Children's National Hospital, Washington, District of Columbia, USA.
Am J Med Genet A. 2021 Jan;185(1):68-72. doi: 10.1002/ajmg.a.61911. Epub 2020 Oct 14.
The national importance of telemedicine for safe and effective patient care has been highlighted by the current COVID-19 pandemic. Prior to the 2020 pandemic the Division of Genetics and Metabolism piloted a telemedicine program focused on initial and follow-up visits in the patients' home. The goals were to increase access to care, decrease missed work, improve scheduling, and avoid the transport and exposure of medically fragile patients. Visits were conducted by physician medical geneticists, genetic counselors, and biochemical dietitians, together and separately. This allowed the program to develop detailed standard operating procedures. At the onset of the COVID-19 pandemic, this pilot-program was deployed by the full team of 22 providers in one business day. Two physicians remained on-site for patients requiring in-person evaluations. This model optimized patient safety and workforce preservation while providing full access to patients during a pandemic. We provide initial data on visit numbers, types of diagnoses, and no-show rates. Experience in this implementation before and during the pandemic has confirmed the effectiveness and value of telemedicine for a highly complex medical population. This program is a model that can and will be continued well-beyond the current crisis.
远程医疗在确保患者安全和治疗效果方面的重要性在当前的 COVID-19 大流行中得到了凸显。在 2020 年大流行之前，遗传与代谢科已经试点了一项远程医疗计划，专注于患者家中的初始和随访就诊。其目标是增加获得医疗服务的机会，减少旷工，改善预约安排，并避免医疗脆弱患者的交通和暴露。就诊由医师医学遗传学家、遗传咨询师和生化学营养师共同或单独进行。这使得该计划能够制定详细的标准操作程序。在 COVID-19 大流行开始时，该试点计划在一天内由 22 名医护人员全部投入使用。仍有两名医生留守在现场，为需要当面评估的患者提供服务。这种模式在大流行期间优化了患者安全和劳动力保护，同时为患者提供了全面的医疗服务。我们提供了就诊数量、诊断类型和爽约率的初步数据。在大流行之前和期间的实施经验证实了远程医疗对于高度复杂的医疗人群的有效性和价值。该计划是一种在当前危机过后仍可继续并具有推广价值的模式。
