Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States.
Biomedical Sciences Graduate Program, College of Medicine, The Ohio State University, Columbus, OH, United States.
JMIR Public Health Surveill. 2020 Apr 7;6(2):e18961. doi: 10.2196/18961.
As the novel coronavirus disease (COVID-19) is widely spreading across the United States, there is a concern about the overloading of the nation's health care capacity. The expansion of telehealth services is expected to deliver timely care for the initial screening of symptomatic patients while minimizing exposure in health care facilities, to protect health care providers and other patients. However, it is currently unknown whether US hospitals have the telehealth capacity to meet the increasing demand and needs of patients during this pandemic.
We investigated the population-level internet search volume for telehealth (as a proxy of population interest and demand) with the number of new COVID-19 cases and the proportion of hospitals that adopted a telehealth system in all US states.
We used internet search volume data from Google Trends to measure population-level interest in telehealth and telemedicine between January 21, 2020 (when the first COVID-19 case was reported), and March 18, 2020. Data on COVID-19 cases in the United States were obtained from the Johns Hopkins Coronavirus Resources Center. We also used data from the 2018 American Hospital Association Annual Survey to estimate the proportion of hospitals that adopted telehealth (including telemedicine and electronic visits) and those with the capability of telemedicine intensive care unit (tele-ICU). Pearson correlation was used to examine the relations of population search volume for telehealth and telemedicine (composite score) with the cumulative numbers of COVID-19 cases in the United States during the study period and the proportion of hospitals with telehealth and tele-ICU capabilities.
We found that US population-level interest in telehealth increased as the number of COVID-19 cases increased, with a strong correlation (r=0.948, P<.001). We observed a higher population-level interest in telehealth in the Northeast and West census region, whereas the proportion of hospitals that adopted telehealth was higher in the Midwest region. There was no significant association between population interest and the proportion of hospitals that adopted telehealth (r=0.055, P=.70) nor hospitals having tele-ICU capability (r=-0.073, P=.61).
As the number of COVID-19 cases increases, so does the US population's interest in telehealth. However, the level of population interest did not correlate with the proportion of hospitals providing telehealth services in the United States, suggesting that increased population demand may not be met with the current telehealth capacity. Telecommunication infrastructures in US hospitals may lack the capability to address the ongoing health care needs of patients with other health conditions. More practical investment is needed to deploy the telehealth system rapidly against the impending patient surge.
随着新型冠状病毒病（COVID-19）在美国广泛传播，人们担心美国的医疗保健能力将不堪重负。扩大远程医疗服务有望为有症状的患者进行初步筛查提供及时的护理，同时最大限度地减少医疗保健设施中的暴露，以保护医疗保健提供者和其他患者。然而，目前尚不清楚美国医院是否有远程医疗能力来满足大流行期间不断增长的患者需求。
我们通过美国各州新的 COVID-19 病例数量和采用远程医疗系统的医院比例，调查了人口层面远程医疗（作为人口兴趣和需求的代表）的互联网搜索量。
我们使用谷歌趋势（Google Trends）的互联网搜索量数据，在 2020 年 1 月 21 日（首次报告 COVID-19 病例）至 2020 年 3 月 18 日期间，测量了人口对远程医疗和远程医疗的兴趣。美国的 COVID-19 病例数据来自约翰霍普金斯冠状病毒资源中心（Johns Hopkins Coronavirus Resources Center）。我们还使用了 2018 年美国医院协会年度调查的数据，以评估采用远程医疗（包括远程医疗和电子就诊）的医院比例，以及具备远程医疗重症监护室（远程 ICU）能力的医院比例。我们使用 Pearson 相关分析来检验远程医疗和远程医疗（综合评分）的人口搜索量与研究期间美国 COVID-19 病例累计数量以及具有远程医疗和远程 ICU 能力的医院比例之间的关系。
我们发现，随着 COVID-19 病例数量的增加，美国人口对远程医疗的兴趣也在增加，相关性很强（r=0.948，P<.001）。我们发现，远程医疗在东北部和西部人口普查区的人口兴趣更高，而在中西部地区，采用远程医疗的医院比例更高。人口兴趣与采用远程医疗的医院比例（r=0.055，P=.70）或具有远程 ICU 能力的医院（r=-0.073，P=.61）之间没有显著的关联。
随着 COVID-19 病例数量的增加，美国人口对远程医疗的兴趣也在增加。然而，人口兴趣水平与美国提供远程医疗服务的医院比例没有相关性，这表明增加的人口需求可能无法满足当前的远程医疗能力。美国医院的电信基础设施可能缺乏满足其他健康状况患者持续医疗需求的能力。需要进行更多实际的投资，以快速部署远程医疗系统，应对即将到来的患者激增。
