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美国医疗保健系统中远程患者监测的应用:一项范围综述。

Utilization of Remote Patient Monitoring Within the United States Health Care System: A Scoping Review.

作者信息

Hayes Corey J, Dawson Leah, McCoy Hannah, Hernandez Michelle, Andersen Jennifer, Ali Mir M, Bogulski Cari A, Eswaran Hari

机构信息

Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA.

Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

出版信息

Telemed J E Health. 2023 Mar;29(3):384-394. doi: 10.1089/tmj.2022.0111. Epub 2022 Jul 11.

Abstract

Limited information exists on the landscape of studies and policies for remote patient monitoring (RPM) in the United States. We conducted a scoping review to assess (1) for which adult patient populations and health care needs is RPM being used and (2) the landscape of national- and state-level reimbursement policies for RPM. This study was guided by the Arksey and O'Malley methodological framework for scoping reviews and the Joanna Briggs Institute Manual for Evidence Synthesis. A total of 399 articles were included in our final sample: 268 study articles and 131 articles of gray literature (e.g., websites, legislative bills). RPM-related articles rose drastically from 2015 to 2021, and the vast majority of articles were peer-reviewed journal articles. Of the study articles, prospective cohort studies were the most common study method, with m-health/smart watches being the most common RPM modality. RPM was found to be most commonly tested within patients with cardiovascular diseases, and the most common outcomes measured were usability and feasibility. Gray literature found 36 U.S. state Medicaid programs had reimbursement policies for RPM in 2021; however, 28 of those had at least one restriction on reimbursement (e.g., limited to specific providers). Despite the rapid growth in the literature on RPM and the adoption of reimbursement policies, retrospective, population-level studies, large randomized controlled trials, studies with a focus on additional favorable outcomes (e.g., quality of life), and studies evaluating trends in RPM reimbursement policies are lacking in the current literature.

摘要

关于美国远程患者监测(RPM)的研究和政策情况,现有信息有限。我们进行了一项范围综述,以评估:(1)RPM正在用于哪些成年患者群体和医疗保健需求;(2)RPM在国家和州层面的报销政策情况。本研究以Arksey和O'Malley的范围综述方法框架以及乔安娜·布里格斯循证综合手册为指导。我们的最终样本共纳入399篇文章:268篇研究文章和131篇灰色文献(如网站、立法法案)。2015年至2021年期间,与RPM相关的文章数量急剧上升,且绝大多数文章为同行评审期刊文章。在研究文章中,前瞻性队列研究是最常见的研究方法,移动健康/智能手表是最常见的RPM模式。研究发现,RPM最常在心血管疾病患者中进行测试,最常测量的结果是可用性和可行性。灰色文献显示,2021年美国有36个州的医疗补助计划对RPM有报销政策;然而,其中28个州至少有一项报销限制(如仅限于特定提供者)。尽管关于RPM的文献迅速增长且报销政策不断采用,但当前文献中缺乏回顾性、人群水平研究、大型随机对照试验、关注其他有利结果(如生活质量)的研究以及评估RPM报销政策趋势的研究。

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