Speedie Stuart M, Ferguson A Stewart, Sanders Jay, Doarn Charles R
University of Minnesota, Minneapolis, Minnesota 55455, USA.
Telemed J E Health. 2008 Nov;14(9):964-7. doi: 10.1089/tmj.2008.0114.
Telehealth possesses a significant potential to revolutionize healthcare delivery processes by challenging some of the long-held assumptions about healthcare delivery and by creating innovative alternative models. Those assumptions relate to the location-linked nature of healthcare and its episodic nature. Telehealth can challenge the assumption that healthcare is inextricably linked to the provider's location. Numerous models involving such approaches as interactive videoconferencing and store-and-forward technologies already exist. Telehealth also challenges the episodic nature of care. One example is provided by the models evolving from the convergence of three technologies: remote monitoring, electronic health records, and clinical decision support systems. Telehealth-based models of care can also lead to a reduced demand for services and greater efficiencies in the care process. These telehealth-enabled care delivery models have the potential to reduce the costs of care, improve quality, and mitigate provider shortages. However, the achievement of these goals is not straightforward. The current healthcare financing system is not designed to support such new models, and the existing healthcare culture is deeply ingrained within workflow processes and provider attitudes. A great deal of work remains to be done before the benefits of telehealth-based care delivery models are fully realized. Change is inherently risky but we must have the courage to assume the risk in order to create telehealth-driven innovations that lead to better and more cost-effective medical care for all.
远程医疗具有巨大的潜力，可通过挑战一些长期以来关于医疗服务的假设并创造创新的替代模式，来彻底改变医疗服务流程。这些假设涉及医疗服务与地点的关联性及其阶段性特点。远程医疗可以挑战医疗服务与提供者所在地紧密相连的假设。已经存在许多涉及交互式视频会议和存储转发技术等方法的模式。远程医疗还对医疗服务的阶段性特点提出了挑战。一个例子是由远程监测、电子健康记录和临床决策支持系统这三种技术融合发展而来的模式。基于远程医疗的护理模式还可以减少对服务的需求，并提高护理过程的效率。这些基于远程医疗的护理服务模式有可能降低护理成本、提高质量并缓解医疗人员短缺的问题。然而，实现这些目标并非易事。当前的医疗融资系统并非为支持此类新模式而设计，而且现有的医疗文化在工作流程和提供者态度中根深蒂固。在基于远程医疗的护理服务模式的益处得以充分实现之前，仍有大量工作要做。变革本身具有风险，但我们必须有勇气承担风险，以便创造由远程医疗驱动的创新，为所有人带来更好且更具成本效益的医疗服务。
