• 동의생리병리학회지
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• 제37권1호
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• pp.9-13
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• 2023

Due to COVID-19, the non-face-to-face era has arrived, and telemedicine has become a demand of the times in the medical community. Accordingly, this study aims to present a way to supplement Korea's telemedicine policy by comparing and analyzing domestic telemedicine policy and China's telemedicine policy, and analyzing the success factors of Chinese telemedicine. Domestic and foreign literature was explored to compare and analyze telemedicine policy cases of Korean, Chinese. Domestic and foreign national legal databases and web DBs were used, and literature were restricted between 2009 and 2022. Prior to COVID-19, the scope of telemedicine was very narrow in Korea, and only some pilot projects were operated. After COVID-19, the scope of telemedicine temporarily expanded, but no specific policies or systems were prepared. On the other hand, in the case of China, related policy institutional discussions on telemedicine have been actively conducted since the past, and accordingly, specific scope of application and related management norms and systems have been prepared. For the development of telemedicine in Korea, it is necessary to supplement the definition of telemedicine, ensure the accuracy and safety of non-face-to-face care through telemedicine, and solve the concentration phenomenon of large hospitals through limited conditions for hospital-level medical institutions.

• 의료법학
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• 제7권1호
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• pp.323-386
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• 2006

A combination of information technology and medical care has given rise to a new type of medicine, i.e., telemedicine. Broadly defined, telemedicine is the transfer of electronic medical data from one location to another. Both at home and abroad, telemedicine has come to success in establishing appropriate equipment and solutions for such non-conventional medicine. Sooner or later, telemedicine is believed to find itself as one of the universal treatments. In order to facilitate the full-fledged development of telemedicine, a number of legal and institutional problems have to be settled. In Korea, the Medical Act was amended to include such provisions as telemedicine, electronic medical records, electronic prescriptions, etc. and the Act came into force on March 31, 2002. Telemedicine is in common with the conventional medicine in that a physician treats a patient. However, telemedicine is basically differentiated in the followings: - The offer and acceptance of treatment and medication are usually made on-line; - Telemedicine is inherently dangerous because a physician cannot meet face-to-face with a patient; and - Joint and several liability is borne by all the physicians involved in a telemedical consultation. As a result, telemedicine is vulnerable in nature to medical malpractice. Accordingly, there must be some new theories and arguments in the formation of contract and torts. The discussion on the civil liability covers the above-mentioned issues, and would give an insight or guidelines in the concerted operation of provisions with respect to telemedicine. This study delves into the civil liability of physicians involved in telemedical consultations and treatments based upon the conventional malpractice theory.

• 의료법학
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• 제23권2호
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• pp.141-169
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• 2022

우리나라는 의료법 제34조에서 의료인 간 원격의료를 규정하고 있다. 따라서 원칙적으로 의료인과 환자 사이의 원격의료는 인정되지 않는다. 그러나 코로나19 팬데믹 이후 원격의료의 필요성에 대한 요구가 증대되었고, 다른 한편으로 원격의료의 경험이 축적되면서 의료계의 강경한 반대입장에도 변화가 감지되고 있다. 본고에서는 의료인-환자간 원격의료를 전제로 한 원격의료법제에 참고가 될 수 있는 프랑스의 원격의료법제를 중심으로 고찰하였다. 프랑스는 「공중보건법전(Code de la santé publique)」을 통해 원격의료의 개념, 유형 및 원격의료 수행 조건을 규정하고 있다. 특히 원격의료는 대면진료와 번갈아 가며 수행되어야 한다는 원칙 및 원격의료 비용과 의료수가, 원격의료장비 지원 등 원격의료 수행에 관한 세부내용을 의료계와 건강보험기구가 체결한 협약을 통해 규정하고 있는 점으로부터 우리법제에 대한 시사점을 제시하였다.

