城市医疗集团发展远程医疗的SWOT分析

远程医疗作为一种新型医疗模式,突破了医疗资源在时间与空间上的限制,为优化医疗资源配置、实现优质医疗资源下沉、提高基层医疗服务能力提供了有效途径,具有良好的经济效益与社会效益。在国家相关政策的有力推动下,城市医疗集团结合自身发展需求开始大力发展远程医疗。文章运用文献研究法和态势分析法(SWOT analysis,SWOT分析),探讨了城市医疗集团发展远程医疗的内部优势(S)、劣势(W)以及外部机会(O)、挑战(T)。最后运用SWOT矩阵分析得出如下结论:抓住发展契机,发挥政策导向(SO策略);增加财政投入,促进多方参与(WO策略);完善政策法规,加强宣传力度(ST策略);线上线下结合,尝试差异化服务(WT策略)。     

Sensory Work of Diagnosis: A Crisis of Legitimacy

Sensory judgments have always been a part of medical practice, as sensory studies scholars have emphasized. However, in current regulatory, management and technological contexts, there is a push toward rational decision-making procedures and test-based evidence over clinical diagnosis. Sociological scholarship highlights that in focusing on explicit medical knowledge and disembodied data we take for granted aspects of healthcare work, including the ways in which health and illness is sensed. Research in sociologies of diagnosis and social studies of science and technology has captured that while the senses continue to play a role in medical work, the status and practice of this sensory work is not straightforward as evidenced by dual use of the senses and tests and the delegation of sensory work. Based on semi-structured interviews with expert doctors in diverse specialties, this article examines the sensory work of medical decision-making, with attention to its legitimacy. It examines applications of the senses from auscultation to ongoing sensing of patients’ bodies unmediated and via technological outputs. While critical to clinical judgments, there is discomfort with this sensory work in light of medico-legal pressures. I argue that the sensory work of diagnosis is vital, to the extent that gaps in sensory information imply gaps in understanding.     

一种适用于远程医疗的水印算法

研究了脑电图(EEG)的水印算法,提出了一种基于自适应滤波的数字水印算法。实验仿真结果表明水印是不可见的,经过低通滤波、中值滤波、维纳滤波、JPEG压缩、小角度旋转等图像处理操作后仍可检验出水印,比空域算法有更高的鲁棒性。     

我国远程医疗的现状、问题及发展对策

随着信息技术及网络通信技术的发展,远程医疗的内涵在不断演变和丰富。我国远程医疗经过近30年的发展,尤其在新冠肺炎疫情促进下,政策体系逐渐完善,远程医疗协作网和互联网医院建设均取得一定成绩,但与此同时也暴露出一些问题,如法律法规不健全、服务定价和补偿机制不完善、系统平台功能不完善、医患双方认识不足、远程医疗专业人才缺乏等。结合发达国家远程医疗发展经验,应进一步加强我国远程医疗法律法规建设、健全财政补偿机制、完善远程医疗系统功能、加快远程医疗人才队伍建设,以促进远程医疗的持续健康发展。     

Substance use disorders and COVID-19: the role of telehealth in treatment and research

ABSTRACT

Telehealth, or the use of telecommunications and virtual technology to deliver health care and engage with patients outside of traditional health-care facilities, can play an important role in addressing the treatment and study of substance use disorders (SUDs) during the ongoing COVID-19 crisis. COVID-19 and related safety restrictions have thrust healthcare workers and researchers into a new reality of healthcare that relies heavily, or even exclusively, on telehealth methods. These changes have forced treatment providers and researchers to be agile in adopting these methods in order to maintain continuity of patient care and data collection. There are unique considerations that should be taken into account as telehealth practices continue to augment SUD care and research, even when restrictions have been lifted. Overall, we propose that telehealth can support innovation in treatment and research focused on SUDs and should be an integral part of our work, beyond COVID-19.     

