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Healthc Inform Res > Volume 21(4); 2015 > Article
Kim, Kim, Lee, Lee, and Kim: Current Clinical Status of Telehealth in Korea: Categories, Scientific Basis, and Obstacles

Abstract

Objectives

Through telehealth, medical services have expanded beyond spatial boundaries and are now available in living spaces outside of hospitals. It can also contribute to patient medical knowledge improvement because patients can access their hospital records and data from home. However, concepts of telehealth are rather vague in Korea.

Methods

We refer to several clinical reports to determine the current clinical status of and obstacles to telehealth in Korea.

Results

Patients' health conditions are now reported regularly to doctors remotely, and patients can receive varied assistance. Self-improvement based on minute details that are beyond medical staff's reach is another possible benefit that may be realized with the help of a variety of medical equipment (sensors). The feasibility, clinical effect, and cost-benefit of telehealth have been verified by scientific evidence.

Conclusions

Patients will be able to improve their treatment adherence by receiving help from various professionals, such as doctors, nurses, nutritionists, and sports therapists. This means that the actual treatment time per patient will increase as well. Ultimately, this will increase the quality of patients' self-administration of care to impede disease progression and prevent complications.

I. Introduction

South Korea recently carried out a national telehealth demonstration project [1,2]. Telehealth is a broad term defined as the provision of medical knowledge or medical technology to remote users through information technology (IT) [3]. There are various categories of telehealth: telemedicine, telemoni toring (home telehealth or telecare), telecounseling, telecon sultation, teleassistance, etc. However, distinctions among these categories are rather vague in Korea. The term ubiquitous healthcare (u-healthcare) is used more widely than telehealth. It is a combination of two words: ubiquitous meaning 'anytime and anywhere' and healthcare. It refers to health care or medical services that are provided regardless of time and place. In other countries, other terms, such as mobile health (m-health), electronic health (e-health), and smart-health (s-health), are in use as well.
The reason telehealth or u-healthcare is a concerning subject in many countries is that the demand for medical services has expanded due to the aging of populations and increases in the prevalence of chronic diseases. Korea is a country with a strong IT base, which could be employed to achieve rapid growth in the telehealth field. However, there have been conflicts of opinion regarding telehealth in Korea [4,5]. There are many issues to be resolved before it can be success fully applied in the healthcare field. In this paper, we will review and elucidate the basic concepts of telehealth (or u-healthcare), examine issues to be resolved for successful application in Korea, and review research on telehealth use in hospitals as evidence.

II. Categories in Telehealth Systems

1. Telemedicine

Telemedicine assists doctors in learning about patients' signs and symptoms through IT so that they can provide patients with diagnosis or treatment (Figure 1). The concept of telemedicine is reflected well in 'live video (telehealth video)'. It is exactly like regular consultation except that the place of communication between the doctor and patient is not in a hos pital. Medical staff and patients can see each other and com municate through live video or telephone in real time. Medical staff and patients in distant places are able to communi cate. Audio and video equipment are essential to enabling communication. Most states in the United States have Medicaid program policies to compensate for the medical costs of live video [6].
In Korea, video telemedicine services have been provided on a trial basis to patients living on islands and in remote rural areas and prisons [1,7]. However, there are many issues to be resolved, including the fact that video is inadequate to replace inspection, palpation, percussion, and auscultation. System resolution, communication server failure, and ambiguity of responsibilities are also concerns.

2. Telemonitoring/Telecoaching (Remote Patient Monitoring)

Most of the rapidly increasing chronic illnesses [8] can only be managed effectively with regular hospital visits and home self-administration. IT advances have enabled systems to assist patients in constant and rigorous self-administration. Among many types of telehealth, telemonitoring is the best known. Telemonitoring regularly transmits biometric data (blood sugar, blood pressure, etc.) of remote patients to medical staff, who can observe and consult patients based on the transmitted data (Figure 2). Ultimately, it enables medical staff to care for patients at all times regardless of time and place. Telemonitoring assists self-administration within living environments outside of hospitals for patients who are already being treated at hospitals. It can be applied to patients with chronic illnesses, but not to patients with acute illnesses or emergency patients.
Recently, telemonitoring has been introduced for diabetic patients in Korea [9,10,11] and abroad [12,13]. Its clinical effects have been consistently reported by university hospitals [9,14,15]. Moreover, various anthropometric sensors and linked solutions are being actively developed with much interest due to the popularization of smartphones. Their short-term [14] and long-term [15] effects are already proven. Such monitoring programs are reported to be satisfactory to their users and effective in chronic disease treatment [16,17].

