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门诊远程医疗的迅猛扩张:对患者安全的影响。

The Abrupt Expansion of Ambulatory Telemedicine: Implications for Patient Safety.

机构信息

Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, San Francisco, USA.

出版信息

J Gen Intern Med. 2022 Apr;37(5):1270-1274. doi: 10.1007/s11606-021-07329-9. Epub 2022 Jan 19.

Abstract

The exponential growth of telemedicine in ambulatory care triggered by the COVID-19 public health emergency has undoubtedly impacted the quality of care and patient safety. In particular, the increased adoption of remote care has impacted communication, care teams, and patient engagement, which are key factors that impact patient safety in ambulatory care. In this perspective, we draw on a scoping review of the literature, our own clinical experiences, and conversations with patient safety experts to describe how changes in communication, care teams, and patient engagement have impacted two high priority areas in ambulatory safety: diagnostic errors and medication safety. We then provide recommendations for research funders, researchers, healthcare systems, policy makers, and healthcare payors for how to improve patient safety in telemedicine based on what is currently known as well as next steps for how to advance understanding of the safety implications of telemedicine utilization.

摘要

由于 COVID-19 公共卫生紧急事件,远程医疗在门诊护理中的指数级增长无疑影响了护理质量和患者安全。特别是远程护理的采用增加了对沟通、护理团队和患者参与的影响,这些都是影响门诊护理患者安全的关键因素。在这个角度上,我们参考了文献的范围综述、我们自己的临床经验以及与患者安全专家的对话,描述了沟通、护理团队和患者参与的变化如何影响门诊安全的两个优先重点领域:诊断错误和药物安全。然后,我们根据目前的情况以及如何推进远程医疗使用的安全影响的理解的下一步措施,为研究资助者、研究人员、医疗保健系统、政策制定者和医疗保健支付者提供了关于如何在远程医疗中提高患者安全的建议。

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