Implementation of Telemedicine in Pediatric and Neonatal Transport.
Implementation of Telemedicine in Pediatric and Neonatal Transport.
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DOI：
10.1016/j.amj.2020.04.008
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发表时间：
2020-07-01
影响因子：
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通讯作者：
Saunders, Scott
中科院分区：
文献类型：
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作者：
Curfman, Alison;Groenendyk, Jacob;Saunders, Scott
目的：远程医疗使用视频技术来传达可视化的临床信息。本研究的目的是实施远程医疗在儿科和新生儿运输，评估其价值，并确定barrier.METHODS：这项前瞻性研究实施远程医疗运输到三级保健儿童医院。实施前的调查评估对远程医疗的态度和感知的障碍。在为期12周的试点期间，在运输和医疗控制之间启动了视频连接。我们收集了每次使用后测量远程医疗有用性和障碍的调查结果。实施后的调查评估意见时，远程医疗是useful.RESULTS：最初，82%的用户没有直接的经验与远程医疗。远程医疗的感知效用和负担因部门而异。在这项研究中，远程医疗在65%的时间内被提供，在47%的病例中启动，在30%的病例中成功。最大的障碍是连通性。随着时间的推移，运输人员和医生发现远程医疗更加有用。在14个案例中，远程医疗改变了患者的结局或管理。供应商谁报告了管理的变化评级远程医疗显着更useful.CONCLUSION：这一前瞻性的试点成功实施远程医疗儿科运输前。远程医疗对检查中有视觉发现的患者更有用，在某些情况下，改变了临床结果。
OBJECTIVE: Telemedicine uses video technology to communicate visual clinical information. This study aimed to implement telemedicine in pediatric and neonatal transport, assess its value, and identify barriers.METHODS: This prospective study implemented telemedicine before transport to a tertiary care children's hospital. A preimplementation survey assessed attitudes toward telemedicine and perceived barriers. During the 12-week pilot, a video connection was initiated between transport and medical control. We collected survey results measuring telemedicine usefulness and hindrance after each use. A postimplementation survey assessed opinions about when telemedicine was useful.RESULTS: Initially, 82% of users had no direct experience with telemedicine. Perceived utility and burden of telemedicine varied significantly by department. During the study, telemedicine was offered 65% of the time, initiated in 47% of cases, and successful in 30% of cases. The greatest barrier was connectivity. Over time, transport members and physicians found telemedicine to be significantly more useful. In 14 cases, telemedicine changed patient outcome or management. Providers who reported a change in management rated telemedicine as significantly more useful.CONCLUSION: This prospective pilot successfully implemented telemedicine before pediatric transport. Telemedicine was more useful in patients with visual findings on examination and, in some cases, changed the clinical outcome.