在一个学术医疗中心的远程皮肤学虚拟诊所的实施评估
Meenal K Kheterpal1, Ethan D Borre2, Udeyvir Cheema3
1Department of Dermatology, Duke University Medical Center, DUMC Box 3135, Durham, NC, 27710, USA. meenal.kheterpal@duke.edu.
Implementation science communications
|October 27, 2023
概括
远程皮肤病学 (TD) 改善了获得皮肤病治疗的机会. 使用EPIS和RE-AIM框架的混合TD模型显示了高患者满意度,但采用程度不同,突出了未来扩张的障碍和促进者.
科学领域:
- 实施科学 实施科学
- 数字健康数字健康
- 皮肤病学 皮肤病学
背景情况:
- 远程皮肤病学 (TD) 是一种基于证据的实践,旨在增加获得皮肤病治疗的机会.
- 探索,准备,实施和维持 (EPIS) 和覆盖范围,效率,采用,实施和维护 (RE-AIM) 的框架被用来指导 TD 的实施.
- 研究设计中解决了以前存储和转发和同步TD模型的障碍.
研究的目的:
- 评估杜克大学卫生系统的混合远程皮肤病学计划的实施情况.
- 充分利用现有系统的优势,解决已知的 TD 实施障碍.
- 评估患者满意度,并确定 TD 采用障碍和促进者的障碍.
主要方法:
- 开发了一种混合TD模型,涉及初级保健提供者 (PCP) 发送带图像的电子推以进行异步审查,随后进行同步视频访问.
- 该试点计划在四个初级保健诊所实施.
- 通过电子健康记录,患者满意度调查和提供者调查收集数据.
主要成果:
- 在2021年9月至2022年4月期间,有218个TD转介.
- 视频访问发生在转诊后7.5天内,报告了100%的患者满意度.
- 临床采用率差异很大 (2%至22%),主要障碍包括时间限制,工作流集成和图像拍摄不适.
结论:
- 实施科学框架促进了对混合TD试点的系统和上下文优势的识别.
- 确定了障碍物和促进者将为未来的远程皮肤病学服务的扩展和维护提供信息.
- 该研究为优化在各种临床环境中实施 TD 提供了指导.
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