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远程监测和虚拟护理技术跨国转移的复杂性:国际研讨会的经验教训。

The Complexity of Transferring Remote Monitoring and Virtual Care Technology Between Countries: Lessons From an International Workshop.

机构信息

Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada.

Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

出版信息

J Med Internet Res. 2023 Aug 1;25:e46873. doi: 10.2196/46873.

Abstract

International deployment of remote monitoring and virtual care (RMVC) technologies would efficiently harness their positive impact on outcomes. Since Canada and the United Kingdom have similar populations, health care systems, and digital health landscapes, transferring digital health innovations between them should be relatively straightforward. Yet examples of successful attempts are scarce. In a workshop, we identified 6 differences that may complicate RMVC transfer between Canada and the United Kingdom and provided recommendations for addressing them. These key differences include (1) minority groups, (2) physical geography, (3) clinical pathways, (4) value propositions, (5) governmental priorities and support for digital innovation, and (6) regulatory pathways. We detail 4 broad recommendations to plan for sustainability, including the need to formally consider how highlighted country-specific recommendations may impact RMVC and contingency planning to overcome challenges; the need to map which pathways are available as an innovator to support cross-country transfer; the need to report on and apply learnings from regulatory barriers and facilitators so that everyone may benefit; and the need to explore existing guidance to successfully transfer digital health solutions while developing further guidance (eg, extending the nonadoption, abandonment, scale-up, spread, sustainability framework for cross-country transfer). Finally, we present an ecosystem readiness checklist. Considering these recommendations will contribute to successful international deployment and an increased positive impact of RMVC technologies. Future directions should consider characterizing additional complexities associated with global transfer.

摘要

国际上部署远程监测和虚拟护理 (RMVC) 技术将有效地利用其对结果的积极影响。由于加拿大和英国具有相似的人口、医疗保健系统和数字医疗保健环境,因此在它们之间转移数字医疗保健创新应该相对简单。然而,成功尝试的例子却很少。在一次研讨会上,我们确定了 6 个可能使加拿大和英国之间的 RMVC 转移复杂化的差异,并提供了应对这些差异的建议。这些关键差异包括:(1) 少数群体;(2) 物理地理;(3) 临床途径;(4) 价值主张;(5) 政府对数字创新的优先事项和支持;以及 (6) 监管途径。我们详细介绍了 4 条广泛的建议,以规划可持续性,包括:需要正式考虑突出的国家特定建议如何影响 RMVC 并进行应急规划以克服挑战;需要为创新者规划哪些途径可用以支持跨国转移;需要报告和应用监管障碍和促进因素方面的经验教训,以便所有人都能从中受益;以及需要探索现有的指导方针,以成功地转移数字健康解决方案,同时制定进一步的指导方针(例如,将非采用、放弃、扩大规模、传播、可持续性框架扩展到跨国转移)。最后,我们提出了一个生态系统准备情况检查表。考虑这些建议将有助于 RMVC 技术的成功国际部署和更大的积极影响。未来的方向应该考虑描述与全球转移相关的其他复杂性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b9f/10427929/7a177a3259ca/jmir_v25i1e46873_fig1.jpg

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