@文章{信息:doi/10.2196/28503，作者=“Bailey, James E和Gurgol, Cathy和Pan, Eric和Njie, Shirilyn和Emmett, Susan和Gatwood, Justin和Gauthier, Lynne和Rosas, Lisa G和Kearney, Shannon M和Robler, Samantha Kleindienst和Lawrence, Raymona H和Margolis, Karen L和Osunkwo, Ifeyinwa和Wilfley, Denise和Shah, Vallabh O”，标题=“早期以患者为中心的结果研究经验与使用远程医疗解决差异:范围综述”，期刊=“J Med Internet Res”，年=“2021”，月=“12”，日=“7”，卷=“23”，号=“12”，页=“e28503”，关键词=“远程医疗;范围审查;差距;背景:美国各地的卫生系统和医疗服务提供者越来越多地采用远程医疗技术，以更好地为医疗服务不足的低收入、少数族裔和农村人口提供服务，这些人群的健康差异风险最高。以患者为中心的结果研究所(PCORI)已投资3.86亿美元用于远程医疗的比较有效性研究，但从这项研究中获得的关于使用远程医疗解决差距的最佳实践的关键早期经验教训鲜为人知。目的:本文描述了从PCORI开创性的以患者为中心的结果研究(PCOR)项目中获得的研究结果和案例研究的初步经验教训。主要目的是查明在存在差异风险的人口中实施远程保健技术的共同障碍和促进因素。方法:对解决差异的远程医疗研究进行了系统的范围审查。它以Arksey和O'Malley范围审查框架为指导，重点关注PCORI的远程医疗研究活跃组合和研究人员确定的关键PCOR。 We drew on this broad literature using illustrative examples from early PCOR experience and published literature to assess barriers and facilitators to implementing telehealth in populations at risk for disparities, using the active implementation framework to extract data. Major themes regarding how telehealth interventions can overcome barriers to telehealth adoption and implementation were identified through this review using an iterative Delphi process to achieve consensus among the PCORI investigators participating in the study. Results: PCORI has funded 89 comparative effectiveness studies in telehealth, of which 41 assessed the use of telehealth to improve outcomes for populations at risk for health disparities. These 41 studies employed various overlapping modalities including mobile devices (29/41, 71{\%}), web-based interventions (30/41, 73{\%}), real-time videoconferencing (15/41, 37{\%}), remote patient monitoring (8/41, 20{\%}), and store-and-forward (ie, asynchronous electronic transmission) interventions (4/41, 10{\%}). The studies targeted one or more of PCORI's priority populations, including racial and ethnic minorities (31/41, 41{\%}), people living in rural areas, and those with low income/low socioeconomic status, low health literacy, or disabilities. Major themes identified across these studies included the importance of patient-centered design, cultural tailoring of telehealth solutions, delivering telehealth through trusted intermediaries, partnering with payers to expand telehealth reimbursement, and ensuring confidential sharing of private information. Conclusions: Early PCOR evidence suggests that the most effective health system- and provider-level telehealth implementation solutions to address disparities employ patient-centered and culturally tailored telehealth solutions whose development is actively guided by the patients themselves to meet the needs of specific communities and populations. Further, this evidence shows that the best practices in telehealth implementation include delivery of telehealth through trusted intermediaries, close partnership with payers to facilitate reimbursement and sustainability, and safeguards to ensure patient-guided confidential sharing of personal health information. ", issn="1438-8871", doi="10.2196/28503", url="//www.mybigtv.com/2021/12/e28503", url="https://doi.org/10.2196/28503", url="http://www.ncbi.nlm.nih.gov/pubmed/34878986" }