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Williams KS, Singh MJ, Elumn JE, Threats M, Sha Y, McCall T, Wang K, Massey B, Peng ML, Wiley K. Enhancing healthcare accessibility through telehealth for justice impacted individuals. Front Public Health 2024; 12:1401950. [PMID: 39175903 PMCID: PMC11340679 DOI: 10.3389/fpubh.2024.1401950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/19/2024] [Indexed: 08/24/2024] Open
Abstract
Telehealth is a great tool that makes accessing healthcare easier for those incarcerated and can help with reentry into the the community. Justice impacted individuals face many hardships including adverse health outcomes which can be mitigated through access to telehealth services and providers. During the federally recognized COVID-19 pandemic the need for accessible healthcare was exacerbated and telehealth use surged. While access to telehealth should be considered a necessity, there are many challenges and barriers for justice impacted individuals to be able to utilize this service. This perspective examines aspects of accessibility, pandemic, policy, digital tools, and ethical and social considerations of telehealth in correctional facilities. Carceral facilities should continue to innovate and invest in telehealth to revolutionize healthcare delivery, and improve health outcomes for justice impacted individuals.
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Affiliation(s)
- Karmen S. Williams
- Department of Health Policy and Management, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Marianna J. Singh
- Department of Health Policy and Management, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Johanna E. Elumn
- SEICHE Center for Health and Justice, General Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Megan Threats
- School of Information, University of Michigan Ann Arbor, Ann Arbor, MI, United States
| | - Yongjie Sha
- School of Information, University of Michigan Ann Arbor, Ann Arbor, MI, United States
| | - Terika McCall
- Division of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States
| | - Karen Wang
- SEICHE Center for Health and Justice, General Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Bria Massey
- Center for Population Health IT, Department of Biomedical Informatics and Data Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Mary L. Peng
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Kevin Wiley
- Department of Healthcare Leadership and Management, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
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2
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Van Denend T, Mathiowetz V, Preissner K, Bethoux F, Finlayson M, Packer T, Ghahari S, Plow M. Adapting the Multiple Sclerosis Functional Composite for Telehealth Administration Using Videoconference Delivery: Methodological Considerations and Interrater Reliability. Arch Rehabil Res Clin Transl 2024; 6:100337. [PMID: 39006110 PMCID: PMC11240042 DOI: 10.1016/j.arrct.2024.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Objective To describe the adaptations made and to examine interrater reliability and feasibility of administering a telehealth version of the Multiple Sclerosis Functional Composite (tele-MSFC). Design The Multiple Sclerosis Functional Composite (MSFC) is a commonly used, in-person clinical outcome assessment. It is composed of the timed 25-Foot Walk Test (T25FWT), Nine-Hole Peg Test (NHPT), and Paced Auditory Serial Addition Test (PASAT). The MSFC was adapted for videoconference administration as part of a larger clinical trial. One of the adaptations included administering a timed 12.5-Foot Walk Test (T12.5FWT) for participants who did not have adequate space in their homes for the T25FWT. Participants, examiners, and raters completed surveys online about their satisfaction and experience with tele-MSFC. Setting Participants underwent the tele-MSFC in their homes using a laptop or smartphone while examiners scored the tele-MSFC in real-time at a remote location. Participants Community-dwelling adults (n=61) with mild-to-moderate multiple sclerosis (MS) symptoms. Interventions Not applicable. Main Outcome Measure Tele-MSFC. Results Intraclass correlation coefficients (ICC) assessed interrater reliability between the examiner and 2 independent raters who later scored a recording of the tele-MSFC. Interrater reliability was excellent (ICC>0.90) for all tests, including the T12.5FWT. Participants were highly satisfied with tele-MSFC. However, challenges included adequate space for T25FWT, technical difficulties, and safety and privacy considerations of individuals with moderate impairments who were requested to have their caregivers present during testing. Conclusion The tele-MSFC is reliable and feasible to administer with adaptations for community-dwelling adults with mild to moderate MS symptoms. Further validation of T12.5FWT is needed.
