Hiratsuka Vanessa, Delafield Rebecca, Starks Helene, Ambrose Adrian Jacques, Mau Marjorie Mala
Research Department, Southcentral Foundation, Anchorage, AK, USA.
Int J Circumpolar Health. 2013 Aug 5;72. doi: 10.3402/ijch.v72i0.21401. eCollection 2013.
Among indigenous populations in remote locations who are at increased risk for chronic diseases such as diabetes, telemedicine has the potential to improve access to health care services and thus may reduce adverse health outcomes. Yet few studies are available on how best to use telemedicine technology in reducing ethnic and racial health care disparities.
We examined perspectives of patients and providers in 2 indigenous populations in Alaska and Hawai'i about the use of telemedicine in primary care chronic disease management.
Six focus groups with patients and providers at 2 sites (3 in Alaska and 3 in Hawai'i).
Three broad themes were common to both sites: (a) benefits and barriers of using telemedicine; (b) building patient-provider relationships; and (c) elements of an acceptable telemedicine primary care encounter. Two key elements were endorsed by both patients and providers as important for an effective telemedicine encounter: (a) the initial patient-provider interaction should be face-to-face; and (b) patients must see the same provider on follow-up visits.
The use of telemedicine in chronic disease management has potential to improve patient care in remote indigenous populations and may supplement patient-provider relationships.
在偏远地区的原住民中，患糖尿病等慢性病的风险增加，远程医疗有潜力改善医疗服务的可及性，从而可能减少不良健康结局。然而，关于如何最好地利用远程医疗技术来减少种族和民族医疗保健差距的研究很少。
我们研究了阿拉斯加和夏威夷两个原住民群体中患者和医疗服务提供者对在初级保健慢性病管理中使用远程医疗的看法。
在两个地点（阿拉斯加3个，夏威夷3个）与患者和医疗服务提供者进行了6个焦点小组讨论。
两个地点都有三个共同的广泛主题：（a）使用远程医疗的益处和障碍；（b）建立患者与医疗服务提供者的关系；（c）可接受的远程医疗初级保健问诊要素。患者和医疗服务提供者都认可两个关键要素对有效的远程医疗问诊很重要：（a）患者与医疗服务提供者的初次互动应该是面对面的；（b）患者在后续就诊时必须看同一位医疗服务提供者。
在慢性病管理中使用远程医疗有潜力改善偏远原住民群体的患者护理，并可能补充患者与医疗服务提供者的关系。
