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肾病科进行视频会诊的十条建议。

Ten tips to carry out video consultations in nephrology.

作者信息

Woywodt Alexander, Payne Rebecca E, Huuskes Brooke M, Hezer Bartu

机构信息

Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK.

General Practitioner and NIHR In-Practice Fellow, Nuffield Department of Primary Health; Care Sciences, Oxford University, Oxford, UK.

出版信息

Clin Kidney J. 2024 Sep 14;17(10):sfae287. doi: 10.1093/ckj/sfae287. eCollection 2024 Oct.

Abstract

Video consultations have seen increasing use in nephrology since the COVID-19 pandemic with an aim to address constraints in F2F outpatient capacity and also patients' concerns around risks of infection when attending healthcare facilities. Nephrologists have learned through experience to use video consultations for providing routine follow up and also for triage of unwell patients. Advantages of video consultations include convenience, cost savings through avoiding clinic overheads, and reducing the carbon footprint of care. The last is increasingly relevant as nephrologists consider climate change and its implications. Video consultations are not a panacea to overcome challenges in nephrology and risks also exist for example when it comes to redesigning pathways and maintaining access to F2F assessments when required. It is equally important to consider practical aspects such as reimbursement, prescribing, and documentation. Some clinicians may wish to carry out video consultations from home to save time spent commuting but this, too, requires careful thought. Another consideration is the digital divide and support should be provided for patients who are less IT literate or who have no access to the digital world. Patients with special needs such as those with visual or hearing impairment and those with language issues also require consideration. We view video consultations as a developing and growing part of the portfolio of renal care. We see their main role in providing routine follow up to stable and IT literate outpatients, particularly where there is provider continuity and where care is provided across a large geographical area.

摘要

自新冠疫情以来,视频会诊在肾脏病学领域的应用日益广泛,其目的是解决面对面门诊能力的限制,以及患者在前往医疗机构就诊时对感染风险的担忧。肾脏病学家通过实践经验学会了使用视频会诊来提供常规随访,以及对病情不适的患者进行分诊。视频会诊的优点包括便利性、通过避免诊所运营成本实现成本节约,以及减少医疗护理的碳足迹。随着肾脏病学家考虑气候变化及其影响,最后一点的相关性日益增加。视频会诊并非解决肾脏病学挑战的万灵药,也存在风险,例如在重新设计诊疗路径以及在需要时维持面对面评估的可及性方面。考虑报销、开处方和记录等实际问题同样重要。一些临床医生可能希望在家中进行视频会诊以节省通勤时间,但这也需要仔细考虑。另一个需要考虑的是数字鸿沟,对于那些信息技术能力较低或无法接入数字世界的患者应提供支持。有特殊需求的患者,如视力或听力受损以及有语言问题的患者,也需要得到考虑。我们将视频会诊视为肾脏护理组合中一个不断发展和增长的部分。我们认为它们的主要作用是为稳定且具备信息技术能力的门诊患者提供常规随访,特别是在有医疗服务连续性且在大面积地理区域提供护理的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70c5/11635361/15fe4770af60/sfae287fig1.jpg

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