Office for High Performance Computing and Communications, National Library of Medicine, National Institutes of Health, Bethesda, Maryland 20894, USA.
Telemed J E Health. 2010 Jan-Feb;16(1):93-5. doi: 10.1089/tmj.2009.0153.
The major goals of telemedicine today are to develop next-generation telehealth tools and technologies to enhance healthcare delivery to medically underserved populations using telecommunication technology, to increase access to medical specialty services while decreasing healthcare costs, and to provide training of healthcare providers, clinical trainees, and students in health-related fields. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers. In the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization are critical pieces to the process. Next-generation tools and technologies are vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity. To cover the full spectrum of dynamic and evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service. Toward that end, our group addressed three overarching questions: (1) What are the high-impact topics? (2) What are the barriers to progress? and (3) What roles can the National Institutes of Health and its various institutes and centers play in fostering the future development of telehealth?
当今远程医疗的主要目标是开发下一代远程医疗工具和技术，利用电信技术为医疗服务不足的人群提供更好的医疗服务，增加获得医学专业服务的机会，同时降低医疗成本，并为医疗保健提供者、临床受训者和卫生相关领域的学生提供培训。这些工具和技术的主要驱动因素是远程医疗利益相关者（包括患者、患者群体、研究资助者、研究人员、医疗服务提供者、专业协会、行业、医疗保健管理人员/经济学家和医疗保健政策制定者）之间合作的需求和兴趣。在这些工具和技术的开发、营销、采用和实施过程中，沟通、培训、文化敏感性和最终用户定制是至关重要的环节。下一代工具和技术是个性化医疗的载体，将远程医疗模式扩展到包括手机和基于互联网的远程医疗工具，用于远程和家庭健康管理，包括视频评估、远程床边监测以及具有事件日志、患者电子档案和医生书写能力的患者特定护理工具。远程医疗最终是一个规模和复杂性的系统的系统。为了满足最终用户不断变化的动态需求的全部范围，我们必须认识到系统的复杂性，因为远程医疗在朝着增加功能、集成、互操作性、扩展和服务质量的方向发展。为此，我们的小组提出了三个总体问题：（1）什么是高影响力的话题？（2）有哪些进展的障碍？（3）美国国立卫生研究院及其各个研究所和中心可以在促进远程医疗的未来发展方面发挥什么作用？