• 한국컴퓨터정보학회논문지
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• 제21권3호
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• pp.47-56
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• 2016

Recently many small and mid-sized hospitals are closing down or experiencing financial difficulties. As a result, in order to provide exceptional service that would increase their competitiveness, they implemented telemedicine service for the prescription of medicine necessary before a colonoscopy. This study is an analysis of how telemedicine service affects patient satisfaction. Through the focus group interview (FGI) of medical service providers, regarding telemedicine service and face-to-face service, it was appraised that telemedicine service was more effective than face-to-face service. Afterward, a second survey aimed at endoscopy patients was conducted in order to find out the value of telemedicine service. First, through the analysis of the three main factors of telemedicine service, conclusions were drawn(safety/reliability, convenience/rapidity, and economics). A follow-up analysis showed that convenience/rapidity had the greatest effect on telemedicine service satisfaction. Next the factors of the quality of medical service were analyzed and 3 main factors were deduced (the superiority of the external and internal environments/appropriateness, superiority of the medical team, telemedicine service). A follow-up analysis found that telemedicine service had the greatest effect on patient satisfaction. This study found that providing exceptional medical service that utilizes telemedicine service would improve patient satisfaction. Therefore, we would be able to form a strategic plan that would strengthen the competitiveness of small and mid-sized hospitals.

• 보건행정학회지
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• 제7권2호
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• pp.65-88
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• 1997

In Korea, telemedicine is still under the beginning stage, but we expect that the developing 'Information Highway' will make this technology more common place and more easily used in coming soon. Currently, three hospitals are providing telemedicine services with their subsidiary hospitals which are far away from their remote place. However, the fee schedule of telemedicine services are not well-settled down, of course not reimbursed through current health insurance system. This study aims to develop new payment system for medical services provided through telemedicaine system. To design appropriate fee schedule for telemedicine services, we, first, review the current insurance payment system and telemedicine system both in domestic and foreign countries focusing on its payment system. A framework of telemedicine payment system is proposed in following steps based on information we acquired from this stage. Second. We decide the span of cost items which should be covered by telemedicine payment scheme. In hear, we suggest payment method for telemedicine services should be designed as dual structure which are telemedicine fee that should be reimbursed through payment scheme and any costs related to capital investment that should not be covered by payment system. Which is, payment system for telemedicine services should cover only service-related costs and any costs related to capital investment should be generated through third party such as government, health insurance association, etc. Finally, we suggest new fee schedules for telemedicine services. The key issues on developing telemedicine fee schedules are related with the determination of appropriate additional rate($\alpha$). The reasonable additional rate($\alpha$) must determine through careful evaluation of any additional efforts(e. g. : additional work hours which are related to providing telemedicine services). This study shows the process of how to determine appropriate additional rate($\alpha$).

• 한국컴퓨터정보학회논문지
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• 제20권11호
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• pp.151-156
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• 2015

Recently, the government tends to address the health policy as an economic logic. However, health policy must be priority to national health right than economic logic. Thus, in this paper analyzes the problems of telemedicine for telemedicine that are at issue in South Korea, based on this, and presents reasonable health policy directions for telemedicine. To amend the law and legislation the health policy and law, analyze the rationality, feasibility of law and sufficient review should be implemented. Comparing to the foreign which introduced telemedicine earlier, discussion on telemedicine in South Korea remains a long way to go and it is now beginning step. Therefore, it should not forget that the health policy of the government with crass insensitivity can bring great disaster. Above all, to the health care, the sufficient review and social consensus which can reduce the side-effects are priority.

• 한국경제지리학회지
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• 제16권2호
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• pp.198-217
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• 2013

본 연구에서는 원격진료 이용자 행태를 시공간 재구조 관점에서 살펴보았고, 원격진료의 양면적 성격, 즉 확장성과 제약성에 관해 고찰하였다. 연구 결과에 의하면, 원격진료의 도입은 직접적인 온라인 서비스의 수혜자인 환자의 행태 변화에 영향을 끼치나, 이는 원격진료 이전의 일반적 의료 행태와 확연한 차이를 보인 것은 아니다. 이와 더해, 의원급 병원의 의료진 및 원격진료 최종 서비스 제공자인 토가네현립병원의 의료진의 행태에는 거의 영향을 주지 않는 것으로 나타났다. 원격진료의 도입으로 인해 의료기관에로의 접근성 및 효용성의 향상에 도움이 된 것은 사실이나, 여전히 원격진료는 최소한 한번 이상의 직접 진료를 요구하고 있고, 인간의 생명과 직접적으로 연계됨에도 불구하고 불완전한 기술적 특성을 가지고 있으며, 원격진료 이용에 있어서의 의사-환자, 의사 사이의 합의 문제로 인해 시공간적 제약성을 내포하게 된다. 결과적으로, 당초 원격진료가 처음 고안되었을 당시 많은 이용자들에게 주었던 기대감(확장성)과 달리, 오늘날의 원격진료는 시공간을 초월한 개념이라기보다는 기술, 사회, 문화, 경제 등의 다양한 요인으로 인해 제약성을 내포한 형태로 발전하고 있다고 할 수 있다.

