remote consultation

远程咨询
  • 文章类型: Journal Article
    背景:这项研究的目的是评估远程工作的法医是否可以使用由操作口腔内摄像机(IOVC)的非牙科法医人员制作的视频准确地进行法医牙齿鉴定。该研究的目的是评估以这种方式进行远程法医牙齿鉴定的准确性和时间。
    方法:解剖和人类识别中心(CAHID)的八具尸体,邓迪大学,英国,由法医牙科医生通过传统的牙科检查进行检查。记录他们的牙齿状况,作为本研究的死前记录。使用医学生操作的IOVC制作每个牙列的视频。由一位不参加传统牙科检查的远程第二法医牙科医生从视频中为每个牙列制作了尸检记录。然后比较了死前和死后的记录,鉴定被归类为积极建立,可能或排除。
    结果:尽管在死前和死后记录之间存在一些非关键的不一致,但在所有8例病例中都取得了积极的确认。在第二种意见之前,每个研究对象85.6%的牙齿被一致地绘制。在第二种意见之后,一致性百分比增加到97.2%。每个视频的平均持续时间约为4.13分钟,第一次尝试解释和绘制死后牙科检查的平均时间为11.63分钟。从视频中绘制图表所需的时间比传统牙科检查所需的时间更长。
    结论:这项初步研究支持进行远程牙科识别的可行性。这种新颖的“远程牙科病毒病”方法可能是传统验尸牙科检查的可行替代方法,在由于地理原因难以获得法医牙科服务或受到限制的情况下,后勤,安全,和/或政治原因。
    BACKGROUND: The aim of this study was to evaluate whether a forensic odontologist working remotely could accurately undertake forensic dental identifications using videos produced by non-dental forensic staff operating an intra-oral video camera (IOVC). The study\'s aims were to assess the accuracy and time taken to perform remote forensic dental identifications in this manner.
    METHODS: Eight cadavers from the Centre for Anatomy and Human Identification (CAHID), University of Dundee, UK, were examined by a forensic odontologist via a traditional dental examination. Their dental condition was recorded to serve as ante-mortem records for this study. Videos of each dentition were produced using an IOVC operated by a medical student. Post-mortem records were produced for each dentition from the videos by a remote second forensic odontologist who was not present at the traditional dental examination. The ante-mortem and post-mortem records were then compared, and identification was classified as positively established, possible or excluded.
    RESULTS: Established identifications were positively made in all eight cases although there were some non-critical inconsistencies between ante-mortem and post-mortem records. Before the second opinion, 85.6% of the teeth per study subject were charted consistently. After the second opinion, the percentage of consistency increased to 97.2%. Each video on average was about 4.13 minutes in duration and the average time taken to interpret and chart the post-mortem dental examination at the first attempt was 11.63 minutes. The time taken to chart from the videos was greater than is typical of a traditional dental examination.
    CONCLUSIONS: This pilot study supports the feasibility of undertaking remote dental identification. This novel \"tele-dental virtopsy\" approach could be a viable alternative to a traditional post-mortem dental examination, in situations where access to forensic dental services is difficult or limited due to geographical, logistical, safety, and/or political reasons.
