Albert Einstein College of Medicine, Bronx, New York, USA.
Princeton University, Princeton, New Jersey, USA.
Telemed J E Health. 2021 Apr;27(4):468-471. doi: 10.1089/tmj.2020.0371. Epub 2020 Sep 30.
The coronavirus disease 2019 (COVID-19) pandemic is straining health care worldwide with >31 million confirmed cases. Currently, 1 in every 100 U.S. residents and 245,000 in New York City are confirmed positive. The Bronx, with high-risk comorbidities, due in part to socioeconomic factors, has seen disproportionately higher rates of COVID-19-related complications. Poor health care access is exacerbated as in-person visits now pose viral transmission risk. There has been limited discourse regarding widespread disparities underlying transitions to telemedicine. We review perspectives in recent literature on telemedicine and its potential within neurology. While telemedicine has reduced strain on in-person visits, preliminary reflections highlight implementation successes and challenges. To provide effective care beyond this crisis, fundamental changes in training, technological accessibility, and health care policy are needed. We propose open access to telehealth training, screening of patient's potential technological inequities and socioeconomic insecurities, and advocacy to secure broad long-term access to telehealth care.
2019 年冠状病毒病（COVID-19）大流行使全球的医疗保健系统承受巨大压力，已确诊病例超过 3100 万例。目前，每 100 名美国居民中就有 1 人，纽约市有 24.5 万人确诊。布朗克斯区（Bronx）由于社会经济因素，存在较高的合并症风险，其 COVID-19 相关并发症的发生率不成比例地更高。由于现在亲自就诊会带来病毒传播的风险，因此医疗保健的机会有限，这进一步加剧了问题。关于向远程医疗转变的广泛差异，相关讨论很少。我们回顾了最近有关远程医疗及其在神经病学中的应用的文献中的观点。虽然远程医疗减轻了面对面就诊的压力，但初步反思强调了实施成功和挑战。为了在这场危机之外提供有效的护理，需要对培训、技术可及性和医疗保健政策进行根本改变。我们建议开放远程医疗培训、筛查患者潜在的技术不平等和社会经济不安全因素，并倡导确保广泛的远程医疗护理的长期获得。
