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同步远程医疗在何时适用于儿童皮肤科?

When is synchronous telehealth acceptable for pediatric dermatology?

机构信息

Department of Dermatology, University of Colorado, Aurora, Colorado, USA.

Children's Hospital Colorado, Aurora, Colorado, USA.

出版信息

Pediatr Dermatol. 2022 Mar;39(2):236-242. doi: 10.1111/pde.14919. Epub 2022 Feb 17.

Abstract

BACKGROUND/OBJECTIVES: We evaluated the acceptance of synchronous (live video) telehealth for pediatric dermatology.

METHODS

This was a prospective, single-center study of patient and dermatologist surveys paired at the encounter level for telehealth encounters with Children's Hospital Colorado Pediatric Dermatology Clinic between 21 April 2020 and 22 May 2020.

RESULTS

Dermatologists were most receptive to a telehealth encounter for isotretinoin monitoring (96.6%) and non-isotretinoin acne (89.5%). In contrast, 71.8% and 58.8% of patients surveyed were open to telehealth for isotretinoin encounters and non-isotretinoin acne encounters, respectively. There was no significant correlation between patient and dermatologist satisfaction regarding a telehealth encounter (r = 0.09, CI [-0.09, 0.26], p = .34) or between patient and dermatologist preference for telehealth encounter (r = 0.07, CI [-0.11, 0.25] p = .46). Dermatologists reported needing a photo to aid their physical examination in 38/363 (10.7%) of encounters and preferred in-person examinations when an encounter would have benefitted from laboratories, procedures, dermatoscopic examination, examination by palpation, and accurate weights in infants.

CONCLUSIONS

Synchronous, live-video telehealth is an effective method of healthcare delivery in certain situations for pediatric dermatology, but it does not replace in-person encounters. Families and dermatologists have different perceptions about its acceptance.

摘要

背景/目的:我们评估了同步(实时视频)远程医疗在儿童皮肤科的接受程度。

方法

这是一项前瞻性、单中心研究,在 2020 年 4 月 21 日至 5 月 22 日期间,对科罗拉多儿童医院儿童皮肤科诊所的远程医疗就诊进行了患者和皮肤科医生调查,并在就诊层面上进行了配对。

结果

皮肤科医生最愿意接受用于异维 A 酸监测(96.6%)和非异维 A 酸痤疮(89.5%)的远程医疗就诊。相比之下,分别有 71.8%和 58.8%的患者愿意接受用于异维 A 酸就诊和非异维 A 酸痤疮就诊的远程医疗就诊。患者和皮肤科医生对远程医疗就诊的满意度之间没有显著相关性(r=0.09,CI[-0.09,0.26],p=0.34),也没有患者和皮肤科医生对远程医疗就诊的偏好之间没有显著相关性(r=0.07,CI[-0.11,0.25],p=0.46)。皮肤科医生在 363 次就诊中的 38 次(10.7%)需要照片来辅助他们的体格检查,并且在某些情况下,他们更喜欢亲自进行检查,这些情况包括:就诊时需要实验室检查、操作、皮肤镜检查、触诊检查和婴儿的准确体重。

结论

同步、实时视频远程医疗是儿童皮肤科在某些情况下有效提供医疗服务的方法,但它不能替代面对面就诊。家庭和皮肤科医生对其接受程度有不同的看法。

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