Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts 01730, USA.
Section of Endocrinology, Diabetes, Nutrition & Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
J Clin Endocrinol Metab. 2022 Nov 23;107(11):2953-2962. doi: 10.1210/clinem/dgac494.
This work aims to guide clinicians practicing endocrinology in the use of telehealth (synchronous patient-clinician visits conducted over video or telephone) for outpatient care.
The Endocrine Society convened a 9-member panel of US endocrinologists with expertise in telehealth clinical care, telehealth operations, patient-centered care, health care delivery research, and/or evidence-based medicine.
The panel conducted a literature search to identify studies published since 2000 about telehealth in endocrinology. One member extracted a list of factors affecting the quality of endocrine care via telehealth from the extant literature. The panel grouped these factors into 5 domains: clinical, patient, patient-clinician relationship, clinician, and health care setting and technology.
For each domain, 2 or 3 members drew on existing literature and their expert opinions to draft a section examining the effect of the domain's component factors on the appropriateness of telehealth use within endocrine practice. Appropriateness was evaluated in the context of the 6 Institute of Medicine aims for health care quality: patient-centeredness, equity, safety, effectiveness, timeliness, and efficiency. The panel held monthly virtual meetings to discuss and revise each domain. Two members wrote the remaining sections and integrated them with the domains to create the full policy perspective, which was reviewed and revised by all members.
Telehealth has become a common care modality within endocrinology. This policy perspective summarizes the factors determining telehealth appropriateness in various patient care scenarios. Strategies to increase the quality of telehealth care are offered. More research is needed to develop a robust evidence base for future guideline development.
本项工作旨在为内分泌科临床医生提供使用远程医疗（通过视频或电话进行的医患同步门诊）进行门诊护理的指导。
内分泌学会召集了 9 名美国内分泌学家组成专家组，这些专家在远程医疗临床护理、远程医疗运营、以患者为中心的护理、医疗服务提供研究和/或循证医学方面具有专长。
专家组对 2000 年后发表的关于内分泌学远程医疗的研究进行了文献检索。一名成员从现有文献中提取了通过远程医疗影响内分泌护理质量的因素列表。专家组将这些因素分为 5 个领域：临床、患者、医患关系、临床医生和医疗保健环境与技术。
对于每个领域，2 至 3 名成员利用现有文献和专家意见起草了一个章节，检查该领域组成因素对内分泌实践中远程医疗使用的适宜性的影响。适宜性是根据医疗保健质量的 6 个研究所目标进行评估的：以患者为中心、公平、安全、有效、及时和高效。专家组每月举行虚拟会议，讨论和修改每个领域。两名成员撰写了其余章节，并将其与各领域整合，形成完整的政策视角，供所有成员审查和修订。
远程医疗已成为内分泌学中常见的护理模式。本政策观点总结了在各种患者护理场景中决定远程医疗适宜性的因素。提出了提高远程医疗护理质量的策略。需要开展更多研究，为未来指南的制定提供更有力的循证依据。