III. Scientific Basis of Telehealth Systems

There are three steps to apply telehealth to the actual clinical healthcare field. First, the system has to be feasible. It depends on clinical use as well as the satisfaction of medical staff and patients after the system is constructed. Second, the telehealth system should be clinically effective when actually applied to patients. This is the most important part because medical treatment must be the main agent. Finally, telehealth has to operate efficiently and economically when applied to actual health care. These three steps should be verified by scientific evidence.

1. Evidence-Based Feasibility of Clinical Applications

Many telehealth-related domestic and foreign articles show high patient satisfaction regarding telehealth [18,19,20,21,22]. In Korea, most chronic patients are willing to participate in chronic disease care services [14,15,17]. Various services have been constructed for many diseases overseas, and they have become commercialized applications for actual healthcare.

2. Evidence-Based Clinical Effect

The clinical effects of telehealth in various fields, including diabetes mellitus, acquired immunodeficiency syndrome (AIDS) [23,24,25], asthma [26,27], cardiac disease [28,29,30,31], and cancer [32,33], have been shown through studies using various methods [34]. Positive reports from its users can also be found in many papers. However, some researchers have suggested that there are negative effects of telehealth due to its application through inadequate systems [9,35,36]. It is necessary for medical professionals and IT developers to cooperate closely from the beginning of a telehealth application to consider target illnesses and patients [37,38,39,40].
Other than clinical research data, empirical data from telehealth services conducted in actual hospital surroundings have shown good results as well. Colorado (USA) has athome telemedicine programs; "Centura Health at Home" is one of the best known [41]. It is a remote patient monitoring program conducted with 200 patients. It has reduced the number of 30-day rehospitalizations of patients with congestive heart failure, chronic obstructive pulmonary failure, and diabetes mellitus by 62%. The patient rehospitalization rate is also significantly lower at 6.3% compared to 18% for traditional home care patients. The frequency of nurse visits has also decreased from 2-3 per week over 60 days to approximately 3 visits over the entire 60-day period. Kansas (USA) also has a telemedicine system. With this system, patient hospital days were reduced from 6 to 3 days. Emergency department (ED) visits were also reduced from 23 to 15 visits [42]. The total cost, which included ED and hospital cost, was also reduced. Thus, hospital days, ED visits, total costs, and hospital costs were significantly reduced during the home telehealth intervention period.

3. Evidence-Based Cost Analysis

Telehealth's cost-benefits and cost-effectiveness should be considered after its clinical effects. Medical-social cost saving effects should also be investigated. Telemedicine services are being provided to patients with congestive heart failure, chronic obstructive lung disease, asthma, and diabetes in Colorado. This at-home remote telemedicine program has achieved cost savings of US $1,000-$1,500 per patient [41]. In Kansas, hospitals and emergency health facilities have achieved cost savings of US $1,350,332 through an at-home remote telemedicine service to monitor a patient's heart rate, blood pressure, mean arterial pressure, body weight, oxygen saturation, and body temperature [43]. According to the Home Care Association of New York State [44], telehealth has reduced readmissions by 4%-26% and saved more than a million dollars annually.
Thus, telehealth's economic aspects should be considered in its commercialization. Particularly in Korea, medical insurance fees for telehealth have not been established. Telehealth commercialization and industrialization cannot be achieved without considering the labor costs of medical professionals, system maintenance costs, and server maintenance costs. Thus, it is absolutely necessary to develop a system in which the time and labor costs of medical professionals are minimized [45] while user satisfaction is increased. Programs to reduce medical professionals' labor have been developed and clinically adapted. Such attempts are ultimately to improve cost affordability and convenient accessibility of medical services through telemedicine. We can expect improvements in people's health and macroeconomic effects to reduce national healthcare costs.

