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远程医疗视域下的呼吸系统疾病门诊中视频会议应用的范围

A perspective on the scope of videoconferencing-based telemedicine in respiratory diseases outpatient clinic.

机构信息

Department of Pulmonary Diseases, Pamukkale University Faculty of Medicine, Denizli, Türkiye.

Department of Pulmonary Diseases, İstinye University Faculty of Medicine, İstanbul, Türkiye.

出版信息

Tuberk Toraks. 2023 Dec;71(4):335-346. doi: 10.5578/tt.20239602.

Abstract

INTRODUCTION

Telemedicine is rapidly expanding across various fields worldwide. While it finds application in respiratory diseases due to the imperative need for protection against the risk of transmission and the close monitoring of patients with chronic diseases, there is a scarcity of publications detailing telemedicine experiences in respiratory diseases. This study aims to retrospectively evaluate the prospective management of patients with respiratory diseases through videoconference-based telemedicine, intending to establish a foundation for its judicious application in pulmonology cases.

MATERIALS AND METHODS

In this descriptive study, anonymized medical records of all 478 patients assessed via videoconference-based telemedicine over an eight-month period from June 2020 to February 2021 were reviewed. The analysis included demographic characteristics, disease history, attendance methods, the necessity for in-person physical examination after the initial videoconference (VC) session, the inclusion of investigations, pre-diagnosis, diagnosis processes, follow-up period, and outcomes. Follow-up data for all patients included in the study were reviewed at the end of June 2021.

RESULT

Median age of the patients was 55 (44-67), with a male predominance of 55%. Approximately 30% resided in a city other than the one in which the physician offering telemedicine was situated. Seventy-nine (16.7%) individuals received telemedicine via VC sessions without the requirement for any in-person examinations. The most prevalent disease among those who applied for telemedicine was asthma. Median duration of the initial VC session was 13 (8-18) minutes. At least half of the individuals seeking videoconference-based telemedicine for chronic respiratory disorders, such as asthma, COPD, and interstitial lung disease, had previously been followed by either the telemedicine provider or another physician in the same hospital. However, the vast majority of telemedicine applications in disease categories such as COVID, post-COVID, pulmonary nodules, and lung cancer were submitted by first-time applicants.

CONCLUSIONS

This pioneering study suggests that videoconference-based telemedicine may be an alternative/complementary tool for patients, particularly those with chronic respiratory diseases.

摘要

简介

远程医疗正在全球范围内迅速扩展。由于需要防范传播风险并密切监测慢性病患者,远程医疗在呼吸系统疾病中得到了应用,但有关呼吸系统疾病远程医疗经验的出版物却很少。本研究旨在通过基于视频会议的远程医疗回顾性评估呼吸系统疾病患者的前瞻性管理,旨在为在肺病病例中合理应用远程医疗奠定基础。

材料和方法

在这项描述性研究中,我们回顾了 2020 年 6 月至 2021 年 2 月期间通过基于视频会议的远程医疗评估的 478 例患者的匿名医疗记录。分析包括人口统计学特征、病史、就诊方式、首次视频会议(VC)后是否需要进行体格检查、检查内容、预诊断、诊断过程、随访期和结果。对所有纳入研究的患者进行了随访,随访数据截至 2021 年 6 月底。

结果

患者的中位年龄为 55 岁(44-67 岁),男性占 55%。约 30%的患者居住在提供远程医疗服务的医生所在城市以外的城市。79 例(16.7%)患者通过 VC 会议接受远程医疗,无需任何体格检查。在申请远程医疗的患者中,最常见的疾病是哮喘。首次 VC 会议的中位持续时间为 13 分钟(8-18 分钟)。至少一半因慢性呼吸系统疾病(如哮喘、COPD 和间质性肺病)而寻求基于视频会议的远程医疗的患者,曾由远程医疗提供者或同一医院的其他医生进行过随访。然而,绝大多数因 COVID、新冠后、肺结节和肺癌等疾病类别而申请远程医疗的患者都是首次申请。

结论

这项开创性的研究表明,基于视频会议的远程医疗可能是患者,特别是慢性呼吸系统疾病患者的一种替代/补充工具。

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