Leong Russell, Sanderson Kate E, Klassen Anne F, Ratcliffe Elyanne M, Zuniga-Villanueva Gregorio
Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Hamilton Health Sciences Centre for Evidence-Based Implementation, McMaster University, Hamilton, ON, Canada.
J Telemed Telecare. 2025 Jun;31(5):667-672. doi: 10.1177/1357633X231205329. Epub 2023 Oct 30.
ObjectivesThe COVID-19 pandemic compelled a portion of healthcare to be delivered virtually. As the pandemic waned, health systems strived to find a balance between re-incorporating in-person care while maintaining virtual care. To find when virtual or in-person encounters are more appropriate, we surveyed pediatricians' perceptions when comparing the suitability of virtual care to in-person care.MethodsWe surveyed a Canadian tertiary-level pediatric hospital where pediatricians assessed whether specific clinical encounters or tasks were more or less effective virtually than when performed in person. Pediatricians also rated the importance of clinical and patient factors when deciding if a patient needs to be seen in person.ResultsOf 160 pediatrics faculty members, 56 (35%) responded to the survey. When assessing different types of clinical encounters, triage, multidisciplinary meetings, discharge, and follow ups were more likely to favor virtual encounters. However, first consultations and family meetings were more likely to favor in-person encounters. Regarding clinical tasks, pediatricians were more likely to endorse explaining test results, offering treatment recommendations, and obtaining patient histories virtually. On the contrary, there was a preference for physical examinations, assessing patients visually, and assessing developmental milestones to be performed in person. When deciding if a patient should be seen in person versus virtual, pediatricians rated the patient's condition and communication barriers as the most important factors favoring an in-person appointment.DiscussionThese results offer an initial framework for pediatricians when choosing which encounter type may be most appropriate for their patients between virtual or in-person appointments.
目标
新冠疫情迫使一部分医疗服务通过虚拟方式提供。随着疫情缓解，医疗系统努力在重新纳入面对面护理的同时维持虚拟护理之间找到平衡。为了确定何时虚拟就诊或面对面就诊更合适，我们调查了儿科医生在比较虚拟护理与面对面护理的适用性时的看法。
方法
我们对一家加拿大三级儿科医院进行了调查，儿科医生在该医院评估特定临床就诊或任务通过虚拟方式进行与亲自进行相比是否更有效或效果更差。儿科医生还对临床和患者因素在决定患者是否需要亲自就诊时的重要性进行了评分。
结果
在160名儿科教员中，56人（35%）回复了调查。在评估不同类型的临床就诊时，分诊、多学科会议、出院和随访更倾向于虚拟就诊。然而，首次咨询和家庭会议更倾向于面对面就诊。关于临床任务，儿科医生更有可能认可通过虚拟方式解释检查结果、提供治疗建议和获取患者病史。相反，他们更倾向于亲自进行体格检查、视觉评估患者和评估发育里程碑。在决定患者应亲自就诊还是虚拟就诊时，儿科医生将患者的病情和沟通障碍列为支持亲自预约的最重要因素。
讨论
这些结果为儿科医生在选择虚拟就诊或面对面就诊中哪种就诊类型可能最适合其患者时提供了一个初步框架。
