Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research
Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research
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DOI：
10.2196/20049
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发表时间：
2020-01-01
影响因子：
3.7
通讯作者：
Radovic, Ana
中科院分区：
文献类型：
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作者：
Badawy, Sherif M.;Radovic, Ana
冠状病毒病（COVID-19）爆发的全球蔓延构成了公共卫生威胁，并以各种前所未有的方式影响了世界各地的人们，无论是个人还是专业。毫无疑问，当前的全球COVID-19危机比以往任何时候都更加突出了在这一大流行病时代利用数字方法优化儿科医疗服务的重要性。在这篇观点文章中，我们重点介绍了一些已经并可以继续用于在COVID-19大流行时代简化远程儿科患者护理的可用数字方法，包括但不限于远程医疗。JMIR Pediatrics and Parenting目前正在出版COVID-19特别主题问题，研究人员可以在其中分享他们的中期和最终研究数据，这些数据与不同环境中远程儿科医疗保健提供的数字方法有关。COVID-19大流行迅速改变了全球的医疗保健系统，在适应方面出现了重大变化和创新。利用和优化数字方法提供保健服务，特别是综合远程医疗和虚拟保健服务的做法迅速扩大。数字化方法已经并将作为宝贵和可靠的资源发挥重要作用，以克服COVID-19大流行期间施加的限制和挑战，并为更多患者和家庭提供有效，方便和消费者友好的护理。然而，仍有一些挑战有待解决，需要进一步研究。在当前的COVID-19疫情和未来其他可能的大流行期间，优化医疗保健提供的数字化方法并将其纳入公共卫生应对措施将是一个持续的过程。监管变革对于支持这些方法的安全和广泛采用至关重要。让所有相关利益攸关方参与解决当前和未来的挑战以及后勤、技术和财政障碍将是成功的关键。今后的研究应考虑评价与远程医疗和其他数字方法有关的以下研究领域：成本效益和投资回报;对护理质量的影响;管理急性疾病和慢性健康状况所需的使用和就诊次数的平衡;系统是否准备好在其他环境中进一步采用，如住院服务、专科医生咨询和农村地区;正在进行的以用户为中心的评估，从患者，家庭和医疗保健提供者的反馈;优化健康公平和解决与种族和民族，社会经济地位，移民身份和农村社区有关的医疗保健获取差异的战略;隐私和安全问题，受保护的健康信息与健康保险流通和责任法案（HIPAA）-安全计划;为某些特定人群，特别是青少年和需要心理健康服务的人提供保密问题;及早发现遭受暴力和忽视儿童的风险;将培训纳入本科和研究生医学教育和专科研究金。解决这些研究领域对于理解远程医疗和其他数字方法的好处，可持续性，安全性和优化策略至关重要，这些方法是现代医疗保健服务的关键部分。这些努力将通过扩大传播和实施工作，为长期采用这些方法提供信息。
The global spread of the coronavirus disease (COVID-19) outbreak poses a public health threat and has affected people worldwide in various unprecedented ways, both personally and professionally. There is no question that the current global COVID-19 crisis, now more than ever, is underscoring the importance of leveraging digital approaches to optimize pediatric health care delivery in the era of this pandemic. In this perspective piece, we highlight some of the available digital approaches that have been and can continue to be used to streamline remote pediatric patient care in the era of the COVID-19 pandemic, including but not limited to telemedicine. JMIR Pediatrics and Parenting is currently publishing a COVID-19 special theme issue in which investigators can share their interim and final research data related to digital approaches to remote pediatric health care delivery in different settings. The COVID-19 pandemic has rapidly transformed health care systems worldwide, with significant variations and innovations in adaptation. There has been rapid expansion of the leveraging and optimization of digital approaches to health care delivery, particularly integrated telemedicine and virtual health. Digital approaches have played and will play major roles as invaluable and reliable resources to overcome restrictions and challenges imposed during the COVID-19 pandemic and to increase access to effective, accessible, and consumer-friendly care for more patients and families. However, a number of challenges remain to be addressed, and further research is needed. Optimizing digital approaches to health care delivery and integrating them into the public health response will be an ongoing process during the current COVID-19 outbreak and during other possible future pandemics. Regulatory changes are essential to support the safe and wide adoption of these approaches. Involving all relevant stakeholders in addressing current and future challenges as well as logistical, technological, and financial barriers will be key for success. Future studies should consider evaluating the following research areas related to telemedicine and other digital approaches: cost-effectiveness and return on investment; impact on quality of care; balance in use and number of visits needed for the management of both acute illness and chronic health conditions; system readiness for further adoption in other settings, such as inpatient services, subspecialist consultations, and rural areas; ongoing user-centered evaluations, with feedback from patients, families, and health care providers; strategies to optimize health equity and address disparities in access to care related to race and ethnicity, socioeconomic status, immigration status, and rural communities; privacy and security concerns for protected health information with Health Insurance Portability and Accountability Act (HIPAA)-secured programs; confidentiality issues for some specific populations, especially adolescents and those in need of mental health services; early detection of exposure to violence and child neglect; and integration of training into undergraduate and graduate medical education and subspecialty fellowships. Addressing these research areas is essential to understanding the benefits, sustainability, safety, and optimization strategies of telemedicine and other digital approaches as key parts of modern health care delivery. These efforts will inform long-term adoption of these approaches with expanded dissemination and implementation efforts.