IV. Obstacles to Telehealth in Korea [46]

The role of Korean policymakers is crucial for successful telehealth application because there are no obvious points to attract medical staff's active participation now. The most urgent issue in successful telehealth application in Korea is health insurance coverage. Telehealth services have not been covered by health insurance, an aggravating burden on consumers and medical professionals that prevents active telehealth utilization. Thus, telehealth should be covered by health insurance and health insurance fees for telehealth to be established. Another urgent issue is the reorganization of medical law related to telehealth. Internet privacy is quite vulnerable in Korea. It is difficult for patients to trust telehealth services while responsibilities remain ambiguous in cases of personal information leaks or medical malpractice. Moreover, responsibility for accidents during telemedicine service (equipment or communication failure) has not been settled. Such matters should be clarified by law to encourage the active participation of medical professionals. In addition, low healthcare incentives and environment changes to improve confidence between medical staff and patients should be resolved. For this, rich experiences should be developed by constant promotion and demonstration. Moreover, there should be additional clinical evidence. At the same time, cost analysis of actual healthcare should be completed.
Low physician compliance in medical facilities is also an important issue. Medical professionals must accumulate telehealth experience and knowledge, and system experts should assist them. For this purpose, a health coordinating center is an essential means to provide medical professionals with training. It needs to be organized by professional expert groups and be able to support medical staff in various ways. Introduction of telehealth licensing should also be considered.
Finally, it is necessary to use IT for telehealth, so the verification of IT-related factors is required. Medical sensors and devices for biomedical measurement should be accurate and trustworthy. In addition, stable network servers should be provided. It has to be easy for elderly patients who are unfamiliar with using electronic devices. Most users are chronic patients and their mean age is relatively high. More studies on user-friendly systems, such as simple interfaces, need to be conducted.

V. Conclusions

The United States is one of the countries with advanced telehealth systems. Both commercialization and institutional telehealth frameworks are being actively developed in private and public sectors. In the United States, telemonitoring has been evolving in all 50 states to fit each state's circumstances. Telemonitoring in the United States is concentrated in the residential environments of patients who are being treated at home. Most of these patients are treated through telemonitoring linked with home healthcare services, and the government supports their telemonitoring costs. Positive outcomes of telemonitoring programs have consistently been reported. Such outcomes include 1) increased number of patients registered for the service, 2) decreased patient hospital visits, 3) decreased re-hospitalization, and 4) reduced yearly costs of rehospitalization as the major performance indicators.
We will also attempt to improve Korea's medical system. Telehealth is a new model in illness administration and a field in which we can achieve great advances. Moreover, telehealth advances can also promote development in medical equipment, wireless communication networks, data processing, software, and other industries. Korea is one of the most advanced countries in the fields of IT and medicine, and it has optimal conditions to advance telehealth (especially telemonitoring) significantly. We expect that advances in medical services, equipment, sensors, and communications will ultimately lead to significant industrial benefits. Together with the popularization of smartphones, we can promote social awareness of telemedicine to accelerate the development of the telemonitoring industry.

Acknowledgments

This research was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health and Welfare (No. HI13C2164) and in part by the ICT R&D program of MSIP/IITP (No. 14-824-10-023, Development of open ICT healing platform using personal health data) and the ICT Standardization program of Ministry of Science, ICT & Future Planning.

Notes

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

References

1. Korean Ministry of Health and Welfare. Promotion of telemedicine: neighborhood clinics-centered approach [Internet]. Sejong, Korea: Ministry of Health and Welfare; 2013. cited at 2015 Jul 23. Available from: http://www.mw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=292828.

2. Korean Ministry of Health and Welfare. The telehealth demonstration project between doctor and patient will start from the end of September [Internet]. Sejong, Korea: Ministry of Health and Welfare; 2014. cited at 2015 Jul 23. Available from: http://www.mw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=305090&SEARCHKEY=TITLE&SEARCHVALUE=%BF%F8%B0%DD%C0%C7%B7%E1.

3. Lustig TA. The role of telehealth in an evolving health care environment: workshop summary. Washington (DC): National Academies Press; 2012.

