I-Telehealth ingase ibe yindlela elandelayo yokusiza iziguli zomgogodla
Abathengi bezempilo baya ngokuya befundiswa ngemibandela yabo kanye nokwelashwa okuphakanyiselwe odokotela babo. Nakuba lo mkhuba ngokuqinisekile-futhi ngokufanele-kuhlanganisa nalabo bantu abahlala nentamo noma ubuhlungu bebuhlungu, inetha liphonswa kakhulu kunalokho.
E-intanethi futhi ivaliwe, iziguli ezinezinhlobo eziningi zokuxilonga manje zenza ucwaningo olwengeziwe, ukwabelana okungaphezulu kokuhlangenwe nakho kwabo kwezokwelapha ngaphandle kwehhovisi likadokotela futhi zibiza isibindi esengeziwe sokuzikhulumela zona uma zizwa zinganqotshwa noma ziphoqelelwe.
Lokhu kungase kungadingeki; i-landscape yesiguli sezokwelapha, ikakhulukazi enkundleni yemilenze yezinhlungu, igcwele abantu abaveza ukuthi bancane, uma kukhona, okukhethwa kukho ukukhululeka.
Isibonelo, akuyona into engavamile kubantu abanemilenze yangemuva, entanyeni noma emlenzeni ohlobene nezimpumputhe noma ngesikhumba ukubika ukuthi kunezinhlobo eziningi zokwelashwa ezihlukahlukene, ngokuvamile ezingaphezu kwesisodwa ngohlobo lwezokwelapha. Lezo zokwelapha zingase zivela emithini yokwelashwa ngokomzimba kanye nemithi yokwelapha kanye nokuhlinzwa.
Nanobe ububanzi bezinketho bazama, noma kunjalo, abaningi bathi basuke kwi-odyssey yabo ngemiphumela encane enganelisayo.
Abakwa-Number-crunchers abavela kwi-Agency for Quality Care Research Quality (AHRQ) babheka ubuhlobo phakathi kwezindleko zokunakekela umgogodla nokuthuthukiswa emhlane nasemaphoyiseni alabo ababafundela amarekhodi abo. Ngenkathi isamba esiphezulu sesilinganiso isiguli ngasinye sifinyelela ku-$ 6096 isiguli ngasinye esingaphezu kuka-6096 ngonyaka ka-2005, abacwaningi abakwazi ukulinganisa lezo zindleko ngokunciphisa ubuhlungu obuhambisanayo noma ukuthuthukiswa komzimba.
Akukhona lokho kuphela, kodwa eminyakeni eyisishiyagalolunye phakathi kuka-1997 no-2005, imali yokunakekelwa komgogodla yenyuka yanda ngamaphesenti angu-65, yize iziphumo zahlala zifana kakhulu. Ngokusho kwabalobi be-AHRQ, "kwakungekho ukuthuthukiswa ngalesi sikhathi esimweni sezempilo esizihlola, ukukhubazeka okusebenzayo, ukulinganiselwa emsebenzini, noma ukusebenza komphakathi phakathi kwabantu [abahlola] abanezinkinga zomgogodla."
Esinye icala kuleso simo kusetshenziswa ukuhlolwa kwe-imaging yokuhlola-ngokungadingekile. Ucwaningo olwenziwa ngo-2017 olwanyatheliswa ku- JAMA Internal Medicine lwathola ukuthi amahhovisi odokotela ahlotshaniswa nezibhedlela athambekele ekudluleleni ukusetshenziswa kwe-MRI, i-X-rays, i-CT yokuhlola izifo ezihlukahlukene, kuhlanganise nobuhlungu bokubuyela emuva.
Ngokuvamile, uma ukucabanga okuhlolwayo kunikezwa iziguli ngokungadingekile (okungukuthi, uma isiguli singenayo izimpawu zesibindi ), kubhekwa "njengenani eliphansi."
Ucwaningo lubuye lwathola ukuthi abahlinzeki bezokwelapha ezihambisana nesibhedlela benza okudluliselwa kokuningi kubathengi.
Uma ngabe awukwazi, kanye nezinsizakalo zokugula, amahhovisi odokotela abanjwe esibhedlela ngokuvamile ahlinzeke ukunakekelwa kwabagulayo kubantu abahlala ezindaweni eziseduze.
Ingabe Isimboni Sokunakekelwa Kwesihlahla Sezinsizwa Saphezu Kokugulisa Iziguli Zabo?
Ukunyakaza kwe-consumer healthism ye-savvier kungathiwa yi-Health 2.0, eyaqala ngama-2000s njengokunika amandla ubuchwepheshe beziguli nabanakekeli abafisa ukuxhuma nabanye mayelana nokukhathazeka kwezokwelapha.