The Print Media and Aging Policy:

This article examines the role of the print media in covering complex ploicy issues. Two models of journalism are considered. "Pack journalism" predicts that print media coverage will be highly consistent in content due to the reliance by those in the media on the same sources of information. In this article another model - "Beltway journalism" - is proposed. It implies that coverage by the print media indigenous to the Washington, D.C. area (inside the Beltway) will diverge from that of other print media, presenting a potentially distorted view of the world to policymakers in Washington. Using the Washington Post and the Los Angeles Times as possible indicators of the two models, aging policy is addressed through a case study of newspaper coverage during passage and repeal of the Medicare Catastrophic Coverage Act of 1988. Findings suggest that Congress was unduly influenced by the way that Medicare Catastrophic was framed in the Washington Post, lending credence to the Beltway journalism model. By paying insufficient attention to the way MEdicare Catastrophic was being framed by sources of print outside the Beltway area, lawmakers allowed themselves to assume a grassroots-level understanding of the issue and support for the bill, both of which turned out to be illusory.     

利益相关者对话实践与远程医疗的伦理困境之解决

远程医疗伦理困境及其产生的原因主要是传统伦理评价中的理性缺陷,以及远程医疗利益相关者之间沟通的不确定性、异质性与对话普遍诉求难题。解决这一伦理困境需要运用对话伦理学的对话理性优势以克服传统伦理评价缺陷,以对话不断解决对话认识的开放性与异质性问题,并付诸远程医疗利益相关者之间不断进行的对话实践,最终达成伦理上的完善,由此建构一种不断在对话中进行且未来可行的动态多元远程医疗评价体系。     

Making mammograms mobile: Suggestions for a sociology of data mobility

Although academic interest in the study of mobilities is on the increase, exactly what it takes and what it means for data to become mobile is seldom asked. This paper addresses that question for the case of digital medical images, more precisely mammograms (X-ray images of the breasts). It is argued that the kind of reasoning which treats mobility as a fixed asset of such images is problematic, because it obscures the particular perceptions, circumstances and practices that play a part in the accomplishment of medical images as mobile. The argument is based on ethnographic involvement with an e-Science/telemedicine research project aimed at demonstrating the benefits of a digital mammography database for breast cancer screening services, epidemiological research and radiology teaching in the UK. By focusing on the ways in which mammograms are re-presented as 'mobile data', and on how their movement is practically organized in the context of this project, the paper indicates a new direction for the sociological study of data mobility: one that understands the relationship between 'data' and 'mobility' as accomplished and emerging rather than fixed and inherent.     

ADHD远程反馈治疗系统的研究

利用脑电反馈治疗技术让注意力缺陷伴多动症(ADHD)患者在家里接受远程的评估和治疗是一种全新的远程医疗模式。该文提出了一种基于Multi-Agent的远程医疗系统的结构与协作模型,设计和实现了针对ADHD的远程评估和反馈治疗系统,建立基于多Agent协同的多参数评估决策体系,将层次分析法用于协同医疗决策和对ADHD的评估。系统结合评估结果指导脑电反馈仪对患者进行治疗,达到远程治疗ADHD的目的。     

Researching Health Communication Technology Intervention Projects: The Challenge of Achieving Utilization Levels Sufficient for Evaluation

ABSTRACT

The deployment of interactive communication technologies to deliver health services and education has grown significantly over the past decade. Telemedicine, the use of telecommunication technologies for health care, is one specific application that has enjoyed significant public and private funding for research projects. However, telemedicine project evaluators have run into a serious barrier in their research efforts, namely, the deployment of telemedicine is often tremendously time-consuming and often yields utilization levels inadequate for research purposes. This article seeks to overview this problem through a case analysis of a multidimensional telemedicine project in Michigan that enjoyed both success and failure. The article concludes with a discussion of five universal challenges that must be addressed for project evaluators to achieve utilization levels to allow for reliable research conclusions.