Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?
Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?
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DOI：
10.1186/1748-5908-1-18
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发表时间：
2006-08-24
期刊：
影响因子：
--
通讯作者：
Landry R
中科院分区：
文献类型：
--
作者：
Gagnon MP;Duplantie J;Fortin JP;Landry R
远程保健，作为其他信息和通信技术（信通技术）的引入，以支持提供医疗保健服务，被认为是一种手段，以回答目前挑战医疗保健系统的许多必要条件。在加拿大，正在开展许多远程保健项目，主要针对农村、偏远或与世隔绝的人口。迄今为止，各种远程保健应用已得到实施，并显示出可喜的成果。然而，尽管技术和电信基础设施的可用性有所增加，但远程保健的利用在许多情况下仍然有限。在四个偏远地区的魁北克（加拿大）进行了定性实地研究，探讨医生和管理人员的看法远程医疗对临床实践和医疗保健服务的组织，以及改善远程医疗实施的条件的影响。共有54名受访者接受了单独或小组访谈。访谈内容分析，并确定了远程医疗的远程医疗实践的几个影响，以及关键条件，以确保远程医疗实施的成功。据医生和管理人员介绍，远程保健的好处包括在偏远地区更好地获得专业服务，改善护理的连续性，以及增加信息的可用性。远程保健还通过促进继续医学教育、与同行接触和获得第二意见来改善医生的做法。在医院和保健区域一级，远程保健有可能支持区域参考资料中心的发展，有利于保留当地专门知识，并节省费用。成功实施远程保健网络的条件包括临床医生参与决策、提供专门的人力和物力资源以及有计划的推广战略。与医生和管理人员的访谈还强调了在偏远和农村地区更广泛的医疗保健服务组织中考虑远程保健的重要性。这项研究确定了在实施远程保健应用时应考虑的核心要素，目的是支持农村和偏远地区的医疗实践。决策者需要了解可能影响远程医疗融入临床实践和医疗保健组织的具体条件。因此，解决已确定的远程保健成功条件的战略将有助于以最佳方式实施这一技术。
Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering telehealth within the broader organisation of health care services in remote and rural regions. This study identified core elements that should be considered when implementing telehealth applications with the purpose of supporting medical practice in rural and remote regions. Decision-makers need to be aware of the specific conditions that could influence telehealth integration into clinical practices and health care organisations. Thus, strategies addressing the identified conditions for telehealth success would facilitate the optimal implementation of this technology.
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影响因子：
--
作者：
Harrison, R;Clayton, W;Wallace, P
通讯作者：
Wallace, P
DOI：
10.1089/tmj.2006.12.363
发表时间：
2006-06-01
期刊：
TELEMEDICINE JOURNAL AND E-HEALTH
影响因子：
--
作者：
Lamothe, Lise;Fortin, Jean-Paul;Messikh, Djamel
通讯作者：
Messikh, Djamel
影响因子：
4.7
作者：
Fortin, JP;Gagnon, MP;Labbé, F
通讯作者：
Labbé, F
影响因子：
4.7
作者：
Hogenbirk, JC;Brockway, PD;Cradduck, T
通讯作者：
Cradduck, T
DOI：
10.1016/s1386-5056(03)00094-7
发表时间：
2003-09-01
影响因子：
4.9
作者：
Gagnon, MP;Godin, G;Cloutier, A
通讯作者：
Cloutier, A