Application and Preliminary Outcomes of Remote Diagnosis and Treatment During the COVID-19 Outbreak: Retrospective Cohort Study
Application and Preliminary Outcomes of Remote Diagnosis and Treatment During the COVID-19 Outbreak: Retrospective Cohort Study
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DOI：
10.2196/19417
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发表时间：
2020-07-03
影响因子：
5
通讯作者：
Zhang, Lianzhong
中科院分区：
文献类型：
--
作者：
Liu, Luwen;Gu, Jianqin;Zhang, Lianzhong
背景资料：由新型严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）引起的冠状病毒病（COVID-19）大流行导致无数人因可能感染而自我隔离。这种情况使得远程医疗成为必要，因为它可以克服地理障碍，增加服务人数，并为患者提供在线临床支持。目的：了解2019冠状病毒病（COVID-19）大流行期间，我院网上门诊远程诊疗患者的流行病学特征和临床症状，分析远程医疗的效果和优势。方法：收集了2020年1月24日至2月17日在河南省人民医院在线门诊通过COVID-19咨询服务接受远程诊断和治疗的患者的数据。结果：为患者提供了与COVID-19相关的在线咨询和建议。我们的医院还提供在线订购和支付后的离线非接触式药物配送服务。共招募了4589名接受远程诊疗的患者。每日线上门诊量先升后降，1月28日达到峰值，当日线上门诊量共计612人次。在4589例患者中，1940例（42.3%）为男性，2649例（57.7%）为女性（年龄范围：78天至85岁）。年龄20-39岁（3714例，80.9%），河南省（3898例，84.9%）。来自其他省份的患者人数为691人（15.1%）。在线咨询期间，患者讨论了以下症状：发热（n=2383）、咳嗽（n=1740）、鼻塞（n=794）、疲乏（n=503）和腹泻（n=276）。在线支付后共完成非接触送药订单873笔。这类订单的日数量在最初的稳步增加后逐渐稳定。对于离线药物交付订单，中位数（IQR）为36（58）。患者在咨询后填写了在线满意度调查;在收到的985份回复中，98.1%（n=966）的受访者对他们所接受的服务感到满意。结论：通过在线门诊咨询提供的远程诊疗有效减轻了医院的负担，防止了过度拥挤，降低了交叉感染的风险，缓解了患者在新冠疫情期间的焦虑。这在大流行病管理中发挥着重要作用。
Background: The coronavirus disease (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in the self-quarantine of countless people due to possible infection. This situation makes telemedicine necessary as it can overcome geographical barriers, increase the number of people served, and provide online clinical support for patients. However, the outcomes of telemedicine have not yet been evaluated.Objective: The aim of our study is to describe the epidemiological features and clinical symptoms of patients receiving remote diagnosis and treatment at the online outpatient clinic of our hospital, as well as to analyze the outcomes and advantages of telemedicine, during the COVID-19 pandemic.Methods: Data from patients receiving remote diagnosis and treatment via consultation services for COVID-19 concerns at the online outpatient clinic of Henan Provincial People's Hospital from January 24 to February 17, 2020, were collected. A retrospective analysis was performed on epidemiological features, clinical symptoms, and preliminary outcomes.Results: Online inquiry, consultation, and suggestions were provided for patient concerns related to COVID-19. Our hospital also offered offline noncontact drug delivery services following online ordering and payment. A total of 4589 patients receiving remote diagnosis and treatment were recruited. The daily number of online outpatient visits initially increased and then decreased, reaching its peak on January 28 when the daily number of online outpatient visits totaled 612. Of 4589 patients, 1940 (42.3%) were males and 2649 (57.7%) were females (age range: 78 days to 85 years). Most patients were aged 20-39 years (n=3714, 80.9%) and came from Henan Province (n=3898, 84.9%). The number of patients from other provinces was 691 (15.1%). During the online consultations, patients discussed the following symptoms: fever (n=2383), cough (n=1740), nasal obstruction (n=794), fatigue (n=503), and diarrhea (n=276). A total of 873 orders of noncontact drug delivery following online payment was completed. The daily number of such orders gradually stabilized after the initial, steady increase. For offline drug delivery orders, the median (IQR) was 36 (58). An online satisfaction survey was filled out postconsultation by patients; of the 985 responses received, 98.1% (n=966) of respondents were satisfied with the service they received.Conclusions: Remote diagnosis and treatment offered via online outpatient consultations effectively reduced the burden on hospitals, prevented overcrowding, reduced the risk of cross-infection, and relieved patients' anxiety during the COVID-19 outbreak. This plays an essential role in pandemic management.