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Affiliation(s)
- Toni Van Denend
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL
| | - Virgil Mathiowetz
- Program in Occupational Therapy, University of Minnesota, Minneapolis, MN
| | - Katharine Preissner
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL
| | - Francois Bethoux
- Department of Physical Medicine and Rehabilitation, Neurological Institute, The Cleveland Clinic Foundation, Cleveland, OH
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Tanya Packer
- School of Occupational Therapy and School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Nursing, Umea University, Umea, Sweden
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Matthew Plow
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
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Colburn DA. The Impact of Telehealth Expansion on Health Care Utilization, Access, and Outcomes During the Pandemic: A Systematic Review. Telemed J E Health 2024; 30:1401-1410. [PMID: 38100326 DOI: 10.1089/tmj.2023.0440] [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] [Indexed: 12/17/2023] Open
Abstract
Introduction: The COVID-19 pandemic brought unprecedented change to the health care industry, including a large and rapid shift to providing care through telehealth technologies. Although the expansion of telehealth services was successful in continuing to provide patients with care while preventing the spread of disease, it is less clear how patient sociodemographic characteristics influenced telehealth use during this time. This study aims to systematically review the published literature on demographic differences in telehealth access, utilization, and health outcomes among a variety of adult patient types in the United States. Methods: Litcovid, PubMed, Web of Science, and MEDLINE databases were searched, resulting in a final sample of n = 32 studies. Results: Results found that studies could be categorized as addressing at least one of eight different areas of inquiry: sociodemographic differences in telehealth use (1) during and (2) before the pandemic, telehealth use versus nonuse (3) during and (4) before the pandemic, (5) telehealth modality, (6) satisfaction with telehealth, (7) outcomes associated with telehealth use, and (8) perceived or actual access to telehealth services. Discussion: Findings are robust across included studies with respect to racial, age, and socioeconomic differences in telehealth utilization and health outcomes, reflecting sociodemographic differences in health care access, utilization, and outcomes more broadly that persist despite this expansion of telehealth services owing to COVID-19. Additional findings across studies are summarized and areas for future research are discussed.
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Affiliation(s)
- Deirdre A Colburn
- Crimes against Children Research Center, University of New Hampshire, Durham, New Hampshire, USA
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Tierney AA, Mosqueda M, Cesena G, Frehn JL, Payán DD, Rodriguez HP. Telemedicine Implementation for Safety Net Populations: A Systematic Review. Telemed J E Health 2024; 30:622-641. [PMID: 37707997 PMCID: PMC10924064 DOI: 10.1089/tmj.2023.0260] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 09/16/2023] Open
Abstract
Background: Telemedicine systems were rapidly implemented in response to COVID-19. However, little is known about their effectiveness, acceptability, and sustainability for safety net populations. This study systematically reviewed primary care telemedicine implementation and effectiveness in safety net settings. Methods: We searched PubMed for peer-reviewed articles on telemedicine implementation from 2013 to 2021. The search was done between June and December 2021. Included articles focused on health care organizations that primarily serve low-income and/or rural populations in the United States. We screened 244 articles from an initial search of 343 articles and extracted and analyzed data from N = 45 articles. Results: Nine (20%) of 45 articles were randomized controlled trials. N = 22 reported findings for at least one marginalized group (i.e., racial/ethnic minority, 65 years+, limited English proficiency). Only n = 19 (42%) included African American/Black patients in demographics descriptions, n = 14 (31%) LatinX/Hispanic patients, n = 4 (9%) Asian patients, n = 4 (9%) patients aged 65+ years, and n = 4 (9%) patients with limited English proficiency. Results show telemedicine can provide high-quality primary care that is more accessible and affordable. Fifteen studies assessed barriers and facilitators to telemedicine implementation. Common barriers were billing/administrative workflow disruption (n = 9, 20%), broadband access/quality (n = 5, 11%), and patient preference for in-person care (n = 4, 9%). Facilitators included efficiency gains (n = 6, 13%), patient acceptance (n = 3, 7%), and enhanced access (n = 3, 7%). Conclusions: Telemedicine is an acceptable care modality to deliver primary care in safety net settings. Future studies should compare telemedicine and in-person care quality and test strategies to improve telemedicine implementation in safety net settings.