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  • 文章类型: Journal Article
    目的:探讨在2019年冠状病毒病(COVID-19)大流行期间,从识别和转诊以提高安全性(IRIS)服务中获得专业家庭暴力和虐待(DVA)支持的患者/服务用户的观点。设计:采用定性方法进行本研究。方法:对通过对11名患者/服务用户进行深入的个人访谈收集的数据进行主题分析,这些患者/服务用户在向全科医生(GP)披露滥用行为后获得了DVA支持,并随后转诊到IRIS服务。研究结果:确定了六个主题-COVID-19期间DVA的体验;对IRIS服务的认识;获得护理的途径;可访问性,安全,和远程咨询;电话支持的充分性;以及IRIS支持的影响。参与者报告了GP团队和IRIS服务的DVA专家的支持。结论:大流行对医疗保健和专业DVA服务提供商产生了重大影响。事实证明,迅速转向远程咨询是识别DVA的有效方法,从他们自己的角度确定那些经历DVA的人的支持需求,并适当推荐专家支持。需要进一步研究以了解卫生保健专业人员和在IRIS服务中工作的人员的观点,以探索影响他们提供远程服务能力的因素。该研究强调了除医生外的医疗保健专业人员(包括护士,助产士,和其他)来建立知识,信心,以及询问DVA的能力。
    Aim: To explore the perspectives of patients/service users receiving specialist domestic violence and abuse (DVA) support from the Identification and Referral to Improve Safety (IRIS) service during the coronavirus disease 2019 (COVID-19) pandemic. Design: A qualitative approach was used to conduct this study. Methods: Thematic analysis of data collected via in-depth individual interviews with 11 patients/service users who received DVA support following their disclosure of abuse to a health-care professional in general practice (GP) and subsequent referral to the IRIS service. Findings: Six themes were identified-experience of DVA during COVID-19; awareness of the IRIS service; pathway to care; accessibility, safety, and remote consultations; adequacy of telephone support; and impact of IRIS support. Participants reported feeling supported by the GP team and the DVA specialists from the IRIS service. Conclusion: The pandemic had a significant impact on health care and specialist DVA service providers. The swift shift to remote consultations proved to be an effective way to identify DVA, determine the support needs of those experiencing DVA from their own perspective, and make appropriate referrals for specialist support. Further research is needed to understand the views of health-care professionals and those working in the IRIS service to explore factors affecting their ability to provide remote services. The study highlighted the need for health-care professionals other than doctors (including nurses, midwives, and others) to build knowledge, confidence, and competence in asking about DVA.
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  • 文章类型: Journal Article
    背景:远程医疗允许在不在同一地点的各方之间进行医疗保健。由于远程医疗用户不在一起,有效的沟通方法对于信息的传递和接收至关重要。这项研究的目的是探索全科医生(GP)和患者对远程医疗咨询的互动组成部分的看法。
    方法:对远程医疗用户进行了半结构化定性访谈;15名全科医生和9名患者从更大的远程医疗研究中自我选择。与会者被问及远程医疗咨询的准备情况,开展远程医疗咨询和咨询后活动。对访谈中确定的笔录进行了主题分析。
    结果:全科医生和患者讨论了他们用来决定是否最好通过远程医疗或面对面进行咨询的因素;要讨论的条件,现有的医患关系以及是否需要体检。与会者还介绍了他们是如何准备远程医疗会诊的,收集相关文件,阅读以前的笔记。参与者描述了他们用来优化远程医疗互动的策略;改善对话流程和建立融洽的关系,以及他们在尝试通过远程医疗提供和接受护理时遇到的困难。
    结论:患者因素包括健康素养和对技术的熟悉程度会影响远程医疗咨询过程中共享的信息的传递,因此在选择远程医疗患者时需要考虑这些因素。许多全科医生和患者具有天生的沟通技巧,可以通过远程医疗有效地提供和接受护理。然而,他们可能没有意识到这些潜意识技术可以用来优化远程医疗咨询。可以提供沟通培训以增加对话流,建立融洽的关系,建立安全网。
    BACKGROUND: Telemedicine allows delivery of healthcare to occur between parties that are not in the same location. As telemedicine users are not co-present, effective communication methods are crucial to the delivery and reception of information. The aim of this study was to explore perspectives of general practitioners (GPs) and patients on the interactional components of telemedicine consultations.
    METHODS: Semi-structured qualitative interviews were held with telemedicine users; 15 GPs and nine patients self-selected from a larger telemedicine study. Participants were asked about their preparation for telemedicine consultations, conducting telemedicine consultations and post-consultation activities. Deidentified transcripts from the interviews were analysed thematically.
    RESULTS: GPs and patients discussed factors they used to decide whether a consultation would be best conducted by telemedicine or in-person; the condition to be discussed, the existing doctor-patient relationship and whether physical examination was required. Participants also described how they prepared for their telemedicine consultations, gathering relevant documents, and reading previous notes. Participants described strategies they employed to optimise the telemedicine interaction; improving conversational flow and building rapport, as well as difficulties they experienced when trying to provide and receive care via telemedicine.
