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COVID-19 大流行期间,三家医疗系统快速部署住院患者远程医疗服务。

Rapid Deployment of Inpatient Telemedicine In Response to COVID-19 Across Three Health Systems.

机构信息

Department of Medicine, Stanford Medicine, 291 Campus Drive, Stanford, CA, 94305, USA.

Division of Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine & Information Services Department, Stanford Children's Health.

出版信息

J Am Med Inform Assoc. 2020 Jul 1;27(7):1102-1109. doi: 10.1093/jamia/ocaa077.

Abstract

OBJECTIVE

To reduce pathogen exposure, conserve personal protective equipment, and facilitate health care personnel work participation in the setting of the COVID-19 pandemic, three affiliated institutions rapidly and independently deployed inpatient telemedicine programs during March 2020. We describe key features and early learnings of these programs in the hospital setting.

METHODS

Relevant clinical and operational leadership from an academic medical center, pediatric teaching hospital, and safety net county health system met to share learnings shortly after deploying inpatient telemedicine. A summative analysis of their learnings was re-circulated for approval.

RESULTS

All three institutions faced pressure to urgently standup new telemedicine systems while still maintaining secure information exchange. Differences across patient demographics and technological capabilities led to variation in solution design, though key technical considerations were similar. Rapid deployment in each system relied on readily available consumer-grade technology, given the existing familiarity to patients and clinicians and minimal infrastructure investment. Preliminary data from the academic medical center over one month suggested positive adoption with 631 inpatient video calls lasting an average (standard deviation) of 16.5 minutes (19.6) based on inclusion criteria.

DISCUSSION

The threat of an imminent surge of COVID-19 patients drove three institutions to rapidly develop inpatient telemedicine solutions. Concurrently, federal and state regulators temporarily relaxed restrictions that would have previously limited these efforts. Strategic direction from executive leadership, leveraging off-the-shelf hardware, vendor engagement, and clinical workflow integration facilitated rapid deployment.

CONCLUSION

The rapid deployment of inpatient telemedicine is feasible across diverse settings as a response to the COVID-19 pandemic.

摘要

目的

为了减少病原体暴露,节约个人防护设备,并促进医护人员在 COVID-19 大流行期间参与工作,三家附属医院于 2020 年 3 月迅速独立部署了住院患者远程医疗计划。我们在医院环境中描述了这些计划的关键特征和早期经验教训。

方法

来自学术医疗中心、儿科教学医院和医疗保障系统的相关临床和运营领导在部署住院远程医疗后不久开会分享经验教训。对他们的经验教训进行总结分析,并重新分发以供批准。

结果

所有三所机构都面临着紧急建立新的远程医疗系统的压力,同时仍要确保安全的信息交换。患者人口统计学和技术能力的差异导致解决方案设计的差异,但关键技术考虑因素相似。每个系统的快速部署都依赖于现成的消费级技术,因为患者和临床医生已经熟悉这些技术,而且基础设施投资很少。根据纳入标准,学术医疗中心一个月的初步数据显示,有 631 例住院患者进行了视频通话,平均(标准差)为 16.5 分钟(19.6),采用情况良好。

讨论

COVID-19 患者即将激增的威胁促使三所机构迅速开发住院远程医疗解决方案。与此同时,联邦和州监管机构暂时放宽了此前可能限制这些努力的限制。来自行政领导的战略方向、利用现成的硬件、供应商参与和临床工作流程整合促进了快速部署。

结论

作为对 COVID-19 大流行的应对措施,在不同环境中快速部署住院远程医疗是可行的。

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