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三级中心对肾移植受者进行常规随访的远程医疗模式:案例研究。

Telehealth model of care for routine follow up of renal transplant recipients in a tertiary centre: A case study.

机构信息

Department of Nephrology, The Royal Melbourne Hospital, Parkville, Australia.

University of Melbourne, Parkville, Australia.

出版信息

J Telemed Telecare. 2020 May;26(4):232-238. doi: 10.1177/1357633X18807834. Epub 2018 Nov 17.

Abstract

Royal Melbourne Hospital (RMH) performs over 140 kidney transplant operations annually. Kidney transplant recipients require regular medical review, which results in loss of time and costs from travel, particularly for regional patients, and places high demand on the hospital outpatient service. The RMH renal transplant unit initiated a telehealth service in 2016 to provide cost effective, patient-centred clinical care for regional patients. To date, 263 clinical reviews have been conducted via telehealth, potentially saving 203,202 kilometres in travel distance; 2771 hours in car travel time; an estimated AUD $31,048 in petrol savings and 51 tonnes CO equivalents of greenhouse gas emissions. Lessons learnt have included the importance of using technology that allows patients to access telehealth from their place of choice. The option of a joint consultation with local healthcare providers has facilitated the development of extended care networks for our patients. Incorporation of telehealth into our outpatient system has been achieved with the existing nephrology workforce, making it a sustainable long-term review option. Our renal transplant telehealth outpatient clinic has been a successful change in the way we provide care to regional patients. Formal comparison of clinical outcomes and the patient experience of telehealth versus in person reviews are underway.

摘要

皇家墨尔本医院每年进行超过 140 例肾脏移植手术。肾脏移植受者需要定期进行医疗复查,这导致他们在旅行方面耗费时间和金钱,特别是对于地区患者而言,同时也对医院的门诊服务提出了很高的要求。皇家墨尔本医院的肾脏移植科于 2016 年启动了远程医疗服务,为地区患者提供具有成本效益且以患者为中心的临床护理。迄今为止,已经通过远程医疗进行了 263 次临床检查,这可能节省了 203202 公里的旅行距离;2771 小时的车程;估计节省了 31048 澳元的汽油费和 51 公吨的温室气体排放当量。得出的经验教训包括使用允许患者从其首选地点访问远程医疗的技术的重要性。与当地医疗保健提供者联合进行会诊的选择,为我们的患者建立了扩展护理网络。通过现有的肾脏科劳动力,已经将远程医疗纳入我们的门诊系统,使其成为一种可持续的长期复查选择。我们的肾脏移植远程医疗门诊已经成功改变了我们为地区患者提供护理的方式。正在对远程医疗和亲自复查的临床结果和患者体验进行正式比较。

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