Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
Int J Environ Res Public Health. 2022 Oct 11;19(20):13029. doi: 10.3390/ijerph192013029.
There is anecdotal evidence of informal telemedicine activity in KwaZulu-Natal (KZ-N), South Africa.
To determine the current extent of telemedicine in district hospitals in KZ-N; the range of clinical activities and technologies used; additional services needed; current knowledge and practice regarding legal, ethical, and regulatory issues; and the need to formalise telemedicine activities.
A cross-sectional survey of telemedicine use by 143 doctors working at 22 District hospitals in KZ-N.
Most doctors (96%) participated in some form of telemedicine across a spectrum of disciplines, but more than half did not consider their activities to constitute telemedicine. To meet their needs, doctors have started their own informal services with colleagues, using mostly instant messaging and chat groups (WhatsApp). Some doctors indicated the need to formalise these services and establish additional services. Few doctors were aware of the national telemedicine guidelines and the required written informed consent for telemedicine was seldom obtained. This could have serious legal, regulatory, and ethical implications.
Practical clinical and technical guidelines and standard operating procedures need to be developed with the active participation of the clinical workforce. These should encourage innovation and greater use of telemedicine, including the use of instant messaging apps.
南非夸祖鲁-纳塔尔省（KwaZulu-Natal，简称 KZ-N）有非正式远程医疗活动的传闻证据。
确定 KZ-N 地区医院远程医疗的当前范围；所使用的临床活动和技术范围；所需的其他服务；当前关于法律、道德和监管问题的知识和实践；以及将远程医疗活动正式化的必要性。
对在 KZ-N 的 22 家地区医院工作的 143 名医生进行了一项关于远程医疗使用的横断面调查。
大多数医生（96%）在一系列学科中参与了某种形式的远程医疗，但超过一半的医生不认为他们的活动构成远程医疗。为了满足他们的需求，医生们已经与同事开始了自己的非正式服务，主要使用即时消息和聊天组（WhatsApp）。一些医生表示需要将这些服务正式化，并建立额外的服务。很少有医生了解国家远程医疗指南，也很少获得远程医疗所需的书面知情同意书。这可能会产生严重的法律、监管和道德影响。
需要在临床工作人员的积极参与下制定实用的临床和技术指南以及标准操作程序。这些指南应鼓励创新和更多地使用远程医疗，包括使用即时消息应用程序。
