• 제목/요약/키워드: telehealth

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원격진료 실시에 수반되는 법적 쟁점들에 대한 고찰 (Legal Issues To Be Considered Before Implementing Telehealth in South Korea)

  • 이원복
    • 의료법학
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    • 제22권1호
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    • pp.57-90
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    • 2021
  • 의료인이 직접 환자를 진료하는 형태의 원격진료가 현행 의료법에서 허용이 되는지 여부와 의료법상 허용을 떠나 정책적으로 허용하는 것이 바람직한지의 문제가 오랫동안 논란이 되어 왔다. 그러다가 코비드19라는 인류가 드물게 겪는 팬데믹 상황으로 인하여 우리나라에서 한시적으로 허용이 되었고 외국에서도 이용이 폭발적으로 증가하면서 다시 관심을 받고 있다. 원격진료의 허용 여부에 관하여는 이미 많은 논문이 존재하지만, 막상 원격진료가 실시될 경우 그에 수반되어 발생할 수 있는 부수적인 법적 쟁점들에 관하여는 논의가 부족했던 부분이 있어 이 글에서 다루었다. 필자는 국민건강보험의 수가정책, 환자 본인 확인, 의약품 비대면 구매, 진료장면 녹화에 관하여는 입법적으로 미리 정비를 하는 것이 바람직하다고 보았고, 원격진료에 필요한 시설 기준은 오히려 법제화를 하면 현실에 뒤떨어지거나 변화에 대응하는 탄력성이 떨어지므로 법제화를 하지 않고 대신 의료인이 의료기기법상 승인을 받은 원격진료용 기기를 사용하는 것으로 충분하다고 판단하였으며, 끝으로 원격진료의 맥락에서 발생한 의료사고의 책임이라든가 개인정보 보호는 기존의 민사법이나 개인정보 보호법으로 이미 충분한 대응이 되므로 별도의 특칙을 제정할 필요는 없다는 결론을 내렸다.

Telehealth for consultation and shoulder rehabilitation: a preliminary study on the perspectives of 30 patients during the COVID-19 lockdown

  • Sahu, Dipit;Rathod, Vaibhavi;Phadnis, Ashish;Bansal, Samarjit S.
    • Clinics in Shoulder and Elbow
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    • 제24권3호
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    • pp.156-165
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    • 2021
  • Background: This study aimed to determine: the perspectives of the patient cohort that underwent telehealth consultation and shoulder rehabilitation during coronavirus disease 2019 (COVID-19) and the differences in the patients' perspectives with the two different telehealth video applications (apps) used in the study. Methods: This is a prospective study carried out during the COVID lockdown period of April to July 2020. Thirty consecutive patients from the orthopedics department of a tertiary institute in India underwent their first-ever session of a video app-based (Zoom or WhatsApp) telehealth consultation with shoulder rehabilitation exercises on a handheld mobile, tablet, or laptop device. After the virtual consultation, the patients were sent a validated telehealth usability questionnaire (TUQ) to evaluate their perspectives. Scores obtained from the TUQ were the primary outcome measure. Results: The study was completed by 30 patients (16 men and 14 women) with an average age of 56 years (range, 20-77 years). The patients who contacted us during the lockdown period with either a stiff shoulder or a conservatively treated shoulder fracture were included in the study. The average TUQ score was 13.6 (median, 14.5; range, 6-21) out of a maximum of 21 points. Eighty percent of the patients were satisfied and found the telehealth service useful. Use of the Zoom app scored significantly higher (median, 17; average, 15.6) than the WhatsApp app (median, 8.5; average, 9.6) (p=0.004). Conclusions: Patients who received telehealth consultation and shoulder rehabilitation were overall satisfied. Telehealth apps with advanced video calling features such as Zoom should be preferred for higher patient satisfaction.

원격의료서비스 수용요인의 구조적 관계 실증연구 (Structural Relationships Among Factors to Adoption of Telehealth Service)

  • 김성수;류시원
    • Asia pacific journal of information systems
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    • 제21권3호
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

농촌의 보건의료문제 해결을 위한 원격보건 : 미국과 한국의 경험 (Telehealth for Rural Health Problems: Experiences in The U.S.A and Korea)

  • 이원재
    • 한국병원경영학회지
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    • 제1권1호
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    • pp.188-202
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    • 1996
  • Telehealth is widely tested in the U.S.A and other developed countries. This system is expected to solve rural health problems reducing professional isolation. Some demonstration projects showed that the system can provide quality care in reasonable prices to rural residents. However, few study has been done on whether telehealth system can attract physicians by reducing professional isolation. The system is not available to most of the rural hospitals because the price for the equipment and telephone charges are not low enough. It is promising that the system cost and telephone charges are decreasing gradually. As time passes, rural hospitals will be more viable for the system. Satisfaction of the physicians and patients is a key factor for the implementation of the system. The physicians need to understand more about telecommunication and computer systems. After physicians are well-versed about the system, we can expect wide use of telehealth in rural areas. Effort for the confidentiality and standardization should be devoted to assure patient's privacy and compatibility of patient records and exam results. In Korea, two projects are being operated in Uljin and Kurye. A study evaluated the economic efficiency of the projects suggesting that increase of the number of patients up to three times of current number or decrease in hardware costs and telecommunication charges into two thirds of the current costs. The hardware and telecommunication charges are decreasing. Another area telehealth system can be applied is psychiatric accommodation facilities. Establishment of telehealth in the psychiatric facilities will increase the access of psychiatric care for patients and is expected to be economically efficient.

