Design and Application of a Telemedicine System Jointly Driven by Videoconferencing and Data Exchange: Practical Experience from Henan Province, China

Zhai, Yunkai; Gao, Jinghong; Chen, Baozhan; Shi, Jiachen; Wang, Linlin; He, Xianying; Sun, Dongxu; Chen, Haotian; Hou, Hongli; Song, Xiaolong; Zhao, Jie

doi:10.1089/tmj.2018.0240

Cited by 35 publications

(26 citation statements)

References 18 publications

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“…Most doctors and patients agreed that the deployment of telemedicine could save financial costs, which is consistent with the views of existing research [ 47 ]. Some researchers found that telemedicine could help patients save US $1000, on average [ 48 ]. Higher level hospitals provide lower level medical institutions with remote consultations so that patients from less capable hospitals also receive advice from experts with senior titles, which is very beneficial for the patients in rural areas.…”

Section: Discussionmentioning

confidence: 99%

Application of Telemedicine Services Based on a Regional Telemedicine Platform in China From 2014 to 2020: Longitudinal Trend Analysis

Cui¹,

He²,

Zhai³

et al. 2021

J Med Internet Res

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Background Telemedicine that combines information technology and health care augments the operational model of traditional medical services and brings new opportunities to the medical field. China promotes telemedicine with great efforts, and its practices in the deployment of telemedicine platforms and delivery of services have become important references for the research and development in this field. Objective Our work described in this paper focuses on a regional telemedicine platform that was built in 2014. We analyzed the system design scheme and remote consultations that were conducted via the system to understand the deployment and service delivery processes of a representative telemedicine platform in China. Methods We collected information on remote consultations conducted from 2015 to 2020 via the regional telemedicine platform that employs a centralized architectural system model. We used graphs and statistical methods to describe the changing trends of service volume of remote consultation, geographical and demographic distribution of patients, and waiting time and duration of consultations. The factors that affect consultation duration and patient referral were analyzed by multivariable linear regression models and binary logistic regression models, respectively. The attitudes toward telemedicine of 225 medical practitioners and 225 patients were collected using the snowball sampling method. Results The regional telemedicine platform covers all levels of medical institutions and hospitals in all 18 cities of Henan Province as well as some interprovince hospitals. From 2015 to 2020, 103,957 remote medical consultations were conducted via the platform with an annual increasing rate of 0.64%. A total of 86.64% (90,069/103,957) of medical institutions (as clients) that applied for remote consultations were tier 1 or 2 and from less-developed regions; 65.65% (68,243/103,945) of patients who applied for remote consultations were aged over 50 years. The numbers of consultations were high for departments focusing in the treatment of chronic diseases such as neurology, respiratory medicine, and oncology. The invited experts were mainly experienced doctors with senior professional titles. Year of consultation, tier of hospital, consultation department, and necessity of patient referral were the main factors affecting the duration of consultations. In surveys, we found that 60.4% (136/225) of medical practitioners and 53.8% (121/225) of patients had high satisfaction and believed that telemedicine is of vital importance for the treatment of illness. Conclusions The development of telemedicine in China shows a growing trend and provides great benefits especially to medical institutions located in less developed regions and senior citizens who have less mobility. Cases of remote consultations are mainly for chronic diseases. At present, the importance and necessity of telemedicine are well recognized by both patients and medical practitioners. However, the waiting time needs to be further reduced to improve the efficiency of remote medical services.

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Section: Discussionmentioning

confidence: 99%

Application of Telemedicine Services Based on a Regional Telemedicine Platform in China From 2014 to 2020: Longitudinal Trend Analysis

Cui¹,

He²,

Zhai³

et al. 2021

J Med Internet Res

Self Cite

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“…The overcrowded high-level medical institutions and other medical institutions with insufficient patients reflect the inefficient utilization and wasting of health resources, and the chaos existing in medical practice [ 4 ]. In recent years, the hierarchical medical policy (HMP) has been proposed to steer patients from higher- to lower-cost providers [ 5 ]. The main idea behind the implementation of HMP is that the initial diagnosis is recommended to be carried out at the grassroots level, chronic and common diseases treated in the primary hospitals, and acute and intractable diseases referred to higher-level hospitals for treatment [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of the Internet on Medical Decisions of Chinese Adults: Longitudinal Data Analysis

