Centre for Rural Health, University of Aberdeen, Inverness, UK.
Health Expect. 2011 Dec;14(4):351-60. doi: 10.1111/j.1369-7625.2010.00637.x. Epub 2010 Oct 28.
Interest and investment in e-health continue to grow world-wide, but there remains relatively little engagement with the public on this subject, despite calls for more public involvement in health-care planning.
This study used two modified citizen juries to explore barriers and facilitators to e-health implementation and the priorities for future e-health research from the perspective of health service users and lay representatives. Citizen juries bring together a group of people to deliberate over a specific issue. They are given information and invited to 'cross-examine' witnesses during the process.
Jurors were very keen for lay views to be included in e-health development and embraced the citizen jury approach. They agreed unanimously that e-health should be developed and thought it was in many ways inevitable. Although there was much enthusiasm for a health-care system which offered e-health as an option, there was as much concern about what it might mean for patients if implemented inappropriately. E-health was preferred as an enhancement rather than substitute for, existing services. Lack of universal access was seen as a potential barrier to implementation but problems such as lack of computer literacy were seen as a temporary issue. Participants emphasized that e-health research needed to demonstrate both clinical and economic benefits.
There was broad support from the citizen juries for the development of e-health, although participants stressed that e-health should enhance, rather than substitute, face-to-face services. One-day citizen juries proved a practical method of public engagement on this subject.
尽管人们呼吁更多地让公众参与医疗保健规划,但全球范围内对电子健康的兴趣和投资仍在继续增长,但在这个问题上,与公众的接触相对较少。
本研究使用了两个经过修改的公民陪审团,从卫生服务使用者和非专业代表的角度探讨电子健康实施的障碍和促进因素,以及未来电子健康研究的重点。公民陪审团将一组人聚集在一起,就一个具体问题进行审议。在这个过程中,他们会被提供信息,并被邀请“盘问”证人。
陪审员非常希望将非专业人士的观点纳入电子健康发展之中,并接受公民陪审团的方法。他们一致认为应该开发电子健康,并认为从很多方面来看,这是不可避免的。尽管人们对提供电子健康作为选择的医疗保健系统充满热情,但如果不恰当地实施,这对患者意味着什么也同样令人担忧。电子健康被认为是对现有服务的补充,而不是替代。全民普及是实施的潜在障碍,但缺乏计算机知识等问题被视为暂时的问题。参与者强调,电子健康研究需要证明其具有临床和经济效益。
公民陪审团普遍支持电子健康的发展,但参与者强调,电子健康应该增强,而不是替代面对面的服务。为期一天的公民陪审团证明了在这个问题上进行公众参与的一种实用方法。