Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia; Department of Telemedicine, Fundación Valle del Lili, Cali, Colombia.
Department of Information Technology, Fundación Valle del Lili, Cali, Colombia.
Int J Med Inform. 2021 Nov;155:104589. doi: 10.1016/j.ijmedinf.2021.104589. Epub 2021 Sep 21.
During the COVID 19 pandemic, direct-to-consumer telehealth (DTC) services allowed patients real-time virtual access to healthcare providers, especially those with an established relationship. In Colombia, this care modality was implemented between 2019 and 2020, under national considerations, it was implemented for outpatient care in a highly complex university hospital in Cali, Colombia.
A descriptive study with prospective information collection was used to describe the implementation of the outpatient teleconsultation care model for patients. We constructed the clinical and process indicators with which we evaluated the model.
A total of 56,560 patients from our institution were treated by virtual outpatient consultation during the first nine months of the health emergency declared by COVID 19 in Colombia. The strategy made it possible to achieve coverage more significant than 100% in Cali and the departments of Colombia. Attention by teleconsultation was 19% of the total ambulatory care. The effectiveness in carrying out scheduled teleconsultations had an overall result of 91.5%. The accessibility results demonstrated the need to strengthen connectivity and accessibility to payments and strengthen technology adoption in the institution, health personnel, and patients.
Implementing an outpatient teleconsultation model allowed the continuity of the management with comprehensive coverage nationwide from a highly complex hospital in southwestern Colombia. The indicators' analysis should help strengthen the policies of access to telemedicine, especially with the consequences of the pandemic in low- and middle-income countries. Latin American evidence is necessary to establish the safety profile of telemedicine and the costs associated with the provision.
在 COVID-19 大流行期间,直接面向消费者的远程医疗(DTC)服务使患者能够实时虚拟访问医疗保健提供者,尤其是那些已经建立关系的提供者。在哥伦比亚,这种护理模式在 2019 年至 2020 年期间实施,根据国家考虑,它在哥伦比亚卡利的一家高度复杂的大学医院实施了门诊护理。
本研究采用前瞻性信息收集的描述性研究,用于描述为患者实施门诊远程咨询护理模式的情况。我们构建了临床和过程指标,用以评估该模型。
在哥伦比亚宣布 COVID-19 卫生紧急状态的头九个月,我们机构的 56560 名患者通过虚拟门诊咨询接受了治疗。该策略使卡利和哥伦比亚其他地区的覆盖率超过 100%成为可能。远程咨询的就诊率占总门诊就诊率的 19%。开展预约远程咨询的总体效果为 91.5%。可及性结果表明,需要加强连接和支付能力,并加强机构、卫生人员和患者对技术的采用。
实施门诊远程咨询模式使全面覆盖全国的管理得以持续,这是从哥伦比亚西南部一家高度复杂的医院实现的。对指标的分析应有助于加强获得远程医疗的政策,特别是在大流行对中低收入国家造成影响的情况下。有必要提供拉丁美洲的证据,以确定远程医疗的安全性概况和提供远程医疗相关的成本。