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Woon LSC, Allison S, Bastiampillai T, Kisely S, Maguire P, Pring W, Reay R, Looi JC. Comparing the trends of MBS telepsychiatry and consultant physician telehealth services from 2017 to 2022: A retrospective study. Australas Psychiatry 2024:10398562241268267. [PMID: 39089229 DOI: 10.1177/10398562241268267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
OBJECTIVE The Medicare Benefit Schedule (MBS) telehealth items were expanded in March 2020 during the COVID-19 pandemic. We measured the use of MBS telepsychiatry items compared to consultant physician telehealth items within the context of these item changes, to understand differences in telepsychiatry and physician telehealth utilisation. METHODS Monthly counts of face-to-face and telehealth (videoconferencing and telephone) MBS items for psychiatrists and physicians from January 2017 to December 2022 were compiled from Services Australia MBS Item Reports. Usage levels were compared before and after telehealth item expansion. Usage trends for MBS telepsychiatry and physician telehealth items were compared in time-series plots. RESULTS Telehealth item expansion resulted in a greater rise of telepsychiatry services from 3.8% beforehand to 43.8% of total services subsequently, compared with physician telehealth services (from 0.6% to 20.0%). More physician telehealth services were by telephone compared with telepsychiatry services. Time-series of both telehealth services displayed similar patterns until mid-2022, when physician telehealth services declined as telephone items were restricted. Telepsychiatry services consistently comprised a greater proportion of total services than physician telehealth services. CONCLUSIONS MBS psychiatrist services showed a more substantial and persistent shift to telehealth than physician services, suggesting a greater preference and use of telepsychiatry.
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Affiliation(s)
- Luke S-C Woon
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Stephen Allison
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Tarun Bastiampillai
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Psychiatry, Monash University, Clayton, VIC, Australia
| | - Steve Kisely
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- School of Medicine, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia
- Departments of Psychiatry, Community Health and Epidemiology, Dalhouise University, Halifax, NS, Canada
| | - Paul Maguire
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - William Pring
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
- Centre for Mental Health Education and Research at Delmont Private Hospital, Melbourne, VIC, Australia
- Private Psychiatrist, Melbourne, VIC, Australia
| | - Rebecca Reay
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School of Medicine and Psychology
| | - Jeffrey Cl Looi
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
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Pilone G, Hentrich T, Schnieders J, Jakubek F, Prugger V, Glasberger M, Mangler M. Prospective Randomized Study on the Use of Robot-Assisted Postoperative Visits. Telemed J E Health 2024. [PMID: 38966967 DOI: 10.1089/tmj.2023.0558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024] Open
Abstract
Introduction: Robot-assisted visits, as part of telemedicine, can offer doctors the opportunity to take care of patients. Due to the COVID-19 pandemic, there has been an increase in telemedicine. The use of teleconsultations, for example, has found its way into the German health care system. However, the practicability and the benefit of robot-assisted postoperative visits have not been systematically investigated in any study worldwide. Methods: Patients were enrolled in a prospective randomized study comparing the standard postoperative visit with the doctor on call and the digital visit through the Double robot between December 2019 and April 2022. All patients and doctors completed a survey after the visit. The primary outcome was patient satisfaction. Secondary outcomes included patients' pain, hospitalization time, and patients' opinions about the usefulness of the robot. Likert scales of arithmetic mean, standard deviation, and subgroup analyses with the Mann-Whitney U test and the Fisher's exact test were used to compare outcomes. Results: We enrolled a total of 106 patients: 54 (50.9%) of them underwent the robot visit and 52 (49.1%) underwent the conventional visit. Baseline demographic and clinical characteristics were similar between groups. Our primary outcome was the same in both arms. Similar results were obtained for the secondary endpoints. Conclusion: Robot-televisits were comparable with standard visits including satisfaction, usefulness, and time of hospitalization. Digitalization in medicine is an irreversible process, especially after the COVID-19 pandemic. We hope that our study will provide concrete help to encourage the allocation of funds for telemedicine in Germany's health care system.
