Latifi Rifat
University of Arizona, Tucson, AZ, USA.
Stud Health Technol Inform. 2011;165:3-10.
Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in the Balkans has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in Kosova. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy developed by IVeH "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services not only in developing countries, but in developed countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs is described. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the very core of healthcare infrastructure. The end point is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova and Albania has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program is transitioned to the Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Macedonia, Montenegro and other countries around the world. The IBOT model has been effective in creating sustainable telemedicine and e-health integrated programs in the Balkans and may be a good model for establishing such programs in developing countries.
建立可持续的远程医疗已成为世界上许多发展中国家的目标。然而，尽管有少数个人乃至各国政府偶尔发起相关倡议，但这些倡议往往从未发展成熟成为可持续的项目。在巴尔干地区引入远程医疗和电子学习，是提升该地区医疗服务质量和可及性的关键一步，该地区的基础设施和资源因战争、忽视、资金短缺和管理不善而遭到严重破坏。国际虚拟电子医院（IVeH）的概念和建立对科索沃的远程医疗和电子健康服务产生了重大影响。IVeH在科索沃的成功促使其他巴尔干国家和其他发展中国家开展了类似项目，以期实现其医疗基础设施的现代化并加以改善。IVeH制定的全面、四管齐下的“启动-建设-运营-移交”（IBOT）战略，可能是一种不仅在发展中国家，而且在发达国家建立远程医疗和电子健康教育服务的有用方法。本文描述了IVeH用于建立和发展远程医疗项目的发展战略IBOT。IBOT包括评估每个国家的医疗需求、制定课程和教育计划、建立全国性远程医疗网络，以及将远程医疗项目融入医疗基础设施的核心。最终目标是将一个可持续的远程健康项目移交给相关国家。通过应用IBOT，科索沃和阿尔巴尼亚建立了一个可持续的远程医疗项目，成为巴尔干地区远程医疗的有效范例。该项目一旦完全成熟，就移交给卫生部，由卫生部确保项目的可持续性和自主权。马其顿、黑山和世界其他国家也在建立类似项目。IBOT模式在巴尔干地区成功创建了可持续的远程医疗和电子健康综合项目，可能是发展中国家建立此类项目的良好模式。
