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数字健康时代的风湿病学:现状与未来走向?

Rheumatology in the digital health era: status quo and quo vadis?

机构信息

Institute for Digital Medicine, University Hospital of Giessen and Marburg, Marburg, Germany.

Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.

出版信息

Nat Rev Rheumatol. 2024 Dec;20(12):747-759. doi: 10.1038/s41584-024-01177-7. Epub 2024 Oct 31.

Abstract

Rheumatology faces a critical shortage of health-care professionals, exacerbated by an ageing patient population and escalating costs, resulting in widening gaps in care. Exponential advances in digital health technologies (DHTs) in the past 5 years offer new opportunities to address these challenges and could contribute to overall improved health care. However, keeping pace with innovations and integrating them into clinical practice can be challenging. This Review explores the transformative potential of DHTs for rheumatology in reshaping the entire patient pathway and redefining the roles of patients and providers, and discusses the potential barriers to DHT integration. Key technologies, such as large language models, clinical decision-support systems, digital therapeutics, electronic patient-reported outcomes, digital biomarkers, robots, self-sampling devices and artificial intelligence-based scribes, can be implemented along the patient pathway. A digital-first hybrid stepped-care patient pathway could combine in-person and remote care, enabling personalized and continuous monitoring through a digital safety net. The potential benefits and risks of transforming the traditional patient-provider relationship into a digital health triad with technology are discussed. Collaborative efforts are needed to navigate the evolving digital health landscape and harness the potential of DHTs to improve rheumatology care.

摘要

风湿病学面临着医疗保健专业人员的严重短缺,老龄化的患者群体和不断上升的成本使这一问题更加严重,导致护理差距扩大。在过去 5 年中,数字健康技术(DHT)的指数级发展为应对这些挑战提供了新的机会,并有助于整体改善医疗保健。然而,跟上创新步伐并将其融入临床实践可能具有挑战性。这篇综述探讨了 DHT 对风湿病学的变革潜力,以重塑整个患者路径并重新定义患者和提供者的角色,并讨论了 DHT 整合的潜在障碍。关键技术,如大型语言模型、临床决策支持系统、数字疗法、电子患者报告结果、数字生物标志物、机器人、自我采样设备和基于人工智能的抄写员,可以沿着患者路径实施。数字化优先的混合分步式患者路径可以结合面对面和远程护理,通过数字安全网实现个性化和持续监测。讨论了将传统的医患关系转变为具有技术的数字健康三方关系的潜在好处和风险。需要共同努力来驾驭不断发展的数字健康领域,并利用 DHT 的潜力来改善风湿病学的护理。

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