Clinical Research Development Unit, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Front Public Health. 2022 Jul 22;10:937207. doi: 10.3389/fpubh.2022.937207. eCollection 2022.
The unexpected emergence of coronavirus disease 2019 (COVID-19) has changed mindsets about the healthcare system and medical practice in many fields, forcing physicians to reconsider their approaches to healthcare provision. It is necessary to add new, unique, and efficient solutions to traditional methods to overcome this critical challenge. In this regard, telemedicine offers a solution to this problem. Remote medical activities could diminish unnecessary visits and provide prompt medical services in a timely manner.
This scoping review aimed to provide a map of the existing evidence on the use of telemedicine during the COVID-19 pandemic by focusing on delineation functions and technologies, analyzing settings, and identifying related outcomes.
This review was conducted following the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed and Scopus databases were systematically searched based on specific eligibility criteria. The English publications included in this study focused on telemedicine systems implemented during the COVID-19 pandemic to provide clinical care services. Two independent reviewers screened the articles based on predefined inclusion and exclusion criteria. The relevant features of telemedicine systems were summarized and presented into the following four domains and their subcategories, including functionality, technology, context, and outcomes.
Out of a total of 1,602 retrieved papers, 66 studies met the inclusion criteria. The most common function implemented was counseling, and telemedicine was used for diagnosis in seven studies. In addition, in 12 studies, tele-monitoring of patients was performed by phone, designed platforms, social media, Bluetooth, and video calls. Telemedicine systems were predominantly implemented synchronously (50 studies). Moreover, 10 studies used both synchronous and asynchronous technologies. Although most studies were performed in outpatient clinics or centers, three studies implemented a system for hospitalized patients, and four studies applied telemedicine for emergency care. Telemedicine was effective in improving 87.5% of health resource utilization outcomes, 85% of patient outcomes, and 100% of provider outcomes.
The benefits of using telemedicine in medical care delivery systems in pandemic conditions have been well-documented, especially for outpatient care. It could potentially improve patient, provider, and healthcare outcomes. This review suggests that telemedicine could support outpatient and emergency care in pandemic situations. However, further studies using interventional methods are required to increase the generalizability of the findings.
2019 年冠状病毒病（COVID-19）的意外出现改变了许多领域对医疗体系和医疗实践的观念，迫使医生重新考虑提供医疗服务的方法。有必要为传统方法增加新的、独特的和有效的解决方案，以克服这一关键挑战。在这方面，远程医疗提供了一种解决方案。远程医疗活动可以减少不必要的就诊，并及时提供及时的医疗服务。
本范围综述旨在通过关注功能和技术的划定、分析环境以及确定相关结果，提供 COVID-19 大流行期间使用远程医疗的现有证据图谱。
本综述遵循阿特赛和奥马利框架以及《系统评价和荟萃分析扩展的首选报告项目》（PRISMA-ScR）清单进行。根据具体的纳入和排除标准，系统地搜索了 PubMed 和 Scopus 数据库。本研究纳入的英文出版物重点关注 COVID-19 大流行期间实施的远程医疗系统，以提供临床护理服务。两名独立审查员根据预先确定的纳入和排除标准筛选文章。总结了远程医疗系统的相关特征，并呈现为以下四个领域及其子类别，包括功能、技术、环境和结果。
在总共检索到的 1602 篇论文中，有 66 篇研究符合纳入标准。实施的最常见功能是咨询，有 7 项研究将远程医疗用于诊断。此外，在 12 项研究中，通过电话、设计平台、社交媒体、蓝牙和视频通话对患者进行了远程监测。远程医疗系统主要是同步实施的（50 项研究）。此外，有 10 项研究同时使用了同步和异步技术。尽管大多数研究都是在门诊或中心进行的，但有 3 项研究实施了针对住院患者的系统，4 项研究将远程医疗用于紧急护理。远程医疗在改善 87.5%的卫生资源利用结果、85%的患者结果和 100%的提供者结果方面非常有效。
在大流行期间，远程医疗在医疗保健提供系统中的益处已得到充分证明，特别是对于门诊护理。它有可能改善患者、提供者和医疗保健结果。本综述表明，远程医疗可以在大流行情况下支持门诊和急诊护理。然而，需要使用干预性方法进行进一步研究，以提高研究结果的普遍性。
