期刊文章JMIR出版物基于异步电子通信的访问对临床结果和医疗保健提供的卡塔尔世界杯8强波胆分析影响:系统综述%A Nguyen,Oliver T %A Alishahi Tabriz,Amir %A Huo,Jinhai %A Hanna,Karim %A Shea,Christopher M %A Turner,Kea %+健康结果和行为部，Moffitt癌症中心，12902 USF Magnolia Drive, MRC-CANCONT，佛罗里达州坦帕，33612,1 (813)745 5213，kea.turner@moffitt.org %K远程医疗%K远程健康%K电子访问%K电子访问%K数字护理%K结果%K交付%K复查%K访问%K利用率%K费用%K患者门户%K eHealth %D 2021 %7 5.5.2021 %9审查%J J医学互联网Res %G英文%X背景:电子访问(e访问)涉及临床医生和患者之间通过一个安全的基于web的平台(如患者门户)进行异步通信，以引出症状并确定诊断和治疗计划。由于COVID-19大流行，电子诊疗现在可以通过医疗保险进行补偿。关于电子会诊的证据状况，如对临床结果和保健服务的影响，尚不清楚。目的:为了解决这一差距，我们研究了电子访问如何影响临床结果和医疗保健质量、获取、利用和成本。方法:系统回顾;从2000年1月到2020年10月，我们搜索了MEDLINE、Embase和Web of Science，以了解评估电子访问对临床和医疗保健提供结果影响的同行评审研究。结果:1859篇论文中，有19篇符合纳入标准。E-visit的使用与改善或类似的临床结果相关，特别是在慢性疾病管理(如糖尿病护理、血压管理)方面。 The impact on quality of care varied across conditions. Quality of care was equivalent or better for chronic conditions, but variable quality was observed in infection management (eg, appropriate antibiotic prescribing). Similarly, the impact on health care utilization varied across conditions (eg, lower utilization for dermatology but mixed impact in primary care). Health care costs were lower for e-visits than those for in-person visits for a wide range of conditions (eg, dermatology and acute visits). No studies examined the impact of e-visits on health care access. It is difficult to draw firm conclusions about effectiveness or impact on care delivery from the studies that were included because many used observational designs. Conclusions: Overall, the evidence suggests e-visits may provide clinical outcomes that are comparable to those provided by in-person care and reduce health care costs for certain health care conditions. At the same time, there is mixed evidence on health care quality, especially regarding infection management (eg, sinusitis, urinary tract infections, conjunctivitis). Further studies are needed to test implementation strategies that might improve delivery (eg, clinical decision support for antibiotic prescribing) and to assess which conditions can be managed via e-visits. %M 33843592 %R 10.2196/27531 %U //www.mybigtv.com/2021/5/e27531 %U https://doi.org/10.2196/27531 %U http://www.ncbi.nlm.nih.gov/pubmed/33843592