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Affiliation(s)
- Giordana Pilone
- Department of Obstetrics and Gynecology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Tino Hentrich
- Department of Obstetrics and Gynecology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Jutta Schnieders
- Department of Obstetrics and Gynecology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Farnaz Jakubek
- Department of Obstetrics and Gynecology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Vera Prugger
- Department of Obstetrics and Gynecology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Marit Glasberger
- Department of Obstetrics and Gynecology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Mandy Mangler
- Department of Obstetrics and Gynecology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
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González MP, Scartascini C. Increasing the use of telemedicine: A field experiment. PNAS NEXUS 2024; 3:pgae239. [PMID: 38966011 PMCID: PMC11223656 DOI: 10.1093/pnasnexus/pgae239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/25/2024] [Indexed: 07/06/2024]
Abstract
Patients are reluctant to use telemedicine health services, compared to its substitute in-person visits. One reason is that telemedicine can be accurately evaluated and compared to its substitute only after the product has been adopted and experienced. As such, an intervention that increases the probability of a first experience can have lasting effects. This article reports the results of a randomized field experiment conducted in collaboration with a health insurance company. During the intervention, half of the households out of 3,469 in the sample received periodic e-mails with information about the available services. It effectively increased the take-up and demand for telemedicine. Within the first 8 months of the experiment, patients assigned to the treatment group were 6 percentage points more likely to have used the service at least once (and had about five times the odds of using telemedicine compared to those in the control group). Eight months after the start of the intervention, the number of virtual consultations by the treatment group was six times larger than that of the control group. These results, even if limited by the sample and context in which the intervention took place, provide additional evidence about how information interventions can increase technological take-up within the health sector and could serve as the stepping stone for evaluating the impact of telemedicine on health outcomes causally.
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Affiliation(s)
- Maria Patricia González
- Digital Inclusion Benchmarks, World Benchmarking Alliance, Prins Hendrikkade 25, 1012 TM Amsterdam, Netherlands
| | - Carlos Scartascini
- Research Department, Inter-American Development Bank, 1300 New York Ave., NW, Washington, DC 20577, USA
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Padilha FVDQ, Rodrigues DLG, Belber GS, Maeyama MA, Spinel L, Pinho APNM, Vitti A, Otero MS, Pompermaier GB, Damas TB, Oliveira Junior H. Analysis of the costs of teleconsultation for the treatment of diabetes mellitus in the SUS. Rev Saude Publica 2024; 58:15. [PMID: 38716927 PMCID: PMC11037897 DOI: 10.11606/s1518-8787.2024058005433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/22/2023] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE To present the results of a cost analysis of remote consultations (teleconsultations) compared to in-person consultations for patients with type 2 diabetes, in the Brazilian public healthcare system (SUS) in the city of Joinville, Santa Catarina (SC). In addition to the costs from the local manager's perspective, the article also presents estimates from the patient's perspective, based on the transportation costs associated with each type of consultation. METHOD Data were collected from 246 consultations, both remote and in-person, between 2021 and 2023, in the context of a randomized clinical trial on the impact of teleconsultation carried out in the city of Joinville, SC. Teleconsultations were carried out at Primary Health Units (PHU) and in-person consultations at the Specialized Health Center. The consultation costs were calculate by the method time and activity-based costing (TDABC), and for the estimate of transportation costs data was collected directly from the research participants . The mean costs and time required to carry out each type of consultation in different scenarios and perspectives were analyzed and compared descriptively. RESULTS Considering only the local SUS manager's perspective, the costs for carrying out a teleconsultation were 4.5% higher than for an in-person consultation. However, when considering the transportation costs associated with each patient, the estimated value of the in-person consultation becomes 7.7% higher and, in the case of consultations in other municipalities, 15% higher than the teleconsultation. CONCLUSION The results demonstrate that the incorporation of teleconsultation within the SUS can bring economic advantages depending on the perspective and scenario considered, in addition to being a strategy with the potential to increase access to specialized care in the public network.