    CONCLUSIONS: Patient factors including health literacy and familiarity with technology affect the transfer of information shared during telemedicine consultations and consideration of these factors when choosing patients for telemedicine is required. Many GPs and patients have innate communication skills to effectively deliver and receive care through telemedicine. However, they may not be aware of these subconscious techniques to use to optimise telemedicine consultations. Communication training could be delivered to increase conversational flow, build rapport, and establish safety netting.
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  • 文章类型: Journal Article
    目的:绘制初级卫生保健中护士远程会诊的技能图。
    方法:这是由JoannaBriggsInstituteReviewer手册的建议指导的范围审查,在七个数据库和论文存储库中进行。研究的选择是由两个独立的Rayyan进行的,盲人评论家。对数据进行描述性分析。
    结果:选择了23项研究,这表明初级保健中护理远程会诊所需的技能是:沟通,临床,技术和伦理。缺乏数字基础设施被认为是实施远程会诊的主要障碍之一。缺乏获取信息和通信技术和/或互联网的机会,还确定了临床状况的严重程度和患者对远程会诊的不依从性.
    结论:初级保健中的护理远程咨询是一种提供医疗保健的新兴方式。然而,为了实施,有必要对护士进行以下技能培训:沟通,临床,技术,伦理和与远程会诊环境基础设施有关的内容。
    OBJECTIVE: to map nurses\' skills for nursing teleconsultation in Primary Health Care.
    METHODS: this is a scoping review guided by the recommendations of the Joanna Briggs Institute Reviewer\'s Manual, carried out in seven databases and repositories of theses and dissertations. The selection of studies was carried out in Rayyan by two independent, blind reviewers. Data analysis was carried out descriptively.
    RESULTS: 23 studies were selected, which showed that the skills necessary for nursing teleconsultation in primary care were: communication, clinical, technological and ethical. The lack of digital infrastructure was identified as one of the main barriers to the implementation of teleconsultation. The lack of access to information and communications technology and/or the internet, the severity of the clinical condition and the patient\'s non-adherence to the remote consultation were also identified.
    CONCLUSIONS: nursing teleconsultation in primary care is an emerging way of providing health care. However, for its implementation it is necessary to train nurses in the following skills: communication, clinical, technological, ethical and those related to the infrastructure of the teleconsultation environment.
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  • 文章类型: Journal Article
    背景我们介绍了在印度东部州开展的telerheumatology咨询服务的经验。方法我们做了这个前瞻性的,2015年12月至2019年5月期间对风湿病患者进行观察性研究,并通过远程医疗进行随访。结果在研究期间,在11201次远程医疗访问的帮助下,我们为3583名患者提供了远程会诊。患者距远程医疗中心的中位距离为248(13至510)km。由于这项服务,患者的累计节省为2.4亿卢比(2400万)。每位患者每次就诊节省的平均旅行时间为7小时(30分钟至12小时),每位患者每次就诊节省的中位数为6700。结论长期的持续努力可以通过远程医疗向隐私不足的人群提供基本的风湿病服务,减轻穷人的经济负担,帮助妇女在低收入和中等收入国家(LMICs)的偏远地区获得医疗服务。
    Background We present the experience of telerheumatology consultation services carried out in an eastern state of India. Methods We did this prospective, observational study of patients with rheumatological disorders and followed through telemedicine between December 2015 and May 2019. Results During the study period, we provided teleconsultation to 3583 patients with the help of 11 201 telemedicine visits. Patients resided at a median distance of 248 (13 to 510) km from the telemedicine hub. The cumulative savings of the patients as a result of this service were ₹2.4 crore (24 million). The median travel time saved was 7 hours (30 minutes to 12 hours) per patient per visit and a median of ₹6700 was saved per visit per patient. Conclusion Sustained efforts over a long period can lead to the delivery of essential rheumatology services via telemedicine to an under-priviledged population, reduce the financial burden of the poor, and help women to access healthcare services in remote parts of low- and middle-income countries (LMICs).
