Pinnock Hilary, Murphie Phyllis, Vogiatzis Ioannis, Poberezhets Vitalii
Usher Institute, The University of Edinburgh, Edinburgh, UK.
Modernising Patient Pathways Programme, National Centre for Sustainable Delivery, Glasgow, UK.
ERJ Open Res. 2022 Jul 25;8(3). doi: 10.1183/23120541.00111-2022. eCollection 2022 Jul.
The World Health Organization defines telemedicine as "an interaction between a healthcare provider and a patient when the two are separated by distance". The coronavirus disease 2019 (COVID-19) pandemic has forced a dramatic shift to telephone and video consulting for follow-up and routine ambulatory care for reasons of infection control. Short message service ("text") messaging has proved a useful adjunct to remote consulting, allowing the transfer of photographs and documents. Maintaining the care of noncommunicable diseases is a core component of pandemic preparedness and telemedicine has developed to enable (for example) remote monitoring of sleep apnoea, telemonitoring of COPD, digital support for asthma self-management and remote delivery of pulmonary rehabilitation. There are multiple exemplars of telehealth instigated rapidly to provide care for people with COVID-19, to manage the spread of the pandemic or to maintain safe routine diagnostic or treatment services. Despite many positive examples of equivalent functionality and safety, there remain questions about the impact of remote delivery of care on rapport and the longer term impact on patient/professional relationships. Although telehealth has the potential to contribute to universal health coverage by providing cost-effective accessible care, there is a risk of increasing social health inequalities if the "digital divide" excludes those most in need of care. As we emerge from the pandemic, the balance of remote face-to-face consulting, and the specific role of digital health in different clinical and healthcare contexts will evolve. What is clear is that telemedicine in one form or another will be part of the "new norm".
世界卫生组织将远程医疗定义为“医疗服务提供者与患者在空间上分离时的互动”。2019年冠状病毒病（COVID-19）大流行因感染控制的原因，迫使后续跟进和日常门诊护理大幅转向电话和视频咨询。短信服务（“文本”）已被证明是远程咨询的有用辅助手段，可实现照片和文件的传输。维持非传染性疾病的护理是大流行防范的核心组成部分，远程医疗已得到发展，以实现（例如）对睡眠呼吸暂停的远程监测、慢性阻塞性肺疾病的远程监测、哮喘自我管理的数字支持以及肺部康复的远程提供。有多个远程医疗迅速兴起的范例，为COVID-19患者提供护理、控制大流行的传播或维持安全的常规诊断或治疗服务。尽管有许多功能等效且安全的积极例子，但远程提供护理对医患关系的影响以及对患者/专业人员关系的长期影响仍存在疑问。虽然远程医疗有可能通过提供具有成本效益的可及护理来促进全民健康覆盖，但如果“数字鸿沟”将最需要护理的人群排除在外，就存在加剧社会健康不平等的风险。随着我们走出大流行，远程与面对面咨询的平衡以及数字健康在不同临床和医疗环境中的具体作用将会演变。显而易见的是，某种形式的远程医疗将成为“新常态”的一部分。