Namuhla, Ukunakekelwa Kwezempilo, Iziguli Ezifana Nami, amaqembu e-Facebook azinikezele ezimweni ezithile noma imithi yokwelashwa, nezinye izingosi ezinokuthunywa okufanayo zikhula. Lapho uzothola izilinganiso zedokotela, ukushintshana kolwazi, i-cheerleading, ne-comradery.
Eqinisweni, eziningi zalezi zingosi ziphumelela kakhulu ekugcwaliseni igebe phakathi kwamakhodi okuxilonga udokotela uhambisa umshwalense kanye nokuhlangenwe nakho kweziguli.
Lokho kusho, khumbula ukuthi ngokuvamile abantu abathumela kulezi zindawo akuzona abasebenzi bezokwelapha, okusho okuningi kolwazi ozoyithola cishe umbono owedlula iqiniso.
Ezinye zezinhlangano nazo zihlanganisa ukuxhumana okubalulekile phakathi kweminyango yentuthuko yabakhiqizi bezidakamizwa kanye nezici namalungu abo. Abaningi balabo basebenzela ngamandla njengabagqugquzeli abanesineke ngokukhulumela abanye abangenakubalwa ngesifo esifanayo.
Nakuba ukucindezelwa kokuthola imithi yezokwelapha ezibhekene nesiguli kuyanda, abahlinzeki abaningi bakhetha ukukhokhelwa inani lezinsizakalo ezinikeziwe. Ngokufanayo, kutholakala izingcingo zedatha , futhi ziqhubeka zikhishwa, zivumelanisa nomqondo wokuthi ukunakekelwa kwentamo nokuphulukisa emuva sekuphelile-kwenziwa imithi eMelika.
Ucwaningo lwango-2013 olwakhicilelwe ku-JAMA luhlolisise amarekhodi angaphezu kuka-23,000 izigulane zomgogodla iminyaka eyishumi nanye phakathi kuka -9999 no-2010. Ucwaningo lufumene ukuthi imiyalelo ye-NSAID ne-Tylenol yehle ngenkathi imiyalelo yokunciphisa ubuhlungu be-narcotic yanda. Akukhona lokho kuphela, kodwa imithi yokwelapha yokwelapha kuphela yayingamaphesenti angu-20 yawo yonke imiyalelo yodokotela.
Ukwethulwa kwe-Telemedicine ne-Telehealth
Ubuchwepheshe obuthembisayo buyasondela. Amasimu amabili amasha, ahlobene ne-telemedicine kanye ne-telehealth athola udoti, hhayi nje kuphela iziguli zomgogodla, kodwa wonke umuntu.
Ebizwa nangokuthi imithi yomthengi, i-telemedicine iyindlela yokwelapha kude, ngokusebenzisa izwi, ividiyo, amadokhumenti kanye nedatha. Ngakolunye uhlangothi, i-Telehealth iyigama elibanzi elihlanganisa izinto ezifana nemfundo yesiguli, ukukhushulwa nokuvimbela. I-Telemedicine ihluke ekubhekaneni ne-telehealth ngoba yinto yokwelashwa yangempela, ephelele nge-HIPPA ukuhambisana, amakhodi wokuxilonga, ukwelashwa, ngisho nakwezinye izimo, ukuhlinzwa. Ungase ucabange nge-telehealth njengezinto ezinjengezinhlelo zokusebenza, uhlelo lwe-inthanethi lokulahlekelwa kwesisindo sokuthuthukisa impilo, nokunye okunjalo.
Zombili izinkambu zisasencane. Kodwa ngokusekelwe ezintweni ezithile, abagqugquzeli bakholelwa ukuthi ekugcineni bangafaka isandla ekuthuthukiseni ikhwalithi yokunakekela wonke umuntu, futhi nokwandisa izinsizakalo zezokwelapha eziningi ezidingekayo kuziguli ezinzima ukufinyelela. Izindawo ezinesidingo esikhulu zihlanganisa ama-US asezindaweni zasemaphandleni kanye namazwe asanda kuthuthukiswa.
Lokho kusho ukuthi iso lezinyoni libheke insimu ye-telemedicine ehlukumezayo yembula ukuthi imiphumela yezempilo ephuma ekusetshenzisweni kwalendlela yokulethwa kwezidingo ihlukile. Abanikezeli abaphatha nge-elektroniki akulandeli njalo imihlahlandlela yomtholampilo, okuyizincomo ezisekelwe ezenzweni ezenzelwe odokotela nabanye abasebenza. (Ukuze kube okulungile, lokhu kuyiqiniso nabahlinzeki abaphulukisa endlini; ngenkathi kulandela imihlahlandlela yemitholampilo mhlawumbe umqondo omuhle kakhulu ozuzayo kokubili abahlinzeki abahlonishwayo neziguli zabo, akudingeki ngokomthetho.)
Yengeza kulokhu ukuthi akuzona zonke iziguli ze-elekthronikhi ezibika ukuthi zinelisekile ukunakekelwa kwazo, futhi ungabona ukuthi umsebenzi omningi udinga ukwenziwa ezindaweni ze-telemedicine kanye ne-telehealth.
Isibonelo, i-2017 eyanyatheliswa ku- JRSM Open yathola ukuthi iziguli ezingapheliyo zezifo ezibona udokotela wazo ngesistimu ye-telemedicine zabika ukwaneliseka okuncane nolwazi. Akukhona lokho kuphela, kodwa imiphumela kulokhu okwamanje yayingalingani, futhi le nsizakalo yehlulekile ukufinyelela iziguli okungenzeka zidinga ukunakekelwa kakhulu.
Enye isifundo se-2017, esanyatheliswa ku- Front Pharmacology sibonise ukuthi, ngenxa yazo zonke izici zayo, i-telemedicine ingase ingakwazi ukuletha ukuthuthukiswa kwezempilo okuhloswe. Abacwaningi abakwazanga ukuthola ubufakazi obanele bokuncoma i-telemedicine kubantu abanesifo sikashukela abadinga ukulawula inkomba yabo ye-glycemic.
I-Telemedicine ku-Industry Spine Care Industry
Kodwa kubantu abanobuhlungu bezintamo nangemuva, kukhona ukukhanya okuncane kwethemba. Uma ucwaningo lwangaphambili lunoma iyiphi inkomba, iziguli ezibuhlungu emuva nangokomugqa zingase zenzeke kangcono kunabo ababona ezinye izinhlobo zochwepheshe bezokwelapha ngokusebenzisa isiphequluli sewebhu.
Kusukela ngo-2017, iningi labacwaningi lincoma izinhlelo ze-telemedicine njengoba ziqondisa ukukhathazeka komuntu siqu. Isibonelo, isifundo se-2017 esanyatheliswa ku- Journal of Physical Medicine kanye nokuvuselelwa kwatholakala ukuthi iziguli ezibuhlungu bezintamo ezikude zazuza usizo lokuphulukisa okungcono, ukusebenza komzimba okuthuthukisiwe nokunamathela ngokujulile ohlelweni lokuzivocavoca lwamazi ekhaya ngaphandle kwalabo abavakashela udokotela wabo umuntu.
Olunye isifundo, lo obuka ucingo lwe-telemedicine ngenxa yezinhlungu eziphansi emuva, weza nemiphumela efanayo. Ucwaningo lwanyatheliswa ngo-Ephreli 2017 umagazini we- Spine Journal.
Kusukela kulolu cwaningo, kutholakale ukuthi ngenkathi kusetshenziselwa ukuxhumana nge-telemedicine, kuphelelise yonke imodeli yokulethwa kwezidingo ze-e-Health okungenzeka ukuthi ufuna ukuthi ukholwe ukuthi, okungenani emhlabeni wezinsizakalo zomgogodla, unomthwalo wokunciphisa ubuhlungu futhi / noma ukukhubazeka kubantu abanobuhlungu obungapheli obuya emuva.
Lokho kusho ukuthi abalobi bathi kusukela ngo-2017, i-telehealth "iphikisiwe," ngisho nokuhambisana nokunakekelwa okujwayelekile.
Enye yezinkinga ezikhungathekisayo ekuxoxweni kokunakekelwa kokunakekelwa kwemithi okuphazamisa izimpande zisezindaweni ezizungeze ukucabanga kwezithombe zokuxilonga, kubuza imibuzo efana namaphi izinhlobo ezahlukene "zamafilimu" ozidingayo ngempela ukuze uthole uhlobo oluyisisekelo emuva ? Noma, kufanele ukuya kudokotela ngezinhlungu zangemuva ngokuzenzakalelayo kudingeke ukuthi ukuhleleka kwe- MRI ?
Iziqondiso ezisekelwe emtholampilo zithi cha-ukuthi uma unezimpawu zesibindi ezingase zikhomba inkinga ebalulekile , amafilimu kanye nokuhlolwa kokuhlola akudingekile kudokotela ukuba ahlolwe umgogodla.
Eqinisweni, isifundo se-2011 eshicilelwe ku- Annals of Internal Medicine , u-Chou, et al, siphetha ngokuthi ukucabanga ngeso lengqondo akuhlotshaniswa nezinzuzo eziphathelene nomtholampilo. Kodwa odokotela abaningi bayaqhubeka bebayala iziguli zabo ezinezinhlungu eziphambene nomzimba.
Ungakwazi ukuxhumana nge-telemedicine?
Uxolo, cha. Nakuba kungakaze kwenziwe ucwaningo oluningi ngalesi sihloko, isifundo esisodwa, esanyatheliswa ngo-March 2016, se- Telemedicine ne-E-Health, sathola ukuthi ucingo lwe-telemedicine lwangaphandle lwabahlengikazi lanikeza inombolo efanayo yamabhayisikobho njengabahlengikazi basehhovisi, okuphakathi kuka-79 no- Amaphesenti angu-88 weziguli abonayo.
Izwi elivela
Okungenani okwamanje, sibuyela emuva kwesigcawu esisodwa. Ochwepheshe futhi babeke abantu ngokufanayo bazi ukuthi sekuhlala amashumi eminyaka ukuthi ukuhlala besebenzayo mhlawumbe kuyisihluthulelo esikhulu kunazo zonke empilweni yangemva kwesikhathi eside, ngisho nangaphansi kwezimo ezidinga ukwelashwa.
Ngokuyinhloko, ukuqiniswa komgogodla nokuqiniswa komgogodla kuye kwazibonakalisa ngokuphindaphinda ngezifundo zocwaningo.
Isibonelo, isifundo se-2001 sathola ukuthi emva kweminyaka emibili kuya kweyithathu, iziguli ezithembele ekuphathweni kwezokwelapha zodwa zazingaphezu kokuphindwe kabili ukubhekana nokuphindaphinda inkinga yazo uma kuqhathaniswa nalabo abaqala uhlelo lokuzivocavoca oluhlelwe ngokuqondile isimo sabo Ukwengeza ekuphathweni kwezokwelapha.
Ngakho-ke, ukufundisa okuvela kumhlinzeki oqeqeshiwe oqonda isimo sakho sangemuva kungase kube ukubheja kwakho okungcono kakhulu ekusizeni ubuhlungu-kungakhathaliseki ukuthi uyabonwa kuyi-intanethi noma emtholampilo.
> Imithombo:
> Chou, R., et. al. Imaging yokuthola ukuzwa ubuhlungu obuphansi emuva: iseluleko sokunakekelwa kwezempilo okuphezulu okuvela eMelika College of Physicians. U-Ann Intern Med. Feb 2011. https://www.ncbi.nlm.nih.gov/pubmed/21282698
> Dario, A. Ukuphumelela kokungenelela kweTelehealth kubantu abathintekayo. Isiphetho. Ngo-Ephreli 2071. https://www.fotoinc.com/news-updates/effectiveness-telehealth-low-back-pain
> I-Gialanella, B., iTechmedicine yasekhaya ehlala ekhaya ezigulini ezine-Chronic Neck Pain. I-American Journal of Medicine Physical & Rehabilitation: May 2017. http://journals.lww.com/ajpmr/Abstract/2017/05000/Home_Based_Telemedicine_in_Patients_with_Chronic.8.aspx
> Ufihla, J., et. al. Imiphumela emide yesikhathi eside sokuzivocavoca okuqondile kokuqala kwesiqephu esibuhlungu obuhlungu emuva. Isiphetho. June 2001. https://www.ncbi.nlm.nih.gov/pubmed/11389408
> Kruse, C., et. al. Ukusebenza kwe-telemedicine ekulawuleni izifo zenhliziyo ezingapheli - ukubuyekezwa okuhlelekile. JRSM Vula. NgoMashi 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347273/
> Lee, S., et. al. I-Telemedicine yokuphathwa kwe-Glycemic Control kanye Nemiphumela Yomtholampilo ye-Type 1 Diabetes Mellitus: Ukubuyekezwa Okuhlelekile kanye Nokuhlaziywa Kwezinguquko Ezilawulwe Ngokungahleliwe. Front Pharmacol. May 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447671/
> Mafi, J., et. al. I-Association of Primary Care Practice Indawo kanye Nobunikazi Ngokuhlinzeka Ngokunakekelwa Kwezindleko Eziphansi E-United States. Ama-Jama wangaphakathi. Juni 2017. https://www.ncbi.nlm.nih.gov/pubmed/28395013
> Mafi, J., et. al. ukuqhubekela phambili kwemikhuba ekulawuleni nasekwelapha ubuhlungu bnack. I-JAMA Intern Med. Sept. 2013. https://www.ncbi.nlm.nih.gov/pubmed/23896698
> Uscher-Pines, L, et. al. Ukufinyelela kanye nekhwalithi yokunakekelwa ku-Direct-to-Consumer Telemedicine. I-Telemedicine ne-E-Health. NgoMashi 2016. http://online.liebertpub.com/doi/10.1089/tmj.2015.0079