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    耳镜和耳镜是最常用的可视化耳朵的仪器。数字耳镜检查(DO)可用于通过利用图像放大来改善初级卫生保健中的诊断。该研究的目的是探索在远程咨询中使用DO的可能性。
    基于现实生活中的推荐,招募了45名耳科门诊患者。在预约了主治耳科医生之后,进行了DO操作,作为黄金标准。在数字平台上分析了24例患者病例,作为远程咨询病例,其中包含给定的转诊信息,并补充了DO视频(DOV)。五位耳科医师共进行了71次评估。DOV的质量,它们适合远程咨询,我们确定了诊断的准确性和远程会诊的有用性.
    判断平均DOV质量为7.4±0.3(平均值±平均值的标准误差;1-10的标度)。79%的病例诊断正确。在59%的患者中,耳科医生认为远程咨询可以取代亲自访问。
    在我们的模拟远程咨询设置中,DOV质量足以用于诊断目的,在大多数情况下,可以改善诊断和治疗计划,并可用于减少面对面就诊的需求。DO辅助远程咨询可以改善诊断和获得护理。证据等级:3。
    UNASSIGNED: Otoscopes and otomicroscopes are the most commonly used instruments for visualizing the ear. Digital otoscopy (DO) could be used to improve diagnostics in primary health care by utilizing image enlargement. The aim of the study was to explore the possibilities of DO in remote consultations.
    UNASSIGNED: Based on real-life referrals, 45 otologic outpatients were recruited. DO was performed followed by an attending otologist\'s appointment, serving as the gold standard. Twenty-four patient cases were analyzed on a digital platform as remote consultation cases containing the given referral information supplemented with DO videos (DOVs). A total of 71 evaluations were performed by five otologists. The quality of the DOVs, their suitability for remote consultations, the accuracy of diagnoses and the usefulness of remote consultations were determined.
    UNASSIGNED: The average DOV quality was judged to be 7.4 ± 0.3 (mean ± standard error of the mean; scale of 1-10). The diagnosis was correct in 79% of the cases. In 59% of the patients, the otologists considered that remote consultation could have replaced an in-person visit.
    UNASSIGNED: In our simulated remote consultation setup, DOV quality was sufficient for diagnostic purposes, DO improved diagnostics and treatment planning in most cases and could be used to reduce the need for in-person visits. DO-aided remote consultation may improve diagnostics and access to care.Level of evidence: 3.
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  • 文章类型: Journal Article
    在设计并实施了远程医疗解决方案后,该解决方案配备了用于远程会诊和远程专业知识的视频呈现工具,并且为了在医疗保健专业人员和患者之间获得忠实的沟通,尽管语言差异,我们的研究是对现有的各种作品进行文学评论,并对不同类型的神经网络进行分析,以设计一种语音智能代理,用于在远程会诊期间医生和患者之间的交流中进行翻译,并为其开发做出工具选择。
    After having designed and implemented a telemedicine solution equipped with a video presence tool for teleconsultation and tele-expertise and in order to obtain a faithful communication between healthcare professional and patient despite language differences, our study was to perform a literary review on the various existing works and to perform analysis on the different types of neural network for designing an voice intelligent agent for translation during exchanges between doctor and patient during teleconsultation and make tool choices for its development.
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  • 文章类型: Journal Article
    2024年3月在法国远程医疗平台上实施了13种标准化的电子访问理由,以改善远程医疗的需求分析,教育患者在电子访问中的可能性,并调整报价。患者可以在13个原因列表中选择1至3个原因进行咨询。我们的目的是评估它们对使用电子访问的影响。电话会诊的主要原因更多是与急症护理有关,特别涉及绝大多数上呼吸道感染,背痛,和尿路感染.他们大多与医生的结论一致,他们可能简化了电子访问的准备。
    Thirteen standardized reasons for e-visits were implemented in March 2024 on a French telemedicine platform to improve the analysis of needs in telemedicine, educate patients on what is possible in e-visit and adapt the offer. Patients could select 1 to 3 reasons for consultations among a list of 13 reasons. Our aim was to evaluate their impact on use of e-visits. The main reasons for consultations in teleconsultations were more linked to acute care, specifically involving a large majority of upper respiratory tract infections, back pain, and urinary tract infections. They were mostly concordant with the physician\'s conclusion and they may have simplified the preparation of the e-visits.
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