Enhancing diabetic retinopathy screening:Non-mydriatic fundus photography-assisted telemedicine for improved clinical management

The utilization of non-mydriatic fundus photography-assisted telemedicine to screen patients with diabetes mellitus for diabetic retinopathy provides an accurate,efficient,and cost-effective method to improve early detection of disease.It has also been shown to correlate with increased participation of patients in other aspects of diabetes care.In particular,patients who undergo teleretinal imaging are more likely to meet Comprehensive Diabetes Care Healthcare Effectiveness Data and Information Set metrics,which are linked to preservation of quality-adjusted life years and additional downstream healthcare savings.

Tele-COVID: A Telemedicine SOA-Based Architectural Design for COVID-19 Patients

In Wuhan,China,a novel Corona Virus(COVID-19)was detected in December 2019;it has changed the entire world and to date,the number of diagnosed cases is 38,756,2891 and 1,095,2161 people have died.This happened because a large number of people got affected and there is a lack of hospitals for COVID-19 patients.One of the precautionary measures for COVID-19 patients is isolation.To support this,there is an urgent need for a platform that makes treatment possible from a distance.Telemedicine systems have been drastically increasing in number and size over recent years.This increasing number intensies the extensive need for telemedicine for the national healthcare system.In this paper,we present Tele-COVID which is a telemedicine application to treat COVID-19 patients from a distance.Tele-COVID is uniquely designed and implemented in Service-Oriented Architecture(SOA)to avoid the problem of interoperability,vendor lock-in,and data interchange.With the help of Tele-COVID,the treatment of patients at a distance is possible without the need for them to visit hospitals;in case of emergency,necessary services can also be provided.

Research on the Comparison of Telemedicine Policies between China and South Korea

In recent years,the impact of telemedicine technology on the medical industry has become an essential issue of common concern in the industry and academia.This paper makes a diachronic review,classification research,and comparative analysis of the telemedicine service also the related literature of the telemedicine industry policy research in China and South Korea.Based on this,the study puts forward the prospect of future research,which provides an essential basis for further research on the influence mechanism of telemedicine service quality on patient satisfaction and recommendation intention.

Development and prospect of telemedicine

With the continuous improvement and development of modern network information technology and the continuous improvement of people’s demands for health care,the traditional health care model has evolved,giving birth to a new telemedicine health care model.Telemedicine refers to the comprehensive application of information technology for medical information transmission and long-distance communication between different places.It integrates medicine,computer technology,and communication technology for remote monitoring,diagnosis,consultation,case discussion,teaching,and surgery as well as a series of medical activities.With the continuous development of communication technology,telemedicine is also constantly changing.As a relatively novel technology,telemedicine is sought after by major hospitals.With the advancement of internet technology,digitization and informatization have been gradually applied in telemedicine,but due to various factors,telemedicine still has great limitations.This paper summarized the development status of telemedicine;discussed in detail the development of telemedicine at home and abroad;reviewed the application of telemedicine as well as the feasibility and limitations of its promotion and development;and put forward an outlook for the future development of telemedicine.

Facilitators of and barriers to emergency medical service use by acute ischemic stroke patients: A retrospective survey

Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records.Among 233 acute ischemic stroke patients enrolled in a large-scale study,160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis.Results: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs.625 min.,p =0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs.31.5%,p =0.013).For those who first contacted emergency medical service,the facilitators of emergency medical service use were the presence of hemiparesis (p =0.003),bilateral paralysis (p =0.040),and loss of balance (p =0.021).The predominant barrier was the failure to recognize the urgency of symptoms (p 0.006).Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h.Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier,public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.

Applications of Norm and Situation Calculus in the Semantic Web Service Composition

Semantic Web service studies are carried out around the OWL-S, however, OWL-S model does not contain the descrip-tion of preferences and constraints when we choose and use them in different organizations, different cultures, different sectors and actors because of OWL capacity limitations in rules. It means that Semantic Web service composition can not compose users’ subjective services from the user requirements. The paper makes up for the semantic shortcoming of OWL-S through using norm semantic scalability, and achieves the formal description of the norm by using the situation calculus. Finally, the paper also takes a tourism composite service as an example how to extend the ability of the semantic description of OWL-S, which shows us the combination of the norm and the situation calculus. It is positive significance for eventually realizing semantic extension of OWL-S.

