Wootton Richard
Centre for Online Health, University of Queensland, Australia.
J Telemed Telecare. 2008;14(3):109-14. doi: 10.1258/jtt.2008.003001.
Telemedicine has been used for some years in the industrialized world, albeit with rather mixed success. There is also a considerable literature on the potential use of telemedicine for the developing world. However, there are few reports of the actual use of telemedicine there. A review identified five telemedicine networks providing second opinions; each network had been in operation for over five years. Although they have different aims and methods of operation, they exhibit some common features. In particular, none of them appear to be dealing with markedly increasing referral rates. Rough calculations suggest that only about 0.1% of the potential telemedicine demand from the developing world is being met. Possible reasons include the referrers being too busy and a perceived loss of control. If this analysis is correct, then the right strategy for future telemedicine in developing countries will be to concentrate on the construction of within-country networks that demonstrably alter health outcomes, can be shown to be cost-effective and sustainable, and will provide a model for other countries to copy.
远程医疗在工业化国家已应用多年，尽管成效参差不齐。关于远程医疗在发展中国家的潜在应用也有大量文献。然而，关于其在发展中国家实际应用的报道却很少。一项综述发现有五个提供二次诊断意见的远程医疗网络；每个网络都已运营了五年以上。尽管它们有不同的目标和运营方式，但呈现出一些共同特征。特别是，它们似乎都没有应对明显增加的转诊率。粗略计算表明，发展中国家潜在的远程医疗需求仅约0.1%得到了满足。可能的原因包括转诊者太忙以及一种控制权丧失的感觉。如果这一分析正确，那么发展中国家未来远程医疗的正确策略将是专注于建设国内网络，这些网络能显著改善健康结果，被证明具有成本效益且可持续，并将为其他国家提供可借鉴的模式。
