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新冠疫情期间的远程医疗干预措施:应用、挑战、隐私和安全问题的范围综述。

Telehealth interventions during COVID-19 pandemic: a scoping review of applications, challenges, privacy and security issues.

机构信息

ICT, Hamad Bin Khalifa University College of Science and Engineering, Doha, Qatar

Computer Science, Gombe State University, Gombe, Nigeria.

出版信息

BMJ Health Care Inform. 2023 Aug;30(1). doi: 10.1136/bmjhci-2022-100676.

Abstract

BACKGROUND

The COVID-19, caused by the SARS-CoV-2 virus, proliferated worldwide, leading to a pandemic. Many governmental and non-governmental organisations and research institutes are contributing to the COVID-19 fight to control the pandemic.

MOTIVATION

Numerous telehealth applications have been proposed and adopted during the pandemic to combat the spread of the disease. To this end, powerful tools such as artificial intelligence (AI)/robotic technologies, tracking, monitoring, consultation apps and other telehealth interventions have been extensively used. However, there are several issues and challenges that are currently facing this technology.

OBJECTIVE

The purpose of this scoping review is to analyse the primary goal of these techniques; document their contribution to tackling COVID-19; identify and categorise their main challenges and future direction in fighting against the COVID-19 or future pandemic outbreaks.

METHODS

Four digital libraries (ACM, IEEE, Scopus and Google Scholar) were searched to identify relevant sources. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used as a guideline procedure to develop a comprehensive scoping review. General telehealth features were extracted from the studies reviewed and analysed in the context of the intervention type, technology used, contributions, challenges, issues and limitations.

RESULTS

A collection of 27 studies were analysed. The reported telehealth interventions were classified into two main categories: AI-based and non-AI-based interventions; their main contributions to tackling COVID-19 are in the aspects of disease detection and diagnosis, pathogenesis and virology, vaccine and drug development, transmission and epidemic predictions, online patient consultation, tracing, and observation; 28 telehealth intervention challenges/issues have been reported and categorised into technical (14), non-technical (10), and privacy, and policy issues (4). The most critical technical challenges are: network issues, system reliability issues, performance, accuracy and compatibility issues. Moreover, the most critical non-technical issues are: the skills required, hardware/software cost, inability to entirely replace physical treatment and people's uncertainty about using the technology. Stringent laws/regulations, ethical issues are some of the policy and privacy issues affecting the development of the telehealth interventions reported in the literature.

CONCLUSION

This study provides medical and scientific scholars with a comprehensive overview of telehealth technologies' current and future applications in the fight against COVID-19 to motivate researchers to continue to maximise the benefits of these techniques in the fight against pandemics. Lastly, we recommend that the identified challenges, privacy, and security issues and solutions be considered when designing and developing future telehealth applications.

摘要

背景

由 SARS-CoV-2 病毒引起的 COVID-19 在全球范围内传播,导致大流行。许多政府和非政府组织以及研究机构正在为控制大流行而共同抗击 COVID-19。

动机

大流行期间提出并采用了许多远程医疗应用程序来控制疾病的传播。为此,广泛使用了人工智能 (AI)/机器人技术、跟踪、监测、咨询应用程序和其他远程医疗干预措施等强大工具。然而,目前这项技术面临着一些问题和挑战。

目的

本范围综述的目的是分析这些技术的主要目标;记录它们对解决 COVID-19 的贡献;确定并分类其在抗击 COVID-19 或未来大流行爆发中的主要挑战和未来方向。

方法

在 ACM、IEEE、Scopus 和 Google Scholar 四个数字图书馆中搜索相关资源。采用扩展后的系统评价和荟萃分析的首选报告项目 (PRISMA-ScR) 作为指南程序,以制定全面的范围综述。从审查的研究中提取了一般远程医疗功能,并根据干预类型、使用的技术、贡献、挑战、问题和局限性对其进行了分析。

结果

分析了 27 项研究。报告的远程医疗干预措施分为两类:基于 AI 的干预措施和非 AI 干预措施;它们对解决 COVID-19 的主要贡献在于疾病检测和诊断、发病机制和病毒学、疫苗和药物开发、传播和流行预测、在线患者咨询、跟踪和观察;报告并分类了 28 项远程医疗干预挑战/问题,分为技术 (14)、非技术 (10) 和隐私和政策问题 (4)。最关键的技术挑战是:网络问题、系统可靠性问题、性能、准确性和兼容性问题。此外,最关键的非技术问题是:所需技能、硬件/软件成本、无法完全替代物理治疗以及人们对使用该技术的不确定性。影响文献中报告的远程医疗干预发展的严格法律/法规、道德问题是一些政策和隐私问题。

结论

本研究为医学和科学界学者提供了远程医疗技术在抗击 COVID-19 中的当前和未来应用的全面概述,以激励研究人员继续最大限度地发挥这些技术在抗击大流行中的优势。最后,我们建议在设计和开发未来的远程医疗应用程序时考虑到确定的挑战、隐私和安全问题以及解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1f7/10407386/b171638685f8/bmjhci-2022-100676f01.jpg

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