Centro de Estudos de Gestão do Instituto Superior Técnico (CEG-IST), Instituto Superior Técnico, Universidade de Lisboa, Portugal; Enterprise Services Portugal, Siemens Healthineers.
Centro de Estudos de Gestão do Instituto Superior Técnico (CEG-IST), Instituto Superior Técnico, Universidade de Lisboa, Portugal; iBB - Institute for Bioengineering and Biosciences and i4HB - Associate Laboratory Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Portugal.
Health Policy. 2023 May;131:104761. doi: 10.1016/j.healthpol.2023.104761. Epub 2023 Mar 5.
Following the pandemic, there is growing pressure in Portugal to adopt new practices that promote more efficient, sustainable, and equitable healthcare. Telemonitoring (TM) has been identified as a valuable solution, particularly for chronically ill, long-term or socially isolated patients. Several initiatives have since emerged. Thus, Portuguese stakeholders recognise the need to reflect upon TM's current state and prospects. This study aims to provide a comprehensive analysis of the TM landscape in Portugal. We begin by analysing the underlying conditions for telehealth development. Then, we describe the governmental strategy and priorities towards TM - the National Strategic Plan for Telehealth development and NHS reimbursement opportunities for TM. To understand TM implementation, adoption, and dissemination in Portugal, we analyse 46 reported initiatives and adoption studies focusing on providers' perspectives. Finally, a structured reflection on current challenges and the way forward is provided, according to the seven domains of the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability (NASSS) framework. The adoption of TM by Portuguese institutions has been growing, leveraged by the telehealth governance model and public reimbursement mechanisms, proving particularly relevant during the pandemic. However, monitored patients are still few. Low digital literacy among patients and providers, lack of care integration and resource scarcity represent barriers hampering pilot TM initiatives' scale-up.
大流行之后，葡萄牙面临越来越大的压力，需要采用新的实践来促进更高效、更可持续和更公平的医疗保健。远程监测（TM）已被确定为一种有价值的解决方案，特别是对于慢性病、长期或社会隔离的患者。此后，出现了一些举措。因此，葡萄牙利益相关者认识到有必要反思 TM 的现状和前景。本研究旨在对葡萄牙的 TM 领域进行全面分析。我们首先分析远程医疗发展的基本条件。然后，我们描述了政府对 TM 的战略和优先事项-国家远程医疗发展战略计划和 NHS 对 TM 的报销机会。为了了解 TM 在葡萄牙的实施、采用和传播情况，我们分析了 46 项报告的举措和采用研究，重点关注提供者的观点。最后，根据非采用、放弃和扩大、传播和可持续性（NASSS）框架的七个领域，对当前挑战和前进方向进行了结构化的反思。葡萄牙各机构对 TM 的采用一直在增长，这得益于远程医疗治理模式和公共报销机制，在大流行期间尤其相关。然而，接受监测的患者仍然很少。患者和提供者的数字素养低、护理整合不足以及资源匮乏是阻碍试点 TM 举措扩大规模的障碍。
