FW-HTF-P: Telemedicine at Scale: Expanding the Healthcare Workforce and Healthcare Access

农村和城市人口获得紧急医疗服务（EMS）的机会受到医疗保健人力资源过度紧张的阻碍。许多医疗保健问题不需要急诊室或医院的资源。相反，他们可以通过“家庭医院”医疗护理或专门的住院病房得到更好的服务。一个多功能的移动卫生工作者队伍提供了一个可扩展的解决方案，可以从现有的EMS基础设施和教育途径中发展出来。例如，许多初级医务人员可以通过与一名训练有素的医疗专家进行远程咨询，在现场提供即时护理。这种方法的一个缺点是，它增加了远程咨询师和本地工作人员的认知、沟通和情感负担。通过合作研讨会、实验研究和一系列访谈，本项目将确定多对一远程医疗的挑战和机遇。其目的是针对未来EMS劳动力的形态、劳动力所需的培训以及对EMS劳动力和医疗保健成本的经济影响提供一组明确的假设。该项目涉及三项主要活动。第一项活动将聚集紧急医疗保健领导者和教育工作者、远程医疗系统设计师和卫生经济学家，参加大规模远程医疗研讨会，以探讨现有的挑战以及潜在的创新方向。其目的是确定这一领域工作的问题空间，包括可以开发的新技术以及所需的教育和财政模式。第二项活动是对一对多远程医疗中固有的协作挑战进行探索性研究。这将包括对现场远程医疗人员和经验丰富的临床医生所经历的认知、沟通和情感负荷的评估。第三项主要活动将把研究小组与社区伙伴联系起来，以了解大规模远程医疗的财政动机和挑战。工作假设是，现场远程医疗可能是对医疗保健感兴趣的高中毕业生的入门途径，同时也提供一线移动医疗服务提供者，以补充过度紧张的救护车队伍。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Access to emergency medical services (EMS) for both rural and urban populations is hampered by an overstretched healthcare workforce. Many healthcare issues do not need the resources of an emergency room or hospital. Instead, they would be better served through "hospital at home" medical care or specialized in-patient units. A versatile, mobile health workforce provides a scalable solution that can be grown out of the already existing EMS infrastructure and education pathways. For example, many entry-level medical personnel can provide immediate care in the field by tele-consulting with a single highly trained medical expert. One negative of this approach is that it increases the cognitive, communicative, and affective load on both the remote consultant and the local worker. Through a collaborative workshop, experimental study, and series of interviews, this project will identify the challenges and opportunities of many-to-one telemedicine. The aim is to provide a clear set of hypotheses towards the shape of the future EMS workforce, the training needed for that workforce, and the economic impact on the EMS workforce and healthcare costs. The project involves three major activities. The first activity will gather emergency healthcare leaders and educators, telemedicine system designers, and health economists for a workshop on Telemedicine-at-Scale, in order to explore the existing challenges, as well as potential directions for innovation. The aim is to define the problem space for work in this area, including new technologies that could be developed and the educational and fiscal models needed. The second activity is an exploratory study on collaboration challenges inherent in one-to-many telemedicine. This will include an assessment of the cognitive, communicative, and affective load experienced by both the field telemedic and the experienced clinician. The third main activity will connect the research team with community partners to understand the fiscal motivations and challenges of Telemedicine-at-Scale. The working hypothesis is that the telemedic in the field could be an entry-level pathway for high-school graduates interested in healthcare while also providing a first line of mobile healthcare providers to supplement an overstretched ambulance corps.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.