Scott Benjamin K, Miller Geoffrey T, Fonda Stephanie J, Yeaw Ronald E, Gaudaen James C, Pavliscsak Holly H, Quinn Matthew T, Pamplin Jeremy C
Department of Anesthesiology, University of Colorado School of Medicine, Denver, Colorado, USA.
Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, Maryland, USA.
Telemed J E Health. 2020 Oct;26(10):1226-1233. doi: 10.1089/tmj.2020.0140. Epub 2020 May 26.
Background:Coronavirus disease 2019 (COVID-19) has led to a national health care emergency in the United States and exposed resource shortages, particularly of health care providers trained to provide critical or intensive care. This article describes how digital health technologies are being or could be used for COVID-19 mitigation. It then proposes the National Emergency Tele-Critical Care Network (NETCCN), which would combine digital health technologies to address this and future crises.
Methods:Subject matter experts from the Society of Critical Care Medicine and the Telemedicine and Advanced Technology Research Center examined the peer-reviewed literature and science/technology news to see what digital health technologies have already been or could be implemented to (1) support patients while limiting COVID-19 transmission, (2) increase health care providers' capability and capacity, and (3) predict/prevent future outbreaks.
Results:Major technologies identified included telemedicine and mobile care (for COVID-19 as well as routine care), tiered telementoring, telecritical care, robotics, and artificial intelligence for monitoring. Several of these could be assimilated to form an interoperable scalable NETCCN. NETCCN would assist health care providers, wherever they are located, by obtaining real-time patient and supplies data and disseminating critical care expertise. NETCCN capabilities should be maintained between disasters and regularly tested to ensure continual readiness.
Conclusions:COVID-19 has demonstrated the impact of a large-scale health emergency on the existing infrastructures. Short term, an approach to meeting this challenge is to adopt existing digital health technologies. Long term, developing a NETCCN may ensure that the necessary ecosystem is available to respond to future emergencies.
2019年冠状病毒病（COVID-19）在美国引发了全国性的医疗紧急情况，并暴露出资源短缺问题，尤其是缺乏经过培训以提供重症或重症监护的医疗服务提供者。本文描述了数字健康技术正在如何或可以如何用于缓解COVID-19疫情。然后提出了国家紧急远程重症监护网络（NETCCN），该网络将结合数字健康技术来应对当前和未来的危机。
重症医学协会和远程医疗与先进技术研究中心的主题专家查阅了同行评审文献和科技新闻，以了解哪些数字健康技术已经或可以用于（1）在限制COVID-19传播的同时为患者提供支持，（2）提高医疗服务提供者的能力，以及（3）预测/预防未来疫情爆发。
确定的主要技术包括远程医疗和移动护理（用于COVID-19以及常规护理）、分层远程指导、远程重症监护、机器人技术以及用于监测的人工智能。其中一些技术可以整合起来形成一个可互操作的可扩展NETCCN。NETCCN将通过获取实时患者和物资数据并传播重症监护专业知识，协助各地的医疗服务提供者。NETCCN的能力应在灾害期间保持，并定期进行测试以确保持续准备就绪。
COVID-19已证明大规模卫生紧急情况对现有基础设施的影响。短期内，应对这一挑战的一种方法是采用现有的数字健康技术。从长期来看，开发NETCCN可能确保有必要的生态系统来应对未来的紧急情况。