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계량서지 분석을 통한 노인 대상 원격보건의 효과성 연구 동향 규명 (A Study on the Research Trends of Effectiveness of Telehealth for the Elderly through Bibliographic Analysis)

  • 박선하;김미경;박혜연
    • 재활치료과학
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    • 제11권1호
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    • pp.7-20
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    • 2022
  • 목적 : 본 연구는 계량서지 분석을 통해 노인 대상 원격보건의 효과성 연구의 국제 학계 동향을 파악하고 국내 연구의 활성화를 위한 기초자료 제공 및 후속 연구를 위한 기반을 확보하고자 한다. 연구방법 : 본 연구는 2010년 1월부터 2020년 12월까지 국제 학계에서 발표된 노인 대상 원격보건의 효과성 논문에 대한 서지정보를 수집하고 VOS viewer(version 1.6.16, CWTS, Netherlands, 2020) 소프트웨어를 사용해 논문 서지정보 간 관계를 분석하고 시각화하였다. 결과 : 본 연구의 주요 결과로는 첫째, 연구 동향 분석 결과 2010년 9건에서 2020년 70건으로 지난 10년간 출판된 논문의 수 678%의 증가율을 보였다. 연구 분야는 Health Care Science Services에서 145건(45.89%)으로 가장 많이 시행되었고, 학술지에서는 Telemedicine and e-Health가 39건(9.11%)으로 가장 많은 논문을 게재하였다. 둘째, 네트워크 분석 결과 국가 중에서는 미국, 기관 중에서는 영국의 옥스퍼드 대학의 총 연결강도가 각각 168로 산출되어 국제학회에서 가장 강한 영향력을 나타내었다. 셋째, 키워드 분석 결과 '노인(64회)', '돌봄(62회)', '건강(50회)', '기술(40회)', '결과(41회)'의 키워드가 논문에 사용되었다. 결론 : 본 연구에서는 노인 대상 원격보건의 효과성에 대한 국제 학계의 동향과 화제 분석을 통해 추후 국내의 노인 대상 원격보건의 연구 활성화 및 제도적 기반에 대한 시사점을 얻을 수 있을 것이라고 생각된다.

코로나19 자가격리자의 원격 디지털 미술치료 체험에 대한 현상학적 사례연구 (Phenomenological Case Study of the Experience of Telehealth Digital Art Therapy in a Self-quarantined Person before Confirmed with COVID-19)

  • 손창배;이지연
    • 한국콘텐츠학회논문지
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    • 제20권12호
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    • pp.646-658
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    • 2020
  • 본 연구는 코로나19 자가격리자의 심리적 건강을 돌보는 심리치료 개입의 필요성을 바탕으로 원격 디지털 미술치료 체험을 현상학적 사례연구 방법으로 파악하였다. 연구 참여자는 캐나다에서 입국한 17세 청소년(여)으로, 자가격리를 하는 동안 7회기, 회기당 90~120분의 원격 디지털 미술치료 프로그램에 참여하였다. 자료분석은 내용분석을 통한 유의미한 진술을 파악하고, 연구자의 선이해와 판단중지를 바탕으로 주제를 도출하는 과정으로 진행되었다. 연구 결과 34개의 주제가 도출되었으며, 이는 공통된 10개의 주제묶음과 최종적으로 '자가격리 심리·정서', '원격 디지털 미술치료의 제한성', '원격 디지털 미술치료의 긍정성'이라는 3개의 대주제로 파악되었다. 본 연구는 코로나19 자가격리자에게 최초로 실시된 원격 디지털 미술치료 실천 사례연구로서, 코로나19라는 위기의 중심에서 자가격리자의 심리적 건강을 위한 적극적인 자기돌봄인 '심리방역'의 중요한 시사점을 제공할 것이라고 기대한다.

