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Information and communication technology-based cardiac rehabilitation homecare programs

机译：基于信息和通信技术的心脏康复家庭护理计划

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Abstract: Cardiac rehabilitation (CR) has, for many years, been a highly recommended approach to secondary prevention for patients recovering after a heart attack or heart surgery. These programs are traditionally delivered from a hospital outpatient center. Despite demonstrated benefits and guideline recommendations, CR utilization has been poor, particularly in women, older patients, and ethnic minority groups. To overcome some of the barriers to the traditional delivery of CR, different delivery platforms and approaches have been developed in recent years. In general, Telehealth solutions which have been used to address the delivery of CR services remotely include: 1) patient–provider contact delivered by telephone systems; 2) the Internet, with the majority of patient–provider contact for risk factor management taking place online; and 3) interventions using Smartphones as tools to deliver CR through (independently or in combination with) short message service messaging, journaling applications, connected measurement devices, and remote coaching. These solutions have been shown to overcome some of the barriers in CR participation and show potential as alternative or complementary options for individuals that find traditional center-based CR programs difficult to commit to. The major benefits of remote platforms for CR delivery are the ability to deliver these interventions without ongoing face-to-face contact, which provides an opportunity to reach large numbers of people, and the convenience of selecting the timing of cardiovascular disease management sessions. Furthermore, technologies have the potential to deliver long-term follow-up, which programs delivered by health professionals cannot afford to do due to staff shortages and budget restrictions. However, change in the existing CR services is not without challenges. There is a need to identify development issues that can hamper the implementation of the interventions outside controlled trial settings systems, which may require new computing infrastructures, specific clinical responsibilities, time for training, and development and openness to new ways of doing things.
机译：摘要：多年来，对于心脏病发作或心脏手术后康复的患者，心脏康复（CR）一直是二级预防的高度推荐方法。传统上，这些程序是从医院的门诊中心提供的。尽管显示出了好处和指导性建议，但是CR的利用率仍然很差，特别是在女性，老年患者和少数民族群体中。为了克服传统CR交付的一些障碍，近年来已经开发了不同的交付平台和方法。通常，用于远程解决CR服务的远程医疗解决方案包括：1）通过电话系统提供的患者-提供者联系; 2）互联网，大多数患者-提供者之间的风险因素管理联系都是在线进行的;和3）使用智能手机作为工具的干预措施，以通过短消息服务消息传递，日记应用程序，连接的测量设备以及远程指导来（独立地或与之组合）提供CR。这些解决方案已显示出克服了CR参与的一些障碍，并显示了对难以实施传统的基于中心的CR计划的个人的替代或补充选择的潜力。远程CR交付平台的主要优势在于无需持续面对面就可以交付这些干预措施的能力，这为接触大量人群提供了机会，并且方便了选择心血管疾病管理会议的时间。此外，技术具有进行长期跟进的潜力，由于人员短缺和预算限制，卫生专业人员无法执行这些计划。但是，现有CR服务的变更并非没有挑战。有必要确定可能妨碍在受控试验设置系统之外实施干预措施的开发问题，这可能需要新的计算基础架构，特定的临床职责，培训时间以及开发和开放新的工作方式。

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