Telemedicine, as a health service provided remotely, is increasingly becoming a common part of health care. Telemedicine is defined as "an umbrella term for health activities, services and systems operated remotely through information and communication technologies to promote global health, prevention and health care, as well as education, health management and health research". It also describes telemedicine as "the provision of services where distance is a critical factor, using information and communication technologies to exchange valid information for the diagnosis, treatment and prevention of disease and injury, for research and evaluation, and for the continuing education of healthcare providers to improve the health of individuals and communities". Both definitions imply that two of the hallmarks of telemedicine include the use of communication and information technologies to overcome distance as a critical factor, a factor that is well known to us, not least from the recent months of the COVID-19 pandemic. Distance medicine can thus act as a tool for improving access to health care and also complement health care itself in a very appropriate way.

• Klíčová slova
• e-health, pandemic, pregnancy, prenatal care, telemedicine, telemonitoring,
• MeSH
• COVID-19 * MeSH
• lidé MeSH
• pandemie prevence a kontrola   MeSH
• poskytování zdravotní péče MeSH
• prenatální péče MeSH
• těhotenství MeSH
• telemedicína * MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Telemedicine, defined as the practice of delivering healthcare services remotely using information and communications technologies, raises a plethora of ethical considerations. As telemedicine evolves, its ethical dimensions play an increasingly pivotal role in balancing the benefits of advanced technologies, ensuring responsible healthcare practices within telemedicine environments, and safeguarding patient rights. Healthcare providers, patients, policymakers, and technology developers involved in telemedicine encounter numerous ethical challenges that need to be addressed. Key ethical topics include prioritizing the protection of patient rights and privacy, which entails ensuring equitable access to remote healthcare services and maintaining the doctor-patient relationship in virtual settings. Additional areas of focus encompass data security concerns and the quality of healthcare delivery, underscoring the importance of upholding ethical standards in the digital realm. A critical examination of these ethical dimensions highlights the necessity of establishing binding ethical guidelines and legal regulations. These measures could assist stakeholders in formulating effective strategies and methodologies to navigate the complex telemedicine landscape, ensuring adherence to the highest ethical standards and promoting patient welfare. A balanced approach to telemedicine ethics should integrate the benefits of telemedicine with proactive measures to address emerging ethical challenges and should be grounded in a well-prepared and respected ethical framework.

• Klíčová slova
• data security, ethical aspects, ethical guidelines, patient privacy, patient welfare, regulations in telemedicine, telemedicine,
• MeSH
• důvěrnost informací etika   MeSH
• lidé MeSH
• práva pacientů etika   MeSH
• telemedicína * etika   MeSH
• vztahy mezi lékařem a pacientem etika   MeSH
• zabezpečení počítačových systémů etika   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Health policy makers are striving to implement new approaches in healthcare with a focus on digital solutions. The COVID-19 pandemic has contributed to an unprecedented acceleration in the spread of information and communication technologies (ICT) in healthcare and has accelerated the use of telemedicine. The aim of the research was to identify problems related to the implementation of telemedicine in practice, to propose possible solutions and to identify the challenges of telemedicine in the Czech Republic in the future. The study is based on the results of a two-phase qualitative expert investigation. Data collection in the first phase took the form of individual semi-structured interviews with experts who have practical experience in the field of telemedicine. The follow-up second phase was conducted in the form of guided group discussions with experts focusing on health, financial and legislative aspects of telecare. It turned out that the introduction and expansion of telemedicine requires changes in the technological infrastructure, in the organization of care and work, and in the adjustment of the legislative environment. It is also necessary to consider the need to overcome several barriers at the level of the healthcare system, healthcare providers, healthcare professionals and patients. On the other hand, a condition for the successful introduction and development of telemedicine is coordinated cooperation between various institutions and stakeholders. The introduction of telemedicine should also be preceded by studies (research) and in-depth analyses. Telemedicine education of healthcare professionals and support for patients in developing their digital competences are also important.

