Telemedicine in support of peacekeeping operations overseas: an audit.
Telemedicine in support of peacekeeping operations overseas: an audit.
复制标题
支持海外维和行动的远程医疗：审计。
DOI：
10.1089/tmj.1.1997.3.207
复制
发表时间：
1997
期刊：
影响因子：
--
通讯作者：
J. Ellis
中科院分区：
文献类型：
--
作者：
J. Navein;J. Hagmann;J. Ellis
背景与目的
自1993年以来，国防部通过远程医疗手段加强了对马其顿维持和平行动陆军部队的医疗支持。该项目被称为“黄金时段1号行动”，是美国军方部署的第一个基于卫星的远程医疗系统，用于支持远程初级保健医生。其宣布的目标是：（1）提高护理标准;（2）减少后送;（3）支持外地的初级医生;（4）提高部署部队的军事效力。本文件审查了1994年1月至1995年4月期间在实现这些目标方面取得的成就。
方法
从转诊单位和转诊医生和咨询医生完成的问卷中整理日志。转诊医生从马其顿返回后接受了访谈，并对结果发生变化的病例进行了更详细的研究。无法对顾问进行后续访谈。
结果
共对47名患者进行了53次咨询。远程医疗的使用影响了13次（13/47）后送的决定，净减少了9次后送。在使用远程医疗的47个案例中，有30个案例改变了对个案的管理。医生的信心和军事效率也得到了提高。该系统的使用水平在很大程度上取决于培训和维护计划。接受过远程医疗临床使用和设备技术维持培训的单位和总医务干事使用了该系统;没有接受过培训的单位和总医务干事则没有使用该系统。大多数患者（45/47）一次会诊治疗满意。在这种情况下，远程医疗似乎具有成本效益。部署的站点选择提供最佳服务的转诊中心。
结论
远程医疗是一种宝贵的工具，能够加强对部署的军事单位的医疗支助。一个成功部署的远程医疗项目需要一个综合支助一揽子计划，其中包括在链路两端提供充分的培训和设备维持。黄金时间行动中的远程医疗经验表明，有可能节省大量费用，并提供具有成本效益的医疗服务。应鼓励进一步应用远程医疗。远程医疗项目的成功部署可能取决于综合支助一揽子计划。
BACKGROUND AND OBJECTIVE
Since 1993, the Department of Defense has augmented the medical support for Army units on peacekeeping operations in Macedonia through the medium of telemedicine. This project, known as Operation Primetime 1, was the first satellite-based telemedicine system deployed in support of remote primary-care physician in the U.S. military. Its declared aims are: (1) to improve the standard of care; (2) to reduce evacuations; (3) to support junior physicians in the field; and (4) to improve the military effectiveness of the deployed units. This paper audits the success in attaining those goals for the period January 1994 to April 1995.
METHODS
A log was collated from the referring units and questionnaires completed by both referring and consulting physicians. The referring physicians were interviewed on their return from Macedonia, and a more detailed study was undertaken of cases in which a change in outcome was noted. Follow-up interview of consultants was not possible.
RESULTS
A total of 53 consults were undertaken on 47 patients. The use of telemedicine affected the decision to evacuate 13 times (13/47), with a net reduction of 9 evacuations. Management of individual cases was changed in 30 of the 47 cases in which telemedicine was used. Physician confidence and military effectiveness were also improved. The level of utilization of the system was largely dependent on a training and sustainment program. Units and General Medical Officers who were trained in the clinical use of telemedicine and the technical sustainment of the equipment used the system; those who were not, did not. Most patients (45/47) were treated satisfactorily with a single consult. Telemedicine under these circumstances seems to be cost effective. The deployed sites chose the referral centers that provided the best service.
CONCLUSIONS
Telemedicine is a valuable tool capable of augmenting medical support to deployed military units. A successful deployed telemedicine project requires an integrated support package that includes adequate provision for training and equipment sustainment at both ends of the link. Experience with telemedicine in Operation Primetime indicates the potential for substantial cost savings as well as cost-effective medical care. Further application of telemedicine should be encouraged. Successful deployment of telemedicine projects may hinge on an integrated support package.