Remote-by-Default Care in the COVID-19 pandemic: addressing the micro-,meso-,and macro-level challenges of a radical new service model

由于COVID-19的传染性如此之强，NHS的工作方式发生了巨大变化。这是自1948年以来的第一次，你不能走进一个家庭医生的手术室，要求被看到。您必须在线申请，致电手术或联系NHS 111。然后你可能会接到临床医生的回电（电话或视频），或者是面对面的预约，可能是在一个“热点”。这些对过去家庭医生服务的改变是激进的，可怕的和困难的。他们切入了关心和被关心的核心，以及“好”和“优秀”的医疗服务的外观和感觉。医生能通过视频或电话对你进行适当的评估吗？我们是一个跨学科的团队，专门研究复杂的，技术支持的健康和护理变化。通过使用各种方法，我们希望做三件事：-开发工具，帮助临床医生通过电话或视频有效地评估人们;-通过“行动研究”支持变革过程-即与GP团队合作收集相关数据，共同分析并支持其快速使用;-使用协作改进技术，加强NHS数字创新的支持基础设施。

Because COVID-19 is so contagious, the way the NHS works has changed dramatically. For the first time since 1948, youcan't walk into a GP surgery and ask to be seen. You must apply online, phone the surgery or contact NHS111. You maythen get a call-back (phone or video) from a clinician, or a face-to-face appointment, possibly in a 'hot hub'.These changes to what used to be the family doctor service are radical, frightening and difficult. They cut to the core ofwhat it is to care and be cared for, and what 'good' and 'excellent' health services look and feel like. Will the doctor be ableto assess you properly by video or phone?We are an interdisciplinary team specialising in the study of complex, technology-supported change in health and caresettings. Using a variety of methods, we want to do three things:- Develop tools to help clinicians assess people effectively by phone or video;- Support the change process through 'action research' - that is, working with GP teams to collect relevant data, analyse ittogether and support its rapid use;- Using collaborative improvement techniques, strengthen the supporting infrastructure for digital innovation in the NHS.