Successful Distancing: Telemedicine in Gastroenterology and Hepatology During the COVID-19 Pandemic.
Successful Distancing: Telemedicine in Gastroenterology and Hepatology During the COVID-19 Pandemic.
复制标题
DOI：
10.1007/s10620-021-06874-x
复制
发表时间：
2021-04
影响因子：
3.1
通讯作者：
Goyal H
中科院分区：
文献类型：
--
作者：
Perisetti A;Goyal H
远程医疗涉及向患者提供医疗保健和预防性护理服务，而无需亲自接触。传统上，远程医疗用于急性事件（例如，中风，用于将基本信息传递给急诊科）和慢性疾病管理（例如，糖尿病和慢性肾病管理）。尽管远程医疗在胃肠病学和肝病学中的使用最多也只是适度的，特别是在炎症性肠病和慢性肝病管理方面，但自2019冠状病毒病（COVID-19）大流行以来，胃肠病学的远程医疗使用在前两周增加了4000%，相当于大流行前六年的增长。医疗保险和医疗补助中心（CMS）放宽了使用远程医疗的规则，放宽了对报销、地点、许可要求（跨州）以及事先建立医患关系的限制。这些变化增加了远程医疗在住院和门诊胃肠病相关转诊中的使用。使用住院电话或视频咨询有助于在大流行期间提供及时护理，同时节省个人防护设备，减少提供者和患者的接触。然而，远程保健的使用是以没有直接的病人接触和较少的报销为代价的。适当使用技术和设备、培训保健提供者、使用可纳入电子健康记录的平台，同时保护隐私和信息流动，这些都是远程医疗的基本组成部分。此外，鼓励患者使用适当的设备远程寻求医疗护理并在不需要体检的情况下提高数字素养是一项挑战，对于老年人或听力障碍患者以及更愿意亲自就诊的患者来说，这一挑战更加复杂。作者将系统地回顾和讨论如何将远程医疗纳入胃肠病学和肝病学的实践中，重点讨论成功的障碍以及减轻这些障碍的方法。
Telemedicine involves delivering healthcare and preventative care services to patients without the need for in-person encounters. Traditionally, telemedicine has been used for acute events (e.g., stroke, used to relay essential information to the emergency department) and chronic disease management (e.g., diabetes and chronic kidney disease management). Though the utilization of telemedicine in gastroenterology and hepatology has been modest at best, especially for inflammatory bowel diseases and chronic liver disease management, since the onset of coronavirus disease 2019 (COVID-19) pandemic, utilization of telemedicine in gastroenterology increased by 4000% in the first two weeks, equivalent to the last six years of growth before the pandemic. The Center for Medicare and Medicaid (CMS) relaxed rules for the use of telemedicine with easing restrictions on reimbursements, location, licensing requirements (across state lines), and the need for a prior provider-patient relationship. These changes increased the use of telemedicine in inpatient and outpatient settings for gastroenterology-related referrals. The use of inpatient telephonic or video consults helps provide timely care during the pandemic while conserving personal protective equipment and decreasing provider and patient exposure. Nevertheless, telehealth use comes at the cost of no direct patient contact and lesser reimbursements. The appropriate use of technology and equipment, training of healthcare providers, use of platforms that can be integrated into the electronic health record while protecting the privacy and the flow of information are essential components of telemedicine. Furthermore, encouraging patients to seek medical care remotely with the proper equipment and improving digital literacy without the need for physical examinations is a challenge, further compounded in elderly or hard-of-hearing patients and in patients who are more comfortable with in-person visits. The authors will systematically review and discuss how telemedicine can be integrated into the practice of gastroenterology and hepatology, with emphasis placed on discussing barriers to success and the ways they can be mitigated.
登录
查看更多内容
影响因子：
12.6
作者：
Cross, Raymond K.;Kane, Sunanda
通讯作者：
Kane, Sunanda
影响因子：
4.7
作者：
Gutovitz, Scott;Leggett, Jonathan;Stillinger, Toni
通讯作者：
Stillinger, Toni
影响因子：
1.7
作者：
Atreja A;Khan S;Rogers JD;Otobo E;Patel NP;Ullman T;Colombel JF;Moore S;Sands BE;HealthPROMISE Consortium Group
通讯作者：
HealthPROMISE Consortium Group
影响因子：
5.3
作者：
Anthony, Bokolo, Jr.
通讯作者：
Anthony, Bokolo, Jr.
影响因子：
8
作者：
Lewin, Sara;Lees, Charles;Mahadevan, Uma
通讯作者：
Mahadevan, Uma