Virtual models of chronic disease management: lessons from the experiences of virtual care during the COVID-19 response
Virtual models of chronic disease management: lessons from the experiences of virtual care during the COVID-19 response
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DOI：
10.1071/ah20190
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发表时间：
2021-02-15
影响因子：
1.8
通讯作者：
Wicker, Christina
中科院分区：
文献类型：
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作者：
Smithson, Rachael;Roche, Elisha;Wicker, Christina
目的 本研究调查了黄金海岸工作人员和患者在 COVID-19 大流行期间慢性病管理虚拟模型快速扩展的体验。方法 该研究对在昆士兰州黄金海岸健康中心提供慢性病项目的登记患者 (n = 24) 和由临床和行政人员 (n = 44) 组成的焦点小组进行了调查。该研究还检查了在 COVID 之前（2020 年 1 月至 2 月）和 COVID-19 应对前 3 个月（2020 年 3 月至 5 月）常规收集的慢性病项目活动数据。结果 在 COVID-19 响应期间，慢性病计划继续提供类似数量的预约，但通过电话或视频会议虚拟进行的预约比例显着增加。大多数患者对他们的虚拟护理体验感到满意，并认为他们的医疗保健需求得到了满足。结论 COVID-19 应对措施提供了学习和进一步开发虚拟护理模型的机会。工作人员和患者普遍支持未来继续包括虚拟预约。持续关注的问题主要是为患者和工作人员提供的支持，以确保他们接受培训并具备管理技术和新沟通模式的能力。关于该主题已知什么？新的证据表明，电话和视频咨询以及远程患者监测等虚拟医疗服务模式可以成为传统面对面慢性病管理计划的安全且经济高效的替代方案。虚拟护理与同等或改善的临床结果以及效率的提高相关，例如减少缺席率。这篇论文添加了什么？澳大利亚各地慢性病负担日益加重，以及需要最大限度地降低弱势患者群体在安全、适当的情况下参加院内预约的风险，这意味着扩大虚拟慢性病管理的提供将变得越来越有必要。这项研究的结果为这些工作人员和患者群体提供了从快速推出虚拟护理中学习的机会，并将有助于了解该领域的进展。对从业者有何影响？现有证据、人口压力和 COVID-19 大流行应对措施都表明，虚拟护理是传统慢性病管理模式的可行且安全的替代方案。这里介绍的经验教训为工作人员和患者所需的支持提供了更详细的指导，以确保虚拟护理成为传统慢性病管理计划的无缝且安全的替代方案或补充。
Objective This study examined Gold Coast staff and patient experiences with the rapid expansion of a virtual model of chronic disease management during the COVID-19 pandemic. Methods The study undertook a survey of enrolled patients (n = 24) and focus groups with clinical and administrative staff (n = 44) delivering chronic disease programs at Gold Coast Health in Queensland. The study also examined routinely collected activity data for the chronic disease programs before COVID (January-February 2020) and for the first 3 months of the COVID-19 response (March-May 2020). Results Chronic disease programs continued to provide similar numbers of appointments over the COVID-19 response period, but there was a marked increase in the proportion of appointments that were delivered virtually, either by telephone or video conference. Most patients were satisfied with their virtual care experiences and felt that their health care needs were met. Conclusions The COVID-19 response provided an opportunity to learn and further develop models of virtual care. Staff and patients were generally supportive of continuing to include virtual appointments in the future. Ongoing concerns were predominantly around the support available to patients and staff to ensure they are trained and equipped to manage the technology and new mode of communicating. What is known about the topic? Emerging evidence suggests that virtual models of health care delivery, such as telephone and video consultations and remote patient monitoring, can be safe and cost-effective alternatives to traditional face-to-face chronic disease management programs. Virtual care is associated with equal or improved clinical outcomes, as well as efficiency improvements, such as reduced failure to attend rates. What does this paper add? The increasing burden of chronic disease across Australia, as well as the need to minimise the risk of vulnerable patient groups attending in-hospital appointments where it is safe and appropriate to do so, means that expanding the delivery of virtual chronic disease management will become increasingly necessary. The results of this study provide an opportunity to learn from a rapid rollout of virtual care for these staff and patient groups and will help inform advances in this area. What are the implications for practitioners? Existing evidence, demographic pressures and the COVID-19 pandemic response all point to virtual care as a viable and safe alternative to traditional models of chronic disease management. The lessons presented here provide more detailed guidance on the support that staff and patients require to ensure virtual care is a seamless and safe alternative or adjunct to traditional chronic disease management programs.