Health Aff (Millwood). 2014 Feb;33(2):251-7. doi: 10.1377/hlthaff.2013.1005.
The US health care system has been slow to adopt Internet, mobile, and video technologies, which have the capability to engage patients in their own care, increase patients' access to providers, and possibly improve the quality of care while reducing costs. Nevertheless, there are some pockets of progress, including Kaiser Permanente Northern California (KPNC). In 2008 KPNC implemented an inpatient and ambulatory care electronic health record system for its 3.4 million members and developed a suite of patient-friendly Internet, mobile, and video tools. KPNC has achieved many successes. For example, the number of virtual "visits" grew from 4.1 million in 2008 to an estimated 10.5 million in 2013. This article describes KPNC's experience with Internet, mobile, and video technologies and the obstacles faced by other health care providers interested in embracing them. The obstacles include the predominant fee-for-service payment model, which does not reimburse for virtual visits; the considerable investment needed to deploy these technologies; and physician buy-in.
美国的医疗保健系统在采用互联网、移动和视频技术方面一直较为缓慢,而这些技术有能力使患者参与自身护理,增加患者与提供者的接触机会,并有可能在降低成本的同时提高护理质量。然而,还是有一些进展的例子,包括 Kaiser Permanente Northern California(KPNC)。2008 年,KPNC 为其 340 万会员实施了住院和门诊医疗电子健康记录系统,并开发了一系列便于患者使用的互联网、移动和视频工具。KPNC 取得了许多成功。例如,虚拟“就诊”的数量从 2008 年的 410 万增加到了 2013 年的估计 1050 万。本文介绍了 KPNC 在互联网、移动和视频技术方面的经验,以及其他有兴趣采用这些技术的医疗保健提供者所面临的障碍。这些障碍包括主要的按服务收费支付模式,该模式不报销虚拟就诊费用;部署这些技术所需的大量投资;以及医生的认同。