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通过即时医疗技术提高医疗服务的可及性。

Improving healthcare accessibility through point-of-care technologies.

作者信息

Price Christopher P, Kricka Larry J

机构信息

Department of Clinical Biochemistry, University of Oxford, John Radcliffe Hospital, Oxford, UK.

出版信息

Clin Chem. 2007 Sep;53(9):1665-75. doi: 10.1373/clinchem.2006.084707. Epub 2007 Jul 27.

Abstract

BACKGROUND

The NIH is committed to improving healthcare quality in the US and has set up initiatives to address problems such as the fragmented nature of healthcare provision. A hypothesis has been developed that testing closer to the point at which care is delivered may reduce fragmentation of care and improve outcomes.

METHODS

The National Institute of Biomedical Imaging and Bioengineering (NIBIB), the NIH's National Heart, Lung, and Blood Institute, and the National Science Foundation sponsored a workshop, "Improving Health Care Accessibility through Point-of-Care Technologies," in April 2006. The workshop assessed the clinical needs and opportunities for point-of-care (POC) technologies in primary care, the home, and emergency medical services and reviewed minimally invasive and noninvasive testing, including imaging, and conventional testing based on sensor and lab-on-a-chip technologies. Emerging needs of informatics and telehealth and healthcare systems engineering were considered in the POC testing context. Additionally, implications of evidence-based decision-making were reviewed, particularly as it related to the challenges in producing reliable evidence, undertaking regulation, implementing evidence responsibly, and integrating evidence into health policy.

RESULTS

Many testing procedures were considered to be valuable in the clinical settings discussed. Technological solutions were proposed to meet these needs, as well as the practical requirements around clinical process change and regulation. From these considerations, a series of recommendations was formulated for development of POC technologies based on input from the symposium attendees.

CONCLUSION

NIBIB has developed a funding initiative to establish a Point-of-Care Technologies Research Network that will work to bridge the technology/clinical gap and provide the partnerships necessary for the application of technologies to pressing clinical needs in POC testing.

摘要

背景

美国国立卫生研究院致力于改善美国的医疗保健质量,并已发起多项举措来解决诸如医疗服务碎片化等问题。有人提出一种假设,即在更接近医疗服务提供点进行检测可能会减少医疗服务的碎片化并改善治疗效果。

方法

美国国立生物医学成像和生物工程研究所(NIBIB)、美国国立卫生研究院的国家心肺血液研究所和美国国家科学基金会于2006年4月共同主办了一次研讨会,即“通过即时检测技术改善医疗保健可及性”。该研讨会评估了基层医疗、家庭医疗和紧急医疗服务中即时检测(POC)技术的临床需求和机遇,并审查了微创和无创检测,包括成像,以及基于传感器和芯片实验室技术的传统检测。在即时检测的背景下考虑了信息学、远程医疗和医疗保健系统工程的新需求。此外,还审查了基于证据的决策的影响,特别是其与产生可靠证据、进行监管、负责任地实施证据以及将证据纳入卫生政策方面的挑战的相关性。

结果

在讨论的临床环境中,许多检测程序被认为具有价值。提出了技术解决方案以满足这些需求以及围绕临床流程变化和监管的实际要求。基于这些考虑,并根据研讨会与会者的意见,为即时检测技术的开发制定了一系列建议。

结论

NIBIB已发起一项资助计划,以建立一个即时检测技术研究网络,该网络将努力弥合技术与临床之间的差距,并为将技术应用于即时检测中紧迫的临床需求提供必要的合作关系。

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