Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States
Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States
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DOI：
10.2196/19264
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发表时间：
2020-06-09
影响因子：
7.4
通讯作者：
Pit, Sabrina Winona
中科院分区：
文献类型：
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作者：
Fisk, Malcolm;Livingstone, Anne;Pit, Sabrina Winona
背景：2020年3月12日，世界卫生组织宣布冠状病毒病（COVID-19）爆发为大流行。截至该日，全球共报告134，576例病例，4981例死亡。到2020年3月26日，仅仅两周后，报告的病例增加了四倍，达到531，865例，死亡人数增加了五倍，达到24，073例。老年人是远程医疗服务的主要用户，也更有可能因COVID-19而死亡。本文研究了澳大利亚、英国和美国在宣布大流行后的两周内，寻求推广远程医疗作为一种工具的程度，这种工具可以帮助在可能独居、体弱或自我隔离的老年人中识别COVID-19，并给予支持或促进治疗的人谁是或可能是infected.Methods：本文报告，为2周的时间之前提到的和紧接着之前，在这三个国家采取的政府或其机构（在国家或州一级）的活动和倡议，连同出版物或专业，贸易和慈善机构发出的指导。在这一点上，利用了不同的信息来源来说明远距离保健在防治这一流行病方面可能带来的好处。本文的目的不是汇总或分析反映对COVID-19日益增长的了解的信息，除非远程医疗被视为一个组成部分。结果：根据确定的来源，这三个国家的情况显示出一些差异。这些差异集中在其卫生服务的性质，对老年人的关注程度（以及与他们相关的情况），不同的地理位置（特别是农村地区）以及可能影响这些的资金框架的变化。这三个国家的共同点是，在更广泛的卫生服务背景下，保持质量保障的价值，但这些服务有时被认为排除了远程医疗的大量使用。结论：COVID-19大流行正在迫使变革，并可能有助于在其后果中更牢固地建立远程医疗。有些变化可能不会持久。然而，目前的势头是，远程保健几乎肯定会在这三个国家的保健服务框架中占有更大的地位，而且很可能会得到病人和保健提供者的更多接受。
Background: On March 12, 2020, the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic. On that date, there were 134,576 reported cases and 4981 deaths worldwide. By March 26, 2020, just 2 weeks later, reported cases had increased four-fold to 531,865, and deaths increased five-fold to 24,073. Older people are both major users of telehealth services and are more likely to die as a result of COVID-19.Objective: This paper examines the extent that Australia, the United Kingdom, and the United States, during the 2 weeks following the pandemic announcement, sought to promote telehealth as a tool that could help identify COVID-19 among older people who may live alone, be frail, or be self-isolating, and give support to or facilitate the treatment of people who are or may be infected.Methods: This paper reports, for the 2-week period previously mentioned and immediately prior, on activities and initiatives in the three countries taken by governments or their agencies (at national or state levels) together with publications or guidance issued by professional, trade, and charitable bodies. Different sources of information are drawn upon that point to the perceived likely benefits of telehealth in fighting the pandemic. It is not the purpose of this paper to draw together or analyze information that reflects growing knowledge about COVID-19, except where telehealth is seen as a component.Results: The picture that emerges for the three countries, based on the sources identified, shows a number of differences. These differences center on the nature of their health services, the extent of attention given to older people (and the circumstances that can relate to them), the different geographies (notably concerned with rurality), and the changes to funding frameworks that could impact these. Common to all three countries is the value attributed to maintaining quality safeguards in the wider context of their health services but where such services are noted as sometimes having precluded significant telehealth use.Conclusions: The COVID-19 pandemic is forcing changes and may help to establish telehealth more firmly in its aftermath. Some of the changes may not be long-lasting. However, the momentum is such that telehealth will almost certainly find a stronger place within health service frameworks for each of the three countries and is likely to have increased acceptance among both patients and health care providers.