Clinical assessment and management of general surgery patients via synchronous telehealth
Clinical assessment and management of general surgery patients via synchronous telehealth
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DOI：
10.1177/1357633x16636245
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发表时间：
2017-02-01
影响因子：
4.7
通讯作者：
Carter, Brandon
中科院分区：
文献类型：
--
作者：
Cain, Steven M.;Moore, Robert;Carter, Brandon
目的：本文介绍了 Landstuhl 地区医疗中心 (LRMC) 的临床团队如何成功地将同步远程医疗 (TH) 融入其日常临床实践。方法和材料：使用 Polycom (R) 软件在外科医生的计算机上进行同步 TH 会诊，并在远程站点的监视器上安装高清 (HD) 摄像头，并在起始站点使用 PolyCom HDX9000 (R) 远程医疗从业者推车。患者提供同意书，并由整个欧洲战区陆军卫生诊所的护士和医疗技术人员向普通外科医生介绍。结果：2014 日历年 (CY)，兰施图尔地区医疗中心的五名普通外科医生和两名外科医师助理 (PA) 以及欧洲各地六个原始诊所的注册护士 (RN) 为 101 名普通外科患者完成了 130 例同步 TH 就诊，最终完成了 73 例手术和推荐手术 16 例。百分之八十八的患者已完成或建议进行手术。初次 TH 评估后计划的手术或程序均未取消。始发地点诊所的距离从 68 英里到 517 英里不等。提供者、患者和临床工作人员的接受度很高。结论：同步 TH 在评估常见的普通外科疾病方面是有效且安全的。我们排除了需要细致入微的体检的敏感和复杂的情况。普外科工作人员的 TH 努力带来了高质量、无缝且可预测的 TH 活动，这些活动继续扩展到普外科以外的其他外科和医学专业。七名外科医生和两名 PA 定期使用同步 TH 为广泛地理区域的患者提供服务。
Objective: This paper describes how a clinical team at Landstuhl Regional Medical Center (LRMC) successfully integrated synchronous telehealth (TH) into their routine clinical practice.Methods and materials: Synchronous TH encounters were performed using Polycom (R) software on surgeons' computers with high-definition (HD) cameras on monitors at distant sites and PolyCom HDX9000 (R) Telehealth Practitioner Carts at originating sites. Patients provided consented and were presented to general surgeons by nurses and medical technicians at Army health clinics throughout the European Theater.Results: In calendar year (CY) 2014, five general surgeons and two surgical physician assistants (PAs) at Landstuhl Regional Medical Center along with registered nurses (RNs) at six originating clinic sites throughout Europe completed 130 synchronous TH encounters for 101 general surgery patients resulting in 73 completed and 16 recommended surgeries. Eighty-eight percent of patients had a completed or recommended surgery. No surgeries or procedures planned after initial TH evaluation were cancelled. Originating site clinics ranged in distance from 68 miles to 517 miles. Acceptance by providers, patients and clinic staff was high.Conclusion: Synchronous TH was effective and safe in evaluating common general surgical conditions. We excluded sensitive and complex conditions requiring a nuanced physical examination. The TH efforts of the general surgery staff have resulted in high-quality, seamless and predictable TH activities that continue to expand into other surgical and medical specialties beyond general surgery. Seven surgeons and two PAs use synchronous TH regularly serving patients over a broad geographic area.