4. Korean Ministry of Health and Welfare. Overall satisfaction appears high in the telehealth demonstration project [Internet]. Sejong, Korea: Ministry of Health and Welfare; 2015. cited at 2015 Jul 23. Available from: http://www.mw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=322478&SEARCHKEY=TITLE&SEARCHVALUE=%BF%F8%B0%DD.

5. Korean Medical Association. Research Institute for Healthcare Policy. Issues and policy advisory opinion in telehealth [Internet]. Seoul, Korea: Research Institute for Healthcare Policy; 2014. cited at 2015 Jul 23. Available from: http://www.rihp.re.kr/monitoring/sub_01_read.asp?idx=1344&page=1&bbs_sec=710&strSearchWord=&strSearchString=.

6. Center for Connected Health Policy. State telehealth laws and reimbursement policies: a comprehensive scan of the 50 states and the District of Columbia [Internet]. Sacramento (CA): Center for Connected Health Policy; 2015. cited at 2015 Jul 23. Available from: http://cchpca.org/sites/default/files/resources/State%20Laws%20and%20Reimbursement%20Policies%20Report%20Feb%20%202015.pdf.

7. Korean Ministry of Health and Welfare. Teleconsultation of emergency patients from emergency specialists in hub metropolitan hospitals [Internet]. Sejong, Korea: Ministry of Health and Welfare; 2015. cited at 2015 Jul 23. Available from: http://www.mw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=319074&SEARCHKEY=TITLE&SEARCHVALUE=%BF%F8%B0%DD.

8. Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, et al. Epidemic obesity and type 2 diabetes in Asia. Lancet 2006;368(9548):1681-1688. PMID: 17098087.
crossref pmid
9. Kim HS, Choi W, Baek EK, Kim YA, Yang SJ, Choi IY, et al. Efficacy of the smartphone-based glucose management application stratified by user satisfaction. Diabetes Metab J 2014;38(3):204-210. PMID: 25003074.
crossref pmid pmc
10. Kim SI, Kim HS. Effectiveness of mobile and internet intervention in patients with obese type 2 diabetes. Int J Med Inform 2008;77(6):399-404. PMID: 17881285.
crossref
11. Cho JH, Kim HS, Han JH, Lee JH, Oh JA, Choi YH, et al. Ubiquitous diabetes management system via interactive communication based on information technologies: clinical effects and perspectives. Korean Diabetes J 2010;34(5):267-273. PMID: 21076573.
crossref pmid pmc
12. Zolfaghari M, Mousavifar SA, Pedram S, Haghani H. The impact of nurse short message services and telephone follow-ups on diabetic adherence: which one is more effective? J Clin Nurs 2012;21(13-14):1922-1931. PMID: 22239205.
crossref pmid
13. Istepanian RS, Zitouni K, Harry D, Moutosammy N, Sungoor A, Tang B, et al. Evaluation of a mobile phone telemonitoring system for glycaemic control in patients with diabetes. J Telemed Telecare 2009;15(3):125-128. PMID: 19364893.
crossref pmid
14. Kwon HS, Cho JH, Kim HS, Song BR, Ko SH, Lee JM, et al. Establishment of blood glucose monitoring system using the internet. Diabetes Care 2004;27(2):478-483. PMID: 14747232.
crossref pmid
15. Cho JH, Chang SA, Kwon HS, Choi YH, Ko SH, Moon SD, et al. Long-term effect of the Internet-based glucose monitoring system on HbA1c reduction and glucose stability: a 30-month follow-up study for diabetes management with a ubiquitous medical care system. Diabetes Care 2006;29(12):2625-2631. PMID: 17130195.
crossref pmid
16. Cho JH, Lee HC, Lim DJ, Kwon HS, Yoon KH. Mobile communication using a mobile phone with a glucometer for glucose control in type 2 patients with diabetes: as effective as an Internet-based glucose monitoring system. J Telemed Telecare 2009;15(2):77-82. PMID: 19246607.
crossref pmid
17. Kwon HS, Cho JH, Kim HS, Lee JH, Song BR, Oh JA, et al. Development of web-based diabetic patient management system using short message service (SMS). Diabetes Res Clin Pract 2004;66(Suppl 1):S133-S137. PMID: 15563964.
crossref pmid
18. Anhoj J, Moldrup C. Feasibility of collecting diary data from asthma patients through mobile phones and SMS (short message service): response rate analysis and focus group evaluation from a pilot study. J Med Internet Res 2004;6(4):e42PMID: 15631966.
crossref pmid pmc
19. Winkler S, Schieber M, Lucke S, Heinze P, Schweizer T, Wegertseder D, et al. A new telemonitoring system intended for chronic heart failure patients using mobile telephone technology: feasibility study. Int J Cardiol 2011;153(1):55-58. PMID: 20851481.
crossref pmid
20. Seto E, Leonard KJ, Cafazzo JA, Barnsley J, Masino C, Ross HJ. Mobile phone-based telemonitoring for heart failure management: a randomized controlled trial. J Med Internet Res 2012;14(1):e31PMID: 22356799.
crossref pmid pmc
21. Britto MT, Munafo JK, Schoettker PJ, Vockell AL, Wimberg JA, Yi MS. Pilot and feasibility test of adolescentcontrolled text messaging reminders. Clin Pediatr (Phila) 2012;51(2):114-121. PMID: 22019792.
crossref pmid
22. Pinnock H, Slack R, Pagliari C, Price D, Sheikh A. Understanding the potential role of mobile phone-based monitoring on asthma self-management: qualitative study. Clin Exp Allergy 2007;37(5):794-802. PMID: 17456228.
crossref
23. Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet 2010;376(9755):1838-1845. PMID: 21071074.
crossref pmid
24. Pop-Eleches C, Thirumurthy H, Habyarimana JP, Zivin JG, Goldstein MP, de Walque D, et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS 2011;25(6):825-834. PMID: 21252632.
crossref pmid pmc
25. Mbuagbaw L, Thabane L, Ongolo-Zogo P, Lester RT, Mills E, Volmink J, et al. The Cameroon mobile phone SMS (CAMPS) trial: a protocol for a randomized controlled trial of mobile phone text messaging versus usual care for improving adherence to highly active antiretroviral therapy. Trials 2011;12:5PMID: 21211064.
crossref
26. Prabhakaran L, Chee WY, Chua KC, Abisheganaden J, Wong WM. The use of text messaging to improve asthma control: a pilot study using the mobile phone short messaging service (SMS). J Telemed Telecare 2010;16(5):286-290. PMID: 20576744.
crossref pmid
27. Seid M, D'Amico EJ, Varni JW, Munafo JK, Britto MT, Kercsmar CM, et al. The in vivo adherence intervention for at risk adolescents with asthma: report of a randomized pilot trial. J Pediatr Psychol 2012;37(4):390-403. PMID: 22167121.
crossref pmid
28. Scherr D, Kastner P, Kollmann A, Hallas A, Auer J, Krappinger H, et al. Effect of home-based telemonitoring using mobile phone technology on the outcome of heart failure patients after an episode of acute decompensation: randomized controlled trial. J Med Internet Res 2009;11(3):e34PMID: 19687005.
crossref pmid pmc
29. Lee JS, Jeon WC, Ahn JH, Cho YJ, Jung YS, Kim GW. The effect of a cellular-phone video demonstration to improve the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation as compared with audio coaching. Resuscitation 2011;82(1):64-68. PMID: 21036457.
crossref pmid
30. Yang CW, Wang HC, Chiang WC, Hsu CW, Chang WT, Yen ZS, et al. Interactive video instruction improves the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation in simulated cardiac arrests. Crit Care Med 2009;37(2):490-495. PMID: 19114904.
crossref pmid
31. Yousef J, Lars AN. Validation of a real-time wireless telemedicine system, using bluetooth protocol and a mobile phone, for remote monitoring patient in medical practice. Eur J Med Res 2005;10(6):254-262. PMID: 16033715.
pmid
32. Greaney ML, Puleo E, Sprunck-Harrild K, Bennett GG, Cunningham MA, Gillman MW, et al. Electronic reminders for cancer prevention: factors associated with preference for automated voice reminders or text messages. Prev Med 2012;55(2):151-154. PMID: 22659227.
crossref pmid pmc
33. Maguire R, McCann L, Miller M, Kearney N. Nurse's perceptions and experiences of using of a mobilephone-based Advanced Symptom Management System (ASyMS) to monitor and manage chemotherapy-related toxicity. Eur J Oncol Nurs 2008;12(4):380-386. PMID: 18539527.
crossref
34. Kim HS, Hwang Y, Lee JH, Oh HY, Kim YJ, Kwon HY, et al. Future prospects of health management systems using cellular phones. Telemed J E Health 2014;20(6):544-551. PMID: 24693986.
crossref
35. Ryan D, Price D, Musgrave SD, Malhotra S, Lee AJ, Ayansina D, et al. Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial. BMJ 2012;344:e1756PMID: 22446569.
crossref pmid pmc
36. Liu WT, Huang CD, Wang CH, Lee KY, Lin SM, Kuo HP. A mobile telephone-based interactive self-care system improves asthma control. Eur Respir J 2011;37(2):310-317. PMID: 20562122.
crossref pmid
37. Kim HS, Lee KH, Kim H, Kim JH. Using mobile phones in healthcare management for the elderly. Maturitas 2014;79(4):381-388. PMID: 25270725.
crossref pmid
38. Yoo HJ, Park MS, Kim TN, Yang SJ, Cho GJ, Hwang TG, et al. A ubiquitous chronic disease care system using cellular phones and the internet. Diabet Med 2009;26(6):628-635. PMID: 19538239.
crossref pmid
39. Park MJ, Kim HS, Kim KS. Cellular phone and Internet-based individual intervention on blood pressure and obesity in obese patients with hypertension. Int J Med Inform 2009;78(10):704-710. PMID: 19643661.
crossref pmid
40. Lim S, Kim SY, Kim JI, Kwon MK, Min SJ, Yoo SY, et al. A survey on ubiquitous healthcare service demand among diabetic patients. Diabetes Metab J 2011;35(1):50-57. PMID: 21537413.
crossref pmid pmc
41. Broderick A, Steinmetz V. Centura Health at Home: home telehealth as the standard of care [Internet]. Washington (DC): The Commonwealth Fund; 2013. cited at 2015 Jul 23. Available from: http://www.commonwealthfund.org/publications/case-studies/2013/jan/telehealth-centura.

