Use of telemedicine for initial outpatient subspecialist consultative visit: A national survey of general pediatricians and pediatric subspecialists.
Use of telemedicine for initial outpatient subspecialist consultative visit: A national survey of general pediatricians and pediatric subspecialists.
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DOI：
10.1016/j.hjdsi.2021.100600
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Kahn JM
中科院分区：
文献类型：
--
作者：
Ray KN;Bohnhoff JC;Schweiberger K;Sequeira GM;Hanmer J;Kahn JM
需要循证战略，以支持适当使用远程医疗的初始门诊专科咨询访问。为了告知这些策略，我们对普通儿科医生和儿科专科医生进行了一项关于使用远程医疗为新转诊的儿科专科护理患者的调查。我们在2020年5月和6月对840名普通儿科医生和840名儿科专科医生进行了电子邮件和邮政调查。在266份已完成的调查（17%的答复率）中，204份（76%）认为应向一些人提供远程医疗，29份（11%）认为应向所有初次专科就诊提供远程医疗。大多数受访者表示，一些初步咨询应提供远程医疗认为，这一决定应由专科主治医生（176/204，86%）。受访者优先考虑了几个数据元素，这些数据元素将为这一决定提供信息，包括临床信息和基于家庭的背景信息（例如，面对面护理的障碍，对远程医疗的兴趣，潜在的沟通障碍）。认为降低远程医疗专科咨询的适当性的因素包括需要口译服务和以前的历史频繁不显示。通才和专科医生的回答很少有显著差异。调查结果表明，潜在的机会，以支持适当使用远程医疗的初始门诊儿科亚专科访问通过结构化转移的具体临床和背景信息在转诊时，并通过战略，以减轻感知的沟通或参与障碍。儿科医生对远程医疗的信念，初步门诊专科咨询访问可能会告知未来的干预措施，以支持适当的远程医疗使用。全国临床医生抽样调查。
Evidence-based strategies are needed to support appropriate use of telemedicine for initial outpatient subspecialty consultative visits. To inform such strategies we performed a survey of general pediatricians and pediatric subspecialists about use of telemedicine for patients newly referred for pediatric subspecialty care. We developed and fielded an e-mail and postal survey of a national sample of 840 general pediatricians and 840 pediatric subspecialists in May and June 2020. Of 266 completed surveys (17% response rate), 204 (76%) thought telemedicine should be offered for some and 29 (11%) thought telemedicine should be offered for all initial subspecialist visits. Most respondents who indicated some initial consultations should be offered telemedicine believed this decision should be made by subspecialty attendings (176/204, 86%). Respondents prioritized several data elements which would inform this decision, including clinical information and family-based contextual information (e.g., barriers to in-person care, interest in telemedicine, potential communication barriers). Factors perceived to reduce appropriateness of telemedicine for subspecialty consultation included need for interpreter services and prior history of frequent no-shows. Responses from generalists and subspecialists rarely differed significantly. Survey results suggest potential opportunities to support the appropriate use of telemedicine for initial outpatient pediatric subspecialty visits through structured transfer of specific clinical and contextual information at the time of referral and through strategies to mitigate perceived communication or engagement barriers. Pediatric physician beliefs about telemedicine for initial outpatient subspeciality consultative visits may inform future interventions to support appropriate telemedicine use. Survey of a national sample of clinicians.
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