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用于临床护理和培训的传感器、可穿戴设备及远程患者监测能力:范围综述

Sensor, Wearable, and Remote Patient Monitoring Competencies for Clinical Care and Training: Scoping Review.

作者信息

Hilty Donald M, Armstrong Christina M, Edwards-Stewart Amanda, Gentry Melanie T, Luxton David D, Krupinski Elizabeth A

机构信息

Mental Health, Northern California Veterans Administration Health Care System, Department of Psychiatry & Behavioral Sciences, UC Davis, 10535 Hospital Way, Mather, CA 95655 (116/SAC) USA.

Department of Veterans Affairs, Connected Health Implementation Strategies, Office of Connected Care, Office of Health Informatics, Washington, DC USA.

出版信息

J Technol Behav Sci. 2021;6(2):252-277. doi: 10.1007/s41347-020-00190-3. Epub 2021 Jan 22.

Abstract

Sensor, wearable, and remote patient monitoring technologies are typically used in conjunction with video and/or in-person care for a variety of interventions and care outcomes. This scoping review identifies clinical skills (i.e., competencies) needed to ensure quality care and approaches for organizations to implement and evaluate these technologies. The literature search focused on four concept areas: (1) competencies; (2) sensors, wearables, and remote patient monitoring; (3) mobile, asynchronous, and synchronous technologies; and (4) behavioral health. From 2846 potential references, two authors assessed abstracts for 2828 and, full text for 521, with 111 papers directly relevant to the concept areas. These new technologies integrate health, lifestyle, and clinical care, and they contextually change the culture of care and training-with more time for engagement, continuity of experience, and dynamic data for decision-making for both patients and clinicians. This poses challenges for users (e.g., keeping up, education/training, skills) and healthcare organizations. Based on the clinical studies and informed by clinical informatics, video, social media, and mobile health, a framework of competencies is proposed with three learner levels (novice/advanced beginner, competent/proficient, advanced/expert). Examples are provided to apply the competencies to care, and suggestions are offered on curricular methodologies, faculty development, and institutional practices (e-culture, professionalism, change). Some academic health centers and health systems may naturally assume that clinicians and systems are adapting, but clinical, technological, and administrative workflow-much less skill development-lags. Competencies need to be discrete, measurable, implemented, and evaluated to ensure the quality of care and integrate missions.

摘要

传感器、可穿戴设备和远程患者监测技术通常与视频和/或面对面护理结合使用,以实现各种干预措施和护理效果。本范围综述确定了确保优质护理所需的临床技能(即能力),以及组织实施和评估这些技术的方法。文献检索集中在四个概念领域:(1)能力;(2)传感器、可穿戴设备和远程患者监测;(3)移动、异步和同步技术;(4)行为健康。从2846篇潜在参考文献中,两位作者评估了2828篇摘要,以及521篇全文,其中111篇论文与这些概念领域直接相关。这些新技术整合了健康、生活方式和临床护理,并在背景上改变了护理和培训文化——为患者和临床医生提供了更多参与时间、经验连续性和用于决策的动态数据。这给用户(如跟上步伐、教育/培训、技能)和医疗保健组织带来了挑战。基于临床研究,并受临床信息学、视频、社交媒体和移动健康的启发,提出了一个能力框架,包括三个学习者水平(新手/高级初学者、胜任/熟练、高级/专家)。提供了将这些能力应用于护理的示例,并就课程方法、教师发展和机构实践(电子文化、专业精神、变革)提出了建议。一些学术健康中心和医疗系统可能自然地认为临床医生和系统正在适应,但临床、技术和行政工作流程——更不用说技能发展了——却滞后了。能力需要是离散的、可衡量的、可实施的和可评估的,以确保护理质量并整合使命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d71/7819828/110331574987/41347_2020_190_Fig1_HTML.jpg

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