MacEwan University, Edmonton, Alberta, Canada.
Massey University, New Zealand.
Yearb Med Inform. 2022 Aug;31(1):60-66. doi: 10.1055/s-0042-1742500. Epub 2022 Jun 2.
The goal of this paper is to provide a consensus review on telehealth delivery prior to and during the COVID-19 pandemic to develop a set of recommendations for designing telehealth services and tools that contribute to system resilience and equitable health.
The IMIA-Telehealth Working Group (WG) members conducted a two-step approach to understand the role of telehealth in enabling global health equity. We first conducted a consensus review on the topic followed by a modified Delphi process to respond to four questions related to the role telehealth can play in developing a resilient and equitable health system.
Fifteen WG members from eight countries participated in the Delphi process to share their views. The experts agreed that while telehealth services before and during COVID-19 pandemic have enhanced the delivery of and access to healthcare services, they were also concerned that global telehealth delivery has not been equal for everyone. The group came to a consensus that health system concepts including technology, financing, access to medical supplies and equipment, and governance capacity can all impact the delivery of telehealth services.
Telehealth played a significant role in delivering healthcare services during the pandemic. However, telehealth delivery has also led to unintended consequences (UICs) including inequity issues and an increase in the digital divide. Telehealth practitioners, professionals and system designers therefore need to purposely design for equity as part of achieving broader health system goals.
本文旨在对新冠疫情前后的远程医疗服务进行共识性回顾，为设计有助于系统弹性和公平健康的远程医疗服务和工具制定一套建议。
国际医学信息学会远程医疗工作组（WG）成员采用两步法来了解远程医疗在实现全球健康公平中的作用。我们首先对该主题进行共识性回顾，然后采用改良 Delphi 法来回答与远程医疗在发展有弹性和公平的卫生系统中可以发挥的作用相关的四个问题。
来自八个国家的 15 名 WG 成员参加了 Delphi 流程，分享了他们的观点。专家们一致认为，尽管新冠疫情前后的远程医疗服务增强了医疗服务的提供和可及性，但他们也担心全球远程医疗服务并非对每个人都平等。该小组达成共识，认为包括技术、融资、医疗用品和设备获取以及治理能力在内的卫生系统概念都可能影响远程医疗服务的提供。
远程医疗在疫情期间提供医疗服务方面发挥了重要作用。然而，远程医疗的提供也带来了意料之外的后果（UICs），包括不公平问题和数字鸿沟的扩大。因此，远程医疗从业者、专业人员和系统设计者需要有目的地设计公平性，作为实现更广泛的卫生系统目标的一部分。
