Shang Lili, Zuo Meiyun, Ma Dan, Yu Qinjun
Research Institute of Smart Senior Care, School of Information, Renmin University of China, Beijing, China.
School of Basic Medicine, Peking University Health Science Center, Beijing, China.
J Med Internet Res. 2019 Sep 25;21(9):e13940. doi: 10.2196/13940.
Online health care services effectively supplement traditional medical treatment. The development of online health care services depends on sustained interactions between health care professionals (HCPs) and patients. Therefore, it is necessary to understand the demands and gains of health care stakeholders in HCP-patient online interactions and determine an agenda for future work.
This study aims to present a systematic review of the antecedents and consequences of HCP-patient online interactions. It seeks to reach a better understanding of why HCPs and patients are willing to interact with each other online and what the consequences of HCP-patient online interactions are for health care stakeholders. Based on this, we intend to identify the gaps in existing studies and make recommendations for future research.
In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic retrieval was carried out from the Web of Science, PubMed, and Scopus electronic databases. The search results were confined to those papers published in English between January 1, 2000 and June 30, 2018. Selected studies were then evaluated for quality; studies that did not meet quality criteria were excluded from further analysis. Findings of the reviewed studies related to our research questions were extracted and synthesized through inductive thematic analysis.
A total of 8440 records were found after the initial search, 28 papers of which were selected for analysis. Accessibility to HCPs, self-management, and unmet needs were the main triggers for patients to participate in online interaction. For HCPs, patient education, career needs, and self-promotion were the major reasons why they took the online approach. There were several aspects of the consequences of HCP-patient online interactions on health care stakeholders. Consequences for patients included patient empowerment, health promotion, and acquisition of uncertain answers. Consequences for HCPs included social and economic returns, lack of control over their role, and gaining more appointments. HCP-patient online interactions also improved communication efficiency in offline settings and helped managers of online health care settings get a better understanding of patients' needs. Health care stakeholders have also encountered ethical and legal issues during online interaction.
Through a systematic review, we sought out the antecedents and consequences of HCP-patient online interactions to understand the triggers for HCPs and patients to participate and the consequences of participating. Potential future research topics are the influences on the chain of online interaction, specifications and principles of privacy design within online health care settings, and roles that sociodemographic and psychological characteristics play. Longitudinal studies and the adoption of text-mining method are worth encouraging. This paper is expected to contribute to the sustained progress of online health care settings.
在线医疗服务有效地补充了传统医疗。在线医疗服务的发展依赖于医护人员（HCPs）与患者之间的持续互动。因此，有必要了解医护人员与患者在线互动中医护利益相关者的需求和收获，并确定未来工作的议程。
本研究旨在对医护人员与患者在线互动的前因后果进行系统综述。旨在更好地理解医护人员和患者为何愿意在网上相互交流，以及医护人员与患者在线互动对医护利益相关者的影响。基于此，我们打算找出现有研究中的差距，并为未来研究提出建议。
按照PRISMA（系统评价和Meta分析的首选报告项目）指南，从Web of Science、PubMed和Scopus电子数据库进行系统检索。检索结果限于2000年1月1日至2018年6月30日期间以英文发表的论文。然后对所选研究进行质量评估；不符合质量标准的研究被排除在进一步分析之外。通过归纳主题分析提取和综合与我们研究问题相关的综述研究结果。
初步检索后共找到8440条记录，其中28篇论文被选作分析。患者能够接触到医护人员、自我管理和未满足的需求是患者参与在线互动的主要触发因素。对于医护人员来说，患者教育、职业需求和自我推广是他们采取在线方式的主要原因。医护人员与患者在线互动对医护利益相关者的影响有几个方面。对患者的影响包括患者赋权、健康促进和获得不确定的答案。对医护人员的影响包括社会和经济回报、对自身角色缺乏控制以及获得更多预约。医护人员与患者在线互动还提高了线下环境中的沟通效率，并帮助在线医疗环境的管理者更好地了解患者需求。医护利益相关者在在线互动中也遇到了伦理和法律问题。
通过系统综述，我们找出了医护人员与患者在线互动的前因后果，以了解医护人员和患者参与的触发因素以及参与的后果。未来潜在的研究主题是对在线互动链条的影响、在线医疗环境中隐私设计的规范和原则，以及社会人口统计学和心理特征所起的作用。纵向研究和文本挖掘方法的采用值得鼓励。本文有望为在线医疗环境的持续发展做出贡献。
