Telemedicine in Liver Disease and Beyond: Can theCOVID-19Crisis Lead to Action?
Telemedicine in Liver Disease and Beyond: Can theCOVID-19Crisis Lead to Action?
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DOI：
10.1002/hep.31276
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发表时间：
2020-08-01
期刊：
影响因子：
13.5
通讯作者：
Rosin, Roy M.
中科院分区：
文献类型：
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作者：
Serper, Marina;Cubell, Allen W.;Rosin, Roy M.
有强有力的证据支持，在肝硬变患者中，获得专科胃肠病学或肝病学治疗与对指南推荐治疗的更高依从性相关，并改善临床结果。目前，只有大约一半的因肝硬变相关并发症而住院的急性护理住院患者需要专科护理，目前的肝病工作人员无法满足全国范围内肝病患者的需求，特别是在人口较少的地区和没有学术中心的社区诊所。远程医疗的定义是使用诊断和治疗的电子手段远程提供医疗服务，它极有希望增加获得广泛的专科护理的机会。这项技术既便宜又易于使用，尽管目前它在规模上受到州际许可限制和报销障碍的限制。严重急性呼吸综合征冠状病毒2型和2019年冠状病毒病的爆发在短期内加速了远程医疗交付作为一种公共卫生和社会距离措施的增长。在这里，我们用我们的远程肝病项目的一个案例系列作为一个务实的例子，研究这场公共卫生危机是否可以加速关于在非危机情况下更广泛地采用远程医疗进行常规医疗的全国性对话。
Evidence strongly supports that access to specialty gastroenterology or hepatology care in cirrhosis is associated with higher adherence to guideline-recommended care and improves clinical outcomes. Presently, only about one half of acute care hospitalizations for cirrhosis-related complications result in inpatient specialty care, and the current hepatology workforce cannot meet the demand of patients with liver disease nationwide, particularly in less densely populated areas and in community-based practices not affiliated with academic centers. Telemedicine, defined as the delivery of health care services at a distance using electronic means for diagnosis and treatment, holds tremendous promise to increase access to broadly specialty care. The technology is cheap and easy to use, although it is presently limited in scale by interstate licensing restrictions and reimbursement barriers. The outbreak of severe acute respiratory syndrome coronavirus 2 and coronavirus disease 2019 has, in the short term, accelerated the growth of telemedicine delivery as a public health and social distancing measure. Herein, we examine whether this public health crisis can accelerate the national conversation about broader adoption of telemedicine for routine medical care in non-crisis situations, using a case series from our telehepatology program as a pragmatic example.