Tenforde Adam S, Iaccarino Mary A, Borgstrom Haylee, Hefner Jaye E, Silver Julie, Ahmed Marwa, Babu Ashwin N, Blauwet Cheri A, Elson Lauren, Eng Christine, Kotler Dana, Homer Scott, Makovitch Steven, McInnis Kelly C, Vora Ariana, Borg-Stein Joanne
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA.
PM R. 2020 Sep;12(9):926-932. doi: 10.1002/pmrj.12422. Epub 2020 Jul 10.
The global pandemic due to SARS-CoV-2 has resulted in an expansion of telemedicine. Measures of quality and barriers for rapid use by patients and physicians are not well described.
To describe results from a quality improvement initiative during a rapid adoptive phase of telemedicine during the pandemic.
Patient and physician satisfaction with synchronous audiovisual telemedicine visits was measured during the early adoptive phase (6 April 2020-17 April 2020) within the division of sports medicine in an academic Physical Medicine and Rehabilitation (PM&R) department. Patients were invited to participate in a quality improvement initiative by completing an online survey at the end of a telemedicine visit. Physicians completed a separate survey.
Patient measures included visit type, duration of encounter, quality, and satisfaction. Physicians reported on experiences performed telemedicine.
Surveys were completed by 119 patients (293 telemedicine encounters, response rate 40.6%) and 14 physiatrists. Telemedicine was utilized primarily for follow-up visits (n = 74, 70.6%), and the most common duration was 15 to 29 minutes. Patients rated their telemedicine visit as "excellent" or "very good" across measures (91.6%-95.0%) including addressing concerns, communication, developing a treatment plan, convenience, and satisfaction. Value of completing a future telemedicine visit was measured at 84.9%. Most reported estimated travel time saved was in excess of 30 minutes. Rate of no-show was 2.7%. Most physicians (57.1%) had no prior experience with telemedicine visits, and most were comfortable performing these visits after completing 1 to 4 sessions (71%). Nearly all physicians (92.9%) rated their telemedicine experience as very good or excellent. The key barrier identified for telemedicine was technical issues. All physicians reported plans to perform telemedicine visits if reimbursement continues.
In summary, rapid expansion of telemedicine during the COVID-19 pandemic was well-received by a majority of patients and physicians. This suggests feasibility in rapid expansion of telemedicine for other outpatient sports medicine practices.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的全球大流行导致了远程医疗的扩展。关于质量的衡量标准以及患者和医生快速使用远程医疗的障碍尚未得到充分描述。
描述在大流行期间远程医疗快速采用阶段的一项质量改进举措的结果。
在一所学术性物理医学与康复（PM&R）部门的运动医学科，于早期采用阶段（2020年4月6日至2020年4月17日）对患者和医生对同步视听远程医疗就诊的满意度进行了测量。患者在远程医疗就诊结束时通过完成在线调查被邀请参与一项质量改进举措。医生完成了一份单独的调查。
患者指标包括就诊类型、诊疗时长、质量和满意度。医生报告了进行远程医疗的经历。
119名患者（293次远程医疗就诊，回复率40.6%）和14名物理治疗师完成了调查。远程医疗主要用于随访就诊（n = 74，70.6%），最常见的时长为15至29分钟。患者对其远程医疗就诊在各项指标（包括解决担忧、沟通、制定治疗计划、便利性和满意度）上的评价为“优秀”或“非常好”（91.6% - 95.0%）。进行未来远程医疗就诊的意愿值为84.9%。大多数报告称节省的估计出行时间超过30分钟。爽约率为2.7%。大多数医生（57.1%）此前没有远程医疗就诊的经验，并且大多数医生在完成1至4次就诊后对进行这些就诊感到自在（71%）。几乎所有医生（92.9%）对其远程医疗经历的评价为非常好或优秀。确定的远程医疗的关键障碍是技术问题。所有医生都报告称，如果报销持续，计划进行远程医疗就诊。
总之，在2019冠状病毒病大流行期间远程医疗的快速扩展受到了大多数患者和医生的欢迎。这表明在其他门诊运动医学实践中快速扩展远程医疗具有可行性。