• 대한지리학회지
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• 제50권3호
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• pp.325-338
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• 2015

원격진료는 정보통신기기를 활용해 의료정보를 주고받는 의료 혁신으로 인식되고 있지만, 사실상 오프라인의 여건에 따라 그 적용이 다양하게 나타난다. 예를 들어, 우리나라에서는 원격진료 시행의 기초 단위인 각 시군의 행정권에 따라 같은 의료권에 내에서도 원격진료는 차별적이다. 이에 본 연구에서는 강원도 원격진료 사례를 통해 원격진료의 지역적 차별성의 원인을 알아보았다. 더 나아가 이러한 차별성은 정보격차와 연관성이 있어 원격진료로 인해 유발되는 정보격차의 문제에 대해서도 고찰하였다. 본 연구의 주요 결과는 다음과 같다. 첫째, 원격진료의 도입과 더불어 행정 인력의 증원, 실질적인 행정 책임자에 대한 경제적 보상, 원격진료 기기에 대한 교육 등이 제대로 마련되지 않아 이를 수용할 수 있는 지역만이 원격진료를 활용하고 있는 것으로 나타났다. 둘째, 원격진료의 차별적 활용은 지역의료의 최고 결정자라 할 수 있는 시장 혹은 군수, 그리고 보건소장의 관심 여부와 연결된다고 할 수 있다. 셋째, 공중보건의는 원격진료의 실질적인 수행자 역할을 하고 있지만, 원격진료에 실시에 반대하고 있는 의사회와의 관계, 실질적인 지역의료 여건의 개선 미비 등으로 원격진료에 대해 회의적 입장인 것으로 드러났다. 넷째, 원격진료 활용의 지역적 차별성으로 인해 나타나는 정보격차는 아직까지 가시적인 것은 아닐뿐더러, 다른 차원의 격차(의료격차, 지역격차 등)로 전이되지 않았다고 판단되나, 앞으로 원격진료를 기반으로 하는 다양한 서비스가 이루어질 것을 예상한다면 이에 대한 적절한 대책이 필요할 것으로 보인다.

• 보건교육건강증진학회지
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• 제30권2호
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• pp.23-39
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• 2013

Objectives: This study was conducted to investigate practical experiences of telemedicine of community health practitioners(CHPs). Methods: Qualitative data were collected by in-depth interviews from 10 CHPs who have experiences in managing telemedicine system. All interviews were recorded and transcribed according to qualitative conventional content analysis processes. Results: As a result, 32 themes were deduced and 11 theme clusters and 3 categories were formed and each coding categories were derived directly from the text data. 11 theme clusters derived from the 32 meaningful themes were as follows: Human resources, equipments and systems, computer program (Input resources), human resource management, patient registration and management, medication, laboratory test (Progress), benefits in telemedicine system managing, difficulties in telemedicine system managing, complains in telemedicine system managing, client responses to telemedicine system (Outcome evaluation). 3 categories derived 11 theme clusters were 'input', 'progress', and 'outcome evaluation'. Conclusions: This study has contributed to the understanding of operation of telemedicine by CHPs in community health posts. For more systematic and comprehensive management, further study should be conducted to reflect experience and positions of public health center physicians, collaborative hospital physician and patients.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2005년도 춘계 종합학술대회 논문집
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• pp.151-155
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• 2005

Telemedicine은 의료진과 환자간의 정보교환을 제공하기 위한 일반적인 기술로 사용되어지고 있다. 더욱이 환자기록측면에서 의료진은 telemedicine applications을 통하여 생체신호와 다양한 환자데이터를 획득할 수 있다. 또한 최근의 RF기술의 발전과 무선통신기술은 Ubiquitous 네트워크의 발전을 가능하게 한다. 원격 모니터링 시스템은 휴대 인터넷기술을 이용하여 Mobile PDA를 이용하여 구현되어지는 대표적인 휴대인터넷기술의 적용분야이다. 본 연구는 임베디드 컴퓨터(SBC)를 기반으로 생체 정보를 모니터링하기 위한 무선 Telemedicine PDA Prototype을 구현하였다. 본 시스템은 휴대 인터넷기술을 이용하여 만성 질환 환자나 긴급한 상황에 매우 효과적으로 사용될 수 있으며, 노령화사회에 의료비용 유지에 효과적일 것이다.