Hodgkins Michael, Barron Meg, Jevaji Shireesha, Lloyd Stacy
American Medical Association, Chicago, IL, USA.
NPJ Digit Med. 2021 Feb 9;4(1):19. doi: 10.1038/s41746-021-00390-y.
It took the advent of SARS-CoV-2, a "black swan event", to widely introduce telehealth, remote care, and virtual house calls. Prior to the epidemic (2019), the American Medical Association (AMA) conducted a routine study to compare physicians' adoption of emerging technologies to a similar survey in 2016. Most notable was a doubling in the adoption of telehealth/virtual technology to 28% and increases in the use of remote monitoring and management for improved care (13-22%). These results may now seem insignificant when compared to the unprecedented surge in telehealth visits because of SARS-CoV-2. Even as this surge levels off and begins to decline, many observers believe we will continue to see a persistent increase in the use of virtual visits compared to face-to-face care. The requirements for adoption communicated by physicians in both the 2016 and 2019 surveys are now more relevant than ever: Is remote care as effective as in-person care and how best to determine when to use these modalities? How do I safeguard my patients and my practice from liability and privacy concerns? How do I optimize using these technologies in my practice and, especially integration with my EHR and workflows to improve efficiency? And how will a mix of virtual and in-person visits affect practice revenue and sustainability? Consumers have also expressed concerns about payment for virtual visits as well as privacy and quality of care. If telehealth and remote care are here to stay, continuing to track their impact during the current public health emergency is critically important to address so that policymakers and insurers will take necessary steps to ensure that the "new normal" will reflect a health care delivery model that can provide comparable or improved results today and into the future.
直到“黑天鹅事件”——新型冠状病毒肺炎(SARS-CoV-2)出现,远程医疗、远程护理和虚拟上门问诊才得到广泛应用。在疫情(2019年)之前,美国医学协会(AMA)进行了一项常规研究,将医生对新兴技术的采用情况与2016年的类似调查进行比较。最值得注意的是,远程医疗/虚拟技术的采用率翻了一番,达到28%,用于改善护理的远程监测和管理的使用率也有所增加(从13%提高到22%)。与因SARS-CoV-2导致的远程医疗问诊前所未有的激增相比,这些结果现在可能显得微不足道。即使这种激增趋于平稳并开始下降,许多观察家认为,与面对面护理相比,我们仍将继续看到虚拟问诊的使用持续增加。在2016年和2019年的调查中,医生提出的采用要求现在比以往任何时候都更具相关性:远程护理与面对面护理一样有效吗?如何最好地确定何时使用这些方式?我如何保护我的患者和我的诊所免受责任和隐私问题的影响?我如何在我的诊所中优化使用这些技术,特别是与我的电子健康记录(EHR)和工作流程集成以提高效率?虚拟问诊和面对面问诊的混合将如何影响诊所的收入和可持续性?消费者也对虚拟问诊的支付以及隐私和护理质量表示担忧。如果远程医疗和远程护理将持续存在,在当前的公共卫生紧急情况期间继续跟踪它们的影响对于解决问题至关重要,这样政策制定者和保险公司将采取必要措施,以确保“新常态”将反映一种能够在现在和未来提供可比或更好结果的医疗服务提供模式。