Ma¹,

Sun²,

Cui³

et al. 2020

J Med Internet Res

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Background The internet has caused the explosive growth of medical information and has greatly improved the availability of medical knowledge. This makes the internet one of the main ways for residents to obtain medical information and knowledge before seeking medical treatment. However, little has been researched on how the internet affects medical decisions. Objective The purpose of this study was to explore the associations between internet behaviors and medical decisions among Chinese adults aged 18 or over, including whether to go to the hospital and which level of medical institution to choose. Methods With the adult residents (≥18 years old) in 12 regions including urban and rural areas taken as the research objects, the differences in medical choices of adults with various characteristics were analyzed, and generalized linear mixed models were adopted to analyze the longitudinal data of the China Health Nutrition Survey from 2006 to 2015. Results Adult groups with different ages, genders, education levels, regions, places of residence, severities of illness and injury, years of suffering from hypertension, and history of chronic diseases showed diverse medical decisions, and the differences were statistically significant (P<.05). After controlling for these potential confounding factors and taking self-care as the reference, the probability of Chinese adults who participated in online browsing activities selecting hospital care was 0.82 (95% CI 0.69-0.98; P=.03) times that of residents who did not participate in online browsing activities. In terms of medical institution choices, adults who participated in online browsing activities were 1.86 (95% CI 1.35-2.58; P<.001) times more likely to opt for municipal medical treatment than primary care. However, the effect of online browsing on the selection probability of county-level hospitals was not significant compared with primary hospitals (P=.59). Robust analysis verified that accessing the internet had a similar effect on Chinese adults’ medical decisions. Conclusions Chinese adults who use the internet are a little less likely to go to the hospital than self-care. The internet has broken down the barriers to obtain knowledge of common diseases and thus has a slight substitution effect of self-care on hospital care. Internet use may increase the probability of adults going to municipal hospitals. The rising tendency of visiting high-level medical institutions may be consequently exacerbated due to knowledge monopoly of severe and complicated diseases that is difficult to eliminate, and the increase in inconsistent and incomplete medical information online will blur the residents’ cognitive boundary of common diseases and severe diseases. Exploring the substantive impact of the internet on medical decision making is of great significance for further rational planning and utilization of the internet, in order to guide patients to appropriate medical institution.

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“…• development of databases, workflow systems and integration of patient data (developed by IBM) [17];…”

Section: Existing Approaches and Methods For Assessing The Investmentmentioning

confidence: 99%

Methodological Approaches to Assessing the Investment Attractiveness of Telemedicine

2020

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The paper considers modern methodological approaches of Russian and foreign authors to assess the investment attractiveness of the industry. The object of analysis is a new industry telemedicine. As a result of the study, industry specifics and factors affecting its investment attractiveness were identified. The work also explores methodological approaches to assessing investment attractiveness and investment efficiency. The uniqueness of the study consist in the fact that previously there were no works, approaches and methods analyzing investment attractiveness in terms of their applicability to the selected industry. Based on the results of a critical analysis of the proposed approaches and methods for assessing investment attractiveness, requirements were formed that need to be considered when developing and applying methodological approaches to assessing the investment attractiveness of telemedicine.

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Design and Application of a Telemedicine System Jointly Driven by Videoconferencing and Data Exchange: Practical Experience from Henan Province, China

Cited by 35 publications

References 18 publications

Application of Telemedicine Services Based on a Regional Telemedicine Platform in China From 2014 to 2020: Longitudinal Trend Analysis

Application of Telemedicine Services Based on a Regional Telemedicine Platform in China From 2014 to 2020: Longitudinal Trend Analysis

Impact of the Internet on Medical Decisions of Chinese Adults: Longitudinal Data Analysis

Methodological Approaches to Assessing the Investment Attractiveness of Telemedicine

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