Zusammenfassung In Anbetracht des demografischen Wandels wurde bereits die Notwendigkeit zur intersektoralen Versorgung der alternden Bevölkerung identifiziert. Die Strategien zur Umsetzung sind vielfältig und setzen an verschiedenen Hebeln an, die jeweils unterschiedliche Sektorenüberschneidungen voraussetzen. Der Artikel bietet einen Überblick über bereits abgeschlossene und noch laufende Projekte zur Versorgung geriatrischer Patienten. Dabei wird deutlich: Der Aufbau von Netzwerken als unverzichtbare Basis für Intersektoralität kann nicht in direkten Interventionseffekten messbar gemacht werden und erschwert somit den Kosten-Nutzen-Nachweis. Ebenso zeigt sich, dass einige Forschungsprojekte bei der Überführung in die Regelversorgung durch finanzielle und personelle Engpässe scheitern. Brauchen wir in Deutschland ein Umdenken oder weniger innovationsbezogene Förderlinien zur besseren Implementierung und Erforschung bereits existierender Konzepte? Internationale Vorbilder wie Japan machen klar: Die Kostenreduktion bei der Versorgung der alternden Bevölkerung sollte langfristig betrachtet werden und bedarf kurzfristig erhöhter Finanzvolumina. Für eine nachhaltige Implementierung von sektorenübergreifenden Ansätzen im Alltag sollte deshalb die Versorgungsforschung fest(gefahren)e Strukturen, Abläufe und Finanzierungen neu ordnen. Durch Verknüpfung der unzähligen Projekte und Ideen verschiedener Bereiche könnte in Zukunft eine Realisierung des Anspruchs der intersektoralen Versorgung geriatrischer Patienten erreicht werden.

The study presents a local large language model pipeline for automated feedback in pediatric simulation-based medical education. The system generates structured reports using the Liverpool Undergraduate Communication Assessment Scale. Four communication simulations were processed and evaluated against human feedback. The model generated structured reports with total scores (mean = 13.9 ± 1.2) comparable to human ratings (mean = 12.8 ± 2.9). Scenario-level analyses indicated variation in some cases but overall reliable performance across simulation runs. The pipeline demonstrated lower inter-rater variability (SD = 0.7–1.7) than human examiners (SD = 1.3–2.9), indicating greater internal consistency. The findings inform a forthcoming prospective evaluation.

Introduction: Urgent and emergency care in Germany is delivered across multiple, loosely connected sectors. In the absence of coherent, time-resolved data on patient movements between emergency medical services (EMS), out-of-hours ambulatory care, emergency departments (EDs) and inpatient care, inefficiencies and coordination gaps remain difficult to quantify. A process-centric, trans-sectoral analysis is required to characterise real-world patient pathways and identify actionable levers for improvement. The study aims to reconstruct, model and analyse patient pathways for urgent health complaints across all relevant sectors of the healthcare system in a German model region. Methods and analysis: We will employ a mixed-methods observational study design. Routine data from EMS, out-of-hours ambulatory care, EDs and subsequent inpatient care will be pseudonymised at source, linked via a trusted third party and analysed within a trusted research environment. Time-stamped event logs will support process mining for discovery, conformance and performance analysis alongside descriptive statistics with stratification by context, such as setting, time of day, urgency and patient cohorts. Anonymous cross-sectional surveys of patients and front-line professionals, complemented by quarterly snapshot surveys in out-of-hours ambulatory care and interviews, will provide convergent evidence on the motives, barriers and coordination of utilisation behaviour. Enrolment for surveys is anticipated from the fourth quarter of 2025; routine data capture covers 1 January–31 December 2026; analyses and dissemination run until 31 December 2027. Ethics and dissemination: The study received ethical approval from the Ethics Committee of the Medical Faculty at RWTH Aachen University (EK 25-351). Survey modules are conducted anonymously with voluntary participation and without collection of direct identifiers; routine care data are processed in pseudonymised form and analysed within a trusted research environment. Stakeholder interviews will be conducted with informed consent. Results will be disseminated through peer-reviewed publications, conference presentations and summary reports for participating institutions and stakeholders, complemented by plain-language materials to support patient-centred navigation. Trial registration number: DRKS00035916.

Background: In paediatric osteoarticular infections, microorganism detection is unsuccessful in up to 55% of cases, which is not satisfactory for targeted antibiotic therapy. In particular, anaerobic fusobacteria may be underdiagnosed owing to a lack of knowledge about their properties. Methods: Based on three of our own cases and a systematic literature review regarding paediatric osteoarticular fusobacterial infections, we extracted characteristic variables and synthesised them in terms of frequencies and mean comparisons. We followed the CARE and PRISMA guidelines. Results: In our three patients with hip area infections (aged 11, 12, and 16 years; two males and one female; two with Fusobacterium nucleatum [FNU] and one with Fusobacterium necrophorum [FNE]), we only detected FNU with PCR. The patient with an FNE infection showed a septic and protracted course with six surgical interventions and secondary coxarthrosis during the follow-up. The FNU infections were milder and healed without sequelae. In the literature, there are no articles with more than 3 cases; overall, we identified 38 case reports and 3 case series with a total of 45 patients. Across all synthesised cases (73% boys), the age was 9.2 ± 4.1 years. Most patients (42%) were affected by hip joint arthritis, with or without accompanying acetabular or femoral osteomyelitis, followed by knee joint arthritis, with or without osteomyelitis, in 24% of patients. In 49% of cases, there was an ear, nose, and throat focus. Depending on the affected structure, arthrotomy (33%), arthroscopy (11%), bone (24%), and soft tissue (9%) debridement were performed, with 34% of the procedures having to be performed several times. Penicillins, metronidazole, and clindamycin were the most used antibiotics. In 32 cases (71%), the authors reported healing without sequelae. Conclusions: When samples are collected in the operating theatre for paediatric osteoarticular infections, orthopaedic surgeons should also ensure correct anaerobic sampling and consider the possibility of performing PCR. A typical child with an osteoarticular fusobacterial infection is a boy of approximately 10 years of age with an infection in the hip area and a previous infection in the ENT area.

Background: Digital transformation in healthcare has progressed rapidly in hospitals and primary care, while long-term care facilities have often been left behind. The CareConnect project, funded under the German Model Program for Telecare (§ 125a SGB XI), aimed to implement and evaluate a comprehensive telecare system in two nursing homes in Germany, to improve collaboration across sectors, enhance communication between professionals, and strengthen nurses’ digital competencies. Objective: This implementation study examined the feasibility, acceptability, and early adoption of a multiprofessional telecare system in nursing homes, identifying key facilitators, barriers, and perceived effects on interprofessional collaboration and care delivery. 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. The intervention consisted of teleconsultations and interdisciplinary case discussions utilizing a certified video platform, combined with diagnostic devices (e.g., otoscopes, dermatoscopes, ECGs). Implementation data included quantitative usage statistics, researcher observations, and user feedback collected during the rollout phase. Data were analyzed descriptively to assess usage patterns, case characteristics, and implementation experiences. 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: The CareConnect pilot demonstrates that telecare can effectively improve access to specialized care and strengthen interprofessional collaboration in nursing homes. A participatory, user-centered approach proved crucial for acceptance and sustainability. Future scale-up requires stable technical infrastructures, clear reimbursement pathways, and harmonized legal frameworks.