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Affiliation(s)
- Frederica Valle de Queiroz Padilha
- Hospital Alemão Oswaldo Cruz. Departamento de Sustentabilidade e Responsabilidade Social. São Paulo, SP, Brasil
- Instituto de Estudos de Políticas de Saúde. São Paulo, SP, Brasil
| | | | - Gisele Silvestre Belber
- Hospital Alemão Oswaldo Cruz. Departamento de Sustentabilidade e Responsabilidade Social. São Paulo, SP, Brasil
| | | | - Lígia Spinel
- Hospital Alemão Oswaldo Cruz. Departamento de Sustentabilidade e Responsabilidade Social. São Paulo, SP, Brasil
| | | | | | | | | | | | - Haliton Oliveira Junior
- Hospital Alemão Oswaldo Cruz. Departamento de Sustentabilidade e Responsabilidade Social. São Paulo, SP, Brasil
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Berlet M, Fuchtmann J, Krumpholz R, Naceri A, Macari D, Jähne-Schon C, Haddadin S, Friess H, Feussner H, Wilhelm D. Toward telemedical diagnostics-clinical evaluation of a robotic examination system for emergency patients. Digit Health 2024; 10:20552076231225084. [PMID: 38205033 PMCID: PMC10777806 DOI: 10.1177/20552076231225084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Introduction The SARS-CoV-2 pandemic has affected global public healthcare for several years. Numerous medical professionals have been infected since the outbreak in 2019, resulting in a shortage of healthcare providers. Since traditional personal protective wear was insufficient to eliminate the virus transmission reliably, new strategies to avoid cross-infection were imperative while enabling high-quality medical care. In the project ProteCT, we investigated the potential of robotic-assisted examination in providing medical examination via a telemedical approach. Material and Methods We constructed a fully functional examination cabin equipped with cameras, microphones, screens and robotic arms to evaluate usability and perception. Therefore, we conducted a preliminary study with 10 healthy volunteers and 10 physicians to gain first insights and optimize the setup. In a second step, we performed telemedical examinations of actual patients from the local emergency department to compare the robotic approach with the classical method of measuring vital signs, auscultation, palpation and percussion. Results The preliminary study identified basic requirements, such as the need for force-feedback and telemedical training for physicians. In the main study, acceptance was high and most patients indicated they would use a telemedical system again. Our setup enabled the physician to make the same diagnoses as by classic examination in the emergency department in most cases. Discussion The potential acceptance of a telemedical system such as ProteCT is high. Robotic telemedical approaches could complement future healthcare beyond the Corona pandemic to reach rural areas or even war zones. Moreover, the daily clinical use of robotic telemedicine could improve patients' safety, the quality of perioperative management and the workflow in any medical facility. Conclusion The development of telemedical and telerobotic systems is a multidisciplinary and complex challenge. However, acceptance of the proposed system was high among patients and physicians, indicating the potential use of similar systems for future healthcare.
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Affiliation(s)
- Maximilian Berlet
- Department of Surgery, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
- MITI Research Group, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jonas Fuchtmann
- MITI Research Group, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - Roman Krumpholz
- MITI Research Group, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - Abdeldjallil Naceri
- Munich Institute of Robotics and Machine Intelligence, Technical University of Munich, Munich, Germany
| | - Daniela Macari
- Franka Emika GmbH, Munich, Germany
- Max Planck Institute for Intelligent Systems, Max Planck ETH Center for Learning Systems, Stuttgart, Germany
| | | | - Sami Haddadin
- Munich Institute of Robotics and Machine Intelligence, Technical University of Munich, Munich, Germany
| | - Helmut Friess
- Department of Surgery, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - Hubertus Feussner
- Department of Surgery, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
- MITI Research Group, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dirk Wilhelm
- Department of Surgery, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
- MITI Research Group, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
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van Kessel R, Srivastava D, Kyriopoulos I, Monti G, Novillo-Ortiz D, Milman R, Zhang-Czabanowski WW, Nasi G, Stern AD, Wharton G, Mossialos E. Digital Health Reimbursement Strategies of 8 European Countries and Israel: Scoping Review and Policy Mapping. JMIR Mhealth Uhealth 2023; 11:e49003. [PMID: 37773610 PMCID: PMC10576236 DOI: 10.2196/49003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/03/2023] [Accepted: 09/08/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND The adoption of digital health care within health systems is determined by various factors, including pricing and reimbursement. The reimbursement landscape for digital health in Europe remains underresearched. Although various emergency reimbursement decisions were made during the COVID-19 pandemic to enable health care delivery through videoconferencing and asynchronous care (eg, digital apps), research so far has primarily focused on the policy