Leviton Alan, Oppenheimer Julia, Chiujdea Madeline, Antonetty Annalee, Ojo Oluwafemi William, Garcia Stephanie, Weas Sarah, Fleegler Eric, Chan Eugenia, Loddenkemper Tobias
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Healthcare (Basel). 2019 Apr 27;7(2):65. doi: 10.3390/healthcare7020065.
Replacement of fee-for-service with capitation arrangements, forces physicians and institutions to minimize health care costs, while maintaining high-quality care. In this report we described how patients and their families (or caregivers) can work with members of the medical care team to achieve these twin goals of maintaining-and perhaps improving-high-quality care and minimizing costs. We described how increased self-management enables patients and their families/caregivers to provide electronic patient-reported outcomes (i.e., symptoms, events) (ePROs), as frequently as the patient or the medical care team consider appropriate. These capabilities also allow ongoing assessments of physiological measurements/phenomena (mHealth). Remote surveillance of these communications allows longer intervals between (fewer) patient visits to the medical-care team, when this is appropriate, or earlier interventions, when it is appropriate. Systems are now available that alert medical care providers to situations when interventions might be needed.
用按人头付费安排取代按服务收费，迫使医生和医疗机构在维持高质量医疗的同时尽量降低医疗成本。在本报告中，我们描述了患者及其家人（或护理人员）如何与医疗团队成员合作，以实现维持——甚至改善——高质量医疗和降低成本这两个双重目标。我们描述了增强的自我管理如何使患者及其家人/护理人员能够根据患者或医疗团队认为合适的频率，提供电子患者报告结局（即症状、事件）（ePROs）。这些功能还允许对生理测量/现象进行持续评估（移动健康）。对这些通信进行远程监测，可以在适当的时候延长（减少）患者就诊医疗团队的间隔时间，或者在适当的时候进行早期干预。现在已有系统能够在可能需要干预的情况下向医疗服务提供者发出警报。
