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德克萨斯州初级保健、心理健康和专科保健设施中 COVID-19 大流行对远程医疗模式的早期影响。

Early Impacts of the COVID-19 Pandemic on Telehealth Patterns in Primary Care, Mental Health, and Specialty Care Facilities in Texas.

机构信息

From the Department of Health Systems and Population Health Sciences, University of Houston College of Medicine, Houston, Texas, Humana Integrated Health Systems Sciences Institute, University of Houston, Houston, Healthcare Administration Program, University of Houston Clear Lake, Houston, Texas, Department of Clinical Sciences, University of Houston College of Medicine, Houston, and Department of Health Systems and Population Health Sciences, University of Houston College of Medicine, Houston.

出版信息

South Med J. 2021 Sep;114(9):593-596. doi: 10.14423/SMJ.0000000000001289.

Abstract

OBJECTIVES

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, many US clinics have shifted some or all of their practice from in-person to virtual visits. In this study, we assessed the use of telehealth among primary care and specialty clinics, by targeting healthcare administrators via multiple channels.

METHODS

Using an online survey, we assessed the use of, barriers to, and reimbursement for telehealth. Respondents included clinic administrators (chief executive officers, vice presidents, directors, and senior-level managers).

RESULTS

A total of 85 complete responses were recorded, 79% of which represented solo or group practices and 63% reported a daily patient census >50. The proportion of clinics that delivered ≥50% of their consults using telehealth increased from 16% in March to 42% in April, 35% in May, and 30% in June. Clinics identified problems with telehealth reimbursement; although 63% of clinics reported that ≥75% of their telehealth consults were reimbursed, only 51% indicated that ≥75% of their telehealth visits were reimbursed at par with in-person office visits. Sixty-five percent of clinics reported having basic or foundational telehealth services, whereas only 9% of clinics reported advanced telehealth maturity. Value-based care participating clinics were more likely to report advanced telehealth services (27%), compared with non-value-based care clinics (3%).

CONCLUSIONS

These findings highlight the adaptability of clinics to quickly transition and adopt telehealth. Uncertainty about reimbursement and policy changes may make the shift temporal, however.

摘要

目的

自 2019 年冠状病毒病(COVID-19)大流行以来,许多美国诊所已将其部分或全部实践从面对面转为虚拟就诊。在这项研究中,我们通过多种渠道针对医疗保健管理人员,评估了初级保健和专科诊所的远程医疗使用情况。

方法

我们使用在线调查评估了远程医疗的使用情况、障碍和报销情况。受访者包括诊所管理人员(首席执行官、副总裁、主任和高级管理人员)。

结果

共记录了 85 份完整的回复,其中 79%代表单一或团体实践,63%报告每天的患者人数>50。通过远程医疗提供≥50%咨询服务的诊所比例从 3 月的 16%增加到 4 月的 42%、5 月的 35%和 6 月的 30%。诊所发现远程医疗报销存在问题;尽管 63%的诊所报告说≥75%的远程医疗咨询得到了报销,但只有 51%的诊所表示≥75%的远程医疗就诊得到了与门诊就诊相同的报销。65%的诊所报告称拥有基本或基础远程医疗服务,而只有 9%的诊所报告称拥有高级远程医疗成熟度。参与基于价值的护理的诊所更有可能报告先进的远程医疗服务(27%),而非基于价值的护理诊所(3%)。

结论

这些发现强调了诊所能够快速适应并采用远程医疗。然而,对报销和政策变化的不确定性可能使这种转变具有暂时性。

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本文引用的文献

1
Telemedicine Pays: Billing and Coding Update.远程医疗有回报:计费和编码更新。
Curr Allergy Asthma Rep. 2020 Jul 27;20(10):60. doi: 10.1007/s11882-020-00956-y.
2
Telemedicine in Orthopaedic Surgery: Challenges and Opportunities.骨科手术中的远程医疗:挑战与机遇。
J Bone Joint Surg Am. 2020 Jul 1;102(13):1109-1115. doi: 10.2106/JBJS.20.00452.
4
Benefits and Barriers to Telehealth Credentialing by Proxy.远程医疗代理认证的益处和障碍。
Telemed J E Health. 2018 Nov;24(11):922-926. doi: 10.1089/tmj.2017.0129. Epub 2018 Mar 13.
5
State of Telehealth.远程医疗状况
N Engl J Med. 2016 Jul 14;375(2):154-61. doi: 10.1056/NEJMra1601705.

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