innovations that facilitated this outside of Europe. OBJECTIVE This study examines the digital health reimbursement strategies in 8 European countries (Belgium, France, Germany, Italy, the Netherlands, Poland, Sweden, and the United Kingdom) and Israel. METHODS We mapped available digital health reimbursement strategies using a scoping review and policy mapping framework. We reviewed the literature on the MEDLINE, Embase, Global Health, and Web of Science databases. Supplementary records were identified through Google Scholar and country experts. RESULTS Our search strategy yielded a total of 1559 records, of which 40 (2.57%) were ultimately included in this study. As of August 2023, digital health solutions are reimbursable to some extent in all studied countries except Poland, although the mechanism of reimbursement differs significantly across countries. At the time of writing, the pricing of digital health solutions was mostly determined through discussions between national or regional committees and the manufacturers of digital health solutions in the absence of value-based assessment mechanisms. Financing digital health solutions outside traditional reimbursement schemes was possible in all studied countries except Poland and typically occurs via health innovation or digital health-specific funding schemes. European countries have value-based pricing frameworks that range from nonexistent to embryonic. CONCLUSIONS Studied countries show divergent approaches to the reimbursement of digital health solutions. These differences may complicate the ability of patients to seek cross-country health care in another country, even if a digital health app is available in both countries. Furthermore, the fragmented environment will present challenges for developers of such solutions, as they look to expand their impact across countries and health systems. An increased emphasis on developing a clear conceptualization of digital health, as well as value-based pricing and reimbursement mechanisms, is needed for the sustainable integration of digital health. This study can therein serve as a basis for further, more detailed research as the field of digital health reimbursement evolves.
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Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Divya Srivastava
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Ilias Kyriopoulos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Giovanni Monti
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - David Novillo-Ortiz
- Division of Country Health Policies and Systems, World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Ran Milman
- Digital Health Division, Israeli Ministry Of Health, Jerusalem, Israel
| | | | - Greta Nasi
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
| | - Ariel Dora Stern
- Harvard Business School, Harvard University, Boston, MA, United States
- Harvard-MIT Center for Regulatory Science, Harvard University, Boston, MA, United States
| | - George Wharton
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Xu D, Huang Y, Tsuei S, Fu H, Yip W. Factors influencing engagement in online dual practice by public hospital doctors in three large cities: A mixed-methods study in China. J Glob Health 2023; 13:04103. [PMID: 37736850 PMCID: PMC10514738 DOI: 10.7189/jogh.13.04103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
Background In the digital age, a rising number of public sector doctors are providing private telemedicine and telehealth services on online health care platforms. This novel practice pattern - termed online dual practice - may profoundly impact health system performance in both developed and developing countries. This study aims to understand the factors influencing doctors' engagement in online dual practice. Methods Using a mixed-methods design, this study concurrently collects quantitative demographic and practice data (n = 71 944) and semi-structured interview data (n = 32) on secondary and tertiary public hospital doctors in three large Chinese cities: Beijing, Shanghai and Guangzhou. We use the quantitative data to examine the prevalence of the online dual practice and its associated factors via the binary logit regression model. The qualitative data are used to further explore associated factors of online dual practice via thematic analysis. The findings about associated factors from the two parts were merged using the categories of personal, professional, and organisational characteristics. Results Our quantitative analysis shows that at least 47.1% of public hospital doctors are involved in online dual practice. The shares in Beijing, Shanghai, and Guangzhou are 43.7%, 53.1%, and 44.8%, respectively. This practice is more prevalent among doctors who are male, senior, and non-managerial. Different specialties, hospital ownership, hospital levels, and locations are also significantly associated with this practice. The qualitative analysis further suggests that financial returns, perceived effectiveness of telemedicine, and hospital directors' attitude towards telemedicine may affect doctors' engagement with online dual practice. Conclusions Online dual practice is prevalent among doctors at tertiary and secondary public hospitals in Beijing, Shanghai, and Guangzhou. Personal, professional, and organisational characteristics are all associated with doctors' choice to engage in online dual practice. The findings in this study provide implications for promoting telemedicine adoption and developing relevant regulatory policies in China and other countries.