Reliability and Validity Inquiry for Tele-assessment Based on Video Conferencing

  • Suha Lee;Changho Song
    • Physical Therapy Rehabilitation Science
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    • 제12권2호
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    • pp.105-114
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    • 2023
  • Objective: The study examined the validity and reliability of tele-assessment of cervical range of motion (ROM) through video conferencing. Design: A cross-sectional study Methods: The study included 22 healthy adults as subjects and 10 physical therapists as evaluators. The subjects underwent both face-to-face and tele-assessment of cervical ROM. The CROM (Cervical Range of Motion) device was used for reference measurements in the face-to-face assessment. The evaluators assessed the subjects' ROM through visual inspection (VI) and using a Universal Goniometer (UG) in the tele-assessment. Results: The results showed a significant correlation between the face-to-face and tele-assessment measurements for all ROM contents. The correlation coefficients ranged from r=0.54 to 0.71 (p<0.05), indicating concurrent validity. In terms of inter-rater reliability, the ICC values for both VI and UG assessments in the tele-assessment were high, with ICCs of 0.93 and 0.92, respectively. Additionally, the study investigated the usability of the tele-assessment method and environment. The satisfaction of the participants and evaluators was assessed using the Telehealth Usability Questionnaire (TUQ), which evaluates perceptions, usability, and satisfaction with telehealth services. Conclusions: In conclusion, tele-assessment of cervical range of motion using video conferencing was valid and reliable. Also, investigated participant and evaluator satisfaction and opinions, providing insights into the clinical value of tele-assessment. It is important to note that the study was conducted only healthy adults, and further research may be needed to validate the tele-assessment method in populations with cervical dysfunction or neck pain. These findings support the potential effectiveness of telerehabilitation services in assessing and managing musculoskeletal disorders.

Study on the Latest Trends of u-Health and Relations of Medical Technologist

  • Sung, Hyun-Ho;An, Yong-Ho;Lee, Dong-Beom;Kim, Sang-Won;Park, Chang-Eun
    • 대한임상검사과학회지
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    • 제44권4호
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    • pp.178-183
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    • 2012
  • We investigated the latest trend of u-Health and relations with clinical technologist. Since 2000, Korea has become an aging society. Korea will become an aged society by 2018, and it is expected to enter the ultra-high aged society by 2026. Increase in over 65 years population means that the desire of medical service and care demand for the elderly is greatly required. In addition, many predicted Korean national health insurance would falter financially. Medical suppression policies and regulations are also amended continuously. U-Health based on the IT industry and development of related technologies and industries contains the variety concepts of telemedicine, telehealth, e-health, u-healthcare and POCT. Especially, the use of POCT supplied quick clinical examination is extending steadily in medical center and hospital, which will generate the field friction between nurses and medical technologists. In the transition situation from provider-centric service to consumer-driven health care system, this study recommended the principal role and correspondence of clinical laboratory workers and offered information about changes in healthcare market and the basic concept of expert system, measurement and the diagnosis principle to clinical technicians throughout the investigation of the recent research and government policy trends.

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A Review of Contemporary Teleaudiology: Literature Review, Technology, and Considerations for Practicing

  • Kim, Jinsook;Jeon, Seungik;Kim, Dokyun;Shin, Yerim
    • 대한청각학회지
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    • 제25권1호
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    • pp.1-7
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    • 2021
  • The scope of teleaudiology has been noted with telehealth due to Coronavirus disease (COVID-19) recently. As the notion has been around us for more than 20 years ever since 1999, it is necessary to perceive the knowledge accurately and prepare for the successful implementation of it. Therefore, the literature review including screening and diagnostic audiometry, cochlear implants and hearing aids, and aural rehabilitation, telecommunications technology regarding several fields of teleaudiology, and considerations for practicing were identified. Although overall internet-based audiological services showed benefits in terms of outcome and accessibility, uncertainties of cost-effectiveness, the optimal level of support, and a need for further studies of many aspects for teleaudiology has arisen. In the view of technology, the store-and-forward (asynchronous/hybrid) and a real-time (synchronous) methods were introduced with one applied and nine registered patents recorded from 2004 to 2020 for the invention of teleaudiology in the United States. Also, 10 checklists were suggested for planning teleaudiology practice from prior experience in hosting the teleaudiology program. Conclusively, it is hoped that this review sheds light on recognizing and improving the existing teleaudiology services and helps overcome the challenges faced in the era of pandemic and untact world to come.

A Review of Contemporary Teleaudiology: Literature Review, Technology, and Considerations for Practicing

  • Kim, Jinsook;Jeon, Seungik;Kim, Dokyun;Shin, Yerim
    • Journal of Audiology & Otology
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    • 제25권1호
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    • pp.1-7
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    • 2021
  • The scope of teleaudiology has been noted with telehealth due to Coronavirus disease (COVID-19) recently. As the notion has been around us for more than 20 years ever since 1999, it is necessary to perceive the knowledge accurately and prepare for the successful implementation of it. Therefore, the literature review including screening and diagnostic audiometry, cochlear implants and hearing aids, and aural rehabilitation, telecommunications technology regarding several fields of teleaudiology, and considerations for practicing were identified. Although overall internet-based audiological services showed benefits in terms of outcome and accessibility, uncertainties of cost-effectiveness, the optimal level of support, and a need for further studies of many aspects for teleaudiology has arisen. In the view of technology, the store-and-forward (asynchronous/hybrid) and a real-time (synchronous) methods were introduced with one applied and nine registered patents recorded from 2004 to 2020 for the invention of teleaudiology in the United States. Also, 10 checklists were suggested for planning teleaudiology practice from prior experience in hosting the teleaudiology program. Conclusively, it is hoped that this review sheds light on recognizing and improving the existing teleaudiology services and helps overcome the challenges faced in the era of pandemic and untact world to come.