I-Telehealth ingaba yintshukumo elandelayo yokunceda izigulana zomgudu
Abathengi bezeMpilo baqhubeka befunda ngeemeko zabo kwaye unyango olucebisa kubo oogqirha babo. Ngoxa lo mkhwenkwe ngokuqinisekileyo-kwaye ngokufanelekileyo-kuquka abo bantu abahlala entanyeni okanye ebuhlungu buhlungu, umnatha uphoswa kakhulu kunoko.
I-intanethi kwaye ikhulile, izigulane ezineentlobo zonke zokuxilonga ngoku zenza uphando olongezelelweyo, zikwabelana ngamava angonyango ngaphandle kweofisi yegqirha kwaye zibiza isibindi sokuba zizithethele xa ziziva ziphosakele okanye zinyanzeliswe.
Oku kungabikho mfuneko; indawo yesigulane sonyango, ingakumbi kwibala leentlungu zentwaba, izele nabantu abavakalisa ukuba bambalwa, ukuba kukho na, iindlela zokunceda.
Ngokomzekelo, akuqhelekanga kubantu abanemva, intamo, okanye umlenze onxulumene nomlenze okanye intlungu yeengalo ukuxela ngaphantsi kwezilwanyana ezininzi kunye nezohlukeneyo unyango, ngokuphindaphindiweyo ngaphezu kweyodwa ngolunye uhlobo lwezokwelapha. Ezi zonyango zingabakho kwiinkqubo zonyango kunye namayeza angenayo kunye nokuhlinzwa.
Nangona ububanzi bezinketho ezizame, nangona kunjalo, abaninzi bathi baphuma kwi-odyssey yabo kunye neziphumo ezingonelonanga.
Inani-i-crunchers kwi-Arhente ye-Quality Quality Research (AHRQ) ijonge ubudlelwane phakathi kweendleko zokunakekela umlwanyana kunye nokuphucula kwiminyango kunye neentamo zezigulana ezizifundayo. Nangona iindleko eziqhelekileyo eziqhelekileyo ngesigulane zangena kwi-$ 6096 yesigulane kwisigulane ngonyaka ka-2005, abaphandi abazange bakwazi ukuthethelela ezo ndleko ngokunciphisa intlungu okanye ukuphucula ukusebenza komzimba.
Akunjalo kuphela, kodwa kwiminyaka emibhozo phakathi ko-1997 no-2005, iimali zokuncedisa umlenze zonyuka ngamaphesenti angama-65, nangona iziphumo zahlala zifana kakhulu. Ngokubhaliweyo kwabalobi be-AHRQ, "kwakungekho phuculo kulo xesha kwiimeko zempilo ezizimeleyo, ukukhubazeka okusebenzayo, ukulinganiselwa komsebenzi, okanye ukusetyenziswa kwentlalo phakathi [nophando] abaphenduli abaneengxaki zengqondo."
Olunye udaba kwinqanaba lokusetyenziswa kweemvavanyo zengqondo-ukungafuneki. Ucwaningo lwango-2017 olupapashwe kwi- JAMA lwangaphakathi lweMithi lufumene ukuba iiofisi zonyango ezidibene nezibhedlele zivame ukusebenzisa i-MRI, i-X-rays, i-CT imihlola yezifo ezahlukeneyo, kuquka intlungu.
Ngokubanzi, xa uvavanyo lweemvavanyo lunikwa izigulane ngokungenasidingo (oko kukuthi, xa isigulane singenazo iimpawu zesibindi ), zibhekwa "zixabiso eliphantsi."
Uphando lufumanise ukuba ababoneleli bezonyango abanxulumene nezibhedlele benza okunye ukuhanjiswa kwiingcali.
Ukuba ungazi, kunye kunye neenkonzo zonyango, iiofisi zonyango ezidibene nezibhedlele zihlala zibonelela ngononophelo lwangaphandle kubantu abahlala kwiindawo ezikufuphi.
Ngaba iShishini Lokunakekelwa Kwesiqhelo Sogqirha-Ukugulisa Izigulane Zabo?
Intshukumo yokufikelela kubanini bempilo ye-savvier ingabanjelwa kwi-Health 2.0, eyaqala ngo-2000 njengoko inika amandla ubuchwepheshe kwizigulane kunye nabanakekeli abanqwenela ukudibanisa nabanye malunga nokukhathazeka kwezokwelapha.