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Affiliation(s)
- Duo Xu
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing, China
| | - Yushu Huang
- Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Sian Tsuei
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hongqiao Fu
- Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, Beijing, China
- Center for Health Policy and Technology Evaluation, National Institute of Health Data Science at Peking University, Beijing, China
| | - Winnie Yip
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Szankin M, Kwasniewska A, Ruminski J. Thermal Image Processing for Respiratory Estimation from Cubical Data with Expandable Depth. J Imaging 2023; 9:184. [PMID: 37754948 PMCID: PMC10532126 DOI: 10.3390/jimaging9090184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/24/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
As healthcare costs continue to rise, finding affordable and non-invasive ways to monitor vital signs is increasingly important. One of the key metrics for assessing overall health and identifying potential issues early on is respiratory rate (RR). Most of the existing methods require multiple steps that consist of image and signal processing. This might be difficult to deploy on edge devices that often do not have specialized digital signal processors (DSP). Therefore, the goal of this study is to develop a single neural network realizing the entire process of RR estimation in a single forward pass. The proposed solution builds on recent advances in video recognition, capturing both spatial and temporal information in a multi-path network. Both paths process the data at different sampling rates to capture rapid and slow changes that are associated with differences in the temperature of the nostril area during the breathing episodes. The preliminary results show that the introduced end-to-end solution achieves better performance compared to state-of-the-art methods, without requiring additional pre/post-processing steps and signal-processing techniques. In addition, the presented results demonstrate its robustness on low-resolution thermal video sequences that are often used at the embedded edge due to the size and power constraints of such systems. Taking that into account, the proposed approach has the potential for efficient and convenient respiratory rate estimation across various markets in solutions deployed locally, close to end users.
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Affiliation(s)
- Maciej Szankin
- Intel Corporation, 16409 W Bernardo Dr Suite 100, San Diego, CA 92127, USA
| | | | - Jacek Ruminski
- Department of Biomedical Engineering, Gdansk University of Technology, Gabriela Narutowicza 11/12, 80233 Gdansk, Poland;
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Shawwa L. The Use of Telemedicine in Medical Education and Patient Care. Cureus 2023; 15:e37766. [PMID: 37213963 PMCID: PMC10198592 DOI: 10.7759/cureus.37766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
The COVID-19 pandemic has accelerated and expanded the adoption of telemedicine globally. This allowed telemedicine to engage medical students in patient care and ensured continuity of care for vulnerable patients. In this review, the history of telemedicine and some of its applications in medical education were reviewed. Furthermore, we also shed light on how to incorporate telemedicine into several curricula and the strategies used to include it. The article also explored how to evaluate telemedicine and the major facilitators and barriers any medical and educational institution must address when using telemedicine. At the end of the review, we explored the future promises telemedicine has for medical education.