• Klíčová slova
• Telemedicine, data sharing, digital literacy, digitization of health care, health care organization, information and communication technologies, telemedicine,
• MeSH
• COVID-19 * epidemiologie   MeSH
• lidé MeSH
• pandemie MeSH
• poskytování zdravotní péče MeSH
• telemedicína * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Telemedicine, understood as the provision of health care by a health professional to a patient who is physically not in the same location as the health professional, has many actual and potential benefits. It also has some disadvantages though, including a higher risk of misdiagnosis or another unfavorable outcome of certain remotely-provided services. In principle, the regime of legal liability for medical malpractice is the same for telemedicine as for traditional physical care. The general outline of the standard of care, which includes respect for medical science, the patient's individuality and objective possibilities, is abstract and flexible enough to be used for remote care without the need for redefinition. The quality of health care should be evaluated on the basis of the whole scale of risks and benefits it brings to a particular patient, including accessibility and comfort. In general, it should be permissible to provide a medical service remotely on the condition that its overall quality is at least as good as its comparable physical alternative. In other words, certain decrease in quality of some aspects of remote care can be compensated by other advantages. In terms of public health, support for telemedicine may bring a great improvement in the access to health care, and thus help significantly the individual members of the population. From the individual perspective, respect for personal autonomy implies that a patient should have every right to opt for a remote service, provided that there exists a true choice between meaningful options which is made on the basis of full information. If telemedicine is to fulfill its potential without sacrificing the protection of patients and their rights, reasonable guidelines for remote services need to be defined for particular medical fields, and for specific procedures within them. Among other issues, these guidelines must address the question of when it is necessary to refer the patient to physical care.

• Klíčová slova
• health law, legal liability in health care, public health, remote health services, standard of care, telemedicine,
• MeSH
• lidé MeSH
• poskytování zdravotní péče MeSH
• právní odpovědnost MeSH
• standardní péče MeSH
• telemedicína * MeSH
• zanedbání povinné péče * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Telemedicine is a way to improve healthcare outcomes with greater efficiency for both patients and care providers. The great potential of digital technologies also lies in strengthening the patient-centered approach. The early successes and benefits of telemedicine in the Czech Republic, amplified by the COVID-19, have contributed to the fact that wider implementation of telemedicine is already generally supported at the expert and public levels. Our research focuses on the identification of key issues in the implementation of telemedicine and the challenges of telemedicine in the future, from the perspective of patients and other stakeholders. The study is based on a qualitative research approach, combining focus groups with key stakeholders, patient panels and expert panels (2021-2022). The lack of rules and uncoordinated development of various activities proved to be the main barriers to the integration of telemedicine in the health system. This regulatory uncertainty can generate a number of problems in the patient-doctor relationship in practice, including ethical ones, and can also lead to inequalities in access to healthcare and affect the overall quality of care provided. Furthermore, it has been shown that patients' interests in the implementation of telemedicine are: 1. a predictable and reliable framework that guarantees them certainty and security in the provision of telemedicine services, 2. telemedicine solutions that increase the availability and efficiency of the care provided while bringing comfort, and 3. user-friendly and simple solutions. At the same time, patients want to understand the new environment and be active participants in the process of digital innovation, including the practical implementation of telemedicine. The research team has developed recommendations for further developments in the implementation of telemedicine that reflect the patient's interest and can be implemented at three levels - the health system, institutional, and community level. In countries with a well-developed and institutionalized patient movement, the community level can be represented by patient organizations, thus becoming the link between telemedicine policy making and implementation at the individual level of healthcare provision. For the further development of telemedicine, the development of a national strategy involving all key stakeholders, including patients, in the implementation has proven essential.

• Klíčová slova
• community, development of telemedicine, patient and public involvement, patient interest, patient organizations, stakeholders, telehealth,
• MeSH
• COVID-19 * epidemiologie   MeSH
• lidé MeSH
• pacienti MeSH
• poskytování zdravotní péče MeSH
• telemedicína * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Today's medical service delivery platforms provide everything from small urgent care 'offices' to large medical centers. Since 2007, an intermediate entity for care has been established, namely, the micro-hospital. Micro-hospitals are 24-hour, small inpatient facilities with an average of 2 to 10 beds, designed to provide a diversity of healthcare services consistent with community demands. In addition, they seek to combine a cost-effective healthcare vehicle with potential time-dependent triage/transfer capabilities to a nearby large medical center. This smaller cost-effective entity represents an ideal vehicle for telemedicine, whereby specialists are always on hand for interpretation and consultation, with minimal patient waiting. In all likelihood, telemedicine, including cloud data storage and retrieval, will develop at a faster pace due to emerging 5G technology. Appropriate modification of the micro-hospital may also lead to creation of specialized centers devoted to endocrine and metabolic disorders, pulmonary diseases, and addiction medicine, which are certainly within the realm of medical necessity.

• MeSH
• lékařská informatika metody   trendy   MeSH
• lidé MeSH
• nemocnice MeSH
• telemedicína statistika a číselné údaje   trendy   MeSH
• využití lékařské informatiky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• úvodníky MeSH

The basis of telemedicine is the use of modern technologies that are used in everyday life, but also in diabetes management. Technology are applied not only in insulin administration and glycemic monitoring, but also in the management of lifestyle interventions such as healthy eating and physical activity. Telemedicine in diabetes can significantly expand our options for the care of patients with diabetes and its complications, leading to convincing improvements in diabetes control and self-management of patients with diabetes. The positive effect of telemedicine depends on the correct setup of data transmission and processing, but also on the education of all involved. Telemedicine promotes the involvement of patients as well as other healthcare professionals in diabetes management, improves care coordination and streamlines communication between patients and healthcare professionals.

