Analysis: US telemedicine service model and service project

First, the top design of the US telemedicine service resources

Currently, there are 14 nationwide telemedicine resource centers and 12 regional resource centers across the United States each state. At the same time, the two state-level telemedicine resource centers mainly provide telemedicine technology assessment, policy specification development and guidance implementation. The American Telemedicine Alliance, funded by the Federal Ministry of Health's Health Resources and Services Management Center, is designed to promote telemedicine services and provide educational and information resources to telemedicine organizations. In particular, providing and expanding telemedicine services to under-resourced areas will ultimately benefit them. All service and resource information provided by the affiliate is free.

Second, clear telemedicine service model

The so-called telemedicine service model is to explore how to establish and operate telemedicine services. Specifically, it provides a range of different medical professional/specialist consulting services through telematics and means, ranging from asthma to urinary system diseases, involving remote examination, diagnosis and treatment. Telemedicine also includes home health services such as disease surveillance and health education. Remote imaging and mobile remote ICU emergency, remote pharmacy, or school-based remote health services.

Therefore, exploring the telemedicine service model can clearly define which services, how to obtain patient approval, how to deploy telemedicine sites and make patients more convenient to participate, and continuously improve the quality of service and standardization. The fees charged by doctors for telemedicine services are usually the same as the fees they see for patients in the clinic.

1, real-time interactive video consultation

Real-time interactive video consultation is a scene where doctors and patients communicate at the same time but at different locations. The doctor is usually in a remote consultation room or office, and the patient is in another place, such as another clinic, nursing center or hospital, and may be at home or nursing home. Interactive communication must transmit the real-time image of the medical professional to the location of the off-site patient via encrypted broadband communication via an encrypted digital video system and digital camera. At the remote endpoint, the patient views the live image through the video screen. Similarly, the patient's real-time image is also provided to the remote medical professional using the same transmission method. Voice communication between medical experts and patients can also be transmitted to the other party. The reason for real-time interactive communication is that the bandwidth and speed of information transmission between the two parties makes the exchanges as if they were in the same place face-to-face or in the clinic.

2, storage and transmission exchange consultation

Storage and transmission communication consultation refers to the evaluation and consultation of the information sent by the remote patient after the information is transmitted to the remote medical expert in another place. It can be understood as obtaining information and storing it in digital form, and then transmitting or transmitting it to a remote expert for consultation. Skin disease is a classic case. During the dermatology telemedicine consultation, the patient's medical assistant uses a digital camera to take pictures of the patient's skin lesions, and then stores the disease picture and related information on an encrypted remote server. At any other time, the consultant can log in to the server to evaluate the patient's dermatological photos and clinical information, and write a corresponding consultation report, which is also stored in the patient's medical record in the server. The doctor or administrator who referred the patient or requested the remote consultation can log in to the patient's medical record database of the server to view the feedback of the submitted consultation content and inform the patient of the proposed medical treatment plan. Remote imaging is another type of more widely used storage and transmission remote consulting model. It is also the only remote service model that can be covered by medical insurance so far, because image consultation is suitable for remote consultation and not because of this remote communication mode.

3. Integrated remote consultation

The integrated telemedicine consultation model refers to a mode that includes real-time interactive video and storage and transmission communication. A typical integrated remote consultation scenario is a remote consultation for skin diseases or heart disease. In remote diagnostics, higher-definition image information is required than normal standard images, as well as direct patient communication and feedback. In the field of pediatric heart disease, when telemedicine experts evaluate pre-transferred cardiogram data, if they want real-time monitoring, they can remotely observe the child through real-time video and communicate with their families. This integrated remote consultation model draws on the technical advantages of both modes to better improve the quality of remote diagnosis and patient treatment without losing opportunities due to a limited telemedicine model.

In recent years, the federal government has introduced a series of medical health bills aimed at reducing the cost of medical treatment and improving the accessibility of medical diseases and medical resources. Therefore, the telemedicine service model has been increasingly supported and participated by various insurance companies and medical service organizations in the United States.

Third, which clinical specialties can carry out telemedicine consultation

The US Department of Health and the National Telemedicine Resource Center offer a range of telemedicine professional/specialist services in a range of existing health care systems:

1. Telemedicine/Specialist

Allergy/Immune Disorders Anesthesia/Intensive Care 急救 Emergency Medicine 心血管 Cardiovascular Diseases

Dental ‖ skin diseases 眼 ophthalmology and optics ‖ ENT diseases

Endocrine disease ‖ Family / general illness 消化 Digestive diseases 感染 Infectious diseases

Neonatal / Perinatal Medicine 儿 Pediatric ‖ Nervous System Disorder ‖ Mental / Behavioral Health Psychology

Tumor and blood diseases 骨 Orthopaedic 病理 Pathology 肺 Pulmonary diseases

Rehabilitation Medicine ‖ Rheumatic Disease ‖ Surgery ‖ Urology

2. Remote consulting service project

Medical record management ‖ medical correction 聋 deaf/hearing training ‖ diet nutrition consultation

Disease Surveillance Management 慢 Slow Disease Consultation ‖ Doctor and Doctor Consultation Consultation 造 Ostomy Treatment (Intestinal and Other Officials)

Forensic and forensic consultation ‖ Genetic counseling 药物 Drug treatment management 新生儿 Neonatal/pediatric critical observation

Pain management 保守 Conservative/soothing therapy 产 Prenatal/postnatal care ‖ Language therapy

Rehabilitation of spinal injury 远程 Remote stroke rehabilitation 远程 Remote wound care 应急 Emergency and health management

Drug addiction treatment (detoxification) ‖ tired of psychological counseling 夫妻 husband and wife relationship consultation 成长 growth and development consultation

Psychiatric drug treatment management ‖ Psychiatric evaluation ‖ Psychiatric efficacy monitoring ‖ Behavioral psychology and rehabilitation (depression and anorexia)

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