Virtual technologies can facilitate clinical monitoring, clinician-patient interactions, and enhance patient-centered approaches to healthcare delivery. Telemedicine, two-way communication between a healthcare provider and a patient not in the same physical location, emphasizes patient preference and convenience by substituting the transportation of patients with information transfer. We present a framework for implementation of a comprehensive, dynamic, patient-centered telemedicine network deployed in 12 opioid treatment programs (OTP) located throughout New York State (NYS). The program aims to effectively manage hepatitis C virus (HCV) infection via telemedicine with co-administration of HCV and substance use medications. We have found that the Sociotechnical System model with emphasis on patient-centered factors provides a framework for telemedicine deployment and implementation to a vulnerable population. The issue of interoperability between the telemedicine platform and the electronic health record (EHR) system as well as clinical information retrieval for medical decision-making are challenges with implementation of a comprehensive, dynamic telemedicine system. Targeting telemedicine to a vulnerable population requires additional consideration of trust in the security and confidentiality of the telemedicine system. Our contribution is the valuable lessons learned from implementing a comprehensive, dynamic, patient-centered telemedicine system among an OTP network throughout NYS as applied to a vulnerable population that can be generalized to other difficult-to-reach populations.

虚拟技术可以促进临床监测，临床医生与患者的互动，并增强以患者为中心的医疗保健方法。远程医疗是医疗服务提供者与不在同一物理位置的患者之间的双向通信，它通过用信息传递代替患者的运输来强调患者的偏爱和便利。我们为在纽约州（NYS）的12个阿片类药物治疗计划（OTP）中部署的综合，动态，以患者为中心的远程医疗网络的实施提供了框架。该计划旨在通过远程医疗以及HCV和药物使用药物的共同管理有效地管理丙型肝炎病毒（HCV）感染。我们发现，注重患者为中心的因素的社会技术系统模型为弱势人群的远程医疗部署和实施提供了框架。远程医疗平台与电子健康记录（EHR）系统之间的互操作性以及用于医疗决策的临床信息检索是实施全面，动态的远程医疗系统所面临的挑战。将远程医疗瞄准脆弱的人群需要额外考虑对远程医疗系统的安全性和保密性的信任。我们的贡献是从实施全面，动态，