# CareConnect: An Implementation Pilot Study of a Participatory Telecare Model in Long-Term Care Facilities

## TL;DR

A pilot study shows that telecare can be successfully used in nursing homes with the right implementation strategies.

## Contribution

The study introduces a participatory telecare model and identifies key factors for its successful adoption in long-term care.

## Key findings

- Telecare was feasible for specific clinical use cases in nursing homes.
- Participatory implementation increased acceptance and use among nurses.
- Most telecare cases did not require in-person visits, saving time and resources.

## Abstract

What are the main findings?
Telecare was rated feasible for certain clinical use cases in nursing homes.Participatory implementation and early involvement facilitated acceptance and use among nurses.

Telecare was rated feasible for certain clinical use cases in nursing homes.

Participatory implementation and early involvement facilitated acceptance and use among nurses.

What is the implication of the main finding?
Sustainable telecare adoption requires interoperable infrastructure, ongoing workforce training, context-sensitivity, and clear reimbursement structures.Co-design and iterative strategies appear essential for successful uptake of telecare in long-term care facilities.

Sustainable telecare adoption requires interoperable infrastructure, ongoing workforce training, context-sensitivity, and clear reimbursement structures.

Co-design and iterative strategies appear essential for successful uptake of telecare in long-term care facilities.

Background: Digital transformation in healthcare has advanced rapidly in hospitals and primary care, while long-term care facilities have often lagged behind. In nursing homes, nurses play a central role in coordinating care and accessing medical expertise, yet digital tools to support these tasks remain inconsistently implemented. The CareConnect study, funded under the German Model Program for Telecare (§ 125a SGB XI), aimed to develop and implement a multiprofessional telecare system tailored to nursing home care. Objective: This implementation study examined the feasibility, acceptability, and early adoption of a multiprofessional telecare system in nursing homes, focusing on implementation processes, contextual influences, and facilitators and barriers to integration into routine nursing workflows. Methods: A participatory implementation design was employed over 15 months (June 2024–August 2025), involving a university hospital, two nursing homes (NHs), and four medical practices in an urban region in Germany. The telecare intervention consisted of scheduled video-based teleconsultations and interdisciplinary case discussions supported by diagnostic devices (e.g., otoscopes, dermatoscopes, ECGs). The implementation strategy followed the Standards for Reporting Implementation Studies (StaRI) and was informed by the Consolidated Framework for Implementation Research (CFIR). Data sources included telecare documentation, nurse surveys, researcher observations, and structured feedback discussions. Quantitative and qualitative data were analyzed descriptively and triangulated to assess implementation outcomes and mechanisms. Results: A total of 152 documented telecare contacts were conducted with 69 participating residents. Most interactions occurred with general practitioners (48.7%) and dermatologists (23%). Across all contacts, in 79% of cases, there was no need for an in-person visit or transportation. Physicians rated most cases as suitable for digital management, as indicated by a mean of 4.09 (SD = 1.00) on a 5-point Likert scale. Nurses reported improved communication, time savings, and enhanced technical and diagnostic skills. Key challenges included delayed technical integration, interoperability issues, and varying interpretations of data protection requirements across facilities. Conclusions: This pilot study suggests that telecare can be feasibly introduced and accepted in nursing home settings when implemented through context-sensitive, participatory strategies. Implementation science approaches are essential for understanding how telecare can be sustainably embedded into routine nursing home practice.