Barrett Stephen, Howlett Owen, Lal Nalini, McKinstry Carol
Research and Innovation, Bendigo Health Care Group, Bendigo, Victoria, Australia.
La Trobe Rural Health School, Bendigo, Victoria, Australia.
Telemed J E Health. 2024 Jun;30(6):e1649-e1666. doi: 10.1089/tmj.2023.0546. Epub 2024 Mar 1.
Introduction:Telehealth is used by allied health professionals to deliver health care remotely. This umbrella review addressed the following questions: (1) What telehealth interventions have been implemented to deliver allied health care? (2) What are the reported clinical benefits, and challenges of the implementation of telehealth delivered allied health interventions? (3) What are the reported experiences of patients and clinicians?
Methods:A rapid umbrella systematic review method was utilized. Following a search of five electronic databases, only systematic reviews reporting on telehealth-delivery allied health interventions published in the past 10 years were included. Reported outcomes included clinical effectiveness, implementation factors, and patient/clinician experiences. Methodological quality was established using the A MeaSurement Tool to Assess systematic Reviews 2.
Results:After applying eligibility criteria to 571 studies, 26 studies were included. Findings indicate that telehealth-delivered allied health interventions may obtain similar clinical outcomes as compared with face-to-face appointments. Patients reported less stress and valued the reduced need to travel when telehealth was used. Patient satisfaction with telehealth delivered care was equal to face-to-face care, and no differences were noted in the capacity to build therapeutic alliance when using telehealth. Difficulties with technology use were reported by clinicians and patients. Clinicians were identified as needing increased time management skills. Cautious interpretation of findings is recommended due to the quality rating of low to critical low for the majority of individual reviews.
Conclusions:Telehealth-delivered care might obtain similar clinical outcomes to face-to-face care; however, difficulties may arise during broad implementation. It is recommended that health services be strategic to overcome implementation barriers and provide targeted support to enable effective, equitable, and sustained allied health service delivery via telehealth.
远程医疗被健康照护相关专业人员用于远程提供医疗服务。本综合性综述探讨了以下问题：（1）已实施了哪些远程医疗干预措施来提供健康照护相关服务？（2）实施远程医疗提供的健康照护相关干预措施所报告的临床益处及挑战有哪些？（3）患者和临床医生报告的体验如何？
采用快速综合性系统评价方法。在检索了五个电子数据库后，仅纳入了过去10年发表的关于远程医疗提供健康照护相关干预措施的系统评价。报告的结果包括临床有效性、实施因素以及患者/临床医生的体验。使用《系统评价的测量工具2》确定方法学质量。
在对571项研究应用纳入标准后，纳入了26项研究。研究结果表明，与面对面就诊相比，远程医疗提供的健康照护相关干预措施可能获得相似的临床结果。患者报告压力较小，并重视使用远程医疗时减少的出行需求。患者对远程医疗提供的护理的满意度与面对面护理相当，并且在使用远程医疗时建立治疗联盟的能力方面未发现差异。临床医生和患者都报告了技术使用方面的困难。临床医生被认为需要提高时间管理技能。由于大多数个体评价的质量等级为低到极低，建议谨慎解读研究结果。
远程医疗提供的护理可能获得与面对面护理相似的临床结果；然而，在广泛实施过程中可能会出现困难。建议卫生服务机构制定战略以克服实施障碍，并提供有针对性的支持，以通过远程医疗实现有效、公平和持续的健康照护相关服务提供。
