1994—2003年远程医学文献统计分析及远程医学发展预测

文章以从中国期刊全文数据库(CJFD)中检索到的数百篇与远程医学有关的文献资料为基础，运用该数据库检索技巧，就1994年以来每年与远程医学相关的文献数量统计作图，并对查找的结果所涉及的领域以及刊载杂志、内容等方面做了简略分析，同时与用MEDLINE检索的国际远程医学文献资料在发展进程和数量上进行了图形对比分析，对近年影响远程医学发展的因素进行了探讨，并对远程医学今后发展趋势做了简单预测。     

远程医学的研究及其发展

远程医学发展将涉及医学的各个领域，形成新的医学模式。本文介绍了远程医学的技术支持、研究方向、法律法规等相关内容，展望了远程医学今后的发展。     

卫星远程医学系统在我院的应用

随着计算机技术、通信技术、网络技术、多媒体技术的发展，我院加入全军远程医学信息网，建成双向卫星远程医学信息系统。本文介绍了我院远程医学业务的开展，远程医学系统应用体会，让大家进一步了解、认识远程医学信息系统，并充分利用该系统从事医疗活动。     

军事远程医学应用现状

随着通讯、电子和计算机技术的不断提高，远程医学作为医学和通讯结合的产物，有着广阔的发展前景。目前，远程医学在军事上主要应用于远程会诊、远程教育和远程手术等，远程会诊和远程教育更是有了突破性的进展。此外，对远程医学的应用方式，包括从单兵到后方医院的必要软、硬件进行了介绍，最后对我军远程医学的发展方向进行展望。     

远程医学技术的发展与应用

介绍了远程医学技术的发展概况,从某院远程医疗会诊、远程医学教育、远程医疗教学查房、远程手术示教、远程在线考试等方面阐述了远程医学应用模式与实践效果,提出了进一步规范远程医疗会诊流程、完善远程医学相关法律法规、制定继续教育学分政策、提高从业人员素质、加强野战化远程医学应用研究和训练等远程医学发展策略与思考。     

远程病理学的发展与应用

远程病理是远程医学领域的重要基础和核心内容之一，随着电子计算机及其网络技术的不断发展，远程病理目前已形成了一门边缘学科，即远程病理学，其发展与应用将对现代医学诊断与教学产生巨大的影响和冲击，同时也是未来的重要医学应用领域。1远程病理学的发展现状到目前为止，远程病理学的发展已有10年的历史。早在1976年，国外学者曾在文献中提出过远程病理这一想法，但当时并未引起人们的重视。1986年，《人类病理学｝）杂志认为，自动化显微镜、摄像机、计算机等硬件和宽带远程通讯网络技术等软件的相互沟通，能够成为远程病理学诊断的…     

军队远程医学支援保障模式研究

技术发展推动卫勤保障模式转变。在远程医学系统多年建设基础上，我军已形成野战远程医疗支援保障新的卫勤模式。本文就军队远程医学支援保障需求、新的保障模式形成、组成与特点、未来展望等方面，进行了探讨。     

军队远程医学卫星网络的设计与技术架构

为改善全军各医疗单位的远程医学通信手段，提高和发展远程医学业务能力，总后卫生部启动了全军远程医学信息网卫星专网工程建设。该网的一项工程由一个主站和20个远端组成，从逻辑上分为数据通信／网络控制子网和远程医疗子网。本网络独立于地面线路工作，支持数据通信，远程医疗，远程教育以及一些其它的通信业务。     

我军远程医学系统建设现状、问题与对策

深化研究并全面提高军队远程医学系统内涵与质量，是我军“十二五”建设与实现数字化卫勤战略目标的重要基础。通过系统回顾、总结“九五”“十五…十一五”期间军队远程医学系统建设与发展，指出建设中存在的问题，提出解决问题的若干对策意见。     

