| Summary: | 碩士 === 東吳大學 === 法律學系 === 106 === Medical care can now overcome its distance barriers through the aid of information and communication technologies, which is beneficial for general medical care and emergency care. This article classifies telemedicine practices into four categories according to on-site personnel and patient’s location. It also dissects traditional medical practice, analyzes compatibility between telemedicine and traditional medical practices. We conclude that although telemedicine practice can be applied in some medical services, such as radiology or pathology, because face-to-face diagnosis is not required for these kinds of services, it is not suitable for critical and emergency care. As for internal and surgical medicine, it is more complicated to determine if applying telemedicine in those medical practices is appropriate. At the stage of medical history taking, inspection, palpation, or non-invasive procedure, use of telemedicine in medical treatments is considered safe. In contrast, when auscultation, percussion, special examinations, or invasive procedure is involved, telemedicine should not be applied in the medical practices.
Telemedicine services are mostly provided through teamwork. Examination of elements of negligence usually focuses on whether or not duty of care is breached. The judgment of breach of duty of care relies on standards of medical care, which are established based on general physicians’ medical knowledge and experiences, and are established to be suitable for local condition. When an actor breaches duty of care, permitted risk and the rule of reliance should be taken into consideration in order to limit the possibility of a case set to against the actor. The share of medical liability should be determined not only based on vertical services and horizontal services, but also based on evaluation of actual situation of medical treatment work division. In principle, the judgment of malpractice in telemedicine should not be different from the judgment of malpractice in traditional medical practice in order to protect human right to medical care.
Before applying telemedicine in management of diseases, one should first inspect if the situation is urgent, and then determine if the available resources and manpower are adequate for telemedicine practices. Next, one should examine if the case is at the telemedicine-compatible phase in order to determine communication methods. The article suggests relaxing regulation of telemedicine to allow telemedicine being practiced in more areas, and loosening restrictions that preventing doctors being qualified for telemedicine practice. We hope this article can help widening scope of telemedicine service, and protecting public health.
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