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新冠出院患者远程患者监测项目:一项横断面研究

Remote Patient Monitoring Program for COVID-19 Patients Following Hospital Discharge: A Cross-Sectional Study.

作者信息

Bouabida Khayreddine, Malas Kathy, Talbot Annie, Desrosiers Marie-Ève, Lavoie Frédéric, Lebouché Bertrand, Taguemout Melissa, Rafie Edmond, Lessard David, Pomey Marie-Pascale

机构信息

University of Montreal Hospital Centre de Recherche du Centre Hospitalier Universitaire de Montréal (CRCHUM), Montreal, QC, Canada.

École de Santé publique, Département de Gestion, Université de Montréal, Montreal, QC, Canada.

出版信息

Front Digit Health. 2021 Nov 8;3:721044. doi: 10.3389/fdgth.2021.721044. eCollection 2021.

Abstract

The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion from healthcare services, protect healthcare providers, and help them maintain satisfactory quality and safety of care. Remote COVID-19 monitoring platforms emerged as potential solutions. The purpose of this study was to evaluate the capacity and contribution of two different platforms used to remotely monitor patients with COVID-19 to maintain quality, safety, and patient engagement in care, as well as their acceptability, usefulness, and user-friendliness from the user's perspective. The first platform is focused on telecare phone calls (Telecare-Covid), and the second is a telemonitoring app (CareSimple-Covid). We performed a cross-sectional study. The data were collected through a phone survey from May to August 2020. Data were analyzed using descriptive statistics and -test analysis. Participants' responses and comments on open-ended questions were analyzed using content analysis to identify certain issues and challenges and potential avenues for improving the platforms. Fifty one patients participated in the study. Eighteen participants used the CareSimple-Covid platform and 33 participants used the Telecare-Covid platform. Overall, the satisfaction rate for quality and safety of care for the two platforms was 80%. Over 88% of the users on each platform considered the platforms' services to be engaging, useful, user-friendly, and appropriate to their needs. The survey identified a few significant differences in users' perceptions of each platform: empathy toward users and the quality and safety of the care received were rated significantly higher on the CareSimple-Covid platform than on the Telecare-Covid platform. Users appreciated four aspects of these telehealth approaches: (1) the ease of access to services and the availability of care team members; (2) the user-friendliness of the platforms; (3) the continuity of care provided, and (4) the wide range of services delivered. Users identified some technical limitations and raised certain issues, such as the importance of maintaining human contact, data security, and confidentiality. Improvement suggestions include promoting access to connected devices; enhancing communications between institutions, healthcare users, and the public on confidentiality and personal data protection standards; and integrating a participatory approach to telehealth platform development and deployment efforts. This study provides preliminary evidence that the two remote monitoring platforms are well-received by users, with very few significant differences between them concerning users' experiences and views. This type of program could be considered for use in a post-pandemic era and for other post-hospitalization clienteles. To maximize efficiency, the areas for improvement and the issues identified should be addressed with a patient-centered approach.

摘要

新冠疫情使得采取行动减少病毒传播、缓解医疗服务拥堵、保护医护人员并帮助他们维持令人满意的医疗质量和安全变得刻不容缓。远程新冠监测平台应运而生,成为潜在的解决方案。本研究旨在评估两个用于远程监测新冠患者的不同平台在维持医疗质量、安全以及患者参与度方面的能力和贡献,同时从用户角度评估其可接受性、实用性和用户友好性。第一个平台侧重于远程护理电话(Telecare - Covid),第二个是远程监测应用程序(CareSimple - Covid)。我们进行了一项横断面研究。数据通过2020年5月至8月的电话调查收集。使用描述性统计和t检验分析数据。对开放式问题的参与者回答和评论采用内容分析法进行分析,以确定某些问题、挑战以及改进平台的潜在途径。51名患者参与了该研究。18名参与者使用CareSimple - Covid平台,33名参与者使用Telecare - Covid平台。总体而言,两个平台的医疗质量和安全满意度为80%。每个平台超过88%的用户认为平台服务具有吸引力、有用、用户友好且符合他们的需求。调查发现用户对每个平台的认知存在一些显著差异:CareSimple - Covid平台在对用户的同理心以及所接受护理的质量和安全方面的评分显著高于Telecare - Covid平台。用户赞赏这些远程医疗方法的四个方面:(1)服务获取的便捷性和护理团队成员的可及性;(2)平台的用户友好性;(3)所提供护理的连续性;(4)提供的服务范围广泛。用户指出了一些技术限制并提出了某些问题,例如保持人际接触的重要性、数据安全和保密性。改进建议包括促进连接设备的获取;加强机构、医疗用户和公众之间关于保密性和个人数据保护标准的沟通;以及在远程医疗平台开发和部署工作中纳入参与式方法。本研究提供了初步证据,表明这两个远程监测平台受到用户好评,在用户体验和观点方面两者之间几乎没有显著差异。这种类型的项目可考虑在疫情后时代以及其他出院后患者群体中使用。为了最大限度地提高效率,应以患者为中心的方法解决已确定的改进领域和问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33e1/8630581/977bbe6ab341/fdgth-03-721044-g0001.jpg

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