• Klíčová slova
• Telemedicine, artificial intelligence, cardiovascular disease, diabetes mellitus, glucose monitoring, technology, telemedicine,
• MeSH
• diabetes mellitus * terapie   MeSH
• inzuliny * MeSH
• krevní glukóza MeSH
• lidé MeSH
• self-management * MeSH
• telemedicína * MeSH
• životní styl MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• inzuliny * MeSH
• krevní glukóza MeSH

Telemedicine can be defined as a health care service that, specifically in the field of diagnostics, employs remote transfer of a large volume of data from a large number of subjects at the same time. This data is subsequently processed on a central basis and returned to a large number of health care providers by whom the service was ordered on national or international level. In arrhythmology, telemedicine is used particularly in long-term ECG monitoring to diagnose arrhythmias and check out treatment outcome via external recorders, smart watch, and implantable devices. To facilitate analysis of large telemedicine data volume, artificial intelligence is being increasingly exploited.

• Klíčová slova
• ECG monitoring, Telemedicine, arrhythmology, artificial intelligence, telemedicine,
• MeSH
• defibrilátory implantabilní * MeSH
• kardiostimulátor * MeSH
• lidé MeSH
• srdeční arytmie diagnóza   terapie   MeSH
• telemedicína * MeSH
• umělá inteligence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The COVID-19 Pandemic contributed to accelerating the process of using information and communication technologies and digital technologies in healthcare management and delivery within healthcare systems. At that time, the Czech healthcare system faced the same problems as other European systems and struggled with a temporary limitation of direct provision of healthcare services. It was solved by switching to telemedicine. The Czech healthcare system used telemedicine to a minimal extent until then. Despite adopting the law on healthcare digitisation, it is still one of the countries with a lower level of digitisation of healthcare processes. The article presents the results of an exploratory expert investigation focused on the implementation and development of telemedicine in the Czech Republic. The conducted research aimed to identify problems related to the implementation of telemedicine in practice, place them in the broader framework of the healthcare system and structure them, propose possible solutions, and identify the future challenges of telemedicine in the Czech Republic. We based our study on the results of a three-phase QUAL-QUAN-QUAL research. Data collection in the first phase took the form of individual semi-structured interviews with patients (25) with practical experience in the field of telemedicine, followed by the second quantitative phase of the questionnaire survey with patients (650). The third qualitative phase included semi-structured interviews with experts (17) with practical experience in telemedicine. The introduction and expansion of telemedicine require several fundamental changes. These include adjustments to the legislative environment and changes to the technological infrastructure, organisation of care and work. Several barriers have been identified at the healthcare system level, healthcare providers, healthcare professionals and patients.

• Klíčová slova
• digitisation of health care, distant care, information and communication technologies, primary care, telemedicine,
• MeSH
• COVID-19 * epidemiologie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• pandemie * MeSH
• poskytování zdravotní péče organizace a řízení   MeSH
• průzkumy a dotazníky MeSH
• rozhovory jako téma MeSH
• SARS-CoV-2 MeSH
• senioři MeSH
• telemedicína * organizace a řízení   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The article examines the effectiveness of remote monitoring and the evaluation of facts about patients with hematologic malignancies using telemedicine based on SMART technologies. The project was carried out in the Department of Haematooncology of the University Hospital Ostrava. Its objective was to test the efficacy of telemedicine in the treatment of patients with blood cancer. The cost-benefit analysis method was used to evaluate effectiveness, which also confirmed the feasibility of using this method to evaluate the costs and benefits of implementing specific medical projects. The conducted analysis demonstrated the effectiveness of using telemedicine procedures in the treatment of these patients, both in terms of quantifiable and non-quantifiable impacts on the Czech Republic's health system. This was mainly due to a large shortening of the length of the hospitalisation period for patients with problems whose deterioration was discovered by remote monitoring and their treatment could begin promptly. The shortening of the hospitalization period was achieved by around 40%. As a result, the complexity of treatment has been greatly reduced, benefiting both the hospital and, most importantly, the patient. With this prevention, the patient's chances of dying are reduced, as he or she is less likely to develop severe septic diseases. The total average financial savings of the Czech Republic's entire health care system for a patient who does not become septic due to a delayed response to deteriorating health only in hospitalisation, treatment, and medications is approximately USD 2,800.

• MeSH
• analýza nákladů a výnosů MeSH
• hospitalizace MeSH
• lidé MeSH
• telemedicína * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH