大型隔离医学场所中远程会诊及设立综合门诊部在隔离医学观察人员精准医疗救治中的应用与思考

Application and Reflection on remote Consultation and Establishment of comprehensive Outpatient Department in large isolated medical Places in precise medical Treatment of isolated medical Observers

目的探讨数字远程会诊系统及设立综合门诊部在大型隔离医学场所中应用于精准医疗救治中的价值。方法选取2021年12月至2022年6月在深圳市第二人民医院隔离场所医学观察的人员中需要医疗救治的远程会诊共计接收240例,其中男115例,女125例;轻型、普通型、重型、危重型各29例、176例、23例、12例。将北科瑞生研发的数字化远程会诊系统应用于隔离医学观察人员的救治过程中,设立综合门诊部。统计采用远程会诊的次数及利用该系统节约医疗物资的情况,从该系统的可靠性、满意以及远程会诊系统的时效性应用于传染性疾病的必要性等展开问卷调查,分析统计结果。结果会诊团队主要包括急诊科、呼吸科、麻醉科、影像科、心理科、中医科等,普通会诊时间约为24 h内响应,急诊会随时响应,远程会诊次数高达2171次,其中包括20次特邀会诊专家。其中轻型、普通型、重型、危重型各330、1452、215、174例次;远程超声影像传输、电子听诊查体、舌苔图像传输各3865次、685次、968次,在诊断过程中调整诊疗方案568例次。目前综合门诊部对隔离人员医疗救治成功率100%,无死亡病例,而且没有发生医护人员感染相关事件。远程会诊系统问卷调查结果基本集中在好和非常好选项,满意度较高。结论应用数字远程会诊系统进行会诊,能够保障隔离医学观察人员接受精准医疗,综合门诊部及时消毒杀菌,工作质量整体情况较好,避免出现交叉感染,运行满意度高,目前在本院隔离医学场所中发挥着重要的作用。

Objective To explore the value of digital remote consultation systems and the establishment of comprehensive outpatient departments in precision medical treatment in large isolated medical facilities.Method A total of 240 remote consultations requiring medical treatment were received from medical observation personnel in isolation facilities of Shenzhen Second People's Hospital from December 2021 to June 2022,including 115 males and 125 females;There were 29 cases of mild type,176 cases of ordinary type,23 cases of severe type,and 12 cases of critically severe type.The digital remote consultation system developed by Beike Ruisheng was applied to the treatment process of isolated medical observers,and a comprehensive outpatient department was established.The times of using remote consultation and the situation of using the system to save medical materials were counted,questionnaire surveys were conducted on the reliability,satisfaction,and timeliness of the remote consultation system and the need for its application to infectious disease,the statistical results were analyzed.Results The consultation team mainly includes emergency department,respiratory department,anesthesia department,imaging department,psychology department,traditional Chinese medicine department,etc.The general consultation time is about 24 hours,and the emergency department will respond at any time.The number of remote consultations is as high as 2171,including 20 specially invited experts.Among them,there were 330,1452,215,and 174 cases of light,ordinary,heavy,and hazardous types each;Long distance ultrasonic image transmission,electronic auscultation examination and tongue coating image transmission were 3865,685 and 968 times respectively,and 568 cases were adjusted during diagnosis.At present,the success rate of medical treatment for isolated personnel in the comprehensive outpatient department is 100%,there are no deaths,and there have been no incidents related to infection among medical staff.The questionnaire survey results of the remote consultation system are mainly focused on good and very good options,with high satisfaction.Conclusion The application of digital remote consultation system for consultation can ensure that isolated medical observation personnel receive precise medical treatment,the comprehensive outpatient department is promptly disinfected and sterilized,the overall quality of work is good,cross infection is avoided,and the operation satisfaction is high.It plays an important role in the current isolated medical facilities of our hospital.