Reifegerste Doreen, Harst Lorenz, Otto Lena
School of Public Health, Bielefeld University, Universitätsstrasse 25, 33615 Bielefeld, Germany.
Technische Universität Dresden, Dresden, Germany.
Z Gesundh Wiss. 2022;30(1):11-20. doi: 10.1007/s10389-021-01513-1. Epub 2021 Mar 24.
Telemedicine is a promising solution to extend traditional health care services. Even though mainly discussed during the past two decades, its roots go back into the past century and even further, considering the use of bonfires to warn other villages of diseases. Insights from historical cases can therefore be useful for the ongoing discussion regarding the successful implementation of telemedicine.
We analyzed three historical telemedicine cases (varying regarding time and place) and extracted their success factors and barriers as well as assessed their maturity by using the Telemedicine Community Readiness Model (TCRM). Evidence-based categories of success factors and barriers as well as the TCRM's dimensions were used as deductive categories to analyze the study material's content.
The analysis showed that the readiness for telemedicine is higher when the technology is the only option to access health care services. In all three cases, core readiness played a central role. However, the health sector, existing technology, and finance were barriers present at all times, while during pandemics, some barriers are only temporarily removed, for example, by putting legal issues on hold. The analyzed cases were all on lower levels of maturity as they mainly represent pilot tests or exceptional circumstances.
Results indicate the important core functions in telemedicine initiatives as well as the diversity of their circumstances. Insights from such historical meta-perspectives can, for example, help to strengthen the sustainability of the increased use of telemedicine during the COVID-19 pandemic and scale up current telemedicine projects.
远程医疗是扩展传统医疗服务的一种有前景的解决方案。尽管它在过去二十年中才受到主要讨论，但其根源可追溯到上个世纪甚至更早，想想利用篝火向其他村庄通报疾病的情况就知道了。因此，历史案例中的见解对于当前有关远程医疗成功实施的讨论可能会有所帮助。
我们分析了三个历史远程医疗案例（时间和地点各不相同），提取了它们的成功因素和障碍，并使用远程医疗社区准备模型（TCRM）评估了它们的成熟度。基于证据的成功因素和障碍类别以及TCRM的维度被用作演绎类别来分析研究材料的内容。
分析表明，当技术是获取医疗服务的唯一选择时，对远程医疗的准备程度会更高。在所有三个案例中，核心准备都发挥了核心作用。然而，卫生部门、现有技术和资金始终是存在的障碍，而在大流行期间，一些障碍只是暂时被消除，例如通过搁置法律问题。所分析的案例都处于较低的成熟度水平，因为它们主要代表试点测试或特殊情况。
结果表明了远程医疗举措中的重要核心功能及其情况的多样性。从这种历史元视角获得的见解，例如，可以有助于加强在COVID-19大流行期间增加使用远程医疗的可持续性，并扩大当前的远程医疗项目。
