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A Practical Guide to Emergency Telehealth最新文献

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Remote Physiologic Monitoring 远程生理监测
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0020
Ksenya K. Badashova, T. Haile-Mariam, Robert Jarrin
{"title":"Remote Physiologic Monitoring","authors":"Ksenya K. Badashova, T. Haile-Mariam, Robert Jarrin","doi":"10.1093/med/9780190066475.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0020","url":null,"abstract":"Remote physiologic monitoring (RPM) allows for the collection and transmission of clinical information from a patient to a clinician for evaluation (and potentially intervention) in a synchronous or asynchronous manner. The initiation and judicious utilization of RPM is fundamental to distance-based medical care and provides opportunities to improve clinical outcomes and decrease utilization of resources. COVID-19’s stress on medical systems has encouraged innovations, including those that incorporate RPM. Emergency Department (ED) RPM programs have shown that COVID-19 patients at risk for clinical decompensation can successfully be monitored and treated at home. RPM can capitalize on emergency medicine’s (EM’s) role as the interface between in-patient and out-patient care to implement increasingly complex medical services to patients in nontraditional health care settings. Despite their promise, the development and implementation of RPM programs is a challenging task that requires investment in human and other resources. The role of RPM in expanding EM and ED-based clinical care to improve patient outcomes and decrease costs will require continued investigations and innovations.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"790 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126953281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of Telemedicine in Guiding Rural Emergent Neurosurgical Care 远程医疗在指导农村神经外科急诊护理中的作用
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0010
M. Chohan, M. Stippler, Susy Salvo Wendt, H. Yonas
{"title":"Role of Telemedicine in Guiding Rural Emergent Neurosurgical Care","authors":"M. Chohan, M. Stippler, Susy Salvo Wendt, H. Yonas","doi":"10.1093/med/9780190066475.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0010","url":null,"abstract":"Teleneurosurgery can play a vital role in the care of patients in hospitals and community health settings where neurosurgical expertise is not available. The combination of audiovisual interaction of a neurosurgeon with the emergency physician, the patient and the patient’s family, combined with an intense education program delivered to the originating site care team, has greatly enhanced the appropriate triage of patients in community hospitals. The result is better patient care, improved patient and family satisfaction, cost savings, and the retention of patients within the local community care system, as well as the improved sustainability of the wider health delivery system. To succeed, start-up financial support is often needed to provide the required technical elements and 24/7 neurosurgical availability.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":" 13","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120834793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality Assessment in Emergency Telehealth 紧急远程医疗的质量评估
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0005
J. Goldwater, Judd E. Hollander
{"title":"Quality Assessment in Emergency Telehealth","authors":"J. Goldwater, Judd E. Hollander","doi":"10.1093/med/9780190066475.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0005","url":null,"abstract":"Telemedicine is a modality for care delivery. The medicine is the same, but the manner in which it is delivered differs. As a result, quality should be assessed based on the care rendered for the given condition as well as in accordance with the National Quality Forum (NQF) Telemedicine framework, which has four domains—access, cost/financial, experience, and effectiveness. This framework for quality provides a foundation for developing objective measures to assess emergency telehealth. Among NQF Committee’s findings was that the use of various telehealth modalities improved access to health care services. The NQF also recommended measuring whether sufficient information was obtained during a telemedicine encounter to make clinical decisions regarding intervening or not intervening. It found that obtaining the appropriate actionable information was more important than measuring diagnostic accuracy.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132276104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Telehealth Adoption and Patient Engagement 远程医疗采用和患者参与
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0004
A. Aalam, K. Osman, Aaron Martin
{"title":"Telehealth Adoption and Patient Engagement","authors":"A. Aalam, K. Osman, Aaron Martin","doi":"10.1093/med/9780190066475.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0004","url":null,"abstract":"Successful implementation of telehealth services should incorporate adoption and engagement strategies for all key stakeholders, including clinicians, patients, and administration, to maximize utilization and benefit. These strategies should be included in an implementation plan developed by an invested leadership team. This team will build the infrastructure, bring resources, assess their institution and population needs, and review policies and regulations needed to execute their strategic plan. Successful telehealth programs live within a comprehensive digital engagement and population health strategy. In this chapter we examine multiple tools and concepts to drive adoption and engagement from each stakeholder’s perspective.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125141312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Telestroke and Teleneurology 远程中风和远程神经学
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0008
H. Gross, J. Switzer
{"title":"Telestroke and Teleneurology","authors":"H. Gross, J. Switzer","doi":"10.1093/med/9780190066475.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0008","url":null,"abstract":"Evaluation and treatment of acute stroke is the oldest and most widespread application of telemedicine. Telestroke systems allow provision of the same high quality of care provided at specialized stroke centers to patients at emergency departments without stroke coverage. The early treatment achieved with telestroke leads to better functional outcomes in stroke patients, thereby lowering overall cost of patient care. Telestroke networks facilitate optimal care, decrease hospital and physician liability, educate health care professionals, and keep many patients closer to home. Admissions to, rather than transfers from, rural sites retain hospitalization revenues locally and help keep small, financially struggling hospitals viable.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"4 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131438163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Telemedicine in the Surgical Disciplines 外科学科中的远程医疗
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0013
Ariel P. Santos, Davin T. Combs, Y. Ajabnoor, Cameron Onks
{"title":"Telemedicine in the Surgical Disciplines","authors":"Ariel P. Santos, Davin T. Combs, Y. Ajabnoor, Cameron Onks","doi":"10.1093/med/9780190066475.003.0013","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0013","url":null,"abstract":"In acute care surgery, regional trauma centers and the American College of Surgeons Committee of Trauma (COT) have worked to address the fundamental challenge of patient stabilization at remote referring facilities, followed by timely patient transfers. However, limitations with patient transport still exist because of adverse weather and lack of emergency vehicles or logistics for emergent transport, demanding ongoing patient care at the originating site. Integration of telemedicine protocols in regional trauma systems has been shown to be effective in facilitating appropriate and timely patient transfers and helps improve the efficacy of resuscitative care in critical-access facilities. Telemedicine has also been shown to be an effective means of service delivery for preoperative, operative and postoperative consultations, reducing time and cost barriers for patients living in remote areas and improving adherence to treatment plans. This increased continuity of care promotes positive outcomes and reduces preventable hospital admissions. Telemedicine also plays a role in surgical education, preceptorship, and mentorship, as well as continuing medical education and multidisciplinary conferences.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115862982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tele-Ultrasound Tele-Ultrasound
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0023
E. Dearing, K. Boniface
{"title":"Tele-Ultrasound","authors":"E. Dearing, K. Boniface","doi":"10.1093/med/9780190066475.003.0023","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0023","url":null,"abstract":"Ultrasound is a noninvasive, nonionizing, relatively low-cost imaging modality that has increased in use in all fields of medicine over the past few decades. With growth in internet connectivity as well as marked improvements in ultrasound technology, ultrasound can now help guide remote clinical decision making using either synchronous or asynchronous imaging. Implementing a tele-ultrasound program requires an ultrasound machine with the ability to share or transmit images, a provider to perform the exam, and a remote expert for guidance and/or interpretation. Tele-ultrasound can therefore be used by a variety of health care professionals with less ultrasound training under the remote guidance of an experienced physician trained in ultrasound to help care for patients. Tele-ultrasound enables more advanced care in resource-limited settings. As telehealth continues to grow, the use of tele-ultrasound will undoubtedly have an important role in guiding clinical care.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115093959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emergency Telepsychiatry 紧急远程精神病治疗
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0009
E. Horwath, Thomas Dell, Zeina Saliba
{"title":"Emergency Telepsychiatry","authors":"E. Horwath, Thomas Dell, Zeina Saliba","doi":"10.1093/med/9780190066475.003.0009","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0009","url":null,"abstract":"Emergency telepsychiatry is the evaluation and treatment of patients experiencing mental health crises using audio/video communications. Patients in hospital emergency departments (EDs) often experience long waits, delayed treatment, and uncomfortable conditions when in-person psychiatric care is not readily available; prolonged lengths of stay in the ED also increase hospital costs. Telepsychiatry can make psychiatric care more accessible and timely by linking mental health specialists in various locations to patients in EDs. Initial data indicate that the financial investment in emergency telepsychiatry is more than offset by savings in ED and hospital costs. Rapid availability of telepsychiatric consultation also improves the quality of care in EDs and leads to more appropriate and timely dispositions of patients.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133861489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical Subspecialty Telehealth Consults 医疗亚专业远程医疗咨询
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0012
S. Lew, Shailendra Sharma, M. Siegel, H. Akselrod, Simranjit Kaur, Anita B. Kumar, M. Borum, H. Gross
{"title":"Medical Subspecialty Telehealth Consults","authors":"S. Lew, Shailendra Sharma, M. Siegel, H. Akselrod, Simranjit Kaur, Anita B. Kumar, M. Borum, H. Gross","doi":"10.1093/med/9780190066475.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0012","url":null,"abstract":"Health care reforms are advancing new care models that emphasize population-based outcomes. Emergency clinicians are challenged to provide coordinated care with limited resources. Emerging value-based models create the incentives for emergency clinicians to collaborate with specialists to provide high-quality care while lowering cost by reducing admissions when possible. Subspecialty consultation may be difficult to obtain in regions where the population does not support a subspecialist or where there is a workforce shortage. However, obtaining a telehealth subspecialist consult from a remote pool, local network, or established patient–physician relationship can provide such a service. Several use-cases are presented to illustrate how telehealth subspecialty consultation from the emergency department can change patient care and outcomes.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"21 12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133530692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Telehealth Facilitates Value-Based Care in Emergency Department Settings 远程医疗促进急诊部门设置的基于价值的护理
A Practical Guide to Emergency Telehealth Pub Date : 2021-11-01 DOI: 10.1093/med/9780190066475.003.0022
D. Mulligan, Krista Drobac, R. Shesser
{"title":"Telehealth Facilitates Value-Based Care in Emergency Department Settings","authors":"D. Mulligan, Krista Drobac, R. Shesser","doi":"10.1093/med/9780190066475.003.0022","DOIUrl":"https://doi.org/10.1093/med/9780190066475.003.0022","url":null,"abstract":"Spurred by the COVID-19 pandemic, the health care industry is increasingly aware of benefits emergency physicians could contribute to value-based care. The use of emergency telehealth—to reduce the number of hospital admissions, readmissions, and missed outpatient follow-up appointments—will play an increasing role in the shift to value-based care paradigms. Although certain legal, regulatory, and reimbursement challenges remain, the COVID-19 outbreak should stimulate lawmakers and regulatory agencies to promulgate further measures that facilitate widespread adoption of telemedicine, which will inevitably extend into emergency care. Emergency physicians should play a leadership role in the development and implementation of coordinated care before, during, and after acute unscheduled care needs of patients. Coordinated care is a recognized role of emergency telehealth in the value chain. For emergency telehealth to be effective, it must be appropriately integrated into standard practice of emergency medicine.","PeriodicalId":413202,"journal":{"name":"A Practical Guide to Emergency Telehealth","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124664242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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