Abstract:
Background: Telehealth care is now a key element of mainstream health care since the COVID-19 pandemic, with all types of health care providers joining the digital revolution. As a population experiencing health care disparities, adults with developmental disabilities and their supporters have described variable experiences with telehealth care that contribute to overall care quality and health outcomes. Methods: This e-Delphi study established consensus on best practices in telehealth care for adults with developmental disabilities in the United States. Online surveys and videoconferencing interviews were conducted with 44 expert panelists with experience with telehealth care and developmental disabilities, including adults with developmental disabilities, family members, direct support professionals, nurses, and health care providers. Results: Three rounds of surveys resulted in a set of 9 guidelines consisting of 42 items. The guidelines addressed 1) appropriate situations for telehealth care, 2) communication needs and preferences, 3) support person collaboration, 4) education and anticipatory guidance, 5) reminders, 6) coordination of care, 7) equitable and fair access, 8) privacy and safety, and 9) evidence-based practice. Conclusion: Health care providers can adopt these best practice guidelines to ensure telehealth care is provided equitably and safely to adults with developmental disabilities. Policy advocacy is needed for the uptake of these guidelines and for health care providers and adults with developmental disabilities to access the resources needed for safe and effective telehealth care use.
摘要:
背景:自COVID-19大流行以来,远程医疗保健现在是主流医疗保健的关键要素,所有类型的医疗保健提供者都加入了数字革命。作为一个经历医疗保健差距的人口,有发育障碍的成年人及其支持者描述了远程医疗保健的不同经历,这些经历有助于整体护理质量和健康结果.方法:这项e-Delphi研究就美国发育障碍成年人的远程医疗保健最佳实践达成了共识。对44名具有远程保健和发育障碍经验的专家小组成员进行了在线调查和视频会议访谈,包括有发育障碍的成年人,家庭成员,直接支持专业人员,护士,和医疗保健提供者。结果:三轮调查得出了9个指南,包括42个项目。准则解决了1)远程医疗保健的适当情况,2)沟通需求和偏好,3)支持人员协作,4)教育和预期指导,5)提醒,6)协调护理,7)公平和公正的准入,8)隐私和安全,和9)循证实践。结论:医疗保健提供者可以采用这些最佳实践指南,以确保向有发育障碍的成年人公平安全地提供远程医疗保健。需要进行政策宣传,以采纳这些准则,并使卫生保健提供者和有发育障碍的成年人获得安全有效地使用远程卫生保健所需的资源。