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快速、廉价且可行:在新冠疫情期间在公立医院实施儿科远程医疗。

Fast, cheap and feasible: Implementation of pediatric telemedicine in a public hospital during the Covid-19 pandemic.

机构信息

Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, Departamento de Emergência, Universidade de São Paulo, São Paulo, SP, Brazil; Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, Universidade de São Paulo, São Paulo, SP, Brazil.

Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, Departamento de Emergência, Universidade de São Paulo, São Paulo, SP, Brazil; Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, Universidade de São Paulo, São Paulo, SP, Brazil.

出版信息

J Pediatr (Rio J). 2022 Mar-Apr;98(2):183-189. doi: 10.1016/j.jped.2021.05.007. Epub 2021 Jun 12.

Abstract

OBJECTIVE

In Brazil, telemedicine was allowed as an exception during the coronavirus disease (COVID-19) pandemic. Despite its recognized value and availability, telemedicine is not universally used, suggesting that some barriers prevent its adoption and acceptance within the community. This study aims to describe the implementation of a low-cost telemedicine service in a pediatric hospital in Brazil.

METHOD

Retrospective descriptive study reporting the first three months (April to June 2020) of the experience of implementing a low-cost telemedicine emergency care program in a public tertiary hospital. The service was available to patients up to 18 years of age enrolled in this hospital. A tool for assessing the severity of the patient was developed, the aim of standardizing the procedure, while maintaining quality and safety. Guardian's satisfaction was assessed with a questionnaire sent after teleconsultations.

RESULTS

255 teleconsultations were carried out with 140 different patients. Of the total consultations, 182 were from 99 patients that had performed the Real-Time Polymerase Chain Reaction (RT-PCR) test for the new coronavirus (SARS-Cov-2) or had direct contact with a person known to be positive for COVID-19. Only 26 (14%) were referred to an in-person consultation. No deaths, adverse events or delayed diagnosis were recorded. 86% of the patients who answered the satisfaction questionnaire were satisfied and 92% would use telemedicine again.

CONCLUSION

This study presents an innovative implementation of a telemedicine program in a public and exclusively pediatric tertiary service, serving as a reference for future implementation in other public services in Brazil and developing countries.

摘要

目的

在巴西,远程医疗在冠状病毒病(COVID-19)大流行期间被允许作为例外。尽管远程医疗具有公认的价值和可用性,但并未得到普遍应用,这表明存在一些障碍阻止了其在社区中的采用和接受。本研究旨在描述在巴西一家儿科医院实施低成本远程医疗服务的情况。

方法

这是一项回顾性描述性研究,报告了在一家公立三级医院实施低成本远程医疗急救服务的头三个月(2020 年 4 月至 6 月)的经验。该服务面向在该院注册的 18 岁以下的患者开放。为评估患者的严重程度开发了一种工具,旨在标准化程序,同时保持质量和安全。通过发送电子咨询后满意度问卷评估监护人的满意度。

结果

共进行了 255 次远程咨询,涉及 140 名不同的患者。在总共的咨询中,有 182 次来自 99 名患者,他们对新的冠状病毒(SARS-CoV-2)进行了实时聚合酶链反应(RT-PCR)检测,或者与已知 COVID-19 阳性的人有直接接触。只有 26 例(14%)被转至面对面咨询。未记录到死亡、不良事件或诊断延迟。回答满意度问卷的患者中 86%表示满意,92%愿意再次使用远程医疗。

结论

本研究在一家公立的、专门的儿科三级服务机构中提出了一种远程医疗计划的创新实施,为巴西和发展中国家其他公共服务机构的未来实施提供了参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/576a/9432024/969e5eb099fd/gr1.jpg

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