Télémédecine 360, TLM360, Paris, France.
Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France.
JMIR Public Health Surveill. 2020 Apr 2;6(2):e18810. doi: 10.2196/18810.
On March 11, 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) outbreak as a pandemic, with over 720,000 cases reported in more than 203 countries as of 31 March. The response strategy included early diagnosis, patient isolation, symptomatic monitoring of contacts as well as suspected and confirmed cases, and public health quarantine. In this context, telemedicine, particularly video consultations, has been promoted and scaled up to reduce the risk of transmission, especially in the United Kingdom and the United States of America. Based on a literature review, the first conceptual framework for telemedicine implementation during outbreaks was published in 2015. An updated framework for telemedicine in the COVID-19 pandemic has been defined. This framework could be applied at a large scale to improve the national public health response. Most countries, however, lack a regulatory framework to authorize, integrate, and reimburse telemedicine services, including in emergency and outbreak situations. In this context, Italy does not include telemedicine in the essential levels of care granted to all citizens within the National Health Service, while France authorized, reimbursed, and actively promoted the use of telemedicine. Several challenges remain for the global use and integration of telemedicine into the public health response to COVID-19 and future outbreaks. All stakeholders are encouraged to address the challenges and collaborate to promote the safe and evidence-based use of telemedicine during the current pandemic and future outbreaks. For countries without integrated telemedicine in their national health care system, the COVID-19 pandemic is a call to adopt the necessary regulatory frameworks for supporting wide adoption of telemedicine.
2020 年 3 月 11 日，世界卫生组织宣布 2019 年冠状病毒病（COVID-19）疫情为大流行，截至 3 月 31 日，203 个以上国家报告了超过 72 万例病例。应对策略包括早期诊断、患者隔离、对接触者以及疑似和确诊病例进行症状监测以及公共卫生检疫。在此背景下，远程医疗，特别是视频咨询，已得到推广和扩大应用，以降低传播风险，特别是在英国和美利坚合众国。基于文献回顾，2015 年发表了远程医疗实施的第一个概念框架。现已确定 COVID-19 大流行期间远程医疗框架的更新版。该框架可大规模应用，以改善国家公共卫生应对。然而，大多数国家缺乏授权、整合和报销远程医疗服务的监管框架，包括在紧急情况和疫情期间。在此背景下，意大利在国家卫生服务范围内向所有公民提供的基本保健服务中不包括远程医疗，而法国授权、报销并积极推广远程医疗的使用。远程医疗在 COVID-19 大流行和未来疫情中的全球使用和整合仍存在若干挑战。鼓励所有利益攸关方应对这些挑战并开展合作，促进在当前大流行和未来疫情期间安全且基于证据的远程医疗使用。对于尚未将远程医疗纳入国家卫生保健系统的国家来说，COVID-19 大流行是呼吁其通过必要的监管框架，以支持远程医疗的广泛应用。
