University of California, San Diego Enterprise Telehealth Program, San Diego, California, USA.
Telemed J E Health. 2021 Jun;27(6):625-634. doi: 10.1089/tmj.2020.0327. Epub 2020 Oct 7.
The authors draw upon their experience with a successful, enterprise-level, telemedicine program implementation to present a "How To" paradigm for other academic health centers that wish to rapidly deploy such a program in the setting of the COVID-19 pandemic. The advent of social distancing as essential for decreasing viral transmission has made it challenging to provide medical care. Telemedicine has the potential to medically undistance health care providers while maintaining the quality of care delivered and fulfilling the goal of social distancing. Rather than simply reporting enterprise telemedicine successes, the authors detail key telemedicine elements essential for rapid deployment of both an ambulatory and inpatient telemedicine solution. Such a deployment requires a multifaceted strategy: (1) determining the appropriateness of telemedicine use, (2) understanding the interface with the electronic health record, (3) knowing the equipment and resources needed, (4) developing a rapid rollout plan, (5) establishing a command center for post go-live support, (6) creating and disseminating reference materials and educational guides, (7) training clinicians, patients, and clinic schedulers, (8) considering billing and credentialing implications, (9) building a robust communications strategy, and (10) measuring key outcomes. Initial results are reported, showing a telemedicine rate increase to 45.8% (58.6% video and telephone) in just the first week of rollout. Over a 5-month period, the enterprise has since conducted over 119,500 ambulatory telemedicine evaluations (a 1,000-fold rate increase from the pre-COVID-19 time period). This article is designed to offer a "How To" potential best practice approach for others wishing to quickly implement a telemedicine program during the COVID-19 pandemic.
作者根据其在一个成功的、企业级远程医疗计划实施方面的经验,为其他希望在 COVID-19 大流行期间快速部署此类计划的学术医疗中心提供了一个“如何做”的范例。为了减少病毒传播,社交距离的出现使得提供医疗保健变得具有挑战性。远程医疗有可能在保持护理质量和实现社交距离目标的同时,使医疗服务提供者不受地域限制。作者不仅详细介绍了企业远程医疗的成功案例,还详细介绍了快速部署门诊和住院远程医疗解决方案所需的关键远程医疗要素。这种部署需要一个多方面的策略:(1)确定远程医疗使用的适宜性,(2)了解与电子健康记录的接口,(3)了解所需的设备和资源,(4)制定快速推出计划,(5)建立一个指挥中心,以提供现场支持后,(6)创建和分发参考资料和教育指南,(7)培训临床医生、患者和诊所调度员,(8)考虑计费和认证影响,(9)建立强大的沟通策略,以及(10)衡量关键结果。报告了初步结果,显示在推出后的第一周,远程医疗率就增加到了 45.8%(58.6%是视频和电话)。在 5 个月的时间里,该企业已经进行了超过 119500 次门诊远程医疗评估(比 COVID-19 前时期增加了 1000 倍)。本文旨在为其他希望在 COVID-19 大流行期间快速实施远程医疗计划的人提供一种“如何做”的潜在最佳实践方法。