42. Spaulding R, Velasquez SE, He J, Alloway GA. Hospital and emergency department resource usage: a cost analysis from a home telehealth project in Kansas. J Telemed Telecare 2012;18(7):423-424. PMID: 23086981.
crossref pmid
43. Spaulding R, Alloway G. Medicaid HCBS/FE home telehealth pilot: final report for study years 1-3 (September 2007-June 2010) [Internet]. Kansas City (KS): Center for Telemedicine & Telehealth; 2010. cited at 2015 Jul 23. Available from: http://media.khi.org/news/documents/2011/04/26/Telehealth_evaluation.pdf.

44. Home Care Association of New York State. Home telehealth: enhancing care, saving costs. Albany (NY): Home Care Association of New York State; 2012. cited at 2015 Jul 23. Available from: http://htcare.com/assets/Home-Telehealth-Enhancing-Care-Saving-Costs.pdf.

45. Cho JH, Choi YH, Kim HS, Lee JH, Yoon KH. Effectiveness and safety of a glucose data-filtering system with automatic response software to reduce the physician workload in managing type 2 diabetes. J Telemed Telecare 2011;17(5):257-262. PMID: 21628421.
crossref pmid
46. Kim HS, Cho JH, Yoon KH. New directions in chronic disease management. Endocrinol Metab (Seoul) 2015;30(2):159-166. PMID: 26194075.
crossref pmid pmc
Figure 1

A telemedicine scheme. Me dical staff diagnose, prescribe, assess problems, and recommend treatments to their patients based on data from a long distance.

hir-21-244-g001.jpg
Figure 2

A telemonitoring scheme. Medical team uses the data measured by individuals to provide medical services for their patients.

hir-21-244-g002.jpg


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