西藏某医院全军远程医学信息网站点建设与应用情况分析

本文所称的全军远程医学信息网（以下简称远程网）是指依托卫星或光纤通信设备，连接全军各医疗卫生机构，从事远程医学服务的信息网络系统。全网由全军网络管理中心站点（网管中心）、各大单位网络管理站点（区域网管站）和各用户站点（远端站）组成。远程网是经全军无线电管理委员会批准建设的全军性远程医学信息网络，其建设目的是推进军队远程医学学科的发展，充分发挥远程医学资源的应用效益，利用先进、实用的计算机技术和卫星通信技术．     

远程会诊系统在地震救灾中的应用

阐述了远程会诊车在“5·12”地震救灾中所发挥的重要作用。通过对远程会诊系统在救灾中的实际应用．提出了该系统在应急状态下的一些改进意见和建议,为远程医学在军事和民用应急条件下的应用提供了第一手资料．对进一步完善和发展远程医学具有重大而深远的意义。     

区域医疗信息资源的共享与应用

本文介绍了医疗信息技术是如何实现区域协同医疗、发展远程医疗平台以及构建数字化医院,由此帮助解决医疗资源分布与利用不合理的问题。随后本文指出,只有在政府主导以及医院领导的带领下,真正转变医疗服务模式,医疗信息技术才能发挥其作用。最后本文介绍了"九五健康"理念,指出信息化的发展促使健康管理模式从过去的疾病治疗向疾病预防方向转变。     

新疆克拉玛依区域卫生信息平台应用分析

新疆克拉玛依市依托"数字城市"建设基础,以信息化为手段,建成地市级区域卫生信息平台,并在此基础上建立了远程医疗平台、居民健康"一卡通"、健康云平台、区域公立医疗卫生机构大联通、卫生综合管理决策支持系统和居民健康网六项应用。通过其应用功能的实现,破解医改中的重点难点问题,使病人、医疗机构、卫生行政管理部门三方实现了共赢。     

A model of the willingness to use telemedicine for routine and specialized care

We examined factors associated with the willingness to use telemedicine for routine and specialized care within a theoretical framework. The conceptual model proposed that willingness to use telemedicine is associated directly with attitudes to telemedicine, attitudes to the patient-physician relationship, and to satisfaction with current health-care. In addition, technology anxiety and past behaviour were both assumed to affect willingness to use telemedicine indirectly. Telephone interviews were conducted with a national sample of 1204 Jewish, non-institutionalized adults in Israel. Structural equation modelling was used to examine the hypothesized relationships. Participants were more willing to use telemedicine for routine than for specialized care. Overall, willingness to use telemedicine was affected by attitudes to telemedicine, attitudes to the patient-physician relationship and by level of technology anxiety. Educational interventions aimed at encouraging the use of telemedicine should target potential users' attitudes, as well as feelings of uneasiness and anxiety regarding technology.     

Successfully developing a telemedicine system

Successfully developing telemedicine systems is primarily about effective change management. The literature suggests that certain principles are likely to increase the chances of success in developing a telemedicine system. These are: (1) telemedicine applications and sites should be selected pragmatically, rather than philosophically; (2) clinician drivers and telemedicine users must own the systems; (3) telemedicine management and support should follow best-practice business principles; (4) the technology should be as user-friendly as possible; (5) telemedicine users must be well trained and supported, both technically and professionally; (6) telemedicine applications should be evaluated and sustained in a clinically appropriate and user-friendly manner; (7) information about the development of telemedicine must be shared. If telemedicine is to realize its full potential, it must be properly evaluated and the results of any evaluations published, whether the results are positive or negative. Since telemedicine is about communication with colleagues and patients across large distances, it should be possible for those involved in it to do the same with their experiences.     

Perspectives from the Veterans Health Administration about opportunities and barriers in telemedicine

We used qualitative interviews to examine the perceptions of direct providers of telemedicine services, primary care providers (PCPs) and hospital administrators about opportunities and barriers to the implementation of telemedicine services in a network of Veterans Health Administration hospitals. A total of 37 interviews were conducted (response rate of 28%) with 17 direct telemedicine providers, nine PCPs and 11 administrators. The overall inter-coder reliability across all themes was high (Scott's pi = 0.94). Direct telemedicine providers generally agreed that telemedicine improved rapport with patients, and respondents in all three groups generally agreed that telemedicine improves access, productivity, and the quality and coordination of care. Respondents mentioned several benefits to home telemedicine, including the ability to better manage chronic diseases, provide frequent clinician contact, facilitate quick responses to patient needs and provide care in patient's homes. Most respondents anticipated future growth in telemedicine services. Barriers to telemedicine implementation included technical challenges, the need for more education and training for patients and staff, preferences for in-person care, the need for programme improvement and the need for additional staff time to provide telemedicine services.     