医务人员远程医疗服务认知情况调查与分析

目的调查医务人员对远程医疗服务的认知情况,促进远程医疗服务在供需双方间的精准匹配。方法以某区域医疗中心合作医院医务人员为研究对象,采用在线问卷调查方式对其进行远程医疗服务认知调查,并对收到的1101份有效问卷进行分析。结果参与过和未参与过远程医疗的医务人员在职称、职务、学历、岗位上存在显著差异(P<0.05)。被调查的医务人员中,44.3%认为远程医疗服务使患者选择留在当地治疗可降低就医负担,36.6%认为远程会诊能解决会诊中提出的50%以上的问题,40.8%认为远程医疗使30%~50%的患者选择在会诊医院继续治疗。年龄、岗位、职称、职务,远程医疗参与情况,医院所在地区、级别、类别等,显著影响医务人员对远程医疗服务的认知。结论医疗机构要创新教学和人才培养方式,依托新媒体平台进行患者宣教,完善基层远程医疗平台建设,通过多种措施提高远程医疗服务质量。同时,有关部门要完善远程医疗保障机制,以更好地促进远程医疗发展。

新疆地区住院患者远程医疗服务满意度现状调查

目的 通过开展远程医疗服务患者满意度调查,进一步改善患者就医体验感,促进新疆地区远程医疗服务质量的提升。方法 在新疆14个地州、92家公立医院随机抽取1 446例住院患者,运用自行设计的电子问卷,对接受远程医疗服务的患者开展满意度调查。结果 新疆地区接受远程医疗服务的住院患者总体满意度较高(94.16%)且受众趋于年轻化(年龄小于50岁患者占79.19%);72.68%的患者主要选择原因为远程医疗服务可降低就医成本,而非远程服务专家水平的高低;在接受远程医疗服务后,93.50%的患者增强了对后续治疗的信心,85.96%的患者认为治疗效果有明显提升。结论 目前,新疆地区住院患者远程医疗服务满意度相对较高,但存在远程医疗服务能力与患者满意度不匹配的问题,因此,仍需拓展远程医疗服务业务范围,加强科普宣传,提升患者诊疗体验感。

医务人员视角下远程医疗满意度及服务效果分析

目的/意义分析医务人员对远程医疗服务的满意度和服务效果、参与意愿,梳理远程医疗服务体系存在的问题。方法/过程面向各地医疗机构开展电子问卷调查,共收集有效问卷1 524份。基于调查问卷数据,构建logistic回归模型,探索影响医务人员评价和态度的关键因素。结果/结论医务人员对远程医疗服务的整体满意度、服务效果处于较高水平,参与意愿较强。需要从加强基础设施建设、优化服务流程、健全激励机制等方面着手,完善远程医疗服务体系,改善医务人员远程医疗体验。

我国远程医疗发展瓶颈及突破策略

经过30多年的发展,我国远程医疗取得了一些成效,但仍存在数据不能互联互通,平台重复建设、使用率不高,收费及医保报销机制不健全,各方参与的积极性不高,法律关系不清晰、法律不健全,服务范围较窄、无法满足需要等问题。结合相关文献及工作实践,在既往研究的基础上,提出要加快远程医疗与先进网络通信的结合,以“互联网+”医疗为抓手,助推检查检验结果互认,完善相关法律法规建设,促进远程医疗与分级诊疗、养老、家庭康复结合,服务向慢病管理、护理、家庭医生签约等方面延伸,拓宽远程医疗服务范围和内涵。

