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远程风湿病学:在全球大流行之前、期间和之后。

Telerheumatology: before, during, and after a global pandemic.

机构信息

Center to Improve Veteran Involvement in Care, VA Portland Health Care System.

Oregon Health & Science University, Portland, Oregon, USA.

出版信息

Curr Opin Rheumatol. 2021 May 1;33(3):262-269. doi: 10.1097/BOR.0000000000000790.

Abstract

PURPOSE OF REVIEW

In early 2020, the COVID-19 global pandemic shifted most healthcare to remote delivery methods to protect patients, clinicians, and hospital staff. Such remote care delivery methods include the use of telehealth technologies including clinical video telehealth or telephone visits. Prior to this, research on the acceptability, feasibility, and efficacy of telehealth applied to rheumatology, or telerheumatology, has been limited.

RECENT FINDINGS

Telerheumatology visits were found to be noninferior to in-person visits and are often more time and cost effective for patients. Clinicians and patients both noted the lack of a physical exam in telehealth visits and patients missed the opportunity to have lab work done or other diagnostic tests they are afforded with in-person visits. Overall, patients and clinicians had positive attitudes toward the use of telerheumatology and agreed on its usefulness, even beyond the pandemic.

SUMMARY

Although telerheumatology has the potential to expand the reach of rheumatology practice, some of the most vulnerable patients still lack the most basic resources required for a telehealth visit. As the literature on telerheumatology continues to expand, attention should be paid to health equity, the digital divide, as well as patient preferences in order to foster true shared decision-making over telehealth.

摘要

目的综述

2020 年初,COVID-19 全球大流行促使大多数医疗服务转向远程医疗方法,以保护患者、临床医生和医院工作人员。这种远程医疗服务方法包括使用远程医疗技术,包括临床视频远程医疗或电话就诊。在此之前,关于远程医疗应用于风湿病学(即远程风湿病学)的可接受性、可行性和疗效的研究一直有限。

最近的发现

远程风湿病学就诊被发现与面对面就诊一样有效,而且对患者来说通常更省时、更具成本效益。临床医生和患者都注意到远程医疗就诊缺乏体格检查,而且患者错过了在面对面就诊时进行实验室检查或其他诊断测试的机会。总的来说,患者和临床医生对远程风湿病学的使用持积极态度,并认为它具有实用性,甚至在大流行之后也是如此。

总结

尽管远程风湿病学有可能扩大风湿病学实践的范围,但一些最脆弱的患者仍然缺乏远程医疗就诊所需的最基本资源。随着远程风湿病学文献的不断扩展,应关注健康公平、数字鸿沟以及患者对远程医疗的偏好,以促进真正的远程医疗共享决策。

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