Namhlanje, i-Healthgrades, izigulane ezinjengam, amaqela e-Facebook anikezelwe kwiimeko ezithile okanye unyango, kunye nezinye izingosi ezinemisebenzi efanayo. Kulapho uya kufumana ukulinganisa ngogqirha, utshintshi lwolwazi, i-cheerleading, kunye ne-comradery.
Enyanisweni, ezininzi zezi ndawo ziphumelele ekuzaliseni ikhefu phakathi kweekhowudi zokuxilonga ugqirha uzithoba kwi-inshorensi nakumava ahlala kuyo.
Okokuthi, gcinani engqondweni ukuba abantu abafakela kulezi ndawo bangabasebenzi bezonyango, oku kuthetha ubuninzi bolwazi oya kufumana lube nolwazi olungakumbi kunoko.
Eminye yemibutho nayo ibandakanya ukudibanisa okuxabisekileyo phakathi kwamasebe nophuhliso lwezixhobo zezilwanyana kunye nezixhobo kunye namalungu abo. Uninzi lwaloo mva lusebenza ngokugqithiseleyo njengabaxhasi besigulane ngokuthetha nabanye abantu abaninzi ngesifo esifanayo.
Nangona uxinzelelo lokufumana imodeli ejongene nesigulane ejongene nesigulane iyaqhubeka, ababoneleli abaninzi banqwenela ukuhlawulwa ngenani leenkonzo ezinikezelweyo. Ngokufanayo, iifom zedatha zikhona, kwaye ziyaqhubeka zikhutshwe, ziqinisekisa ukuba intloko yentloko kunye nokunyamezela intlungu kuphelile-unyango eMelika.
Ucwaningo olwenziwa ngo-2013 olupapashwe kwi-JAMA luhlolisise iirekhodi ezingaphezu kwama-23,000 ezigulane zezigulane kwiminyaka elishumi elinesibhozo phakathi kwe -999 no-2010. Uphando lufumene ukuba imimiselo ye-NSAID kunye neTylenol yehle ngoxa imiqathango yokunciphisa ubuhlungu be-narcotic iyancipha . Akunjalo kuphela, kodwa imiqathango yonyango yonyango kuphela yaba neepesenti ezingama-20 yazo zonke imiyalelo ngabagqirha.
Ukuzisa iTelemedicine kunye neTelehealth
Ubuchwephesha obuthembisayo bubungqongqo. Iinkalo ezimbini ezitsha, ezihlobene kunye ne-telemedicine kunye ne-telehealth ziyafumana umbane, kwaye kungekhona nje kwizigulana zogulane, kodwa wonke umntu.
Kwakhona kuthiwa ngokuthe ngqo kumachiza wabathengi, i-telemedicine yinkqubo yeyeza kumgama, ngokusetyenziswa kwezwi, ividiyo, amaxwebhu kunye nedatha. I-Telehealth, ngakolunye uhlangothi, lixesha elibanzi eliquka izinto ezifana nemfundo yesigulane, ukukhuthazwa kunye nokukhusela. I-Telemedicine ihluke kwi-telehealth kwimeko yokuba yile nkcazo yonyango, igqibeleleyo ngokuthotyelwa kwe-HIPPA, iikhowudi zokuxilonga, unyango, kunye nakwezinye iimeko, utyando. Unokucinga nge-telehealth njengezinto ezinjengezinhlelo zokusebenza, inkqubo yokulahlekelwa kwezinto eziku-intanethi yokuphucula impilo, kunye nokunye okunjalo.
Zomibini iinkalo zisencinane. Kodwa ngokusekelwe kwimiba ethile, abacebisi bakholelwa ukuba ekugqibeleni bangabonakalisa inxaxheba ekuphuculeni umgangatho wokunyamekela wonke umntu, kunye nokwandisa iinkonzo ezonyango ezifunekayo kwizigulane ezinzima. Iindawo ezinomfuno omkhulu zibandakanya amazwe aseMerika kunye namaphandleni asandula ukukhutshwa.
Oko kwathiwa, isohlo leentaka lijongene nomhlaba osasazekayo we-telemedicine intsimi yembula ukuba iziphumo zempilo ezibangelwa ukusetyenziswa kwezi ndlela zonikezelo ziyimpawu ezifaniyo. Abanikezeli abasebenzisa iikhompyutheni abayilandela rhoqo imihlahlandlo yeekliniki, eziyiziphakamiso ezisekelwe kwiingcali ezijoliswe kuogqirha kunye nabanye oogqirha. (Ukulungelelanisa, oku kunjalo nangabo banikezelayo baphatha indlu; ngelixa ukulandela izikhokelo zeklinikhi kungengcamango ecacileyo yokuba inzuzo yabanikezeli abahloniphekileyo kunye nezigulane zabo, akufunwa ngumthetho.)