参与合作社能提升农户绿色生产行为吗?——基于技术服务的中介与社会规范的调节效应分析

基于2021年江西省“百村千户”调查数据,运用OLS回归和倾向得分匹配(PSM)法,结合中介与调节效应模型,实证分析参与合作社对农户绿色生产行为的影响机理,并使用工具变量法验证模型的稳健性。结果表明:参与合作社能显著提升农户绿色生产行为;技术服务在参与合作社影响农户绿色生产行为采纳的过程中发挥部分中介作用,中介效应占比为10.43%;社会规范在参与合作社经由增加农户获得的绿色生产技术或服务来促进其采纳绿色生产行为过程的前半路径中发挥负向调节作用,即社会规范水平越高,技术服务的中介效应越弱。基于此,在大力支持并规范合作社发展,敦促合作社提供优质技术服务以满足个体农户绿色生产需求的同时,应注重全方位激活农村社会规范水平,运用社会规范手段优化农户绿色生产行为,实现农业可持续发展。

北京某市属医院远程医疗服务效果评价实证研究

目的:选取北京市某市属医院进行远程医疗服务质量评价体系的实证研究,评估远程医疗服务质量,了解远程医疗当前存在的不足,为远程医疗服务发展与改进提供理论基础和新的思路。方法:通过设计、发放调查问卷,收集具有代表性的某市属三甲医院及其合作的远程医疗服务站点医院的评价数据,评价其服务质量,验证该评价体系的评价能力。最后对调查结果进行分析和评价,并提出提高远程医疗服务质量的策略和建议。结果:本调查问卷信度、效度分析的内容效度及效标效度结果均较好,最后使用回归分析进行模型的验证,结果表明本远程医疗评价体系模型有效。结论:本研究所构建的公立医院远程医疗服务质量评价体系从患者角度出发,同时兼顾医生视角,覆盖6个核心维度,科学、客观、全面,通过实证研究为远程医疗服务质量评价指标体系的进一步推广及远程医疗的发展提供参考。

远程健康教育在日间手术患者中的应用研究进展

远程健康教育对于日间手术患者具有重要作用。通过文献回顾,总结国内外远程健康教育在日间手术患者中的应用形式、内容要素与评价要素。远程健康教育在日间手术患者中的应用取得了显著成效,但也存在远程系统不完善、教育内容不规范以及受益人群受限等问题。建议进一步完善远程系统与教育内容,关注远程健康教育在不同患者群体中的应用效果,提高远程健康教育的实施效果等。

面向远程医疗覆盖网络模型的研究与应用

目的研究一种面向远程医疗的覆盖网络(Overlay Network for Telemedicine,ONTM)模型,以改善传统互联网无法完全满足远程医疗服务多样化服务质量的难题。方法基于覆盖网络的架构建立ONTM模型,并分为控制平面和数据平面,负责整体的策略调控和网络传输。在ONTM模型的接入侧采用多链路聚合策略,同时将其传输层进一步细分为信源/信道传输子层。使用网络监控软件测试终端之间的网络性能参数。结果基于ONTM模型的新型远程医疗系统累计完成了超过10000次的远程医疗服务,涵盖了15个临床科室。在ONTM模型的调控下,5G远程大脑起搏器手术期间北京到三亚的平均延时低至76 ms,丢包率几乎为0,流量稳定在10 Mbps,优于通用5G网络。结论ONTM模型能够保证远程医疗数据的稳定传输,可为特殊环境下开展远程医疗提供新思路。

受邀方及邀请方医务人员开展远程医疗服务感知收益差异研究

目的探究医务人员作为受邀方和邀请方对开展远程医疗服务的感知收益差异,为优化远程医疗协作和利益格局提供理论依据及建议。方法围绕远程医疗服务的角色和感知收益对997名医务人员开展问卷调查,运用相关性分析、多元线性回归、单因素分析及logistic回归分析探究医务人员对开展远程医疗服务的感知收益差异。结果在声誉感知收益方面,受邀方认为开展远程医疗服务能够宣传并提升个人影响力(OR=1.771)、提升本医院品牌影响力(OR=1.455),而邀请方相反(OR=0.737)。在能力提升感知收益方面,受邀方认为开展远程医疗不利于提升个人诊治疑难病例的能力(OR=0.651),邀请方认为有利于本医院学科发展(OR=1.317)。结论受邀方以声誉感知收益为主,邀请方以能力提升感知收益为主。二者感知收益互补,但可能存在利益博弈,需围绕受邀方动机和邀请方难处优化远程医疗服务的参与激励、帮扶运营和绩效考核等机制。

