儿科亚专科远程医疗的使用：患者和提供者的视角。
Pediatric subspecialty telemedicine use from the patient and provider perspective.
机构信息
Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Palo Alto, CA, USA.
出版信息
Pediatr Res. 2022 Jan;91(1):241-246. doi: 10.1038/s41390-021-01443-4. Epub 2021 Mar 22.
BACKGROUND
To characterize telemedicine use among pediatric subspecialties with respect to clinical uses of telemedicine, provider experience, and patient perceptions during the COVID-19 pandemic.
METHODS
We performed a mixed-methods study of telemedicine visits across pediatric endocrinology, nephrology, orthopedic surgery, and rheumatology at a large children's hospital. We used deductive analysis to review observational data from 40 video visits. Providers and patients/caregivers were surveyed around areas of satisfaction and communication.
RESULTS
We found adaptations of telemedicine including shared-screen use and provider-guided parent procedures among others. All providers felt that it was safest for their patients to conduct visits by video, and 72.7% reported completing some component of a clinical exam. Patients rated the areas of being respected by the clinical staff/provider and showing care and concern highly, and the mean overall satisfaction was 86.7 ± 19.3%.
CONCLUSIONS
Telemedicine has been used to deliver care to pediatric patients during the pandemic, and we found that patients were satisfied with the telemedicine visits during this stressful time and that providers were able to innovate during visits. Telemedicine is a tool that can be successfully adapted to patient and provider needs, but further studies are needed to fully explore its integration in pediatric subspecialty care.
IMPACT
This study describes telemedicine use at the height of the COVID-19 pandemic from both a provider and patient perspective, in four different pediatric subspecialties. Prior to COVID-19, pediatric telehealth landscape analysis suggested that many pediatric specialty practices had pilot telehealth programs, but there are few published studies evaluating telemedicine performance through the simultaneous patient and provider experience as part of standard care. We describe novel uses and adaptations of telemedicine during a time of rapid deployment in pediatric specialty care.
背景
在 COVID-19 大流行期间，描述儿科学亚专业中远程医疗的使用情况，包括远程医疗的临床用途、提供者的经验以及患者的看法。
方法
我们对一家大型儿童医院的儿科学内分泌学、肾脏病学、矫形外科和风湿病学的远程医疗访问进行了混合方法研究。我们使用演绎分析来审查 40 个视频访问的观察数据。在满意度和沟通方面，对提供者和患者/护理人员进行了调查。
结果
我们发现了远程医疗的一些调整，包括共享屏幕使用和提供者指导家长操作等。所有的提供者都认为通过视频进行访问对他们的患者最安全，并且 72.7%的人报告完成了临床检查的某些部分。患者对临床工作人员/提供者的尊重、关心和关注给予了高度评价，平均总体满意度为 86.7±19.3%。
结论
在大流行期间，远程医疗已被用于为儿科患者提供护理，我们发现患者对这一紧张时期的远程医疗访问感到满意，并且提供者在访问期间能够进行创新。远程医疗是一种可以根据患者和提供者的需求成功调整的工具，但需要进一步研究以充分探索其在儿科亚专业护理中的整合。
影响
本研究从提供者和患者的角度描述了 COVID-19 大流行高峰期的远程医疗使用情况，涉及四个不同的儿科亚专业。在 COVID-19 之前，儿科远程医疗景观分析表明，许多儿科专业实践已经开展了远程医疗试点项目，但很少有研究评估远程医疗的性能，通过同时从患者和提供者的角度评估远程医疗在标准护理中的应用。我们描述了在儿科专业护理中快速部署期间远程医疗的新用途和调整。
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