1 Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, USA.
2 486017 Medical Advocacy and Outreach of Alabama, USA.
J Telemed Telecare. 2019 Jun;25(5):301-309. doi: 10.1177/1357633X18755227. Epub 2018 Feb 15.
Using a mixed-methods formative evaluation, the purpose of this study was to provide a broad overview of the Alabama eHealth programme set-up and initial patient outcomes. The Alabama eHealth programme uses telemedicine to provide medical care to people living with HIV in rural Alabama. It was led by a community-based organisation, Medical Advocacy and Outreach (MAO), and supported by AIDS United and the Corporation for National Community Service's Social Innovation Fund with matching support from non-federal donors.
We conducted and transcribed in-depth interviews with Alabama eHealth staff and then performed directed content analysis. We also tracked patients' ( n = 240) appointment attendance, CD4 counts, and viral loads.
Staff described the steps taken to establish the programme, associated challenges (e.g., costly, inadequate broadband in rural areas), and technology enabling this programme (electronic medical records, telemedicine equipment). Of all enrolled patients, 76% were retained in care, 88% had antiretroviral therapy and 75% had a suppressed viral load. Among patients without missing data, 96% were retained in care, 97% used antiretroviral therapy and 93% had suppressed viral loads. There were no statistically significant demographic differences between those with and without missing data.
Patients enrolled in a telemedicine programme evaluation successfully moved through the HIV continuum of care.
本研究采用混合方法形成性评估，旨在全面概述阿拉巴马电子健康计划的设立情况和初步患者结果。阿拉巴马电子健康计划利用远程医疗为阿拉巴马州农村地区的艾滋病毒感染者提供医疗服务。该计划由一个以社区为基础的组织医疗倡导和外联组织（MAO）领导，并得到艾滋病联合组织和国家社区服务公司社会创新基金的支持，同时得到非联邦捐助者的配套支持。
我们对阿拉巴马电子健康计划的工作人员进行了深入访谈并记录，然后进行了有针对性的内容分析。我们还跟踪了患者（n=240）的预约出席情况、CD4 计数和病毒载量。
工作人员描述了为设立该计划所采取的步骤，以及相关挑战（例如，农村地区宽带成本高、宽带不足）和支持该计划的技术（电子病历、远程医疗设备）。所有入组的患者中，76%的患者继续接受治疗，88%的患者接受了抗逆转录病毒治疗，75%的患者病毒载量得到了抑制。在没有缺失数据的患者中，96%的患者继续接受治疗，97%的患者使用抗逆转录病毒治疗，93%的患者病毒载量得到了抑制。在有缺失数据和无缺失数据的患者之间，没有统计学上显著的人口统计学差异。
参加远程医疗项目评估的患者成功地通过了艾滋病毒连续护理的各个阶段。
