新冠疫情期间安全网医院网络中临床医生的远程医疗经验：一项横断面调查

Clinician experience with telemedicine at a safety-net hospital network during COVID-19: a cross-sectional survey.

作者信息

Sharma Anjana E, Khoong Elaine C, Nijagal Malini A, Lyles Courtney R, Su George, DeFries Triveni, Sarkar Urmimala, Tuot Delphine

机构信息

Center for Excellence in Primary Care, Dept of Family and Community Medicine, UCSF (University of California San Francisco) School of Medicine and the UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital (CVP).

Division of General Internal Medicine, UCSF School of Medicine, and CVP.

出版信息

J Health Care Poor Underserved. 2021 May;32(2 Suppl):220-240. doi: 10.1353/hpu.2021.0060.

OBJECTIVE

The COVID-19 pandemic prompted unprecedented expansion of telemedicine services. We sought to describe clinician experiences providing telemedicine to publicly-insured, low-income patients during COVID-19.

METHODS

Online survey of ambulatory clinicians in an urban safety-net hospital system, conducted May 28 2020-July 14 2020.

RESULTS

Among 311 participants (response rate 48.3%), 34.7% (N=108/311) practiced in primary/urgent care, 37.0% (N=115/311) medical specialty and 7.7% (N=24/311) surgical clinics. 87.8% (273/311) had conducted telephone visits, 26% (81/311) video. Participants reported observing both technical and non-technical patient barriers. Clinicians reported concerns about the diagnostic safety of telephone (58.9%, 129/219) vs video (35.3%, 24/68). However, clinician comfort with telemedicine was high (89.3% (216/242) for telephone, 91.0% (61/67) for video), with many clinicians (220/239 or 92.1% telephone, 60/66 or 90.9% video) planning to continue telemedicine after COVID-19.

CONCLUSIONS

Clinicians in a safety-net healthcare system report high comfort with and intention to continue telemedicine after the pandemic, despite patient challenges and safety concerns.

目的

新冠疫情促使远程医疗服务得到前所未有的扩展。我们试图描述临床医生在新冠疫情期间为参加公共保险的低收入患者提供远程医疗服务的经历。

方法

于2020年5月28日至2020年7月14日对一家城市安全网医院系统的门诊临床医生进行在线调查。

结果

在311名参与者中（回复率48.3%），34.7%（N = 108/311）在初级/紧急护理科室工作，37.0%（N = 115/311）在医学专科科室，7.7%（N = 24/311）在外科诊所。87.8%（273/311）进行过电话问诊，26%（81/311）进行过视频问诊。参与者报告观察到了患者在技术和非技术方面的障碍。临床医生报告称担心电话问诊（58.9%，129/219）与视频问诊（35.3%，24/68）的诊断安全性。然而，临床医生对远程医疗的接受度很高（电话问诊为89.3%（216/242），视频问诊为91.0%（61/67）），许多临床医生（电话问诊220/239或92.1%，视频问诊60/66或90.9%）计划在新冠疫情后继续开展远程医疗服务。