远程医疗:现状与未来展望

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL Clinical Management Issues Pub Date : 2021-07-30 DOI:10.7175/cmi.v15i1.1511
Andrea Tinnirello
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引用次数: 0

摘要

使用一种广泛可用的技术(带有网络摄像头的计算机和可以确保患者数据安全的专用平台),可以在患者和临床医生之间完全安全地建立虚拟会诊。除了对病人明显的便利(他们可以克服旅行和停车的问题,而且不需要找一个陪伴的人),远程医疗还提供了一些特殊的优势,例如:由于有机会在病人的家庭环境中观察病人,可以对他们的精神状态进行更非正式的评估;收集其他社会信息,例如:生活环境;与家人和照顾者的互动;Y病人在家生活b[11]。最重要的问题是,就结果和质量而言,远程医疗是否与面对面咨询相当(“一样好”)。在一些非劣等性研究中,远程精神病学结果被认为在诊断和治疗、缩短住院时间、改善药物依从性和减轻创伤后应激障碍等症状方面不逊于亲自护理。不幸的是,在其他专业中还没有这样的比较。尽管它很有吸引力,但这个工具有一些明显的局限性:远程医疗和远程医疗通常被认为是同义词,但是远程医疗特别指临床患者护理,远程医疗包括所有教育、管理和其他非临床医疗保健活动。尽管远程医疗的起源可以追溯到很久以前,但远程医疗的现代时代始于1968年:在那一天,马萨诸塞州总医院(MGH)成为第一家以医院为基础的多专业远程医疗实践,为洛根国际机场的旅客和机场工作人员提供远程临床检查。历史上,远程医疗已在精神病学、心脏病学、儿科、妇科、老年医学等多个医学专业得到应用,患者满意度普遍[2-9]。随着技术的发展,远程医疗的更多具体应用已经被开发出来,例如,远程皮肤镜(安装在网络摄像头或智能手机上的特定普通患者摄像头,由应用程序控制)已被用于监测皮肤病变bbb。在2019冠状病毒病大流行期间,远程医疗越来越多地用于绕过对门诊就诊和进入医院的严格限制。正如经常发生的那样,迫切需要(在这种情况下,必须保证对无法推迟就诊的慢性病患者进行随访)成为迅速发展和实施远程医疗和远程卫生系统的动力。编辑
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Telemedicine: Current Status and Future Perspectives
41 Using a widely available technology (a computer with a webcam and dedicated platforms that can ensure patients’ data safety), a virtual consultation can be established between patient and clinicians in total safety. Besides the evident convenience for patients (who can overcome the travel and parking issues and are not required to find an accompanying person), telemedicine offers some peculiar advantages, such as: y getting a more informal assessment of mental status thanks to the opportunity to observe patients in their home environment; y gather other social information, e.g.: y living environment; y interactions with family and caregivers; y patients’ lives at home [11]. The most significant question is whether telemedicine is comparable (“as good as”) to in person consultation in terms of outcomes and quality. In some non-inferiority studies, tele-psychiatric outcomes were deemed as not inferior to in person care in terms of diagnosis and treatment, decreasing length of hospital stays, improving medication adherence, and reducing symptoms in conditions such as posttraumatic stress disorder on an evidenced based level [2]. Unfortunately, this comparison has not been made in other specialties. Despite its attractivity, this tool has some obvious limitations: Telemedicine and telehealth are often considered synonyms, but while telemedicine refers particularly to clinical patient care, telehealth includes all the educational, administrative, and other non-clinical healthcare activities. Although the roots of telemedicine date quite far back, the modern era of telemedicine started in 1968: in that date, the Massachusetts General Hospital (MGH) became the first hospital-based multispecialty telemedicine practice offering remote clinical examinations to travelers and airport workers at Logan International Airport [1]. Historically, telemedicine has been applied in several medical specialties such as psychiatry, cardiology, pediatrics, gynecology, geriatrics, with general patient satisfaction [2-9]. With the evolving technology, more specific applications of telemedicine have been developed, e.g., tele-dermatoscopes (pecific general patient cameras mounted on webcams or smartphones and controlled by app) have been used to monitor skin lesions [10]. During the COVID-19 pandemic, telemedicine has been increasingly used to bypass the severe restrictions for outpatients’ visits and access to hospitals. As often happens, an urgent need (in this case the necessity to guarantee follow up for patients suffering from chronic conditions who cannot postpone their visits) became the driving force to rapidly develop and implement telemedicine and telehealth systems. Editorial
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来源期刊
Clinical Management Issues
Clinical Management Issues MEDICINE, GENERAL & INTERNAL-
自引率
0.00%
发文量
3
审稿时长
13 weeks
期刊介绍: Clinical Management Issues is an open access, peer-reviewed journal published by SEEd Medical Publishers (online ISSN = 2283-3137). The aim of the published case reports is to expand medical knowledge, allowing a better explanation of the practical application of a clinical guideline, or including an up-to-date review of medical knowledge in that field, or helping doctors to make better decisions in a “grey area”, or explaining how to manage a disease with an integrated approach between different specialists involved. Clinical Management Issues also publishes unusual case reports (i.e. unusual side effects or adverse interactions involving medications, unexpected or unusual presentations of a disease, etc.), articles on clinical management of a disease, case series, editorials, and brief reports. Acceptance rate of submitted articles is about 90%. Content is subject to peer-review and is editorially independent. This journal provides immediate open access to all of its articles (both HTML and PDF versions). Authors are asked to state any professional and financial situations that might be perceived as causing a conflict of interest with respect to integrity of content. The Declaration of Financial Competing Interests, that should be filled, signed and sent to the Publisher, is downloadable here.
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