因應COVID-19台灣遠距醫療應用探討

Application of telemedicine for COVID-19 in Taiwan

本研究目的為了解台灣應用遠距醫療現況，共調查台灣16家醫學中心及區域醫院在遠距醫療使用情形。因應衛福部於2010.02.10通過配合檢疫與防治採行措施之居家檢疫與居家隔離者，可採用通訊方式詢問病情、為之診療、開給方劑，或依全民健康保險醫療辦法第7條規定，得委託他人向醫師陳述病情並領取方劑，或依「通訊診察治療辦法」之特殊情形病人，以遠距醫療方式提供服務。本研究發現使用遠距醫療的比率以國際病人視訊診療最高占54％、其次為防疫用途占46％；使用的視訊軟體以Line最高占54％、其次為ZOOM占39％；硬體設備以手機使用比率最高62％、繳費方式以信用卡使用比率最高為62％、網路頻寬以4G使用比率最高為62％、遠距醫療客製化程度為30％；並針對疫情等級提出遠距因應策略。依本研究就遠距醫療軟體的統一性、遠距醫療適用對象的再擴大、發展相關e-Health穿戴設備、開放健保行政作業規範，提出衛生政策與產業發展建議，期盼遠距醫療不止改善城鄉的醫療資源差距，對發展台灣國際醫療有實質的幫助之外，對於社區防疫能夠提供無距離的醫療服務。研究建議未來可探討醫病雙方因使用遠距醫療而產生的心理壓力、改善城鄉醫療差距定義研究，以使我國國民能夠享有更高品質、更多元之遠距醫療選擇。

The aim of this study was to investigate the status of telemedicine in Taiwan. A total of 16 medical centers and regional hospitals in Taiwan were recruited to investigate the application of telemedicine. In response to the home quarantine and segregation implemented by the Ministry of Health and Welfare on February 10, 2020, medical practitioners have used various communication methods to inquire about the condition of patients, diagnose and treat disorders, and prescribe medications. According to Article 7 of the National Health Insurance Medical Measures, a third party may be entrusted to state the condition of a patient and receive prescriptions, and telemedicine services may be provided to patients under special circumstances in accordance with Communication Diagnosis and Treatment Measures. This study revealed that the percentage of telemedicine use was 54% for international medical consultations and 46% for epidemic prevention; in 54% of consultations, LINE video call software was used, whereas ZOOM was used in 39%. The hardware devices used were predominantly mobile phones (62%), the main payment method was credit card (62%), and the most common network bandwidth was 4G (62%). The rate of telemedicine customization was 30%. Other strategies have also been planned on the basis of the epidemic situation. Suggestions for unity of telemedicine software were proposed for future health policy and industry development on the basis of these study results. The range of telemedicine applicable services should be expanded, related e-health wearable devices should be developed, open health insurance administrative practices should be developed further, and the medical resource gap between urban and rural areas should be reduced by providing distanceless medical services for community epidemic prevention. Future studies should explore the psychological pressure caused by telemedicine for medical personnel and patients; the gap between urban and rural medical services should also be reduced so that citizens can enjoy higher-quality and more diverse telemedicine options.