May Carl R
Faculty of Health Sciences, University of Southampton, Building 67 (Nightingale), University Road, Southampton, SO17 1 BJ, UK.
BMC Med. 2015 Apr 23;13:92. doi: 10.1186/s12916-015-0305-8.
It has been clear for some time that the development of telecare faces significant problems. Large scale studies and clinical trials seem to suggest that the cost and clinical effectiveness of telecare systems is doubtful, and the claim that these systems empower or enable service users often seems greatly overstated. The question that stems from this is, can these problems be overcome? Greenhalgh et al. have critiqued the construction of telecare as a generalised technological solution to problems of the delivery of care and have offered a new framework for defining quality in telecare and telehealth. They outline a set of principles that focus on user-centredness, co-creation, integration, and evaluation. This is a valuable approach, and is part of a much wider transformation of the way in which policy and practice researchers conceptualise healthcare delivery as a problem of performativity. Recognising that this is an important shift, in this paper I argue that we also need to keep in mind the meso-level factors that structure new technology applications in practice. Please see the related article: http://dx.doi.org/10.1186/s12916-015-0279-6.
一段时间以来，远程护理的发展面临重大问题已十分明显。大规模研究和临床试验似乎表明，远程护理系统的成本和临床效果存疑，而且称这些系统能增强或帮助服务使用者的说法往往被严重夸大。由此产生的问题是，这些问题能否被克服？格林哈尔希等人批评了将远程护理构建为解决护理提供问题的通用技术解决方案的做法，并为界定远程护理和远程健康的质量提供了一个新框架。他们概述了一套以用户为中心、共同创造、整合和评估为重点的原则。这是一种有价值的方法，并且是政策和实践研究人员将医疗保健提供概念化为一个绩效问题的方式发生更广泛转变的一部分。认识到这是一个重要转变，在本文中我认为我们还需要牢记在实践中构建新技术应用的中观层面因素。请参阅相关文章：http://dx.doi.org/10.1186/s12916-015-0279-6 。
