In the Face of the Epidemic, How Does the Telemedicine System Get Ahead of Its Subordinates?

What Is Telemedicine Consultation?

Telemedicine consultation is the use of information and telecommunications technology to exchange medical and clinical data and expert opinions from patients in two places to overcome obstacles in space and even time.

• Follow-up treatment of acute inpatients within 3 months after discharge
• Residents of residential long-term institutions require medical treatment by doctors of the medical institution due to their medical conditions
• Patients under the integrated care regulations of family doctors need to be diagnosed and treated by family doctors due to their condition
• Follow-up treatment related to laws and regulations related to home care
• Overseas patients who have not participated in the National Health Insurance

1. Step 1: Planning consultation
   First, confirm whether the institution, department, and doctor you want to see provides telemedicine consultations. Some medical institutions only open specific departments, some only provide patients for follow-up consultations, and some are fully open.
2. Step 2: Start connection
   To ensure a smooth connection during the consultation, it is recommended to find a smooth and quiet environment for the Internet to maintain the quality of audio and video and diagnosis and treatment.
   After the connection is successful, according to laws and regulations, you must present your health insurance card or other documents to confirm your identity. If it is through voice communication, at least you need to inform the physician of your personal information to confirm your identity. To maintain the privacy of both parties, it is necessary to confirm who is in each other's space, and if it is necessary to record because of need, the consent of both parties should be obtained.
   Remarks: It is necessary to understand that telemedicine consultations are limited. For example, although medical history can be obtained, some palpation and special physical examinations may not be performed, and there is no way to obtain imaging examination information in real-time.
3. Step 3: Confirm purpose and quick assessment
   It is best to tell the doctor the purpose of the medical treatment first. Common purposes include pain control (drugs, etc.), examination and evaluation, arranging treatment, tracking the status, second opinion consultation, issuing medical certificates, referral recommendations, etc.
   If it is the first visit, tell the doctor clearly where the pain is and describe the cause of the pain or injury in detail. If you need to use accident insurance or medical insurance, you also need to clarify the needs at the beginning.
4. Step 4: Describe the medical history
   To allow doctors to obtain sufficient information and improve the efficiency of diagnosis and treatment, it is recommended that you organize the following information before going to the doctor, including the location of the pain, the nature of the pain, the degree of the pain, the time when the pain occurred, the cause of the pain, the aggravating factor, the alleviating factor, etc. This information can help doctors determine the root cause of the problem and make a quick diagnosis.
   If you are an athlete or a sports enthusiast, tell the doctor your exercise type, training intensity, competition intensity, competition plan, and personal performance, so that the doctor will arrange your treatment direction more in line with your needs.
   Some chronic diseases, old injuries, or physical conditions may be related to the risk of injury, treatment planning, and drug choice. Therefore, it is best to sort out your chronic disease, injury history, surgery history, allergy history, and other information and tell the doctor.
5. Step 5: Check
   After the doctor obtains the medical history, he will perform a physical examination to confirm the problem. As long as the light is sufficient, the image resolution is good enough, and the injured part can be exposed, the doctor can usually check whether the affected part is red, swollen, deformed, or bruised. If the injured place is behind the back and other parts that are difficult for you to present, you can ask others to assist in moving the camera to facilitate the observation of the doctor.
   The doctor may also ask the patient to perform movements, test the motion of the joints, and confirm whether the movements are painful. Some examinations can be performed by themselves or with the assistance of others under the guidance of a doctor, but there are still some examinations that rely on the experience of the doctor and may not be able to be performed during telemedicine consultations.
6. Step 6: Listen to diagnosis and treatment
   After diagnosis, if the doctor has confirmed the diagnosis, he can listen to the doctor for analysis and discuss the treatment plan with the doctor. If the diagnosis is still not confirmed, the doctor may further arrange face-to-face consultation or arrange other instrumental examinations to clarify the patient's problem.
   If the symptoms are mild, the doctor may prescribe drugs or recommend home treatment. If you cannot handle it by yourself, you must cooperate with the doctor to arrange follow-up treatment in the hospital or refer to another expert for treatment. At this time, you should inform the doctor of your considerations and treatment preferences, so that the doctor can plan the most suitable treatment plan for the individual.
   At the end of the outpatient clinic, apart from making an appointment for the next follow-up time and asking about the follow-up treatment process, you only need to confirm the payment and medicine method with the institution and follow the instructions to complete the telemedicine consultation.

• Forward triage:
  Before the patient arrives in the emergency department, through the video system, the medical staff can ask about the patient's condition and travel history and can observe the patient's breathing status on the screen to determine whether the patient needs to come to the hospital for treatment. In this way, the rate of contact between the patient and others can be reduced, and there is no time limit. Once the patient needs to come to the hospital for treatment, the patient-related information has already been obtained, which can also speed up the time for rapid screening.
• People in home isolation or home quarantine:
  This is also a project currently being implemented by the Ministry of Health and Welfare. For some less complicated cases, telemedicine consultation should also be able to meet their medical or health needs.
• Home screening:
  After the video assessment, medical staff can go to the patient’s home for examination for some high-risk and bed-ridden patients.
• Sub-specialist consultation:
  Not limited by space and time, in an emergency, the sub-specialist consultation function can be activated at any time, so that the patient's diagnosis and treatment will be more accurate.

Telemedicine consultation is bound to become a trend in the future. Combining wearable devices, artificial intelligence assistance, mobile payment, and other online service modes will change the way of medical treatment and improve convenience in the future.