从卫生政策制定者的角度看伊朗实施远程医疗所面临的挑战和解决方案。
Challenges and solutions for implementing telemedicine in Iran from health policymakers' perspective.
机构信息
Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran.
Health Economics Policy Research Center, Tehran Medical Branch, Islamic Azad University, Tehran, Iran.
出版信息
BMC Health Serv Res. 2024 Jan 10;24(1):50. doi: 10.1186/s12913-023-10488-6.
BACKGROUND
Despite significant progress in health technology and growing interest among countries in incorporating telemedicine into healthcare delivery, its usage remains limited in Iran. The aim of this study is to investigate the challenges related to telemedicine in Iran and pinpoint potential solutions from the viewpoint of health policymakers, marking the first such endeavor.
METHODS
This qualitative study was conducted in Iran in 2022. Data were gathered from 19 health policymakers who were selected using purposeful and snowball sampling techniques via in-depth and semi-structured interviews. The research findings were analyzed using the content analysis technique, with coding performed using MAXQDA software. The content analysis approach developed by Erlingsson was utilized to analyze the data.
RESULTS
The study revealed eight main challenges that inhibit the widespread use of telemedicine in Iran. These challenges include policy weaknesses, uncertainty around operating mechanisms, inadequate communication and telecommunication infrastructure, insufficient cultural infrastructure, lack of electronic requirements, redundant bureaucracies, legal gaps, and economic factors. Furthermore, four key solutions to these challenges were identified. These include a national commitment to the development of telemedicine, the establishment of a telemedicine roadmap, the enhancement of e-health requirements and infrastructure, and the preparation of the community to accept telemedicine as a viable option for healthcare delivery.
CONCLUSION
The implementation of telemedicine in Iran faces significant challenges, some of which are related to the national healthcare system, while others stem from various policy-related institutions and organizations. Addressing these challenges will require extensive inter-organizational cooperation and strong leadership at the governance level. However, it should be noted that fully resolving these issues is a time-consuming process.
背景
尽管在医疗技术方面取得了重大进展，各国对将远程医疗纳入医疗服务的兴趣也日益浓厚，但远程医疗在伊朗的使用仍然有限。本研究旨在调查伊朗远程医疗面临的挑战，并从卫生政策制定者的角度找出潜在的解决方案，这是首次进行此类尝试。
方法
本定性研究于 2022 年在伊朗进行。通过目的抽样和滚雪球抽样技术，从 19 名卫生政策制定者中收集数据，对他们进行深入的半结构化访谈。采用 MAXQDA 软件对数据进行编码，使用 Erlingsson 开发的内容分析法对研究结果进行分析。
结果
研究揭示了八项阻碍远程医疗在伊朗广泛应用的主要挑战。这些挑战包括政策薄弱、运营机制不确定、通信和电信基础设施不足、文化基础设施不足、电子需求不足、冗余官僚机构、法律空白以及经济因素。此外，还确定了应对这些挑战的四项关键解决方案。这些解决方案包括国家对远程医疗发展的承诺、制定远程医疗路线图、加强电子医疗需求和基础设施、以及使社区做好准备，接受远程医疗作为医疗服务的可行选择。
结论
远程医疗在伊朗的实施面临重大挑战，其中一些与国家医疗体系有关，而另一些则源自各种与政策相关的机构和组织。解决这些挑战需要广泛的组织间合作和治理层面的强有力领导。然而，应当指出，完全解决这些问题是一个耗时的过程。
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