從COVID-19疫情期間遠距診療經驗展望後疫情時代之落地實現與其教育考量

Telemedicine learnt from the COVID-19 pandemic: the issues on implementation and medical education

張濱璿(Brian Pin-Hsuan Chang) ； 蔡淳娟(Tsuen-Chiuan Tsai)

《台灣擬真醫學教育期刊》 7卷2期 (2020/12) Pp. 23-34

https://doi.org/10.6582/JTSSH.202012_7(2).0003

摘要

從2019年底COVID-19疫情爆發後，因為社交距離與隔離措施，使病人必須藉由數位科技與醫療人員醫療在不同空間進行診療，遠距醫療即扮演關鍵角色。疫情期間國際間執行的防疫與抗疫之新醫療模式，在台灣落地執行時，有賴科技、系統與經濟的配套規劃，更需要在醫療人才培育上快速轉型。疫情中醫學教育面臨的挑戰，COVID-19病患暴增，醫療人力與醫療資源緊繃，而一般疾病案例減少，加上為了保持社交距離，致師生與病人分隔，甚至醫學生減少了進入醫療機構實地學習的機會，於是臨床經驗學習大受影響，部分國家因醫師人力不足，對於執業醫師資格予以放寬，例如例外允許尚未取得執照的醫學系畢業生先行從事醫療行為，或要求退休的醫師重行執業等。對醫療品質與病人安全的保障已引起關注。又疫情期間執行醫療數位轉型，應用智慧數位科技，採用遠距診療方式學習，學習跨團隊跨地區對病人的整合式診療、追蹤與評估，新醫療能力與新角色的重塑訓練是必要的。對於上述遠距醫療照護之學習外，配套的成本效益以及新醫療模式下之倫理議題，都應先進行模擬實作，以瞭解執行遠距醫療存在的缺口。

關鍵字

遠距醫療 ； COVID-19全球疫病 ； 醫療品質 ； 醫學教育 ； 科技輔助教育

並列摘要

Since the beginning of the COVID-19 pandemic in the end of 2019, under the must behaviors of social distance and isolation, patients can only interact with medical professionals in different locations in the majority of encounters. Telehealth with the advances of communications technology and devices has played a key role in the healthcare crisis. The innovated healthcare model launched internationally in a short period after the COVID-19 outbreak. What learnt in the healthcare and the medical education in this pandemic period will be applied in Taiwan, it needs integration of technology, system and economic design. Further, the education on healthcare professional is also a key factor. The challenges on medical education during the pandemic crisis include, the short of professional manpower and medial resources, the decrease of case experience on the ＂regular diseases＂, plus the decreased encounters among patients, medical teachers and learners. The healthcare personnel's clinical competency, the healthcare quality and safety have become a great concern. With the short of manpower, medical students and retired aging personnel have been expected to turn for healthcare. The emerging new roles involving the current healthcare need innovated medical education. The application of technology, the interdisciplinary collaboration and learning on new practice behaviors, plus the involved ethics and value-based cost design, are all necessary for the success.

並列關鍵字

Telehealth ； COVID-19 pandemic ； Healthcare quality ； Medical education ； Technology-enhanced education