遠距醫療的風險與挑戰—簡介美國健康照護促進協會（IHI）「遠距醫療：確保安全、公平、以人為本的虛擬照護」白皮書

Risks and Challenges in Telemedicine: Introduction to the Institute for Healthcare Improvement’s White Book Telemedicine: Ensuring Safe, Equitable, Person-centered Virtual Care

遠距醫療在各國有不同的發展進程，國際間也不斷探討遠距醫療難以發展或被廣泛使用的原因，其不外乎受科技基礎建設、社會進步程度、醫療環境、政策、保險制度的差異、民眾需求與就醫習慣及文化背景等因素之影響。2021年，美國健康照護促進協會（Institute for Healthcare Improvement, IHI）發布一份有關遠距醫療發展建議的白皮書，提供一個高品質的虛擬照護模式，並擬定一個確保安全、公平、以人為本的遠距醫療架構，其中包含了六個要素：「可近性」、「隱私」、「診斷準確性」、「溝通」、「安全感」及「人因與系統設計」，並提出相關執行建議。遠距醫療已成為各國後疫情時代的新醫療常態，遠距醫療發展過程中，醫療照護體系和醫療服務提供者除維持照護品質外，更應重視虛擬照護獨特且潛在地意外和風險。期待透過本文的分享，可以讓醫療照護體系及單位重視並建立安全、公平、以人為本的遠距醫療制度。

 

Telemedicine has been developed in different processes in each country. International academic circles have discussed the causes of difficulty in developing or spreading the use of telemedicine, which is affected by factors such as technological infrastructure, social progress, medical environment, policies, differences in insurance systems, public needs, medical habits, and cultural backgrounds. In 2021, the Institute for Healthcare Improvement from the United States of America published a white book on telemedicine development. The white book advocates for providing a high-quality virtual care model and developing a safe, equitable, and person-centered telemedicine framework. The framework consists of 6 elements: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design. The white book also provides practical suggestions on telemedicine. Telemedicine has become a new medical normal for various countries in the post-COVID era. In developing telemedicine, healthcare systems and providers must not only maintain the quality of care, but also pay attention to the unique and potential accidents and risks involved in virtual care. The results of this study provide a key reference to health care systems and personnel in establishing a safe, equitable, and person-centered telemedicine system.