学校课后服务对家长教育焦虑的影响机制——基于倾向得分匹配法的实证分析

缓解家长教育焦虑是当前教育改革亟须关切的现实问题。已有研究对学校课后服务与家长教育焦虑关系进行了实证分析,但并未打开“黑箱”对学校课后服务影响家长教育焦虑的传导调节机制进行实证探索分析。本研究以全国152个地级市10947份中小学生家长问卷为依据,采用倾向得分匹配的方法探究学校课后服务对家长教育焦虑的影响效应及调节机制。结果显示,学校课后服务对家长教育焦虑具有显著正向影响,学校课后服务越是能满足需求,家长的教育焦虑情绪越是能得到缓解;家校沟通频率和校外教育规范程度在学校课后服务与家长教育焦虑之间起调节机制作用。未来应在拓展学校课后服务功能、加强家校沟通、持续治理校外教育以及推动义务教育高位均衡等方面着力缓解家长教育焦虑。

基于信息技术的“互联网 远程医疗健康”服务模式应用

随着信息技术的不断发展和互联网的普及,远程医疗健康服务成为一种创新模式,为企业员工提供了更加便捷、高效的医疗服务。本文以企业与医院合作的模式为例,探讨了基于信息技术的互联网远程医疗健康服务在解决企业员工看病问题方面的应用。通过分析该模式的优势和挑战,旨在为其他企业提供借鉴和启示。

形式规范与互惠合作:社区心理服务组织的差异化发展

心理建设逐步成为中国社会治理的重要组成部分,越来越多心理服务人才加入基层社会治理的一线工作,许多地方政府从功能创新视角积极引导心理服务组织参与社会治理。在此过程中,当地熟人型和外来输入型两类心理服务组织表现出不同的发展路径、行业风格和运行机制。由外来输入型人才主导的心理服务组织通常注重业务流程的形式规范、技术严谨和操作层级,但缺乏同当地更为紧密的社会联系,加上完成项目制任务的时间约束,难以利用更多机会去熟悉当地的市井生活,也不足以培育充分的地方情感,社区心理服务效果有时存在一定折扣。当地熟人型人才主导的心理服务组织虽然有待继续提高专业实力和干预成效,但这类组织更注重强化地方身份优势,善于发挥社区的熟悉价值,致力开展互惠合作,因此能够获得理想的社区心理服务效果。上述两类心理服务组织存在一定的竞争关系,也发挥着互补作用,合理利用其功能有助于提高社区心理服务水平。

药师参与远程药学服务研究进展

药师是远程药学服务团队的重要成员,在高血压、血脂异常、糖尿病、抗凝及哮喘等疾病患者的预后中,扮演着重要的角色。已发展的远程药学服务包括药物选择、医嘱审查和配药、患者咨询和用药监测以及提供其他临床用药服务。远程药学的优势包括增加药房和药师的价值,适应患者的需求,加强专业性咨询的可及性,提高卫生系统的效率,增加以患者为中心的服务的提供等。未来可通过远程药学平台开展分层和个体化随诊提高患者用药安全性和治疗依从性。

远程医疗服务质量问题及改进策略

远程医疗服务在当前医疗体系中正发挥着巨大的作用,它不仅有效促进了医疗资源均衡分布,还为患者提供了更为便捷的就诊途径。然而,远程医疗服务也面临一系列的挑战和问题。为了提高我国远程医疗服务的质量和效果,本文选取具有代表性的多家医院的远程医疗服务站点进行服务质量评价,对当前远程医疗服务存在的问题进行总结、分析、归纳,进而提出远程医疗服务质量改进策略。