Cardiovascular Department, Papa Giovanni XXIII Hospital Bergamo, Bergamo.
Department of Cardiology, S. Chiara Hospital, Trento.
J Cardiovasc Med (Hagerstown). 2022 Oct 1;23(10):685-690. doi: 10.2459/JCM.0000000000001350.
Telemedicine may be of benefit in patients with heart failure (HF), although virtual visits are often carried out on an ad hoc basis. Herein, we discuss a structured protocol that defines all the steps needed for virtual visits, LEAP Virtual Visit, which includes guides and support kits for clinicians and patients.
A working group of clinicians was established to develop a protocol for virtual visits. The virtual model for monitoring HF patients was based on measurement and sizing of patient flows, type of services, and critical organizational points. The process of virtual visits was broken down to identify the specific activities, players, roles, and support tools needed for implementation in daily practice.
In the protocol developed, sections were included on patient eligibility, exams, supportive tools, and practical organizational aspects. IT requirements were also considered and the most widely used teleconference platforms were compared according to features that were considered to be priority for virtual visits. Protocols and support kits were developed, including guides for clinicians and patients, two questionnaires to assess the level of satisfaction, patient diary, disease awareness brochure, and template to monitor key performance indicators. The phases include an enrolment phase, document sharing phase, pre-evaluation phase, the virtual visit itself, and the post-visit phase. The protocol for the virtual visit was divided into 8 sequential steps to be carried out between the clinic and patient/caregiver.
The protocol described can be expected to have a number of benefits for the patient, clinic, and healthcare structure.
远程医疗可能对心力衰竭(HF)患者有益,尽管虚拟就诊通常是临时进行的。在此,我们讨论了一种结构化的协议,该协议定义了虚拟就诊所需的所有步骤,即 LEAP 虚拟就诊,其中包括为临床医生和患者提供的指南和支持工具包。
成立了一个临床医生工作组来制定虚拟就诊协议。HF 患者的虚拟监测模型基于患者流量、服务类型和关键组织要点的测量和规模。分解虚拟就诊流程以确定在日常实践中实施所需的具体活动、参与者、角色和支持工具。
在制定的协议中,包括了患者资格、检查、支持工具和实际组织方面的内容。还考虑了 IT 要求,并根据对虚拟就诊具有优先考虑的功能对最常用的远程会议平台进行了比较。制定了协议和支持工具包,包括临床医生和患者的指南、两个评估满意度的问卷、患者日记、疾病意识手册以及用于监测关键绩效指标的模板。该协议包括入组阶段、文件共享阶段、预评估阶段、虚拟就诊本身以及就诊后阶段。虚拟就诊协议分为 8 个连续步骤,在诊所和患者/护理人员之间进行。
所描述的协议有望为患者、诊所和医疗保健结构带来诸多益处。