Woo Christine, Guihan Marylou, Frick Christine, Gill Carol M, Ho Chester H
National SCI/D Telehealth Program Coordinator, Cleveland SCI/D Clinical and Research Telehealth Programs, Cleveland, OH, USA.
J Spinal Cord Med. 2011;34(3):322-31. doi: 10.1179/2045772311Y.0000000003.
Spinal cord injury and/or disorders (SCI/D) is a costly chronic condition. Impaired mobility, and lengthy travel distances to access specialty providers are barriers that can have adverse impact on expenses and quality of care. Although ample opportunities for use of telehealth technologies exist between medical facilities, and from clinical to home settings, field experience has largely been focused on home telehealth services to promote better patient self-management skills and improve clinical outcomes.
This paper provides an overview of published literature on use of telehealth technologies with the SCI/D population. Presentation of case studies describe telehealth as a potential strategy for addressing disparities in providing quality care, and explore comprehensive management of multiple health issues in individuals with SCI/D. Experiences of providers in both private sector health-care systems and VHA medical facilities are described. Development of telehealth clinical protocols and adaptive devices that can be integrated with equipment to accommodate for the functional limitations in the SCI/D population are discussed as necessary for expansion of use of telehealth services. Rigorous research studies are lacking. As use of this technology spreads and issues surrounding implementation are addressed, we look forward to increased research to assess and evaluate its efficacy in the SCI/D population.
CONCLUSION/CLINICAL RELEVANCE: Telehealth in the home setting appears to be able to help persons with SCI/D remain in the community. As the use of telehealth increases, research will be necessary in both clinical and home settings to assess its efficacy in improving outcomes in the SCI/D population.
脊髓损伤和/或疾病(SCI/D)是一种代价高昂的慢性病。行动不便以及前往专科医疗机构路途遥远是阻碍因素,可能对费用和医疗质量产生不利影响。尽管医疗机构之间以及从临床到家庭环境都有大量使用远程医疗技术的机会,但实际经验主要集中在家庭远程医疗服务上,以提高患者的自我管理技能并改善临床结果。
本文概述了已发表的关于对SCI/D人群使用远程医疗技术的文献。案例研究表明,远程医疗是解决优质医疗服务差距的一种潜在策略,并探讨了对SCI/D患者多种健康问题的综合管理。文中描述了私营部门医疗保健系统和退伍军人健康管理局(VHA)医疗机构中医疗服务提供者的经验。讨论了开发远程医疗临床方案和可与设备集成以适应SCI/D人群功能限制的自适应设备,这对于扩大远程医疗服务的使用是必要的。目前缺乏严格的研究。随着这项技术的应用推广以及实施过程中出现的问题得到解决,我们期待有更多研究来评估其在SCI/D人群中的疗效。
结论/临床意义:家庭环境中的远程医疗似乎能够帮助SCI/D患者留在社区。随着远程医疗使用的增加,有必要在临床和家庭环境中进行研究,以评估其对改善SCI/D人群治疗效果的疗效。