強化急重症網絡區域聯防之嶄新紀元-偏遠地區遠距醫療系統建置

隨著全國每萬人醫師數逐年上升，醫療資源仍集中於都會區域，偏遠地區緊急醫療資源仍相對不足。衛生福利部於2018年「通訊診療治療辦法」放寬遠距醫療之照護對象與模式，並在2021年正式將急診納入「全民健康保險遠距醫療給付計畫」給付範圍。遠距醫療在急重症病人照護已有實證應用，基於遠距醫療專科門診系統建置經驗，結合醫療與資訊科技發展，建置急診遠距醫療會診系統。在面臨緊急醫療搶救，急診遠距醫療須具備好的工具進行資訊傳遞，包含友善操作介面、即時且重要的醫療資訊交換、紀錄留存及綠色通道團隊預先啟動，並可提供大量傷患迅速應變支援，縮短急重症病人醫療處置等待時間。急診遠距醫療會診系統之建置已開啟創新之急重症就醫模式，惟系統功能仍須透過滾動式修正及持續教育訓練，使醫護人員熟悉操作並列入常規系統使用，以作為偏遠地區醫院急診病人第二意見諮詢及轉診評估，降低病人不必要之轉診，提升病人醫療品質。  Although the number of medical doctors per 10,000 residents in Taiwan has been increasing, most medical resources remain concentrated in metropolitan areas, and emergency medical resources in remote areas remain insufficient. In 2018, the Ministry of Health and Welfare passed the Rules of Medical Diagnosis and Treatment by Telecommunications to expand the coverage of people and models eligible for telemedicine services. In 2021, emergency services were included in the coverage of the National Health Insurance Telemedicine Benefits Plan. Telemedicine has been applied in emergency and critical care with empirical evidence. Based on the experience in establishing a telemedicine specialist outpatient system and the incorporation of medical and information technologies, a remote emergency consultation system was established. To ensure effective emergency care, an emergency telemedicine model must incorporate favorable tools for information transmission, including a user-friendly interface that facilitates real-time and critical medical information exchange and record keeping. The model should also allow for early preparation of the green channel team, ensure that support is at hand for rapid response to a large number of patients, and shorten the waiting time of emergency and critically ill patients for medical treatment. The establishment of the remote emergency consultation system has opened the door to an innovative emergency and critical care model. However, the system functions should be improved on a rolling basis, and continuous staff training is required to familiarize staff with the operation of the system as a routine system. Thus, the system can be used for second opinion consultation and referral assessment for emergency patients in remote hospitals, thereby reducing unnecessary referrals and improving the quality of medical care.