PDF(Pubmed)
Abstract：
BACKGROUND: Few studies have been conducted on the usage of telehealth focusing on consultations between patients\' families and physicians. This study aimed to identify the usage and limitations of online medical consultations with patients\' families compared to the traditional in-person consultations.
METHODS: We conducted a prospective cohort study from April 1, 2020, to September 30, 2021, at an educational acute-care hospital in Japan. The study included hospitalized patients aged 20 years or older and their family members for whom an online or in-person medical consultation between the family member and physician was conducted during the hospitalization period. The primary endpoints assessed were three topics pertaining to medical consultation: medical conditions and treatment plans, policies for life-threatening events, and post-discharge support. The secondary endpoint was the number of consultations required.
RESULTS: Online consultations and traditional in-person consultations were provided to 58 and 53 patients\' families, respectively. Of the patients in the online consultation group who underwent multiple consultations, 46 (79%) also underwent in-person consultations. Regarding the topics, all the patients\' families in both consultation groups had consultations on medical conditions and treatment plans; regarding the policy for life-threatening events, 47% of patient families in the online consultation group were consulted compared to 53% of those in the in-person group. Regarding post-discharge support, 59% of patient families in the online group were consulted compared to 40% in the in-person group. In the online consultation group of 58 patients\' families, 188 consultations were conducted, including 95 online and 93 in-person consultations. Consultations on policy for life-threatening events were significantly more frequent in in-person consultations than in online consultations (p < 0.05). Regarding post-discharge support, online consultations were significantly more frequent than in-person consultations (p < 0.05). The number of family members who attended online consultations was significantly higher than those who attended in-person consultations (p < 0.05).
CONCLUSIONS: Online consultation between the physician and patient\'s family may be an alternative to in-person consultation for explaining medical conditions and treatment plans. However, in-person consultation still plays an important role in sensitive topics, such as policy consultation for life-threatening events.
METHODS: We conducted a prospective cohort study from April 1, 2020, to September 30, 2021, at an educational acute-care hospital in Japan. The study included hospitalized patients aged 20 years or older and their family members for whom an online or in-person medical consultation between the family member and physician was conducted during the hospitalization period. The primary endpoints assessed were three topics pertaining to medical consultation: medical conditions and treatment plans, policies for life-threatening events, and post-discharge support. The secondary endpoint was the number of consultations required.
RESULTS: Online consultations and traditional in-person consultations were provided to 58 and 53 patients\' families, respectively. Of the patients in the online consultation group who underwent multiple consultations, 46 (79%) also underwent in-person consultations. Regarding the topics, all the patients\' families in both consultation groups had consultations on medical conditions and treatment plans; regarding the policy for life-threatening events, 47% of patient families in the online consultation group were consulted compared to 53% of those in the in-person group. Regarding post-discharge support, 59% of patient families in the online group were consulted compared to 40% in the in-person group. In the online consultation group of 58 patients\' families, 188 consultations were conducted, including 95 online and 93 in-person consultations. Consultations on policy for life-threatening events were significantly more frequent in in-person consultations than in online consultations (p < 0.05). Regarding post-discharge support, online consultations were significantly more frequent than in-person consultations (p < 0.05). The number of family members who attended online consultations was significantly higher than those who attended in-person consultations (p < 0.05).
CONCLUSIONS: Online consultation between the physician and patient\'s family may be an alternative to in-person consultation for explaining medical conditions and treatment plans. However, in-person consultation still plays an important role in sensitive topics, such as policy consultation for life-threatening events.
摘要：
背景：很少有关于远程医疗使用的研究侧重于患者家属和医生之间的咨询。这项研究旨在确定与传统的面对面咨询相比，与患者家属进行在线医疗咨询的用法和局限性。
方法：我们于2020年4月1日至2021年9月30日在日本一家教育急性护理医院进行了一项前瞻性队列研究。该研究包括20岁或以上的住院患者及其家庭成员，在住院期间进行家庭成员和医生之间的在线或面对面医疗咨询。评估的主要终点是与医疗咨询有关的三个主题：医疗条件和治疗计划，针对危及生命事件的政策，和出院后的支持。次要终点是所需的咨询次数。
结果：为58和53名患者家属提供了在线咨询和传统的面对面咨询，分别。在线咨询小组中接受多次咨询的患者中，46人(79%)也接受了面对面的咨询。关于主题，两个咨询小组中的所有患者家属都就医疗条件和治疗计划进行了咨询；关于危及生命事件的政策，在线咨询小组中有47％的患者家属接受了咨询，而当面小组中有53％的患者家属接受了咨询。关于放电后的支持，在线组中59％的患者家属接受了咨询，而当面组中则为40％。在由58名患者家属组成的在线咨询小组中，进行了188次磋商，包括95次在线咨询和93次面对面咨询。关于危及生命事件政策的咨询在面对面咨询中明显高于在线咨询(p<0.05)。关于放电后的支持，在线咨询明显高于面对面咨询(p<0.05).参加在线咨询的家庭成员数量明显高于参加面对面咨询的家庭成员（p<0.05）。
结论：医生和患者家属之间的在线咨询可能是解释医疗状况和治疗计划的面对面咨询的替代方法。然而,面对面咨询在敏感话题中仍然发挥着重要作用，如危及生命事件的政策咨询。
方法：我们于2020年4月1日至2021年9月30日在日本一家教育急性护理医院进行了一项前瞻性队列研究。该研究包括20岁或以上的住院患者及其家庭成员，在住院期间进行家庭成员和医生之间的在线或面对面医疗咨询。评估的主要终点是与医疗咨询有关的三个主题：医疗条件和治疗计划，针对危及生命事件的政策，和出院后的支持。次要终点是所需的咨询次数。
结果：为58和53名患者家属提供了在线咨询和传统的面对面咨询，分别。在线咨询小组中接受多次咨询的患者中，46人(79%)也接受了面对面的咨询。关于主题，两个咨询小组中的所有患者家属都就医疗条件和治疗计划进行了咨询；关于危及生命事件的政策，在线咨询小组中有47％的患者家属接受了咨询，而当面小组中有53％的患者家属接受了咨询。关于放电后的支持，在线组中59％的患者家属接受了咨询，而当面组中则为40％。在由58名患者家属组成的在线咨询小组中，进行了188次磋商，包括95次在线咨询和93次面对面咨询。关于危及生命事件政策的咨询在面对面咨询中明显高于在线咨询(p<0.05)。关于放电后的支持，在线咨询明显高于面对面咨询(p<0.05).参加在线咨询的家庭成员数量明显高于参加面对面咨询的家庭成员（p<0.05）。
结论：医生和患者家属之间的在线咨询可能是解释医疗状况和治疗计划的面对面咨询的替代方法。然而,面对面咨询在敏感话题中仍然发挥着重要作用，如危及生命事件的政策咨询。
