Connected Subspecialty Care: Applying Telehealth Strategies to Specific Referral Barriers
Connected Subspecialty Care: Applying Telehealth Strategies to Specific Referral Barriers
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DOI：
10.1016/j.acap.2019.08.002
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发表时间：
2020-01-01
影响因子：
3.1
通讯作者：
Kahn, Jeremy M.
中科院分区：
文献类型：
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作者：
Ray, Kristin N.;Kahn, Jeremy M.
近四分之一需要专科护理的儿童家庭报告难以获得这种护理。远程保健是克服专科护理障碍的一种方法。然而，通过远程保健改善亚专科护理的可及性需要细粒度地确定具体的亚专科障碍，并认识到每项远程保健战略在解决已确定的障碍方面的优势和局限性。专注于每一个连续的步骤，在专科转诊和潜在的相关障碍，我们总结了具体的远程医疗和技术支持的战略，以改善获得专科护理，包括电子咨询，现场互动远程医疗，存储和转发远程医疗，远程指导，病人门户网站，和远程病人监护。有意识地选择远程保健战略，以针对具体的专科转诊障碍，可以避免远程保健的误用风险，可以更明确地提升公平获得远程保健举措内的一个基本目标，也可能导致协同使用的战略，克服连续的障碍。
Nearly a quarter of families of children with need of subspecialty care report difficulty accessing that care. Telehealth is a method to overcome barriers to subspecialty care. However, improving access to subspecialty care through telehealth requires granular identification of specific subspecialty barriers and recognition of the strengths and limitations of each telehealth strategy for addressing identified barriers. Focusing on each sequential step in subspecialty referrals and potential associated barriers, we summarize specific telehealth and technology-enabled strategies to improve access to subspecialty care, including electronic consultations, live interactive telemedicine, store-and-forward telemedicine, tele-mentoring, patient portals, and remote patient monitoring. Intentionally selecting telehealth strategies to target specific subspecialty referral barriers may avoid risks from misapplication of telehealth, may more clearly elevate equitable access as an essential goal within telehealth initiatives, and may also lead to synergistic use of strategies that overcome sequential barriers.