Will the Doctor "See" You Now? The Development and Implementation of a Targeted Telemedicine System for Primary Care.
Will the Doctor "See" You Now? The Development and Implementation of a Targeted Telemedicine System for Primary Care.
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DOI：
10.1055/s-0043-1776038
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发表时间：
2023-07
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2019冠状病毒病（COVID-19）大流行导致远程医疗迅速普及。对于没有互联网接入的服务不足的人群，远程医疗是通过电话而不是音频视频连接来实现的。后者被认为是更有效的形式，更接近于亲自访问。我们试图提供一个远程医疗平台，以克服障碍，为服务不足的群体举行视频访问与他们的医疗保健提供者和评估医生和患者评估的两种远程医疗模式之间的差异。我们设计了一种简化的视频访视平板电脑解决方案，并在原本只能完成音频访视的患者中试用。患者同意参与研究，并以1：1的比例随机分配，继续进行计划的电话访视（对照），而不是运送平板电脑以促进视频访视（干预）。参与者和供应商完成了沟通和满意度调查。平板电脑和连接设计特征包括移除除远程医疗程序之外的所有功能、LTE始终在线无线互联网连接、不使用外部设备（电线、充电器和键盘）以及不使用数字门户注册。共入组18例患者。与对照组患者相比，使用视频支持设备的干预组患者更强烈地同意他们对就诊感到满意（4.75/5 vs. 3.75/5，p = 0.02）。提供的简化平板电脑视频访问解决方案有望改善服务不足群体的视频访问。需要促进患者接受器械的策略，以扩大这一努力的范围和潜在影响。
The coronavirus disease 2019 (COVID-19) pandemic led to a rapid adoption of telehealth. For underserved populations lacking internet access, telemedicine was accomplished by phone rather than an audio–video connection. The latter is presumed a more effective form and better approximation of an in-person visit. We sought to provide a telehealth platform to overcome barriers for underserved groups to hold video visits with their health care providers and evaluate differences between the two telehealth modalities as assessed by physicians and patients. We designed a simplified tablet solution for video visits and piloted its use among patients who otherwise would have been completing audio-only visits. Patients consented to participation and were randomized in a 1:1 fashion to continue with their scheduled phone visit (control) versus being shipped a tablet to facilitate a video visit (intervention). Participants and providers completed communication and satisfaction surveys. Tablet and connectivity design features included removal of all functions but for the telemedicine program, LTE always-on wireless internet connectivity, absence of external equipment (cords chargers and keyboard), and no registration with a digital portal. In total, 18 patients were enrolled. Intervention patients with video-enabled devices compared to control patients agreed more strongly that they were satisfied with their visits (4.75/5 vs. 3.75/5, p = 0.02). The delivered simplified tablet solution for video visits holds promise to improve access to video visits for underserved groups. Strategies to facilitate patient acceptance of devices are needed to expand the scope and potential impact of this effort.