VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, Iowa, USA.
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
J Hosp Med. 2022 Apr;17(4):291-302. doi: 10.1002/jhm.12801. Epub 2022 Mar 6.
Despite the proliferation of telehealth, uptake for acute inpatient services has been slower. Hospitalist shortages in rural and critical access hospitals as well as the COVID-19 pandemic have led to a renewed interest in telehealth to deliver acute inpatient services. Understanding current evidence is crucial for promoting uptake and developing evidence-based practices.
To conduct a systematic review of telehealth applications in acute inpatient general medicine and pediatric hospital wards and synthesize available evidence.
A search of five databases (PubMed, CINAHL, Embase, Scopus, and ProQuest Theses, and Dissertations) using a combination of search terms including telemedicine and hospital medicine/inpatient care keywords yielded 17,015 citations.
Two independent coders determined eligibility based on inclusion and exclusion criteria. Data were extracted and organized into main categories based on findings: (1) feasibility and planning, (2) implementation and technology, and (3) telehealth application process and outcome measures.
Of the 20 publications included, three were feasibility and planning studies describing the creation of the program, services provided, and potential cost implications. Five studies described implementation and technology used, including training, education, and evaluation methods. Finally, twelve discussed process and outcome measures, including patient and provider satisfaction and costs.
Telehealth services for hospital medicine were found to be effective, well received, and initial cost estimates appear favorable. A variety of services were described across programs with considerable benefit appreciated by rural and smaller hospitals. Additional work is needed to evaluate clinical outcomes and overall program costs.
尽管远程医疗已经普及，但急性住院服务的采用速度较慢。农村和基层医疗机构的医院医生短缺，以及 COVID-19 大流行，使得人们重新关注通过远程医疗提供急性住院服务。了解当前的证据对于促进采用和制定基于证据的实践至关重要。
对急性住院内科和儿科病房的远程医疗应用进行系统评价，并综合现有证据。
通过组合使用包括远程医疗和医院医学/住院护理在内的关键词，对五个数据库（PubMed、CINAHL、Embase、Scopus 和 ProQuest 论文和学位论文）进行了搜索，共产生了 17015 条引文。
两名独立的编码员根据纳入和排除标准确定了资格。根据发现将数据提取并组织成主要类别：（1）可行性和规划，（2）实施和技术，（3）远程医疗应用程序流程和结果测量。
在纳入的 20 篇文章中，有 3 篇是可行性和规划研究，描述了项目的创建、提供的服务以及潜在的成本影响。有 5 项研究描述了所使用的实施和技术，包括培训、教育和评估方法。最后，有 12 项讨论了流程和结果测量，包括患者和提供者的满意度和成本。
医院医学的远程医疗服务被证明是有效、受欢迎的，初步成本估算似乎有利。各个项目描述了各种服务，农村和较小的医院都从中获得了相当大的收益。需要进一步的工作来评估临床结果和整体项目成本。
