Fisk Malcolm, Livingstone Anne, Pit Sabrina Winona
De Montfort University, Leicester, United Kingdom.
Global Community Resourcing, Brisbane, Australia.
J Med Internet Res. 2020 Jun 9;22(6):e19264. doi: 10.2196/19264.
On March 12, 2020, the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic. On that date, there were 134,576 reported cases and 4981 deaths worldwide. By March 26, 2020, just 2 weeks later, reported cases had increased four-fold to 531,865, and deaths increased five-fold to 24,073. Older people are both major users of telehealth services and are more likely to die as a result of COVID-19.
This paper examines the extent that Australia, the United Kingdom, and the United States, during the 2 weeks following the pandemic announcement, sought to promote telehealth as a tool that could help identify COVID-19 among older people who may live alone, be frail, or be self-isolating, and give support to or facilitate the treatment of people who are or may be infected.
This paper reports, for the 2-week period previously mentioned and immediately prior, on activities and initiatives in the three countries taken by governments or their agencies (at national or state levels) together with publications or guidance issued by professional, trade, and charitable bodies. Different sources of information are drawn upon that point to the perceived likely benefits of telehealth in fighting the pandemic. It is not the purpose of this paper to draw together or analyze information that reflects growing knowledge about COVID-19, except where telehealth is seen as a component.
The picture that emerges for the three countries, based on the sources identified, shows a number of differences. These differences center on the nature of their health services, the extent of attention given to older people (and the circumstances that can relate to them), the different geographies (notably concerned with rurality), and the changes to funding frameworks that could impact these. Common to all three countries is the value attributed to maintaining quality safeguards in the wider context of their health services but where such services are noted as sometimes having precluded significant telehealth use.
The COVID-19 pandemic is forcing changes and may help to establish telehealth more firmly in its aftermath. Some of the changes may not be long-lasting. However, the momentum is such that telehealth will almost certainly find a stronger place within health service frameworks for each of the three countries and is likely to have increased acceptance among both patients and health care providers.
2020年3月12日，世界卫生组织宣布冠状病毒病（COVID-19）疫情为大流行病。当日，全球报告病例达134576例，死亡4981例。到2020年3月26日，仅两周后，报告病例增加了四倍，达到531865例，死亡人数增加了五倍，达到24073例。老年人既是远程医疗服务的主要使用者，也是因COVID-19死亡风险更高的群体。
本文考察了在宣布大流行后的两周内，澳大利亚、英国和美国在多大程度上试图推广远程医疗，将其作为一种工具，以帮助在可能独居、体弱或正在自我隔离的老年人中识别COVID-19，并为已感染或可能感染的人提供支持或便利治疗。
本文报告了上述为期两周以及紧接之前的时间段内，三个国家政府或其机构（在国家或州层面）采取的行动和举措，以及专业、行业和慈善机构发布的出版物或指南。利用了不同的信息来源，这些信息表明了远程医疗在抗击疫情中可能带来的益处。本文的目的不是汇总或分析反映对COVID-19认识不断增加的信息，除非将远程医疗视为其中一个组成部分。
根据所确定的信息来源，这三个国家呈现出一些差异。这些差异集中在其医疗服务的性质、对老年人的关注程度（以及与他们相关的情况）、不同的地域（特别是与农村地区相关的情况）以及可能影响这些方面的资金框架变化。这三个国家的共同之处在于，在其更广泛的医疗服务背景下，都重视维持质量保障，但这些服务有时被指出阻碍了远程医疗的大量使用。
COVID-19大流行正在促使变革，疫情过后可能有助于更稳固地确立远程医疗。其中一些变革可能不会持久。然而，目前的势头表明，远程医疗几乎肯定会在这三个国家各自的医疗服务框架中占据更重要的地位，并且可能会在患者和医疗服务提供者中获得更高的接受度。
