Telemedicine in the state of Maine: A model for growth driven by rural needs
Telemedicine in the state of Maine: A model for growth driven by rural needs
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DOI：
10.1089/153056203763317620
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发表时间：
2003-03-01
期刊：
影响因子：
--
通讯作者：
Patel, AC
中科院分区：
文献类型：
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作者：
Edwards, MA;Patel, AC
截至2002年中期，缅因州拥有全州最大的远程医疗系统之一，包括两个协作网络中90个健康、心理健康和社会服务提供者组织的150多个设施。远程医疗的快速增长，在这个农村，经济上处于不利地位的状态，在很大程度上是由于合作发展和缅因州远程医疗服务部门的农村社区卫生中心，健康之路/区域医疗中心在卢贝克（RMCL）的服务活动。该系统在广泛的交互式视频会议应用中的年度临床使用目前超过1000例机构远程医疗和800例家庭远程医疗。主要应用包括心理健康/精神病学、内分泌学/糖尿病管理、初级保健、儿科专科、遗传学和皮肤病学。初级保健的使用来自一个相对新颖的使用移动的远程医疗船，以服务于中部沿海的小岛屿缅因州。监狱远程医疗、紧急医疗分诊和非传统服务，如聋人视频转播口译服务、家庭暴力宣传和法律的服务以及少年犯重返社区的案件管理，预计未来将有强劲增长。由RMCL的缅因州远程医疗服务管理的两个大型网络的相对成功从以下标准中显而易见：系统使用（1）满足定义的临床需求，（2）具有可证明的组织支持，（3）被医生和患者接受，（4）表现出可衡量的成本和临床效益，以及（5）正在走向可持续运营。与其他网络相比，这种成功的潜在基础进行了讨论。
As of mid-2002, Maine had one of the largest state-wide telemedicine systems, comprising over 150 facilities among 90 health, mental health, and social service provider organizations in two collaborative networks. The rapid growth of telemedicine in this rural, economically disadvantaged state is largely attributable to collaborative development and the service activities of the Maine Telemedicine Services division of a rural community health center, HealthWays/Regional Medical Center at Lubec (RMCL). Annual clinical uses of the system across a broad array of interactive videoconferencing applications currently exceed 1, 000 instances for institutional telemedicine and 800 instances for home telehealth. The major applications include mental health/psychiatry, endocrinology/diabetes management, primary care, specialty pediatrics, genetics, and dermatology. Primary care usage derives from a relatively novel use of a mobile telemedicine boat to serve small islands off mid-coastal Maine. Strong future growth is expected in prison telemedicine, emergency medical triage, and non-traditional services such as video relay interpretive services for the deaf, domestic violence advocacy and legal services, and case management for community reintegration of juvenile offenders. The relative success of the two large networks managed by RMCL's Maine Telemedicine Services is evident from the criteria that system usage (1) addresses defined clinical needs, (2) has demonstrable organizational support, (3) is accepted by physicians and patients, (4) exhibits measurable cost and clinical benefits, and (5) is moving toward sustainable operations. Potential bases for this success are discussed in comparison with other networks.