Rapid Increase in Telemental Health Within the Department of Veterans Affairs During the COVID-19 Pandemic
Rapid Increase in Telemental Health Within the Department of Veterans Affairs During the COVID-19 Pandemic
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DOI：
10.1089/tmj.2020.0233
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发表时间：
2020-09-14
影响因子：
4.7
通讯作者：
Miller, Christopher J.
中科院分区：
文献类型：
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作者：
Connolly, Samantha L.;Stolzmann, Kelly L.;Miller, Christopher J.
背景：在2019冠状病毒病（COVID-19）大流行期间，由于非紧急面对面预约的限制，通过视频会议（TMH-V）使用远程健康变得至关重要。目前的简要报告显示，在美国最大的医疗保健系统退伍军人事务部（VA）宣布大流行后的几周内，TMH-V预约人数迅速增长。方法：在世界卫生组织宣布大流行后的六周内（2020年3月11日至2020年4月22日），记录了TMH-V预约的COVID-19变化。评估了2017年10月1日至2020年3月10日期间的COVID-19前TMH-V感染情况。结果：TMH-V的每日遭遇从3月11日的1,739次上升到4月22日的11,406次（增长556%，总遭遇222,349次）。在3月11日至4月22日期间，114，714名患者通过TMH-V就诊，77.5%是首次使用TMH-V。在3月11日至4月22日期间，12，342名MH提供者完成了TMH-V预约，其中34.7%是首次TMH-V用户。TMH-V预约的百分比增长高于电话预约的增长（增长442%）;在此期间，面对面预约下降了81%。讨论和结论：在COVID-19大流行之后，VA的TMH-V预约增长速度得益于其现有的远程医疗基础设施，包括早期国家为增加使用TMH-V的提供者数量所做的努力。在大流行的背景下，TMH-V实施的长期障碍有所减少，在此期间，非紧急的面对面MH护理大幅减少。未来的工作是必要的，以了解在TMH-V使用的COVID-19相关变化可能会永久影响精神卫生保健提供的程度。
Background:The use of telemental health via videoconferencing (TMH-V) became critical during the Coronavirus disease 2019 (COVID-19) pandemic due to restriction of non-urgent in-person appointments. The current brief report demonstrates the rapid growth in TMH-V appointments in the weeks following the pandemic declaration within the Department of Veterans Affairs (VA), the largest healthcare system in the United States. Methods:COVID-19 changes in TMH-V appointments were captured during the six weeks following the World Health Organization's pandemic declaration (March 11, 2020-April 22, 2020). Pre-COVID-19 TMH-V encounters were assessed from October 1, 2017 to March 10, 2020. Results:Daily TMH-V encounters rose from 1,739 on March 11 to 11,406 on April 22 (556% growth, 222,349 total encounters). Between March 11-April 22, 114,714 patients were seen via TMH-V, and 77.5% were first-time TMH-V users. 12,342 MH providers completed a TMH-V appointment between March 11-April 22, and 34.7% were first-time TMH-V users. The percentage growth of TMH-V appointments was higher than the rise in telephone appointments (442% growth); in-person appointments dropped by 81% during this time period. Discussion and Conclusions:The speed of VA's growth in TMH-V appointments in the wake of the COVID-19 pandemic was facilitated by its pre-existing telehealth infrastructure, including earlier national efforts to increase the number of providers using TMH-V. Longstanding barriers to TMH-V implementation were lessened in the context of a pandemic, during which non-urgent in-person MH care was drastically reduced. Future work is necessary to understand the extent to which COVID-19 related changes in TMH-V use may permanently impact mental health care provision.