Carter Cordelia W., Herrero Christina P., Bloom David A., Karamitopoulos Mara, Castañeda Pablo G.
Bull Hosp Jt Dis (2013). 2020 Dec;78(4):236-242.
The purpose of this study was to identify and characterize challenges and benefits to the use of tele-medicine for the treatment of pediatric orthopedic patients during and after the COVID-19 pandemic.
A novel survey was sent to all faculty members at an academic pediatric orthopedic practice in New York City regarding their use of telemedicine in response to the COVID-19 pandemic.
Faculty members performed 227 unique tele-health visits with pediatric orthopedic patients over a 7-week period in early 2020, and this formed the basis for responses to the survey. The results of the faculty survey suggest that telemedicine has substantial clinical benefits for pediatric orthopedic surgeons and our patients that extend beyond the COVID-19 pandemic. Providers recognize the limits of conducting physical exams over telemedicine and should always use clinical judgment when evaluating patients, par-ticularly trauma patients who may require prompt referral for additional care.
The ability to provide pediatric orthopedic care through telemedicine has allowed us to safely evaluate and treat pediatric patients with musculoskeletal problems in New York City and its environs despite the COVID-19 pandemic. The efficient evaluation of both new and exist-ing pediatric orthopedic patients via telehealth is viable. Physical examination is the most challenging aspect of the physician-patient encounter to replicate virtually. Targeted educational efforts for patients and their families before the visit about what to expect and how to prepare improves efficiency with virtual pediatric orthopedic visits. Efforts to limit disparities in access to telemedicine will be needed to allow all pediatric orthopedic patients to participate in telemedicine equitably.
本研究的目的是确定并描述在2019冠状病毒病大流行期间及之后使用远程医疗治疗小儿骨科患者所面临的挑战和益处。
向纽约市一家学术性小儿骨科诊所的所有教职员工发送了一份关于他们在应对2019冠状病毒病大流行时使用远程医疗情况的新型调查问卷。
2020年初的7周内，教职员工对小儿骨科患者进行了227次独特的远程健康问诊，这构成了调查问卷回复的基础。教职员工的调查结果表明，远程医疗对小儿骨科外科医生和我们的患者具有重大的临床益处，且这种益处超出了2019冠状病毒病大流行的范畴。医疗服务提供者认识到通过远程医疗进行体格检查的局限性，在评估患者时应始终运用临床判断力，尤其是对于可能需要迅速转诊接受进一步治疗的创伤患者。
尽管有2019冠状病毒病大流行，但通过远程医疗提供小儿骨科护理的能力使我们能够安全地评估和治疗纽约市及其周边地区患有肌肉骨骼问题的小儿患者。通过远程健康对新的和现有的小儿骨科患者进行高效评估是可行的。体格检查是在虚拟环境中最难复制的医患接触环节。在就诊前针对患者及其家属开展有针对性的教育，告知他们预期情况以及如何做好准备，可提高虚拟小儿骨科就诊的效率。需要努力减少远程医疗获取方面的差距，以使所有小儿骨科患者都能公平地参与远程医疗。
