JMIR Publications

ABSTRACT

Background:

Telemedicine, a typical application combining information technology and medical services, breaks the operational model of traditional medical services and brings new opportunities and challenges to the medical industry. China promotes telemedicine with great efforts, and its practices in the deployment of telemedicine platforms and delivery of services have become important references for the research and development of telemedicine globally.

Objective:

Our work described in this paper focuses on a regional telemedicine platform that was built in 2014. We analyzed the design scheme of the platform and remote consultations that were conducted via the telemedicine system to understand the deployment and service delivery processes of a typical telemedicine system in China.

Methods:

We collected information on remote consultations conducted from 2015 to 2020 via the regional telemedicine platform that employs a centralized architectural system model. We employed graphs and statistical methods to describe the changing trends of service volume of remote consultation, geographical and demographical distribution of patients, waiting time and duration of consultations. The factors that affect consultation duration and patient referral were analyzed by multiple linear regression models and binary logistic regression models, respectively. The attitudes towards telemedicine of 225 medical practitioners and 225 patients were collected using the snowball sampling method.

Results:

The regional telemedicine platform covers all levels of medical institutions and hospitals in all 18 cities of Henan Province as well as some inter-province hospitals. From 2015 to 2020, a total of 103,957 remote medical consultations were conducted via the platform with an annual increasing rate of 0.64%. 86.64% of medical institutions (as clients) that applied for remote consultations were with lower ranks (i.e., tier two or lower) and from less-developed regions. 65.65% of patients that applied for remote consultations were more than 50 years old. The numbers of consultations were high for departments majoring in the treatment of chronic diseases such as neurology, respiratory medicine, and oncology. The invited medical experts are mainly with senior titles. Year of consultation, tier (i.e., level) of a hospital, consultation department, and necessity of patient referral were the main factors affecting the duration of consultations. 66.44% of patients and 53.78% of medical practitioners had high satisfaction with telemedicine and believed that it is of vital importance for treatments of illness.

Conclusions:

The development of telemedicine in China is showing a growing trend, and medical institutions located in less developed regions and senior citizens are the primary service objects. Cases of remote consultations are mainly with chronic diseases. At present, the importance and necessity of telemedicine are well recognized by both patients and medical practitioners. However, the waiting time needs to be further reduced to improve the efficiency of remote medical services. Clinical Trial: The research does not involve experiments.