门诊医生大规模远程医疗的实施:从一个流行病适应的学习协作成果
David Wong1, Israel H Cross, Christian B Ramers
1Author Affiliations: Healthcare Resilience Working Group, U.S. National COVID-19 Response, Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services, Washington, District of Columbia (Drs Wong, Cross, Manteuffel, Hunt, England, and Jolly, and Ms Imtiaz, and Mr Jones, Mr Daly, Ms Yeager, and Ms Riley); Commissioned Corps of the U.S. Public Health Service (Drs Wong, Cross, and Manteuffel, Mr Daly, and Ms Riley); Laura Rodriguez Research Institute - Family Health Centers of San Diego, San Diego, California (Dr Ramers); ECHO Institute, University of New Mexico Health Sciences Center, Albuquerque, New Mexico (Drs Ramers and Struminger, Ms Dezan, and Ms Armistad); Deloitte Consulting, LLP, Arlington, Virginia (Ms Imtiaz and Ms Yeager); Digital Health, University of Washington, Seattle, Washington (Dr Scott); Yes And Leadership, LLC, Alexandria, Virginia (Mr Wagner); Center for Connected Health Policy, Sacramento, California (Ms Kwong and Mr Dizon); Public Health Foundation, Washington, District of Columbia (Ms Lamers and Mr Plotkin); Telehealth Consultant, Aveshka, Inc., Vienna, Virginia (Dr Jolly); Southwest Telehealth Resource Center, Tucson, Arizona (Dr Krupinski); Northeast Telehealth Resource Center, Augusta, Maine (Mr Solomon); Mid-Atlantic Telehealth Resource Center, Charlottesville, Virginia (Dr Wibberly).
在COVID-19大流行期间,一个为期10周的学习协作迅速扩大了门诊临床医生的远程医疗采用. 这种模式有效地传播了知识,并在紧急情况下解决了健康不平等问题.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学教育 医学教育
- 公共卫生 公共卫生
背景情况:
- 在专业环境之外,学习协作在改善医疗保健质量方面未得到充分利用.
- 由于COVID-19大流行,门诊医生需要快速采用远程医疗.
- 现有的知识传播模式对于公共卫生紧急情况可能不够灵活.
研究的目的:
- 描述一个缩写的,为期10周的学习协作模式 (远程医疗黑客),以促进远程医疗的实施.
- 评估该模型在各种门诊临床医生中的覆盖范围和影响.
- 评估该模型在快速扩展知识和解决健康差异方面的潜力.
主要方法:
- 实施了为期10周的"冲刺"学习协作格式.
- 从参与者那里收集了现场出席和调查数据.
- 分析了参与者的人口统计和实践特征,以及远程医疗访问计费数据.
主要成果:
- 学习协作",远程医疗黑客",每次会议平均有1688名参与者的现场出席.
- 基线调查包括1005名受访者:57%是临床医生,其中三分之一来自种族/种族少数群体.
- 71%的实践是初级保健,51%的农村和28%的社区卫生中心.
- 81% (438/540) 的临床医生在课程结束后至少收取了一次基于视频的远程医疗访问.
结论:
- 缩小学习协作"冲刺"模式是有效的快速远程医疗实施.
- 在公共卫生危机期间,这种方法成功地将知识传播扩展到一个庞大,多样化的临床医生群体.
- 该模型显示,通过改善获得远程医疗培训的机会,有望解决健康不平等问题.
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