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探讨联合健康专业人员(AHP)远程医疗咨询指南中的实施、财务和技术考虑因素:一项包括英国 AHP 专业机构指南的范围综述。

Exploration of implementation, financial and technical considerations within allied health professional (AHP) telehealth consultation guidance: a scoping review including UK AHP professional bodies' guidance.

机构信息

Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK.

Orthotic Service, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.

出版信息

BMJ Open. 2021 Dec 27;11(12):e055823. doi: 10.1136/bmjopen-2021-055823.

Abstract

OBJECTIVES

The COVID-19 pandemic has resulted in a shift to remote consultations, but telehealth consultation guidelines are lacking or inconsistent. Therefore, a scoping review was performed to chart the information in the articles exploring telehealth for the UK allied health professionals (AHPs) and compare them with the UK AHP professional bodies' guidelines.

DESIGN

Scoping review following Aksey and O' Malley methodological framework.

DATA SOURCES

CINHAL and MEDLINE were searched from inception to March 2021 using terms related to 'telehealth', 'guidelines' and 'AHPs'. Additionally, the UK AHP professional bodies were contacted requesting their guidelines.

STUDY SELECTION

Articles exploring telehealth for patient consultations, written in English and published in peer-reviewed journal or guidelines available from UK AHP professional bodies/their websites were considered eligible for review.

DATA EXTRACTION

One reviewer extracted data concerning three overarching domains: implementation, financial and technological considerations.

RESULTS

2632 articles were identified through database searches with 21 articles eligible for review. Eight guidelines were obtained from the UK AHP professional bodies with a total of 29 included articles/guidelines. Most articles were published in the last two years; there was variety in telehealth terminology, and most were developed for occupational therapists, physiotherapists and speech and language therapists. Information was lacking about the assessment of telehealth use and effectiveness, barriers and limitations, the logistical management, the family's and caregiver's roles and the costs. There was lack of clarity on the AHPs' registration requirements, costs and coverage, and legal aspects.

CONCLUSION

This study identified gaps in current guidelines, which showed similarities as well as discrepancies with the guidance for non-AHP healthcare professionals and revealed that the existing guidelines do not adequately support AHPs delivering telehealth consultations. Future research and collaborative work across AHP groups and the world's leading health institutions are suggested to establish common guidelines that will improve AHP telehealth services.

摘要

目的

新冠疫情大流行导致远程咨询有所增加,但目前缺乏或不一致的远程医疗咨询指南。因此,进行了范围综述,以了解探索英国联合卫生专业人员(AHPs)远程医疗的文章中的信息,并将其与英国 AHP 专业机构的指南进行比较。

设计

根据 Aksey 和 O'Malley 的方法学框架进行范围综述。

数据来源

从 CINHAL 和 MEDLINE 数据库中检索了从建库到 2021 年 3 月使用与“远程医疗”、“指南”和“AHPs”相关的术语的文章。此外,还联系了英国 AHP 专业机构,要求提供他们的指南。

研究选择

考虑了可用于审查的以英语撰写并发表在同行评议期刊或英国 AHP 专业机构/其网站上的指南中,探索针对患者咨询的远程医疗的文章。

数据提取

一位评审员提取了有关三个总体领域的信息:实施、财务和技术考虑因素。

结果

通过数据库搜索共确定了 2632 篇文章,其中有 21 篇文章符合审查条件。从英国 AHP 专业机构获得了 8 项指南,共纳入了 29 篇文章/指南。大多数文章是在过去两年内发表的;远程医疗术语种类繁多,大多数是为职业治疗师、物理治疗师和言语和语言治疗师开发的。有关远程医疗使用和效果评估、障碍和限制、后勤管理、家庭和照顾者的角色以及成本的信息缺乏。AHPs 的注册要求、成本和覆盖范围以及法律方面也不够明确。

结论

本研究发现了当前指南中的差距,这些指南与非 AHP 医疗保健专业人员的指南既存在相似之处,也存在差异,并表明现有的指南不能充分支持 AHPs 提供远程医疗咨询。建议未来的研究和 AHP 团体以及世界领先的卫生机构之间的合作,以制定共同的指南,从而改善 AHP 的远程医疗服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7dd/8718347/2a6efcc0cae0/bmjopen-2021-055823f01.jpg

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