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远程医疗和新兴技术在过敏/免疫学中的应用。

Telemedicine and emerging technologies for health care in allergy/immunology.

机构信息

Children's Mercy Hospital, Kansas City, Mo.

Children's Mercy Hospital, Kansas City, Mo.

出版信息

J Allergy Clin Immunol. 2020 Feb;145(2):445-454. doi: 10.1016/j.jaci.2019.12.903.

Abstract

Telemedicine (TM) has become a popular method of accessing medical services between providers and patients and is viewed as a cost-effective alternative to more traditional episodic face-to-face encounters. TM overcomes 2 barriers that patients face when seeking health care: distance and time. It is as effective as in-person visits for outpatient treatment of asthma, and it is a convenient way to provide inpatient consultations for patients when the allergist practices outside of the hospital. TM also has been used to manage patients with asthma in schools. Patients tend to be as satisfied with TM or they prefer TM over in-person visits, but infrequently they do prefer in-person visits. In addition to virtual visits using TM, there are several emerging technologies that are relevant to the practice of allergy/immunology including electronic diaries (eg, symptoms and medication use), wearable technology (eg, to monitor activity and vital signs), remote patient monitoring (eg, environmental exposures and medication adherence) as well as electronic medical records augmented with clinical decision support. We believe that the use of TM, particularly when combined with information technologies such as electronic health records, has the potential to cause a transformational change in the way care is delivered by altering the process of interaction between patient and provider. TM addresses the shortage of allergy specialists in rural and underserved urban communities and facilitates patient access to allergy services. As patients take more control of their health care, use of TM is likely to increase because a large part of the move to adopt TM is driven by patient preference.

摘要

远程医疗 (TM) 已成为一种获取医患间医疗服务的流行方法,被视为比传统的偶发性面对面就诊更具成本效益的替代方法。TM 克服了患者在寻求医疗保健时面临的 2 个障碍:距离和时间。它在哮喘的门诊治疗方面与面对面就诊一样有效,并且当过敏症医生在医院外执业时,它是为患者提供住院咨询的便捷方式。TM 还被用于管理学校中的哮喘患者。患者对 TM 的满意度与面对面就诊相当,或者他们更喜欢 TM,但很少有患者更喜欢面对面就诊。除了使用 TM 的虚拟就诊外,还有几种新兴技术与过敏/免疫学实践相关,包括电子日记(例如症状和用药情况)、可穿戴技术(例如,监测活动和生命体征)、远程患者监测(例如,环境暴露和用药依从性)以及电子病历与临床决策支持相结合。我们认为,TM 的使用,特别是与电子健康记录等信息技术相结合,有可能通过改变医患互动的过程,彻底改变医疗服务的提供方式。TM 解决了农村和服务不足的城市社区中过敏专家短缺的问题,并为患者提供了获得过敏服务的机会。随着患者更多地控制自己的医疗保健,TM 的使用可能会增加,因为采用 TM 的很大一部分原因是出于患者的偏好。

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