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Affiliation(s)
- Lana Shawwa
- Medical Education, King Abdul Aziz University, Jeddah, SAU
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Hosseinzadeh H, Ratan ZA, Nahar K, Dadich A, Al-Mamun A, Ali S, Niknami M, Verma I, Edwards J, Shnaigat M, Malak MA, Rahman MM, Okely A. Telemedicine Use and the Perceived Risk of COVID-19: Patient Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3061. [PMID: 36833755 PMCID: PMC9960459 DOI: 10.3390/ijerph20043061] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/23/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The COVID-19 outbreak resulted in an increased demand for telemedicine worldwide. Telemedicine is a technology-based virtual platform that allows the exchange of clinical data and images over remote distances. This study aims to examine the impact of the perceived risk of COVID-19 on telemedicine use in Bangladesh. METHODS This explanatory study was conducted in hospital settings across Dhaka city in Bangladesh. Patients were eligible to participate if they were aged 18 years or over and had used telemedicine in a hospital at least once since the COVID-19 outbreak. Outcome variables included sociodemographic, the perceived risk of COVID-19, and telehealth use. Study data were collected using an online and paper-based survey. RESULTS A total of 550 patients participated in this study, mostly male (66.4%), single (58.2%), and highly educated (74.2%). The means of the different domains of telemedicine use reflected a high degree of perceived benefit, accessibility, and satisfaction but a lower degree of privacy and discomfort, care personnel expertise, and usability. COVID 19 perceived risk predicted between 13.0% and 26.6% of variance in telemedicine domains, while the effects of demographic variables were controlled or removed. The perceived risk of COVID-19 was negatively correlated with privacy and discomfort, as well as care personnel concerns. Low and high levels of perceived COVID-19 risk were less likely to encourage the use of telemedicine as a risk reduction tool. DISCUSSION The participants were mainly satisfied with telemedicine, finding it beneficial and accessible; however, many were concerned about privacy, care personnel expertise, and its usability. The perceived risk of COVID-19 was a strong predictor (contributor) of telemedicine use, suggesting that risk perception can be used to encourage telemedicine use as a risk reduction strategy during pandemics; however, a medium level of risk was more promising.
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Affiliation(s)
- Hassan Hosseinzadeh
- School of Health & Society, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Zubair Ahmed Ratan
- School of Health & Society, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Kamrun Nahar
- Institute of Child and Mother Health (ICMH), Matuail, Dhaka 1362, Bangladesh
| | - Ann Dadich
- School of Business, Western Sydney University, Penrith, NSW 2751, Australia
| | - Abdullah Al-Mamun
- School of Business, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Searat Ali
- School of Business, University of Wollongong, Wollongong, NSW 2522, Australia
| | | | - Iksheta Verma
- School of Health & Society, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Joseph Edwards
- School of Health & Society, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Mahmmoud Shnaigat
- School of Health & Society, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Md Abdul Malak
- Department of Geography and Environment, Jagannath University, 9-10 Chittaranjan Ave, Dhaka 1100, Bangladesh
| | - Md Mustafizur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Anthony Okely
- School of Health & Society, University of Wollongong, Wollongong, NSW 2522, Australia
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Mavragani A, Kyriopoulos I, Wong BLH, Mossialos E. The Effect of the COVID-19 Pandemic on Digital Health-Seeking Behavior: Big Data Interrupted Time-Series Analysis of Google Trends. J Med Internet Res 2023; 25:e42401. [PMID: 36603152 PMCID: PMC9848442 DOI: 10.2196/42401] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/20/2022] [Accepted: 01/05/2023] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Due to the emergency responses early in the COVID-19 pandemic, the use of digital health in health care increased abruptly. However, it remains unclear whether this introduction was sustained in the long term, especially with patients being able to decide between digital and traditional health services once the latter regained their functionality throughout the COVID-19 pandemic. OBJECTIVE We aim to understand how the public interest in digital health changed as proxy for digital health-seeking behavior and to what extent this change was sustainable over time. METHODS We used an interrupted time-series analysis of Google Trends data with break points on March 11, 2020 (declaration of COVID-19 as a pandemic by the World Health Organization), and December 20, 2020 (the announcement of the first COVID-19 vaccines). Nationally representative time-series data from February 2019 to August 2021 were extracted from Google Trends for 6 countries with English as their dominant language: Canada, the United States, the United Kingdom, New Zealand, Australia, and Ireland. We measured the changes in relative search volumes of the keywords online doctor, telehealth, online health, telemedicine, and health app. In doing so, we capture the prepandemic trend, the immediate change due to the announcement of COVID-19 being a pandemic, and the gradual change after the announcement. RESULTS Digital health search volumes immediately increased in all countries under study after the announcement of COVID-19 being a pandemic. There was some variation in what keywords were used per country. However, searches declined after this immediate spike, sometimes reverting to prepandemic levels. The announcement of COVID-19 vaccines did not consistently impact digital health search volumes in the countries under study. The exception is the search volume of health app, which was observed as either being stable or gradually increasing during the pandemic. CONCLUSIONS Our findings suggest that the increased public interest in digital health associated with the pandemic did not sustain, alluding to remaining structural barriers. Further building of digital health capacity and developing robust digital health governance frameworks remain crucial to facilitating sustainable digital health transformation.
