Sanders J H, Bashshur R L
Telemedicine Center, Medical College of Georgia, Augusta, USA.
Telemed J. 1995 Summer;1(2):115-23. doi: 10.1089/tmj.1.1995.1.115.
In the United States, we are witnessing a renewed emphasis on the potential role of telemedicine in redressing issues of accessibility, cost, and quality of medical care. This paper describes several major problems confronting the current generation of telemedicine projects as they move toward maturity. In fact, it is argued here, the future development of telemedicine as an integral component of the health care system depends on the successful resolution of these concerns. Included for discussion are issues related to physicians, institutions, patients, and the general public. On the basis of the tenets of telemedicine and its capacity to transcend traditional boundaries of medical care via telecommunications, informed speculations are presented that are intended to stimulate discussion and provide direction for addressing a number of potential problems. Included are suggestions pertaining to restructuring the medical licensure system to accommodate telemedicine and the virtual regionalization of health care; implications for provider liability and reimbursement; patient privacy; system design; and diffusion of information.
在美国，我们看到人们重新重视远程医疗在解决医疗可及性、成本和质量问题方面的潜在作用。本文描述了当前一代远程医疗项目在走向成熟过程中面临的几个主要问题。事实上，本文认为，远程医疗作为医疗保健系统不可或缺的一部分，其未来发展取决于这些问题能否得到成功解决。讨论内容包括与医生、机构、患者和公众相关的问题。基于远程医疗的原则及其通过电信超越传统医疗界限的能力，本文提出了一些有见地的推测，旨在激发讨论并为解决一些潜在问题提供方向。其中包括有关重组医疗执照制度以适应远程医疗和医疗保健虚拟区域化的建议；对提供者责任和报销的影响；患者隐私；系统设计；以及信息传播。
