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远程医疗及其在各专业领域应用的叙述性综述。

A narrative review of telemedicine and its adoption across specialties.

作者信息

Garcia John P, Avila Francisco R, Torres-Guzman Ricardo A, Maita Karla C, Lunde Julianne J, Coffey Jordan D, Demaerschalk Bart M, Forte Antonio J

机构信息

Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA.

Center for Digital Health, Mayo Clinic, Rochester, MN, USA.

出版信息

Mhealth. 2024 Apr 15;10:19. doi: 10.21037/mhealth-23-28. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVE

Telemedicine and video consultation are crucial advancements in healthcare, allowing remote delivery of care. Telemedicine, encompassing various technologies like wearable devices, mobile health, and telemedicine, plays a significant role in managing illnesses and promoting wellness. The corona virus disease 2019 (COVID-19) pandemic accelerated the adoption of telemedicine, ensuring convenient access to medical services while maintaining physical distance. Legislation has supported its integration into clinical practice and addressed compensation issues. However, ensuring clinical appropriateness and sustainability of telemedicine post-expansion has gained attention. We south to identify the most friendly and resistant specialties to telemedicine and to understand areas of interest within those specialties to grasp potential barriers to its use.

METHODS

We aimed to identify articles that incorporated telemedicine in any medical or surgical specialty and determine the adoption rate and intent of this new form of care. Additionally, a secondary search within these databases was conducted to analyze the advantages, disadvantages, and implementation of telemedicine in the healthcare system. Non-English articles and those without full text were excluded. The study selection and data collection process involved using search terms such as "medicine", "surgery", "specialties", "telemedicine", and "telemedicine".

KEY CONTENT AND FINDINGS

Telemedicine adoption varies among specialties. The pandemic led to increased usage, with telemedicine consultations comprising 30.1% of all visits, but specialties like mental health, gastroenterology, and endocrinology showed higher rates of adoption compared to optometry, physical therapy, and orthopedic surgery.

CONCLUSIONS

The data shows that telemedicine uptake varies by specialty and condition due to the need for physical exams. In-person visits still dominate new patient visits despite increased telemedicine use. Telemedicine cannot fully replace in-person care but has increased visit volume and is secure. The adoption of telemedicine is higher in medical practices than in surgical practices, with neurosurgery and urology leading. Further research is needed to assess telemedicine's suitability and effectiveness in different specialties and conditions.

摘要

背景与目的

远程医疗和视频会诊是医疗保健领域的重要进展,可实现远程医疗服务。远程医疗涵盖可穿戴设备、移动健康和远程医疗等多种技术,在疾病管理和促进健康方面发挥着重要作用。2019年冠状病毒病(COVID-19)大流行加速了远程医疗的采用,确保在保持身体距离的同时方便获得医疗服务。立法支持将其纳入临床实践并解决了补偿问题。然而,在扩张后确保远程医疗的临床适用性和可持续性受到了关注。我们旨在确定对远程医疗最友好和最抗拒的专科,并了解这些专科内的关注领域,以掌握其使用的潜在障碍。

方法

我们旨在识别将远程医疗纳入任何医学或外科专科的文章,并确定这种新的医疗形式的采用率和意图。此外,在这些数据库中进行了二次检索,以分析远程医疗在医疗保健系统中的优点、缺点和实施情况。排除非英文文章和无全文的文章。研究选择和数据收集过程涉及使用“医学”“外科”“专科”“远程医疗”和“远程医学”等搜索词。

关键内容与发现

远程医疗在各专科中的采用情况各不相同。大流行导致使用率增加,远程医疗会诊占所有就诊的30.1%,但与验光、物理治疗和整形外科手术相比,心理健康、胃肠病学和内分泌学等专科的采用率更高。

结论

数据表明,由于需要进行体格检查,远程医疗的采用因专科和病情而异。尽管远程医疗使用增加,但新患者就诊仍以面对面就诊为主。远程医疗不能完全取代面对面护理,但增加了就诊量且安全可靠。远程医疗在医疗实践中的采用率高于外科实践,神经外科和泌尿外科领先。需要进一步研究以评估远程医疗在不同专科和病情中的适用性和有效性。

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