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Affiliation(s)
- Aaron A. Tierney
- Department of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Mariana Mosqueda
- Department of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Gabriel Cesena
- Department of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Jennifer L. Frehn
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Denise D. Payán
- Department of Health, Society, and Behavior, University of California, Irvine, Irvine, California, USA
| | - Hector P. Rodriguez
- Department of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, California, USA
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Punzalan JK, Guingona M, Gregorio E, Ferraren J, Sta Elena MA, Valaquio M, Arnuco FD, Punzalan MG, Arciaga R, Woolley T, Kunting A, Miravite DA, Cristobal F. Telehealth program for symptomatic COVID-19 patients in Mindanao, Philippines: a whole-of-system, pragmatic interventional study on patient monitoring from isolation facilities to community reintegration. Int J Equity Health 2024; 23:20. [PMID: 38310299 PMCID: PMC10838445 DOI: 10.1186/s12939-024-02115-5] [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: 09/04/2023] [Accepted: 01/19/2024] [Indexed: 02/05/2024] Open
Abstract
The COVID-19 pandemic is impacting individuals and society's physical and mental health. Despite the lack of any definite and effective therapeutic regimen, public health measures such as quarantine and isolation have been instituted to contain this pandemic. However, these mitigating measures have also raised issues regarding isolated patients' mental and psychological well-being. Several stakeholders were engaged in this approach, including the university, the local health office, the tertiary hospital, and the local communities. This intervention addresses concerns regarding the health status of isolated individuals due to COVID-19 infection, making the program available to anyone who agrees to participate. This was done through telehealth services delivered via phone calls and SMS. The university provided technical support and telehealth manpower through medical students. The local health unit manages the isolation facilities, while the referral hospital offers specialty care for isolated patients through teleconsultation. Finally, the local community is the one that reintegrates discharged patients into their communities. Three hundred forty-four (344) participants were provided seven sessions on telehealth education and tracking of their COVID-19 prescribed practices and mental health. The mean age of the patients was 37 years; half were females, and 15% had comorbidities. Regarding their mental health status, the level of depression dropped from 6% to 1% (p<0.0001), the level of anxiety dropped from 12% to 2% (p<0.0001), and the level of stress dropped from 3% to 0% (p<0.0001) from the first day of admission to 2 weeks after discharge. Moreover, a general trend of statistically significant increase in various practices was noted: wearing face masks, physical distancing, disinfecting frequently held objects, hand hygiene, and self-monitoring for COVID-19 symptoms. Those with progressing symptoms of COVID-19 were referred immediately to the referral hospital. There were also no reports of complications of co-morbidities during their stay in the isolation facilities or social isolation upon community reintegration. The study concludes that telehealth services have the potential to address many challenges in providing continuous healthcare services to isolated patients until they are reintegrated into their community. Furthermore, a whole-of-society approach is necessary to provide holistic care to patients affected by the pandemic.
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Affiliation(s)
- Jaime Kristoffer Punzalan
- Ateneo de Zamboanga University, Zamboanga City, Philippines.
- Zamboanga City Medical Center, Zamboanga City, Philippines.
