Angaran D M
Angaran Associates, Ltd., Powell, OH 43065, USA.
Am J Health Syst Pharm. 1999 Jul 15;56(14):1405-26. doi: 10.1093/ajhp/56.14.1405.
Uses of telemedicine are described and potential roles for pharmacists are discussed. Telemedicine has been defined as "the use of electronic information and communications technologies to provide and support health care when distance separates the participants." Technologies included in telemedicine are videoconferencing, telephones, computers, the Internet, fax, radio, and television. Telepharmacy has the same basic definition but refers to pharmaceutical care provision. Although the videotelemedicine market is expected to grow considerably, lack of reimbursement and high costs are continuing obstacles. Pharmacy is using video-conferencing for education, training, and management purposes. The telephone has changed from a dial-and-talk instrument to a multimedia access tool. Medical devices are being attached to telephone lines to provide remote monitoring and therapy, and call centers are providing medication counseling, prior authorization, refill authorization, and formulary compliance monitoring. Although the Internet has quickly become a star performer, utilization by health care lags behind that of other industries. The Internet-fueled empowerment of consumers and their expectations for speed, access, and convenience are creating more unmet expectations of the traditional health care system. Pharmacy has both organizational and individual practitioner Web sites, but it is online drugstores that are attracting most attention. Potential benefits of telemedicine include improved access to care, greater efficiency in diagnosis and treatment, higher productivity, and market positioning for the coming century. Telemedicine will tax the economic, regulatory, legal, ethical, and clinical care expertise of the entire health care system. Studies of the effectiveness, cost, and societal implications of telemedicine are needed, along with practice models and standards, training programs, and solutions to regulatory, licensing, and legal questions. Securing reimbursement for cognitive services remains a problem for telemedicine and telepharmacy. Telemedicine presents profound opportunities and challenges to pharmacy and other health care professions.
本文描述了远程医疗的用途，并讨论了药剂师的潜在作用。远程医疗被定义为“当参与者之间存在距离时，利用电子信息和通信技术提供和支持医疗保健”。远程医疗所包含的技术有视频会议、电话、计算机、互联网、传真、无线电和电视。远程药学的基本定义相同，但指的是提供药学服务。尽管视频远程医疗市场预计将大幅增长，但报销不足和成本高昂仍是持续存在的障碍。药学领域正在将视频会议用于教育、培训和管理目的。电话已从拨号通话工具转变为多媒体接入工具。医疗设备正连接到电话线上以提供远程监测和治疗，呼叫中心正在提供用药咨询、事先授权、续方授权和处方集合规性监测。尽管互联网迅速成为明星，但医疗保健领域对其的利用仍落后于其他行业。互联网赋予消费者的权力以及他们对速度、接入和便利性的期望，正在使传统医疗保健系统产生更多未得到满足的期望。药学领域既有机构网站，也有个体从业者网站，但最受关注的是在线药店。远程医疗的潜在益处包括改善医疗服务的可及性、提高诊断和治疗效率、提高生产力以及为下个世纪进行市场定位。远程医疗将考验整个医疗保健系统的经济、监管、法律、伦理和临床护理专业知识。需要对远程医疗的有效性、成本和社会影响进行研究，同时还需要实践模式和标准、培训项目以及解决监管、许可和法律问题的方案。为认知服务争取报销仍然是远程医疗和远程药学面临的一个问题。远程医疗给药学和其他医疗保健专业带来了深刻的机遇和挑战。
