TY -非盟的濑户,艾米丽AU -史密斯,达拉斯盟——雅克·马特盟——盛田Plinio Pelegrini PY - 2019 DA - 2019/11/1 TI -远程医疗在偏远社区的机遇和挑战:育空远程医疗系统的案例研究乔-地中海JMIR通知SP - e11353六世- 7 - 4 KW -卫生保健系统KW -远程医疗KW -远程咨询KW -育空地区KW -远程医疗KW -项目评估KW -医学信息学AB -背景:远程保健已被证明可以改善获得卫生保健的机会，并降低病人和卫生保健系统的费用，特别是对生活在农村环境中的病人而言。然而，在偏远社区实施远程保健时出现了独特的挑战。目的:本研究旨在探索育空远程医疗系统的当前使用、挑战和机遇。从这项研究中获得的经验教训被用来确定在试图推进和扩大偏远社区远程医疗项目时需要考虑的重要因素。方法:采用混合方法评估育空远程医疗系统，并确定可能的未来进展。定量数据通过使用日志获得。基于网络的调查问卷被分发给Whitehorse以外的14个育空社区卫生中心的护士和使用过远程保健的患者。定性数据包括对36个远程保健利益攸关方的焦点小组和半结构化访谈。结果:自2008年以来，远程医疗会议的数量一直保持在每年1000次左右，以临床护理为主要用途(2015年占所有会议的69.06%[759/1099])。 From the questionnaire (11 community nurses and 10 patients) and the interview data, there was a consensus among the clinicians and patients that the system provided timely access and cost savings from reduced travel. However, they believed that it was underutilized, and the equipment was outdated. The following 4 factors were identified, which should be considered when trying to advance and expand a telehealth program: (1) patient and clinician buy-in: past telehealth experiences (eg, negative clinician experiences with outdated technology) should be considered when advancing the system. Expansion of services in orthopedics, dermatology, and psychiatry were found to be particularly feasible and beneficial in Yukon; (2) workflow: the use and scheduling of telehealth should be streamlined and automated as much as possible to reduce dependencies on the single Yukon telehealth coordinator; (3) access to telehealth technology: clinicians and patients should have easy access to up-to-date telehealth technology. The use of consumer products, such as mobile technology, should be leveraged as appropriate; and (4) infrastructure: the required human resources and technology need to be established when expanding and advancing telehealth. Conclusions: While clinicians and patients had generally positive perceptions of the Yukon Telehealth System, there was consensus that it was underutilized. Many opportunities exist to expand the types of telehealth services and the number of telehealth sessions, including the expansion of services in several new specialty areas, updating telehealth equipment to streamline workflows and increase convenience and uptake, and integrating novel technologies. The identified barriers and recommendations from this evaluation can be applied to the development and expansion of telehealth in other remote communities to realize telehealth’s potential for providing efficient, safe, convenient, and cost-effective care delivery. SN - 2291-9694 UR - http://medinform.www.mybigtv.com/2019/4/e11353/ UR - https://doi.org/10.2196/11353 UR - http://www.ncbi.nlm.nih.gov/pubmed/31682581 DO - 10.2196/11353 ID - info:doi/10.2196/11353 ER -