Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Feb 26, 2020
Date Accepted: Oct 2, 2020
Construction and Application of Telemedicine in China: a Cross-Sectional Study of 161 Tertiary Hospitals across 29 Provinces, Municipalities and Autonomous Regions
ABSTRACT
Background:
Telemedicine has been used widely in China and benefited a large number of patients, while little is known about the overall development of telemedicine.
Objective:
A national survey was conducted to identify the overall construction and application of telemedicine in Chinese tertiary hospitals and provide a scientific basis for the successful expansion of telemedicine in the future.
Methods:
The method of probability proportionate to size sampling was adopted to collect data from 161 tertiary hospitals in 29 provinces, autonomous regions and municipalities. Charts and statistical tests were applied to compare the development of telemedicine, including management, network, data storage, software and hardware equipment, and application of telemedicine. The ordinal logistic regression was used to analyze the relationship between these factors and telemedicine service effect.
Results:
93.8% (151/161) of the tertiary hospitals carried out telemedicine services in Business-to-Business(B2B) mode. The most widely used type of telemedicine network was the Virtual Private Network(VPN) with a usage rate of 55.3% (89/161). Only a few tertiary hospitals did not establish data security and cybersecurity measures. 100 out of 161 hospitals (62.1%) in the survey conducted remote video conference supported by hardware instead of software. The top five telemedicine services implemented in hospitals were teleconsultation, remote education, telediagnosis of medical images, tele-electrocardiogram and telepathology, with the coverage rates of 86.3% (139/161), 57.1% (92/161), 49.7% (80/161), 37.9% (61/161) and 33.5% (54/161), respectively. The average annual service volume of teleconsultation reached 714 cases per hospital. Teleconsultation and telediagnosis were the core charging services. The multivariate analysis indicated that the adoption of Direct-to-Consumer (DTC) mode (P=.003), support of scientific research funds (P=.01), charging for services (P<.001), number of medical professionals (P=.04), network type (P=.02), sharing data with other hospitals (P=.04), duration of the consultation (P<.05) and experts level (P=.03) were related to the teleconsultation effect. DTC mode (P=.01), research funding (P=.01), charging for services (P=.01), establishing of professional management departments (P=.04), 15 or more instances of remote education every month (P=.01) would significantly influence the effect of remote education.
Conclusions:
A variety of telemedicine services have been implemented in tertiary hospitals in China with a promising prospect, whereas the sustainability and further standardization of telemedicine in China are still far from accomplished.
Citation
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