A systematic review of the methodology of telemedicine evaluation in patients with postural and movement disorders

We reviewed the methodology used in telemedicine research concerning patients with postural and movement disorders. Literature searches were performed using various computerized databases through to October 2005. Twenty-two studies met the criteria for review. Two broad models of telemedicine delivery were represented in the literature: (1) telemedicine between health-care professionals at each telemedicine site (n=16) and (2) telemedicine between health-care professionals and a patient at a remote site (n=6). Disparate research methodologies were used to investigate these two models. Most studies were limited to investigating the technical feasibility and acceptability of a telemedicine service rather than focusing on the overall effect of introducing the telemedicine service into routine health care. Nonetheless, it is possible to conclude that telemedicine is acceptable for both patients and professionals when used in rehabilitation. Since the two models of telemedicine evaluation tend to explore different outcomes (diagnostic accuracy versus health status), it is recommended that separate methodologies should be used. In contrast to evaluations of telemedicine model 2, randomized controlled trials appear to be less valuable for telemedicine model 1.     

Provision of Telemedicine Services by Community Health Centers

The objective of this study was to assess the use of telemedicine services at community health centers. A national survey was distributed to all federally qualified health centers to gather data on their use of health information technology, including telemedicine services. Over a third of responding health centers (37%) provided some type of telemedicine service while 63% provided no telemedicine services. A further analysis that employed ANOVA and chi-square tests to assess differences by the provision of telemedicine services (provided no telemedicine services, provided one telemedicine service, and provided two or more telemedicine services) found that the groups differed by Meaningful Use compliance, location, percentage of elderly patients, mid-level provider, medical, and mental health staffing ratios, the percentage of patients with diabetes with good blood sugar control, and state and local funds per patient and per uninsured patient. This article presents the first national estimate of the use of telemedicine services at community health centers. Further study is needed to determine how to address factors, such as reimbursement and provider shortages, that may serve as obstacles to further expansion of telemedicine services use by community health centers.     

Telemedicine activity at a Canadian university medical school and its teaching hospitals

Dalhousie University Medical School and its teaching hospitals have been providing clinical telemedicine services since 1987. The object of the present study was to assess the extent and growth of telemedicine at the medical school and teaching hospitals, as well as to evaluate the obstacles to its deployment. This was achieved by conducting structured personal interviews with telemedicine providers. Twenty telemedicine programmes were identified, of which 15 were operational and five were being planned. The number of established telemedicine projects had doubled in the six months preceding the study. A wide variety of telemedicine services were provided, ranging from clinical consultations in a number of medical specialties to patient education, grand rounds and continuing medical education. These services were provided to sites in a wide area in the Maritime region and internationally. The three most important obstacles to the implementation of telemedicine were a lack of knowledge about telemedicine (80% of respondents), time constraints (75%) and funding (70%).     

Information on telemedicine

Although the practice of telemedicine is still not considered part of mainstream health care, there has been a steady growth in information about telemedicine since 1999. The increasing body of literature about telemedicine, the staying power of various telemedicine societies and Websites, and the growing number of well-attended conferences about telemedicine all attest that interest in and the practice of telemedicine worldwide are very much alive and well. Searching for information has also become easier with the advent of better and faster search engines, particularly Google. Nonetheless, many Websites are out of date and the semantic confusion between 'telemedicine' and other terms such as 'telehealth' means that considerable perseverance is required to sift the wheat from the chaff. There is a wide variety of both electronic and print resources that have proven to be reliable sources of information. These include: the Internet (Web), books and reports, journals and trade magazines, telemedicine societies and conferences. While telemedicine cannot yet be considered to be part of mainstream health care, it has become a more familiar part of health terminology worldwide.