University of California, San Diego (UCSD), San Diego, CA 92103-8466, USA.
Acad Med. 2012 Aug;87(8):1032-40. doi: 10.1097/ACM.0b013e31825cdd3a.
The authors draw on their experience with the University of California, San Diego Medical Center's successful enterprise-level clinical telemedicine program to present a paradigm for other academic health centers (AHCs) that wish to develop such a program. They detail key telemedicine program elements, or "tele-ments," that they consider essential to the development of a centralized, structured telemedicine program and relevant to the development of smaller programs. These tele-ments include an overall organizational vision, a centralized telemedicine infrastructure, telemedicine-specific policies and procedures, medical record documentation, relationships between the AHC clinical hub and its remote (spoke) partners, identification of and training for specialty providers, a business plan based on service agreements and/or insurance billing, and licensure/privileging. They discuss the importance of delaying equipment purchases until a plan is in place for sustaining the telemedicine enterprise and of establishing measures to define success at the outset of program development. In addition, they detail the benefits and concerns associated with telemedicine, provide a comprehensive listing of the roles and responsibilities of providers and staff involved in all aspects of telemedicine, and share samples of their program's informed consent forms and workflow checklists. Their goal is to offer support and guidance to other AHCs entering the telemedicine arena, enabling them to replicate key elements of a successful, enterprise-wide telemedicine infrastructure.
作者借鉴了加利福尼亚大学圣地亚哥医疗中心成功的企业级临床远程医疗计划的经验，为其他希望开发此类计划的学术健康中心（AHC）提出了一种模式。他们详细介绍了远程医疗计划的关键要素，即“远程要素”，这些要素对于开发集中式、结构化的远程医疗计划至关重要，也与较小计划的开发相关。这些远程要素包括整体组织愿景、集中式远程医疗基础设施、针对远程医疗的特定政策和程序、病历记录文档、AHC 临床中心与其远程（分支）合作伙伴之间的关系、专科医生的确定和培训、基于服务协议和/或保险计费的业务计划，以及许可/特权。他们讨论了在为远程医疗企业提供支持的计划到位之前延迟设备购买的重要性，以及在项目开发之初就确定成功标准的重要性。此外，他们详细介绍了远程医疗相关的益处和关注点，提供了一份全面的参与远程医疗各个方面的提供商和工作人员的角色和职责清单，并分享了他们计划的知情同意书和工作流程检查表的样本。他们的目标是为进入远程医疗领域的其他 AHC 提供支持和指导，使他们能够复制成功的、全企业范围的远程医疗基础设施的关键要素。
