使用远程评估工具替代常规门诊护理:范围审查。

IF 8.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Journal of Medical Internet Research Pub Date : 2025-03-04 DOI:10.2196/65938
Jayne Barclay, Clair Sullivan, Michael Beckmann, Graeme Mattison, Rebecca Runciman, Elizabeth Martin
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引用次数: 0

摘要

背景:受人口结构变化、个性化医疗的兴起和技术创新的驱动,全球对卫生保健的需求不断增加,这需要新的卫生保健提供方法。数字远程评估工具已经成为一种很有前途的解决方案,它实现了结合传统和远程患者管理的混合护理模式。这些工具通过加强对患者报告数据的监测和评估来支持医疗保健的四重目标,从而改善患者护理、提高操作效率、降低成本并改善患者和临床医生的体验。本综述旨在了解远程评估工具如何用于成人三级保健中心的常规咨询替代。目的:本综述旨在评估成人三级保健中心用于常规会诊替代的数字远程评估工具的实施和健康结果。目的包括评估这些工具在替代传统门诊护理中的使用程度、类型和有效性。方法:根据PRISMA-ScR(系统评价和荟萃分析扩展范围评价的首选报告项目)清单进行全面的范围评价。这篇综述的重点是在三级医疗机构中使用依赖互联网的远程评估技术进行患者数据转移的研究。在多个数据库中使用了详细的搜索策略,根据预定义的纳入和排除标准选择研究。数据提取和分析由独立审查人员执行,重点关注工具的功能及其与医疗保健四重目标的一致性。结果:该综述包括12项研究,强调了在不同临床环境中对远程评估技术日益增长的兴趣。干预时间长短不等,从4周到12个月不等,并展示了一系列功能,包括症状监测和术后随访。这些工具的使用与临床结果的改善有关,如对临床恶化的及时干预和增强临床方案的依从性。此外,少数研究确定了在减少计划外医疗接触和优化临床资源利用方面可能节省的成本。患者和临床医生的体验总体上是积极的,他们高度遵守远程评估,并对这些技术促进的个性化和及时护理表示赞赏。障碍包括数字技术的初始设置成本高,导致小样本研究中每位患者的成本过高。结论:数字远程评估工具通过改善健康结果、降低成本和丰富患者和临床医生的经验,为加强医疗服务提供了巨大的潜力。它们的灵活性和适应性使它们适合各种临床环境,支持个性化护理和操作效率。虽然数字远程评估工具提供了巨大的潜力,但仔细考虑实施策略、公平性、成本以及临床医生和患者的经验对于成功的临床整合至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Use of Remote Assessment Tools to Substitute Routine Outpatient Care: Scoping Review.

Background: The increasing global demand for health care, driven by demographic shifts, the rise of personalized medicine, and technological innovations necessitate novel approaches to health care delivery. Digital remote assessment tools have emerged as a promising solution, enabling hybrid care models that combine traditional and remote patient management. These tools support the quadruple aim of health care by enhancing the monitoring and evaluation of patient-reported data, thereby improving patient care, boosting operational efficiency, reducing costs, and improving the experience of patients and clinicians. This review seeks to understand how remote assessment tools are used for routine consultation substitution in adult tertiary care centers.

Objective: This scoping review aims to evaluate the implementation and health outcomes of digital remote assessment tools used for routine consultation substitutions in adult tertiary care centers. The objectives include assessing the extent of use, types, and effectiveness of these tools in substituting conventional outpatient care.

Methods: A comprehensive scoping review was conducted, adhering to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. The review focused on studies that used internet-dependent remote assessment technologies for patient data transfer in tertiary care settings. A detailed search strategy was used across multiple databases, with studies selected based on predefined inclusion and exclusion criteria. Data extraction and analysis were performed by independent reviewers, with a focus on the functionalities of the tools and their alignment with the Quadruple Aim of Healthcare.

Results: The review included 12 studies, highlighting a growing interest in remote assessment technologies across diverse clinical settings. The interventions varied in length, from 4 weeks to 12 months, and demonstrated a range of functionalities, including symptom monitoring and postsurgical follow-ups. The use of these tools was associated with improved clinical outcomes, such as timely intervention for clinical deterioration and enhanced clinical protocol adherence. Additionally, a small number of studies identified potential cost savings in terms of reduced unplanned health care contacts and optimized clinical resource use. Patient and clinician experiences were generally positive, with high adherence to remote assessments and an appreciation for the personalized and timely care facilitated by these technologies. Barriers included high initial setup costs for digital technologies, leading to an inflated cost per patient in small sample studies.

Conclusions: Digital remote assessment tools offer significant potential to enhance health care delivery by improving health outcomes, reducing costs, and enriching patient and clinician experiences. Their flexibility and adaptability make them suitable for various clinical contexts, supporting the personalization of care and operational efficiency. While digital remote assessment tools offer significant potential, careful consideration of implementation strategies, equity, cost, and clinician and patient experiences is crucial for successful clinical integration.

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来源期刊
CiteScore
14.40
自引率
5.40%
发文量
654
审稿时长
1 months
期刊介绍: The Journal of Medical Internet Research (JMIR) is a highly respected publication in the field of health informatics and health services. With a founding date in 1999, JMIR has been a pioneer in the field for over two decades. As a leader in the industry, the journal focuses on digital health, data science, health informatics, and emerging technologies for health, medicine, and biomedical research. It is recognized as a top publication in these disciplines, ranking in the first quartile (Q1) by Impact Factor. Notably, JMIR holds the prestigious position of being ranked #1 on Google Scholar within the "Medical Informatics" discipline.
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