Jacobson P D, Selvin E
University of Michigan School of Public Health, Ann Arbor 48109-2029, USA.
Telemed J E Health. 2000 Winter;6(4):429-39. doi: 10.1089/15305620050503915.
The expansion of information technology has shattered geographic boundaries, allowing for extraordinarily increased access to health information and expanded opportunities for telemedicine practice across state boundaries. But despite its recent growth, telemedicine technology remains embedded in a state-based licensure system that places severe limits on its expansion. The current system of medical licensure is based primarily on statutes written at the turn of the 20th century. This system is inadequate to address the emerging medical practices and future uses of medical technology in the telecommunications age. To respond to the changes offered by the telecommunications revolution, we need to design a new regulatory structure for the 21st century. The purpose of this article is to propose a policy of national telemedicine licensure. The primary goal here is not to simply develop a policy proposal, but to discuss the rationale for national licensure and place it on the policy agenda. A national licensure system will expand the market for telemedicine, promote both the use and development of new technologies, and simultaneously eliminate many of the legal and regulatory ambiguities that plague and constrain the present system.
信息技术的发展打破了地域界限，极大地增加了人们获取健康信息的机会，并拓展了跨州开展远程医疗实践的可能性。尽管远程医疗技术近来有所发展，但它仍受限于基于州的执照颁发制度，这严重限制了其扩张。当前的医疗执照颁发制度主要基于20世纪初制定的法规。这种制度不足以应对电信时代新兴的医疗实践和医疗技术的未来应用。为了应对电信革命带来的变化，我们需要为21世纪设计一种新的监管结构。本文的目的是提出一项全国性远程医疗执照颁发政策。这里的主要目标并非仅仅制定一项政策提案，而是讨论全国性执照颁发的基本原理，并将其提上政策议程。全国性执照颁发制度将扩大远程医疗市场，促进新技术的应用与发展，同时消除困扰和限制当前制度的许多法律和监管方面的模糊之处。
