinical Research Unit at the Benjamin Franklin Campus, which is part of the Berlin Institute of Health. He also serves as senior physician for Neurology at the Charité – Universitätsmedizin Berlin. Dr. Weber is Network Coordinator of the ANNOTeM (Acute Neurological Care in North-East Germany with Tele-medical Support) project.
Time is brain
Patients with acute neurological damage (for example, through suffering a stroke) require immediate treatment in order to minimize future neurological impairments (Saver, 2006). This is problematic in rural areas in which patients have to travel large distances to reach the nearest hospital with adequate resources and expertise (Dorsey, Glidden, Holloway, Birbeck, & Schwamm, 2018). The recently started ANNOTeM project aims to improve neurological care in the German states of Brandenburg and Mecklenburg-Vorpommern by using telemedicine. Another objective is to validate the outcome of applying the latest teleneurological technologies to provide optimal healthcare support from a distance.
The ANNOTeM project
ANNOTeM is a large-scale project funded by the German Federal Joint Committee (Gemeinsamer Bundesausschuss G-BA) that brings together experts in the fields of neurology, telemedicine, and neuro-imaging manufacturers in cooperation with health insurance companies to improve emergency care in remote areas in northeastern Germany. The project is led by Professor Audebert, Medical Director of the Clinic for Neurology at the Campus Benjamin Franklin of the Charité Universitätsmedizin Berlin, and Professor Endres, Director of the Department of Neurology at the Charité Universitätsmedizin Berlin. Project members include centers with high-end neurological expertise and regional hospitals in less populated areas, mainly without their own neurological department (see Figure 1). Using a network station, neurologists from central hospitals are available around the clock to examine patients telemedically in remote clinics and to advise treating physicians without leaving their office.
One of the crucial technologies for enabling remote diagnostics is the use of suitable brain imaging techniques and equipment, which can be applied quickly and easily without the need of expert knowledge in remote regions. ANT Neuro’s dry EEG cap waveguardTM touch and eegoTM mylab EEG amplifiers have been selected as the optimal solution for these requirements. Two major advantages of dry EEG over conventional gel-based EEG are the significantly reduced time for electrode application and that it requires minimal training to operate. waveguard touch enables rapid EEG acquisition in rural hospitals while the experts from central hospitals can focus on the review of the received EEG signals for quick initial diagnosis. Such quick screening is especially crucial in the case of acute neurological emergencies such as altered mental status caused by status epilepticus. An additional advantage of combining waveguard touch and eego mylab is that it can be performed in a multitude of environments such as the emergency room or intensive care unit (ICU). waveguard touch and eego mylab work optimally together to ensure robust signal acquisition in the noisy ICU or emergency room due to the integrated active shielding.
Dr. Weber and the teams in the neurological centers in Berlin and Greifswald can access the EEG recordings performed at the remote clinics through dedicated computer systems and networks. Data collected during the three-year project will help the project team to draw well-founded conclusions about the efficacy and efficiency of teleneurological care. This approach could prove to be an ideal solution for clinics in remote areas that do not have a neurology department.
Figure 1: Scope of the ANNOTeM project, showing both the larger hospitals (yellow stars) and regional clinics (blue dots).
Future directions
The ANNOTeM project is currently in full swing. Ultimately, it aims to compare performance of clinics that use telemedicine support to those applying conventional care. If the use of telemedicine and quick imaging technologies is proven to increase coverage and quality of care and to positively influence health outcomes in patients with acute neurological emergencies, then this could mean a milestone for better clinical care for a huge population living in rural areas across the world.
For more information about the ANNOTeM project, please visit the dedicated website: https://www.annotem.de