Yongeza kule nto ukuba zonke izigulane zeekhompyutheni zithi ziyaneliseka ngononophelo lwabo, kwaye unokubona ukuba umsebenzi omnye kufuneka ukwenziwa kwiindawo ze-telemedicine kunye ne-telehealth.
Ngokomzekelo, i-2017 eyapapashwa kwi- JRSM Open ifumene ukuba izigulane ezingapheliyo zezigulane ezazibona ugqirha nge-telemedicine system zivakalisa ukwaneliseka okwangaphandle kunye namava. Akunjalo kuphela, kodwa iziphumo kulo mzekelo zilingqinisiso, kwaye inkonzo yahluleka ukufikelela kwizigulane ezifuna ukunyamekela.
Olunye uphando lwe-2017, olupapashwe kwi- Front Pharmacology lubonise ukuba, ngenxa yazo zonke izinto ezintle, i-telemedicine ayinakho ukubonelela ukuphucula impilo. Abaphandi abazange bakwazi ukufumana ubungqina obaneleyo bokuncoma i-telemedicine kubantu abanesifo sikashukela abafuna ukulawula i-index glycemic index.
I-Telemedicine kwi-Industry Care Industry
Kodwa kubantu abanentlungu nentlungu emva, kunomncinci wethemba. Ukuba uphando lwangaphambili lukho nawuphi na umqondiso, izigulane zentlungu neentamo zentlungu zingase zibe bhetele kunokuba zibona ezinye iindidi zeengcali zonyango kwi-browser.
Ukususela ngo-2017, inani labaphandi lincoma iiseshoni ze-telemedicine njengoko zichazela kumntu onomntu. Ngokomzekelo, uphando olwenziwa ngo-2017 olupapashwe kwiNcwadi yeMpilo yezoPhilisa kunye nokuBuyiselwa kweNtlungu kuboniswe ukuba izigulane ezisezintanyeni eziqhelekileyo zafumana ukuphuculwa kabuhlungu okungcono, ukusebenza komzimba kunye nokunyamekela ngakumbi kwiprogram yokuzivocavoca yonyango ngaphandle kwalabo abaye bahamba uhambo lwabo baya kugqirha ugqirha. umntu.
Olunye uphando, lo ukhangele i-telemedicine ngenxa yeentlungu ezisezantsi, weza neziphumo ezifanayo. Uphando lwapapashwa ngo-Aprili 2017 umxholo we- Spine Journal.
Kule kophando, yafunyaniswa ukuba ngelixa i-telemedicine ayikho yonke into, iphelisa yonke imodeli yokuhambisa ukuba i-e-Health advocates ingafuna ukuba ukholwe kukuba, ubuncinane kwihlabathi lokunakekelwa kweminwe, liba nelokunciphisa intlungu kunye / okanye ukukhubazeka kubantu abaneentlungu ezingapheliyo.
Oko kwathiwa, abalobi baqaphele ukuba ngo-2017, i-telehealth "iyahlanjululwa," njengokuba isondlo sokunyamekela ngokuqhelekileyo.
Enye yezinto ezixhamlayo kwiindawo zokuxubusha zogqirha zokunakekelwa kweengxaki zogqirha, ukubuza imibuzo efana neyiphi iindidi ezahlukahlukeneyo ze "iifilimu" ozifuna ngokwenene ukuxhamla komqolo ongundoqo? Okanye, ukuba ufunde ugqirha ngenxa yentlungu emva koko kufuneke ukuba kwenziwe umyalelo we- MRI ?
Izikhokelo ezisekelwe kwizikhokelo zesikliniki zithi hayi-ukuba ngaphandle kokuba unempawu zesibindi ezingabhekisela kwingxaki ebalulekileyo , iifrimu kunye neemvavanyo zokuxilonga akukho mfuneko ukuba ugqirha wenze uvavanyo lwesigulane.
Enyanisweni, uphando olwenziwa ngo-2011 olupapashwe kwi- Annal of Medicine Internal , u-Chou, et al, lwagqiba ukuba ukucinga ngesoloko kungabandakanywa neenzuzo ezinokliniki. Nangona kunjalo oogqirha abaninzi bayaqhubeka beyalela ukuba izigulane zabo zibe nobuhlungu obunzima bentlungu.
