O'Hara Valerie M, Johnston Starr V, Browne Nancy T
Northern Light Health, Eastern Maine Medical Center, Department of Pediatrics, WOW Pediatric & Adolescent Weight & Cardiometabolic Clinic, Orono, Maine, USA.
Pediatr Obes. 2020 Aug;15(8):e12694. doi: 10.1111/ijpo.12694. Epub 2020 Jul 6.
Telemedicine is a powerful tool that erases many logistical barriers to care and may increase access. Due to the need for social distancing, the COVID-19 pandemic has temporarily reduced in-person visits for clinical care. Providers, clinical staff and patients are pressed to acutely learn new skills and adapt clinical care through the use of telemedicine whilst administrators, policy makers and regulatory organizations make changes to existing policies to meet this national emergency. Our tertiary care, interdisciplinary paediatric weight management clinic began the use of telemedicine 5 years ago to bring access to an underserved, rural population at their primary care office, which has allowed our clinic to pivot seamlessly to in-home telemedicine visits during the pandemic. Telemedicine rules and regulations are rapidly changing to meet the COVID-19 national emergency, but many supports for new telemedicine providers are already in place. In this article, we provide an overview of telemedicine components, policies and regulations. We review the operationalization of our clinic's telemedicine visit prior to the pandemic. We discuss how telemedicine services are impacted by COVID-19 and key resources are provided. Finally, we reimagine telemedicine services post-pandemic to expand effective, coordinated health care, particularly for patients with chronic needs such as obesity.
远程医疗是一种强大的工具，它消除了许多医疗服务中的后勤障碍，并可能增加医疗服务的可及性。由于需要保持社交距离，新冠疫情暂时减少了临床护理的面对面就诊。医疗服务提供者、临床工作人员和患者迫切需要迅速学习新技能，并通过使用远程医疗来调整临床护理，而管理人员、政策制定者和监管组织则对现有政策进行修改，以应对这一国家紧急情况。我们的三级医疗、跨学科儿科体重管理诊所于5年前开始使用远程医疗，以便让服务不足的农村人口在其初级保健办公室就能获得医疗服务，这使得我们诊所在疫情期间能够无缝转向家庭远程医疗就诊。远程医疗的规则和法规正在迅速变化，以应对新冠疫情这一国家紧急情况，但对新的远程医疗服务提供者的许多支持措施已经到位。在本文中，我们概述了远程医疗的组成部分、政策和法规。我们回顾了我们诊所在疫情之前远程医疗就诊的实施情况。我们讨论了新冠疫情对远程医疗服务的影响，并提供了关键资源。最后，我们重新构想疫情后的远程医疗服务，以扩大有效、协调的医疗保健，特别是为肥胖等有慢性需求的患者提供服务。
