Crowley Susan T, Belcher Justin, Choudhury Devasmita, Griffin Cassandra, Pichler Raymond, Robey Brooks, Rohatgi Rajeev, Mielcarek Bessie
Department of Medicine, Section of Nephrology, VA Connecticut Healthcare System, West Haven, CT; Department of Medicine, Section of Nephrology, Yale University School of Medicine, New Haven, CT; Department of Medicine, Section of Nephrology, Salem VA Medical Center, Salem, VA; Department of Medicine, Section of Nephrology, Virginia Tech Carilion School of Medicine, Roanoke, VA; Department of Medicine, Section of Nephrology, VA Puget Sound Healthcare System, Seattle, WA; Division of Nephrology, University of Washington School of Medicine, Seattle, WA; Department of Medicine, Section of Nephrology, VA White River Junction VAMC, White River Junction, VT; Department of Medicine, Section of Nephrology, Dartmouth School of Medicine, Hanover, NH; Department of Medicine, Section of Nephrology, VA Northport Healthcare Systems, Northport, NY; and Department of Medicine, Section of Nephrology, State University of New York at Stony Brook School of Medicine, Stony Brook, NY.
Department of Medicine, Section of Nephrology, VA Connecticut Healthcare System, West Haven, CT; Department of Medicine, Section of Nephrology, Yale University School of Medicine, New Haven, CT; Department of Medicine, Section of Nephrology, Salem VA Medical Center, Salem, VA; Department of Medicine, Section of Nephrology, Virginia Tech Carilion School of Medicine, Roanoke, VA; Department of Medicine, Section of Nephrology, VA Puget Sound Healthcare System, Seattle, WA; Division of Nephrology, University of Washington School of Medicine, Seattle, WA; Department of Medicine, Section of Nephrology, VA White River Junction VAMC, White River Junction, VT; Department of Medicine, Section of Nephrology, Dartmouth School of Medicine, Hanover, NH; Department of Medicine, Section of Nephrology, VA Northport Healthcare Systems, Northport, NY; and Department of Medicine, Section of Nephrology, State University of New York at Stony Brook School of Medicine, Stony Brook, NY.
Adv Chronic Kidney Dis. 2017 Jan;24(1):22-30. doi: 10.1053/j.ackd.2016.11.005.
The Veterans Affairs (VA) is the largest integrated health care system in the United States and is responsible for the care of a population with a disproportionately high rate of CKD. As such, ensuring access to kidney health services is a VA imperative. One facet of the VA's strategy to reduce CKD is to leverage the use of teletechnology to expand the VA's outreach to Veterans with kidney disease. A wide array of teletechnology services have been deployed to both pull in Veterans and push out kidney health services to Veterans in their preferred health care venue. Teletechnology, thus, expands Veteran choice, facilitates their access to care, and furthers the goal of delivering patient-centered kidney specialty care. The VA has demonstrated the feasibility of virtual delivery of kidney specialty care services and education via synchronous and asynchronous approaches. The challenges ahead include determining the relative health care value of kidney telehealth services, identifying Veterans most likely to benefit from specific technologies and optimizing the adoption of effective kidney telehealth services by both providers and patients alike to ensure optimal and timely kidney health care delivery.
美国退伍军人事务部（VA）是美国最大的综合医疗保健系统，负责照顾慢性肾脏病（CKD）发病率极高的人群。因此，确保退伍军人能够获得肾脏健康服务是退伍军人事务部的当务之急。退伍军人事务部减少慢性肾脏病的战略的一个方面是利用远程技术，扩大退伍军人事务部对肾病退伍军人的服务范围。已经部署了一系列远程技术服务，以吸引退伍军人，并将肾脏健康服务推送到退伍军人喜欢的医疗保健场所。因此，远程技术扩大了退伍军人的选择范围，便利了他们获得医疗服务，并进一步推进了提供以患者为中心的肾脏专科护理的目标。退伍军人事务部已经证明了通过同步和异步方式虚拟提供肾脏专科护理服务和教育的可行性。未来的挑战包括确定肾脏远程医疗服务的相对医疗保健价值，确定最有可能从特定技术中受益的退伍军人，以及优化医疗服务提供者和患者对有效的肾脏远程医疗服务的采用，以确保及时提供最佳的肾脏医疗保健服务。
