解读远程会诊中的患者参与

Zhening Liu, Alistair Brandon‐Jones, Christos Vasilakis
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引用次数: 0

摘要

本文旨在研究远程咨询服务中的患者参与问题,鉴于过去十年中远程医疗和其他形式的远程医疗在全球范围内的显著扩张,患者参与已成为医疗运营管理(HOM)面临的一个日益重要的问题。我们通过对文献的分析,建立了一个综合框架,其中包含患者旅程、多维度、前因后果、干预和改进方案,以及患者参与的周期性。我们还提出了适用于对我们框架的不同方面进行实证评估的措施。我们从三个关键方面对患者参与远程会诊进行了概念化:维度、过程以及参与的前因后果。我们确定了影响这种参与的九个背景类别。我们提出了在远程会诊的三个阶段(会诊前、会诊中和会诊后)衡量患者参与度的几种可能的衡量标准,以及在这些阶段提高患者参与度的干预措施和可能的方案。此外,我们还将参与度的三个维度与临床过程联系起来,为未来的参与度评估创建了一个结构。此外,我们还确定了参与远程会诊的影响因素和结果,通过了解这些因素和结果,有助于提高远程会诊的采用率、应用率和满意度,并减少医疗不平等现象。最后,我们采用了 "循环 "视角,并确定了可结合使用的潜在干预措施,以进一步提高患者对远程会诊的参与度。
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Unpacking patient engagement in remote consultation
PurposeThe purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the significant expansion in this and other forms of telehealth worldwide over the last decade. We use our analysis of the literature to develop a comprehensive framework that incorporates the patient journey, multidimensionality, antecedents and consequences, interventions and improvement options, as well as the cyclic nature of patient engagement. We also propose measures suitable for empirical assessment of different aspects of our framework.Design/methodology/approachWe undertook a comprehensive review of the extant literature using a systematic review approach. We identified and analysed 63 articles published in peer-reviewed scientific journals between 2003 and 2022.FindingsWe conceptualise patient engagement with remote consultation across three key aspects: dimensions, process, and the antecedents and consequences of engagement. We identify nine contextual categories that influence such engagement. We propose several possible metrics for measuring patient engagement during three stages (before service, at/during service and after service) of remote consultation, as well as interventions and possible options for improving patient engagement therein.Originality/valueThe primary contribution of our research is the development of a comprehensive framework for patient engagement in remote consultation that draws on insights from literature in several disciplines. In addition, we have linked the three dimensions of engagement with the clinical process to create a structure for future engagement assessment. Furthermore, we have identified impact factors and outcomes of engagement in remote consultation by understanding which can help to improve levels of adoption, application and satisfaction, and reduce healthcare inequality. Finally, we have adopted a “cyclic” perspective and identified potential interventions that can be combined to further improve patient engagement in remote consultation.
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