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[将专业知识引入该领域:新冠疫情远程会诊分析及基于场景的建议]

[Bringing Expertise to the Field: Analysis of COVID-19 Teleconsultations and Scenario-based Recommendations].

作者信息

Neft Florian, Kappler Karolin Eva, Dohmen Sandra Maria, Juhra Christian, Sperling Kathrin, Bause Daniela, Smolnik Stefan

机构信息

FernUniversität in Hagen, Hagen, Deutschland.

Katholische Hochschule Nordrhein-Westfalen, Köln, Deutschland.

出版信息

HMD Prax Wirtsch Inform. 2022;59(6):1564-1576. doi: 10.1365/s40702-022-00920-6. Epub 2022 Oct 31.

DOI:10.1365/s40702-022-00920-6
PMID:40477733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9628489/
Abstract

The emergence of the unknown disease COVID-19 and the increasing number of COVID-19 cases challenged the health system. General, standard care hospitals were largely unfamiliar with the treatment of severe respiratory failure up to then, and so this knowledge had to be transferred from university hospitals to standard care ones. Therefore, intensive care physicians within the preliminary stage of the virtual hospital North Rhine-Westphalia (VKh.NRW) used teleconsultations. Teleconsultations occur between two intensive care physicians, make expertise anywhere available and increase treatment quality and efficiency. The evaluation of these teleconsultations shows different scenarios. Whereas initially, the enquirers largely addressed general diagnostic and therapy question regarding the COVID-19 treatment, they arose more detailed questions later, necessitating a specialist, such as a pharmacologist. This scenario demands more explicit knowledge, and, thus, increased technology requirements. Barriers appear in the context of this technical infrastructure. Therefore, we evaluate which knowledge is transferred within different teleconsultation scenarios and which technology requirements must be fulfilled to increase the use of teleconsultation and, thus, improve the health system.

摘要

未知疾病新冠病毒病(COVID-19)的出现以及COVID-19病例数量的增加给卫生系统带来了挑战。在此之前,普通的标准护理医院对严重呼吸衰竭的治疗大多并不熟悉,因此这种知识必须从大学医院传授给标准护理医院。因此,在北莱茵-威斯特法伦虚拟医院(VKh.NRW)的初始阶段,重症监护医生采用了远程会诊。远程会诊发生在两名重症监护医生之间,能让专业知识随时随地可用,并提高治疗质量和效率。对这些远程会诊的评估显示出不同的情况。最初,咨询者大多提出关于COVID-19治疗的一般诊断和治疗问题,后来他们提出了更详细的问题,这就需要一名专家,比如一名药理学家。这种情况需要更明确的知识,因此对技术的要求也更高。在这种技术基础设施的背景下出现了障碍。因此,我们评估在不同的远程会诊场景中传递了哪些知识,以及必须满足哪些技术要求才能增加远程会诊的使用,从而改善卫生系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/044c/9628489/1b2e851340f4/40702_2022_920_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/044c/9628489/1b2e851340f4/40702_2022_920_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/044c/9628489/1b2e851340f4/40702_2022_920_Fig1_HTML.jpg

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本文引用的文献

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Anasthesiol Intensivmed Notfallmed Schmerzther. 2022 Mar;57(3):211-220. doi: 10.1055/a-1423-7982. Epub 2022 Mar 23.
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An Innovative Telemedical Network to Improve Infectious Disease Management in Critically Ill Patients and Outpatients (TELnet@NRW): Stepped-Wedge Cluster Randomized Controlled Trial.一种创新的远程医疗网络,用于改善危重症患者和门诊患者的传染病管理(TELnet@NRW):阶梯式楔形集群随机对照试验。
J Med Internet Res. 2022 Mar 2;24(3):e34098. doi: 10.2196/34098.
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医疗保健中的远程医疗:能力、特点、障碍及应用
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