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ANNOTeM stands for Acute Neurological Network in Northeast Germany with TeleMedicine support.

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Project description

Z-1 and Z-2: Charité Campuses CBF and CCM, Z-3: Unfallkrankenhaus Berlin, Z-4: Universitätsmedizin Greifswald, Z-5: Epilepsieklinik Tabor Bernau

Acute neurological diseases such as stroke, epileptic seizures, encephalitis, meningitis, paraplegic syndromes, and traumatic brain injury are among the most common causes of permanent disability. Therapies that have shown to improve the prognosis of those affected are often not available in rural, structurally weak regions due to the lack of neurological expertise, or are only available with delay. The ANNOTeM network aims to improve the quality of treatment of neurological emergencies in Brandenburg, Mecklenburg-Western Pomerania and Saxony-Anhalt. To this end, ANNOTeM connects general care clinics in rural areas with highly specialized neurological maximum care clinics.

Central elements are

  • establishment of structures and personnel for regional units specializing in acute neurological diseases ("neuro-acute units")
  • acute neurological teleconsultation services around the clock ("24/7")
  • establishment of standardized processes in line with current guidelines, taking into account regional possibilities
  • optimizing and coordinating transfers when patients need therapies that are not available in the regional network hospitals (e.g. thrombectomy)
  • continuous quality assurance for all acute neurological diseases
  • Continuous, regional and central training for all professional groups (doctors, nurses, and therapists)


"Time is brain": The earlier treatment of acute neurological emergencies begins, the better are the chances that symptoms will disappear and that those affected will not suffer permanent limitations. In rural areas however, rapid on-site neurological care is not always possible.

By providing specialists from supra-regional neurological centers with the information they need for a comprehensive assessment of the disease via telemedicine, they can support regional emergency departments in diagnosis and initial treatment steps. Acute neurological symptoms such as paralysis, speech and consciousness disorders can be easily assessed audio-visually. Likewise, data from a CT or MRI examination as well as results of laboratory tests can be transmitted very well in digital form.

Telemedical networks have already proven their worth in stroke therapy. An extension of the telemedical treatment spectrum to other neurological emergency diseases is now being implemented within the framework of the ANNOTeM project.

Scientific evaluation and outlook

The project was funded by the Innovation Fund at the Federal Joint Committee from February 2017 to January 2021. Within this framework, an evaluation of the effects of telemedically supported emergency care of acute neurological clinical diseases was carried out. In addition, the effects of telemedically supported differential diagnoses and therapies of epileptic seizures were examined.

The evaluation is currently being assessed (as of May 2021). The results will be presented to the Federal Joint Committee (G-BA) and can be incorporated into the medical guidelines or serve the legislator as a basis for structural changes to the legal framework.

The ANNOTeM project intends to realize a form of health care that can also be used as a health care model in other structurally weak regions of Germany – by adapting it to regional requirements. In the medium term, the concept can be expanded in a modular way, for example by integrating rescue services and outpatient aftercare. The infrastructure for telemedical examinations and transmission of findings (e.g. X-ray or ECG transmission) can also be used in the future for the care of non-neurological clinical pictures, e.g. in traumatology, cardiology, gynecology or pediatrics.


Project Coordination and Steering Committee

  • Charité – Universitätsmedizin Berlin
    • Prof. Heinrich A. Audebert, MD (Principal Investigator)
    • Prof. Matthias Endres, MD (Director of the Department of Neurology and Experimental Neurology)
    • Hebun Erdur, MD (Network Coordinator)
    • Christiana Franke, MD (Regional Network Coordinator Charité)

  • Unfallkrankenhaus Berlin
    • Ingo Schmehl, MD (Director of the Department of Neurology)
    • Stephan Kinze, MD (Regional Network Coordinator Charité)

  • Universitätsmedizin Greifswald
    • Prof. Agnes Flöel, MD (Director of the Department of Neurology)
    • Stephan Kinze, MD (Regional Network Coordinator UKB)

  • Epilepsieklinik Tabor Bernau
    • Prof. Hans-Beatus Straub, MD (Chief Physician of Epilepsieklinik Tabor Bernau)
    • Ali Sotoodeh, MD (Network Coordinator Tele-Epilepsy)

Tele-Neurologists (Charité only)

  • Janina Behrens, MD
  • PD Thomas Liman, MD
  • PD Ludwig Schlemm, MD

Management and Administration

  • Claudia Gorski

Stroke Nurses

  • Birgit Landes-Fritzsche
  • Ulrike Hopf

Evaluating Institute: Berlin School of Public Health

  • Prof. Tobias Kurth, MD ScD
  • Sara Theen
  • Farid Ihab Kandil, PhD

Consortium partners

  • Charité – Universitätsmedizin Berlin
  • Universitätsklinikum Greifswald
  • Unfallkrankenhaus Berlin
  • Epilepsie-Zentrum Berlin-Brandenburg (Epilepsieklinik Tabor Bernau)
  • AOK-Nordost
  • Techniker Krankenkasse

Network clinics

  • Bergen/Rügen, Sana Krankenhaus Rügen GmbH
  • Kyritz, KMG-Klinikum Kyritz
  • Luckenwalde, KMG-Klinikum Luckenwalde
  • Ludwigsfelde-Teltow, Evangelisches Krankenhaus Ludwigsfelde-Teltow gGmbH
  • Nauen, Havelland Kliniken – Klinik Nauen
  • Strausberg, Krankenhaus Märkisch-Oderland
  • Templin, Sana Krankenhaus Templin
  • Ueckermünde, AMEOS-Klinikum Ueckermünde
  • Rathenow, Havelland Kliniken – Klinik Rathenow
  • Prenzlau, GLG Kreiskrankenhaus Prenzlau
  • Gardelegen, Altmark-Klinikum Krankenhaus Gardelegen