@文章{信息:doi/10.2196/31374，作者=“Wherton, Joseph和Greenhalgh, Trisha和Shaw, Sara E”，标题=“在COVID-19大流行期间，苏格兰以速度和规模扩大视频咨询服务:国家混合方法案例研究”，期刊=“J Med Internet Res”，年=“2021”，月=“10”，日=“7”，卷=“23”，数=“10”，页=“e31374”，关键词=“技术支持的护理;视频磋商;质量改进;COVID-19;PERCS框架”，摘要=“背景:苏格兰是一个拥有550万人口的国家，地势崎岖，有许多偏远的岛屿，这给许多公民的出行带来了挑战。长期以来，政府一直试图通过一系列措施来缓解这些问题，其中包括一项雄心勃勃的技术支持护理计划。2017年开始实施全国视频咨询服务发展战略。我们的混合方法评估于2019年年中启动，并扩展到2020年的大流行应对。目的:从大流行之前和期间对苏格兰视频咨询服务的引入、传播和扩大进行的全国评估中吸取教训。方法:数据来源包括223次访谈(与患者、工作人员、技术提供者和政策制定者)、60小时的人种学观察(包括亲自前往偏远地区)、患者和工作人员满意度调查(n=20,349)、专业和公众参与问卷(n=5400)、统计数据以及地方和国家文件。 Fieldwork during the pandemic was of necessity conducted remotely. Data were analyzed thematically and theorized using the Planning and Evaluating Remote Consultation Services (PERCS) framework which considers multiple influences interacting dynamically and unfolding over time. Results: By the time the pandemic hit, there had been considerable investment in material and technological infrastructure, staff training, and professional and public engagement. Scotland was thus uniquely well placed to expand its video consultation services at pace and scale. Within 4 months (March-June 2020), the number of video consultations increased from about 330 to 17,000 per week nationally. While not everything went smoothly, video was used for a much wider range of clinical problems, vastly extending the prepandemic focus on outpatient monitoring of chronic stable conditions. The technology was generally considered dependable and easy to use. In most cases (14,677/18,817, 78{\%}), patients reported no technical problems during their postconsultation survey. Health care organizations' general innovativeness and digital maturity had a strong bearing on their ability to introduce, routinize, and expand video consultation services. Conclusions: The national-level groundwork before the pandemic allowed many services to rapidly extend the use of video consultations during the pandemic, supported by a strong strategic vision, a well-resourced quality improvement model, dependable technology, and multiple opportunities for staff to try out the video option. Scotland provides an important national case study from which other countries may learn. ", issn="1438-8871", doi="10.2196/31374", url="//www.mybigtv.com/2021/10/e31374", url="https://doi.org/10.2196/31374", url="http://www.ncbi.nlm.nih.gov/pubmed/34516389" }