Krishna Vinay N, Managadi Kamesha, Smith Michael, Wallace Eric
Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL; and Alabama Department of Public Health, Montgomery, AL.
Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL; and Alabama Department of Public Health, Montgomery, AL.
Adv Chronic Kidney Dis. 2017 Jan;24(1):12-16. doi: 10.1053/j.ackd.2016.11.014.
Geographic and socioeconomic barriers may pose a significant difficulty in delivering home dialysis care to remote underserved populations leading to low utilization rates and poor outcomes. Telehealth may serve as a solution to overcome geographic barriers in delivering home dialysis care. Although technologic advances in telehealth have progressed rapidly making it accessible and inexpensive, it has been underused by nephrologists. Components of a regular face-to-face visit that can be successfully accomplished remotely using telehealth techniques include physician-patient communication, physical examination, laboratory and treatment data monitoring, nursing and nutrition education. Regulatory and reimbursement-related policies continue to present barriers that need to be overcome in operationalizing telehealth and widespread adoption of telehealth solutions. Although more quality evidence is needed to study the impact of telehealth on home dialysis outcomes and uptake, telehealth holds the promise of increasing access to care, improving quality of life, and improving quality of care for current and would be home dialysis patients.
地理和社会经济障碍可能给偏远地区医疗服务不足的人群提供家庭透析护理带来重大困难，导致利用率低下和治疗效果不佳。远程医疗可能是克服提供家庭透析护理时地理障碍的一种解决方案。尽管远程医疗技术进步迅速，使其变得易于使用且成本低廉，但肾脏病学家对其使用不足。通过远程医疗技术可以成功远程完成的常规面对面就诊的组成部分包括医患沟通、体格检查、实验室和治疗数据监测、护理和营养教育。监管和报销相关政策仍然是在实施远程医疗和广泛采用远程医疗解决方案时需要克服的障碍。尽管需要更多高质量证据来研究远程医疗对家庭透析结果和接受度的影响，但远程医疗有望增加获得护理的机会、改善生活质量，并提高当前及未来家庭透析患者的护理质量。
