Angelovská Olga, Dobiášová Karolína, Těšinová Jolana Kopsa
First Faculty of Medicine, Institute of Public Health and Medical Law, Charles University, Praha, Czech Republic.
Int J Health Plann Manage. 2025 Jan;40(1):271-286. doi: 10.1002/hpm.3863. Epub 2024 Nov 4.
The COVID-19 Pandemic contributed to accelerating the process of using information and communication technologies and digital technologies in healthcare management and delivery within healthcare systems. At that time, the Czech healthcare system faced the same problems as other European systems and struggled with a temporary limitation of direct provision of healthcare services. It was solved by switching to telemedicine. The Czech healthcare system used telemedicine to a minimal extent until then. Despite adopting the law on healthcare digitisation, it is still one of the countries with a lower level of digitisation of healthcare processes. The article presents the results of an exploratory expert investigation focused on the implementation and development of telemedicine in the Czech Republic. The conducted research aimed to identify problems related to the implementation of telemedicine in practice, place them in the broader framework of the healthcare system and structure them, propose possible solutions, and identify the future challenges of telemedicine in the Czech Republic. We based our study on the results of a three-phase QUAL-QUAN-QUAL research. Data collection in the first phase took the form of individual semi-structured interviews with patients (25) with practical experience in the field of telemedicine, followed by the second quantitative phase of the questionnaire survey with patients (650). The third qualitative phase included semi-structured interviews with experts (17) with practical experience in telemedicine. The introduction and expansion of telemedicine require several fundamental changes. These include adjustments to the legislative environment and changes to the technological infrastructure, organisation of care and work. Several barriers have been identified at the healthcare system level, healthcare providers, healthcare professionals and patients.
新冠疫情推动了医疗系统在医疗管理和服务中加速使用信息通信技术和数字技术的进程。当时，捷克医疗系统面临着与其他欧洲系统相同的问题，且在直接提供医疗服务方面暂时受限。这一问题通过转向远程医疗得以解决。在此之前，捷克医疗系统对远程医疗的使用程度极低。尽管通过了医疗数字化相关法律，但它仍是医疗流程数字化水平较低的国家之一。本文展示了一项探索性专家调查的结果，该调查聚焦于捷克共和国远程医疗的实施与发展。所开展的研究旨在识别远程医疗在实践中实施相关的问题，将其置于更广泛的医疗系统框架中并进行梳理，提出可能的解决方案，以及确定捷克共和国远程医疗未来面临的挑战。我们的研究基于一项三阶段的质性-量化-质性研究结果。第一阶段的数据收集采用对有远程医疗实践经验的患者（25名）进行个别半结构化访谈的形式，随后是对患者（650名）进行问卷调查的第二量化阶段。第三质性阶段包括对有远程医疗实践经验的专家（17名）进行半结构化访谈。远程医疗的引入和扩展需要若干根本性变革。这些变革包括对立法环境的调整以及技术基础设施、护理组织和工作方面的变化。在医疗系统层面、医疗服务提供者、医疗专业人员和患者方面都已识别出若干障碍。
