Demartines N, Battegay E, Liebermann J, Oberholzer M, Rufli T, Harder F
Département de chirurgie, Hôpital Cantonal de Bâle.
Schweiz Med Wochenschr. 2000 Mar 4;130(9):314-23.
Telemedicine is use of the new computer-based communication technologies for medical purposes. It augments the exchange of scientific information, while its applications in the fields of patient care and medical education cover remote diagnosis and therapy as well as remote education and training.
This article reviews the development of telemedicine and its application to specialties such as anaesthesiology, dermatology, medicine, surgery and pathology at the University Hospital of Basle, Switzerland.
Since 1980 the Department of Medicine has held multidisciplinary teleconferences for expert consultation and medical education. Since 1992 the Institute of Pathology has been linked to remote hospitals for real-time biopsy, and, since 1997, remote dermato-histopathological diagnosis has been performed in conjunction with a number of centres and practitioners. International academic teleconferences have been held in the field of surgery since 1986 and there is an interactive education programme via telemedicine in the field of anaesthesiology. The technology in use must be adapted to needs: since few practitioners are currently connected to the Internet, teleconferencing will still be the rule in the Department of Medicine. Remote diagnosis in dermatology and pathology requires high-resolution images transmitted by self-developed software via 64 Kb/s ISDN connection, while surgery works with ISDN teleconferencing at 384 Kb/s to ensure live transmission of surgical procedures with high-quality images.
Our practice, based on several hundred cases, suggests that telemedicine is useful in simplifying and expanding access to remote interdisciplinary expertise, as well as improving medical education in a number of specialties. Telemedicine's multidisciplinary approach is to be recommended.
远程医疗是指利用新型的基于计算机的通信技术来实现医疗目的。它促进了科学信息的交流,其在患者护理和医学教育领域的应用涵盖远程诊断与治疗以及远程教育与培训。
本文回顾了远程医疗的发展及其在瑞士巴塞尔大学医院麻醉学、皮肤病学、医学、外科和病理学等专业中的应用。
自1980年以来,医学部一直举办多学科远程会议以进行专家会诊和医学教育。自1992年以来,病理学研究所已与远程医院建立联系以进行实时活检,并且自1997年以来,已与多个中心和从业者联合开展远程皮肤组织病理学诊断。自1986年以来,在外科领域举办了国际学术远程会议,并且在麻醉学领域有通过远程医疗的交互式教育项目。所使用的技术必须适应需求:由于目前很少有从业者连接到互联网,远程会议在医学部仍将是常态。皮肤病学和病理学的远程诊断需要通过自行开发的软件经64 Kb/s综合业务数字网连接传输高分辨率图像,而外科手术则使用384 Kb/s的综合业务数字网远程会议以确保高质量图像的手术过程实时传输。
我们基于数百个案例的实践表明,远程医疗有助于简化和扩大获取远程跨学科专业知识的途径,并改善多个专业的医学教育。远程医疗的多学科方法值得推荐。