描述在大流行的早期阶段将老年病诊所转变为远程医疗就诊的经验。
一项组织案例研究，采用混合方法评估，从老年诊所从面对面就诊转变为视频和电话就诊的前8周。
北加州的退伍军人健康管理局参与者社区居住的老年退伍军人在VAPaloAlto老年病诊所接受护理。退伍军人的平均年龄为85.7岁（SD=6.8），72.1％的人患有认知障碍。
进行面对面预约的退伍军人被转换为视频或电话访问，以减少接触COVID-19的社区传播。
完成了32个患者评估和80个临床医生反馈评估。这提供了满意的信息，大流行期间的护理机会，旅行和节省时间。
在62个预定的预约中,进行了43次虚拟访问（69.4％）。二十六(60.5%)次探访是透过录影进行,17（39.5%）通过电话。虚拟访问平均为患者节省了118.6分钟。患者和提供者有类似的情况，关于远程医疗与面对面访问比较的积极看法，限制暴露,参观满意。在远程医疗预约之后,患者表示未来使用虚拟访问更舒适。31项评价包括用于定性分析的评论。我们确定了技术设置和可用性的三个主要主题，参观满意,以及临床评估和沟通。
在大流行期间，安全地进行亲自服务的能力受到限制，虚拟格式为临床复杂的老年患者提供了可行和可接受的替代方案.尽管潜在的障碍和远程医疗访问需要额外的努力，患者表示愿意使用这种格式。患者和提供者报告了很高的满意度，特别是能够在保持安全的同时获得类似于面对面的护理。在大流行期间投资远程医疗服务可确保弱势老年患者能够获得医疗服务，同时保持社交距离，一项重要的安全措施。
To characterize the experience of converting a geriatrics clinic to telehealth visits in early stages of a pandemic.
An organizational
case study with mixed methods evaluation from the first 8 weeks of converting a geriatrics clinic from in-person visits to video and telephone visits.
Veteran\'s Health Administration in Northern California Participants Community-dwelling older Veterans receiving care at VA Palo Alto Geriatrics clinic. Veterans had a mean age of 85.7 (SD = 6.8) and 72.1% had cognitive impairment.
Veterans with face-to-face appointments were converted to video or telephone visits to mitigate exposure to community spread of COVID-19.
Thirty-two patient evaluations and 80 clinician feedback evaluations were completed. This provided information on satisfaction, care access during pandemic, and travel and time savings.
Of the 62 scheduled appointments, 43 virtual visits (69.4%) were conducted. Twenty-six (60.5%) visits were conducted via video, 17 (39.5%) by telephone. Virtual visits saved patients an average of 118.6 minutes each. Patients and providers had similar, positive perceptions about telehealth to in-person visit comparison, limiting exposure, and visit satisfaction. After the telehealth appointment, patients indicated greater comfort with using virtual visits in the future. Thirty-one evaluations included comments for qualitative analysis. We identified 3 main themes of technology set-up and usability, satisfaction with visit, and clinical assessment and communication.
During a pandemic that has limited the ability to safely conduct inperson services, virtual formats offer a feasible and acceptable alternative for clinically-complex older patients. Despite potential barriers and additional effort required for telehealth visits, patients expressed willingness to utilize this format. Patients and providers reported high satisfaction, particularly with the ability to access care similar to in-person while staying safe. Investing in telehealth services during a pandemic ensures that vulnerable older patients can access care while maintaining social distancing, an important safety measure.
PDF(Sci-hub)