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Affiliation(s)
| | - Ilias Kyriopoulos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Brian Li Han Wong
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.,Steering Committee, Digital Health Section, European Public Health Association, Utrecht, Netherlands
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.,Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Zhang X, Zhang W, Sun W, Song A. A new soft tissue deformation model based on Runge-Kutta: Application in lung. Comput Biol Med 2022; 148:105811. [PMID: 35834968 DOI: 10.1016/j.compbiomed.2022.105811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/25/2022] [Accepted: 07/03/2022] [Indexed: 11/30/2022]
Abstract
Flexible body deformation model is the most critical research in the field of telemedicine, which decides whether the deformation process of tissues and organs can be simulated in real time and realistically. Basically, the improvement of model accuracy often means the loss of real-time performance. In order to effectively balance between accuracy and real-time performance, this paper proposes a new model, which uses the step-variable fourth-order Runge-Kutta method for the first time to solve the relationship problem between the external force and displacement of the nodes in the finite element deformation of the lung. To improve the real-time performance of the model, a one-stage solution optimization algorithm is proposed to optimize the step size selection problem. Finally, an accelerated two-level node update algorithm is proposed to further improve the real-time performance. A lung surgery simulation platform with 3DMax2020 and OpenGL4.5 is built to verify the accuracy, efficiency, realism and applicability of the model. Experimental results show that the proposed lung model can achieve real-world visual reproduction during remote surgery, and exceeds other 13 reference models in real-time performance, with natural deformation effect, high simulation accuracy, which is suitable for modeling normal lung and four types of lungs suffering from diseases.
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Affiliation(s)
- Xiaorui Zhang
- Wuxi Research Institute, Nanjing University of Information Science & Technology, Wuxi, 214100, China; Engineering Research Center of Digital Forensics, Ministry of Education, Jiangsu Engineering Center of Network Monitoring, School of Computer and Software, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Wenzheng Zhang
- Engineering Research Center of Digital Forensics, Ministry of Education, Jiangsu Engineering Center of Network Monitoring, School of Computer and Software, Nanjing University of Information Science & Technology, Nanjing, 210044, China.
| | - Wei Sun
- School of Automation, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Aiguo Song
- State Key Laboratory of Bioelectronics, Jiangsu Key Lab of Remote Measurement and Control, School of Instrument Science and Engineering, Southeast University, Nanjing, 210096, China
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Singular Spectrum Analysis of Tremorograms for Human Neuromotor Reaction Estimation. MATHEMATICS 2022. [DOI: 10.3390/math10111794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Singular spectrum analysis (SSA) is a method of time series analysis and is used in various fields, including medicine. A tremorogram is a biological signal that allows evaluation of a person’s neuromotor reactions in order to infer the state of the motor parts of the central nervous system (CNS). A tremorogram has a complex structure, and its analysis requires the use of advanced methods of signal processing and intelligent analysis. The paper’s novelty lies in the application of the SSA method to extract diagnostically significant features from tremorograms with subsequent evaluation of the state of the motor parts of the CNS. The article presents the application of a method of singular spectrum decomposition, comparison of known variants of classification, and grouping of principal components for determining the components of the tremorogram corresponding to the trend, periodic components, and noise. After analyzing the results of the SSA of tremorograms, we proposed a new algorithm of grouping based on the analysis of singular values of the trajectory matrix. An example of applying the SSA method to the analysis of tremorograms is shown. Comparison of known clustering methods and the proposed algorithm showed that there is a reasonable correspondence between the proposed algorithm and the traditional methods of classification and pairing in the set of periodic components.
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