PDF(Pubmed)
Abstract：
UNASSIGNED: The call to scale up telemedicine services globally as part of the digital health transformation lacks an agreed-upon set of constructs to guide the implementation process. A lack of guidance hinders the development, consolidation, sustainability and optimisation of telemedicine services. The study aims to reach consensus among telemedicine experts on a set of implementation constructs to be developed into an evidence-based support tool.
UNASSIGNED: A modified Delphi study was conducted to evaluate a set of evidence-informed telemedicine implementation constructs comprising cores, domains and items. The study evaluated the constructs consisting of five cores: Assessment of the Current Situation, Development of a Telemedicine Strategy, Development of Organisational Changes, Development of a Telemedicine Service, and Monitoring, Evaluation and Optimisation of Telemedicine Implementation; seven domains: Individual Readiness, Organisational Readiness, Clinical, Economic, Technological and Infrastructure, Regulation, and Monitoring, Evaluation and Optimisation; divided into 53 items. Global telemedicine specialists (n = 247) were invited to participate and evaluate 58 questions. Consensus was set at ≥70%.
UNASSIGNED: Forty-five experts completed the survey. Consensus was reached on 78% of the constructs evaluated. Regarding the core constructs, Monitoring, Evaluation and Optimisation of Telemedicine Implementation was determined to be the most important one, and Development of a Telemedicine Strategy the least. As for the domains, the Clinical one had the highest level of consensus, and the Economic one had the lowest.
UNASSIGNED: This research advances the field of telemedicine, providing expert consensus on a set of implementation constructs. The findings also highlight considerable divergence in expert opinion on the constructs of reimbursement and incentive mechanisms, resistance to change, and telemedicine champions. The lack of agreement on these constructs warrants attention and may partly explain the barriers that telemedicine services continue to face in the implementation process.
UNASSIGNED: A modified Delphi study was conducted to evaluate a set of evidence-informed telemedicine implementation constructs comprising cores, domains and items. The study evaluated the constructs consisting of five cores: Assessment of the Current Situation, Development of a Telemedicine Strategy, Development of Organisational Changes, Development of a Telemedicine Service, and Monitoring, Evaluation and Optimisation of Telemedicine Implementation; seven domains: Individual Readiness, Organisational Readiness, Clinical, Economic, Technological and Infrastructure, Regulation, and Monitoring, Evaluation and Optimisation; divided into 53 items. Global telemedicine specialists (n = 247) were invited to participate and evaluate 58 questions. Consensus was set at ≥70%.
UNASSIGNED: Forty-five experts completed the survey. Consensus was reached on 78% of the constructs evaluated. Regarding the core constructs, Monitoring, Evaluation and Optimisation of Telemedicine Implementation was determined to be the most important one, and Development of a Telemedicine Strategy the least. As for the domains, the Clinical one had the highest level of consensus, and the Economic one had the lowest.
UNASSIGNED: This research advances the field of telemedicine, providing expert consensus on a set of implementation constructs. The findings also highlight considerable divergence in expert opinion on the constructs of reimbursement and incentive mechanisms, resistance to change, and telemedicine champions. The lack of agreement on these constructs warrants attention and may partly explain the barriers that telemedicine services continue to face in the implementation process.
摘要：
■作为数字健康转型的一部分，在全球范围内扩大远程医疗服务的呼吁缺乏一套商定的架构来指导实施过程。缺乏指导阻碍了发展,合并，远程医疗服务的可持续性和优化。该研究旨在在远程医疗专家之间就一套将开发为基于证据的支持工具的实施结构达成共识。
■进行了一项改良的Delphi研究，以评估一组包含核心的循证远程医疗实施结构，域和项目。该研究评估了由五个核心组成的结构：现状评估，制定远程医疗战略，组织变革的发展，远程医疗服务的发展，监测,远程医疗实施的评估和优化；七个领域：个人准备情况，组织准备,临床,经济,技术和基础设施，Regulation,监测,评估和优化；分为53项。全球远程医学专家（n=247）应邀参加并评估了58个问题。共识设定为≥70%。
■45名专家完成了调查。对78%的评估结构达成共识。关于核心结构，Monitoring,远程医疗实施的评估和优化被确定为最重要的一项，和远程医疗战略的发展最少。至于域，临床上有最高的共识，而经济的是最低的。
■这项研究推进了远程医疗领域，就一套实施结构提供专家共识。调查结果还突显了专家对补偿和激励机制结构的意见分歧，抵抗变化,和远程医疗冠军。对这些结构缺乏共识值得关注，并可能部分解释了远程医疗服务在实施过程中继续面临的障碍。
■进行了一项改良的Delphi研究，以评估一组包含核心的循证远程医疗实施结构，域和项目。该研究评估了由五个核心组成的结构：现状评估，制定远程医疗战略，组织变革的发展，远程医疗服务的发展，监测,远程医疗实施的评估和优化；七个领域：个人准备情况，组织准备,临床,经济,技术和基础设施，Regulation,监测,评估和优化；分为53项。全球远程医学专家（n=247）应邀参加并评估了58个问题。共识设定为≥70%。
■45名专家完成了调查。对78%的评估结构达成共识。关于核心结构，Monitoring,远程医疗实施的评估和优化被确定为最重要的一项，和远程医疗战略的发展最少。至于域，临床上有最高的共识，而经济的是最低的。
■这项研究推进了远程医疗领域，就一套实施结构提供专家共识。调查结果还突显了专家对补偿和激励机制结构的意见分歧，抵抗变化,和远程医疗冠军。对这些结构缺乏共识值得关注，并可能部分解释了远程医疗服务在实施过程中继续面临的障碍。