Ngaba unomnxeba uncedo?
Uxolo, akukho. Nangona uphando oluninzi luye lwazama kwesi sihloko, uphando oluthile, olupapashwe ngo-Matshi 2016 lwe- Telemedicine kunye ne-E-Health, lwafumanisa ukuba i-telemedicine oogqirha bezilwanyana babala inani elifanayo lefilimu njengogqirha be-office, ephakathi kwama-79 Iipesenti ezingama-88 zezigulane zibonwe.
ILizwi
Ubuncinane ngoku, sibuyela kwisikwere esinye. Iingcali kunye nokubeka abantu ngokufanayo baziwa ngamaxesha eminyaka ukuba ukuhlala kusebenza mhlawumbi kubaluleke kakhulu kwixesha elide lempilo, nangona imeko ifuna unyango.
Ngokukodwa, ukuzinza umgudu kunye nokuqiniswa komgaqo-siseko kuye kwazibonakalisa ngokuphindaphindiweyo kwizifundo zophando.
Ngokomzekelo, uphando olwenziwa ngo-2001 lufumene ukuba emva kweminyaka emibili ukuya kwimithathu, izigulane ezithembele ekulawulweni kwezokwelapha zodwa zazingaphezu kokuphindwe kabini ukufumana ukuphindaphinda kwengxaki yazo xa kuthelekiswa nalabo abaqalisa inkqubo yovavanyo ngokukodwa eyenzelwe imeko yabo Ukongezwa kolawulo lwezokwelapha.
Ngoko, sebenzisa umyalelo ovela kumboneleli ofanelekileyo oyaqonda imeko yakho yangasemva, unokuthi ube yinto efanelekileyo yokubethelela intlungu-nokuba uyababona kwi-intanethi okanye kwiklinikhi.
> Imithombo:
> Chou, R., et. al. Ukucinga ngeentlobo zeentlungu ezibuhlungu: iinqununu zokunakekelwa kwempilo ephakamileyo evela kwi-American College of Physicians. Ann Intern Med. Feb 2011. https://www.ncbi.nlm.nih.gov/pubmed/21282698
> Dario, A. Ukuphumelela kweeNkqubo zokuSebenza ngeTerehealth kubantu abaNyango oluPhantsi. Isihlwele. Epreli 2071. https://www.fotoinc.com/news-updates/effectiveness-telehealth-low-back-pain
> I-Gialanella, B., iTelemediki yaseKhaya kwiZiGulane ezine-Chronic Neck Pain. I-American Journal of Medicine Physical & Rehabilitation: Meyi 2017. http://journals.lww.com/ajpmr/Abstract/2017/05000/Home_Based_Telemedicine_in_Patients_with_Chronic.8.aspx
> Ufihla, J., et. al. Imiphumo emide yexesha elide lokuzivocavoca oluthile lwexesha lokuqala lokuqala lentlungu. Isihlwele. Juni 2001. https://www.ncbi.nlm.nih.gov/pubmed/11389408
> Kruse, C., kunye. al. Ukusebenza kwe-telemedicine ekulawuleni izifo zengqondo ezingapheliyo-ukuhlolwa ngokufanelekileyo. JRSM Open. Matshi 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347273/
> Lee, S., kunye. al. I-Telemedicine yokulawulwa koLawulo lwe-Glycemic kunye neziPhulo zeeNtsholongwane zoLwabiwo lwesifo sikashukela seMellitus: Uhlolo lokuHlola kunye nokuHlola kweeSifundo eziLawulayo ngokuHlangeneyo. Front Pharmacol. NgoMeyi 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447671/
> Mafi, J., kunye. al. Umbutho woLondolozo lweNqununu loMmandla kunye noBumnini kunye neNkonzo yokuNakekelwa kweNtengo ePhantsi eMelika. Jama Internal Med. Juni 2017. https://www.ncbi.nlm.nih.gov/pubmed/28395013
> Mafi, J., kunye. al. ukunyuka kwezinto eziqhubekayo ekulawuleni nasekunyangeni kwintlungu ye-bnack. JAMA Intern Med. Sept. 2013. https://www.ncbi.nlm.nih.gov/pubmed/23896698
> Uscher-Pines, L, et. al. Ukufikelela kunye neNqanaba loKhathalelo kwi-Direct-to-Consumer Telemedicine. I-Telemedicine kunye ne-E-Health. Matshi 2016. http://online.liebertpub.com/doi/10.1089/tmj.2015.0079