Van Cleave Jeanne, Stille Christopher, Hall David E
Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado (J Van Cleave and C Stille), Aurora, Colo.
Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado (J Van Cleave and C Stille), Aurora, Colo.
Acad Pediatr. 2022 Mar;22(2S):S34-S40. doi: 10.1016/j.acap.2021.10.010.
Telehealth, or the use of telecommunications technology and infrastructure to deliver health-related services and information that support patient care, has the potential to improve the quality of care, particularly deficiencies related to access and patient experience of care. Telehealth may also reduce disparities for children and youth with special health care needs (CYSHCN) with barriers to accessing in-person care, for example, those residing in rural areas and children with medical complexity who are particularly fragile. While important foundational work has been done to study telehealth's effectiveness and implementation, key gaps remain regarding its use for CYSHCN. The CYSHCNet national research agenda development process, described in a companion article, identified as key priority areas for future research telehealth as an innovative care delivery model for all CYSHCN and as a mechanism to address rural-urban disparities in health care access. Here, we review the current knowledge around telehealth, identify populations for whom telehealth could be especially beneficial, discuss the important gaps identified, and make recommendations for specific studies that will move the field forward. There are ample opportunities for telehealth to improve health and patient/family experience of care and quality of life for CYSHCN while requiring less time and resources from families accessing this care. Innovative research to inform best practices around incorporation and implementation of telehealth will improve its efficiency and effectiveness and achieve optimal outcomes.
远程医疗，即利用电信技术和基础设施提供支持患者护理的健康相关服务和信息，有潜力提高护理质量，尤其是改善与医疗服务可及性和患者护理体验相关的不足。远程医疗还可能减少有特殊医疗需求的儿童和青少年（CYSHCN）在获得面对面护理方面遇到障碍时的差异，例如，居住在农村地区的儿童以及医疗情况复杂且特别脆弱的儿童。虽然在研究远程医疗的有效性和实施方面已经开展了重要的基础性工作，但在其用于CYSHCN方面仍存在关键差距。在一篇配套文章中描述的CYSHCNet国家研究议程制定过程，将远程医疗确定为所有CYSHCN的创新护理模式以及解决城乡医疗服务可及性差距的机制，作为未来研究的关键优先领域。在此，我们回顾了关于远程医疗的现有知识，确定了可能特别受益于远程医疗的人群，讨论了已发现的重要差距，并为推动该领域发展的具体研究提出了建议。远程医疗有充足的机会改善CYSHCN的健康状况、患者/家庭的护理体验和生活质量，同时减少寻求此类护理的家庭所花费的时间和资源。开展创新研究以了解远程医疗纳入和实施的最佳实践，将提高其效率和效果并实现最佳结果。