| | | | - Elgie Gregorio
- Zamboanga City Medical Center, Zamboanga City, Philippines
| | | | | | | | | | - Mary Germeyn Punzalan
- Ateneo de Zamboanga University, Zamboanga City, Philippines
- Zamboanga City Medical Center, Zamboanga City, Philippines
| | | | | | - Afdal Kunting
- Zamboanga City Medical Center, Zamboanga City, Philippines
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Malakhov KS. Insight into the Digital Health System of Ukraine (eHealth): Trends, Definitions, Standards, and Legislative Revisions. Int J Telerehabil 2023; 15:e6599. [PMID: 38162941 PMCID: PMC10754247 DOI: 10.5195/ijt.2023.6599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Purpose This article aims to provide an in-depth examination of the digital health system of Ukraine, focusing on the emerging trends, precise definitions, established standards, and recent legislative revisions that shape the practice and implementation of eHealth solutions within the country. Background The digital health landscape in Ukraine has witnessed significant transformations, especially in the wake of the COVID-19 pandemic and subsequent military conflicts. These events have catalyzed the expansion of telemedicine services, leading to innovative approaches in healthcare delivery. The national strategy underscores the necessity for human-centric and accessible telemedicine, reinforced by technological neutrality, and harmonization with global standards. Methods A review of the current literature, national strategies, and legal documents was conducted, alongside an analysis of data usage and service provision patterns in various Ukrainian regions. Participation in the "Science for Safety and Sustainable Development of Ukraine" competition facilitated project initiatives like the development of a cloud-based platform for patient-centered telerehabilitation for oncology patients. Findings The utilization of telemedicine has significantly increased in conflict-affected regions, demonstrating the need for, and the effective deployment of, digital health strategies under crisis conditions. Private health facilities and entrepreneurs have been pivotal in the provision of telemedicine services. Legislative efforts have been geared toward framing telemedicine as an integral component of the national eHealth system, ensuring interoperability, and aligning with international standards and the Internet of Medical Things (IoMT). Interpretation The findings underscore the resilience and adaptability of the Ukrainian healthcare system in the face of adversity. There is a clear trend towards a more integrated, patient-focused, and technologically advanced healthcare model, aligning with international trends and prioritizing public health goals over private profits. This progress, however, is contingent upon continuous development, investment in technological infrastructure, and legislative support to sustain and advance digital health initiatives.
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Affiliation(s)
- Kyrylo S. Malakhov
- V. M. Glushkov Institute of Cybernetics of the National Academy of Sciences of Ukraine
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7
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Mikesell L, Rea S, Cuddihy C, Perry M, Allison B. Exploring the Connectivity Paradox: How the Sociophysical Environment of Telehealth Shapes Adolescent Patients' and Parents' Perceptions of the Patient-Clinician Relationship. HEALTH COMMUNICATION 2023; 38:2854-2864. [PMID: 36102361 DOI: 10.1080/10410236.2022.2124056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Even before the widespread transition to telehealth as a result of COVID-19, there was a considerable amount of research exploring its value and impact. However, telehealth research with adolescent patients is somewhat limited, with most work focusing on access, feasibility, and acceptability but reporting far less frequently on relationship building and rapport. This study examines qualitative interviews with adolescent patients (n = 14) and parents (n = 20) from a larger convergent parallel mixed methods study to explore how they understand telehealth to have altered the sociophysical environment of primary care clinic encounters and whether they perceive these changes to influence adolescents' relationships with clinicians. We show that participants perceived the sociophysical environment of telehealth to be both less institutional (e.g. more relaxed and less rushed) and more instrumental (e.g. more focused on the chief complaint), which shaped interactions with clinicians in ways that were experienced as paradoxically less personal (e.g. lacking social connection) and more person-centered (e.g. more attentive to the individual patient). We discuss theoretical and practical implications of these findings and what they mean for defining person-centered communication for adolescent care.
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Affiliation(s)
| | - Samantha Rea
- Transitional Year Residency Program, Henry Ford Health System
| | | | - Martha Perry
- Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Bianca Allison
- Department of Pediatrics, University of North Carolina at Chapel Hill
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Mathews D, Abernethy A, Butte AJ, Ginsburg P, Kocher B, Levy L, Novelli C, Sandy L, Smee J, Fabi R, Offodile AC, Sherkow JS, Sullenger RD, Freiling E, Balatbat C. Telehealth and Mobile Health: Case Study for Understanding and Anticipating Emerging Science and Technology. NAM Perspect 2023; 2023:202311e. [PMID: 38812841 PMCID: PMC11136501 DOI: 10.31478/202311e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
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Grinberg K, Sela Y. The Quality of Telenursing-Israeli Nursing Staff's Perceptions. Healthcare (Basel) 2023; 11:2915. [PMID: 37998408 PMCID: PMC10671182 DOI: 10.3390/healthcare11222915] [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: 10/06/2023] [Revised: 10/26/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The outbreak of the COVID-19 pandemic has increased telemedicine and telenursing services worldwide, developed this innovative treatment's potential, and emphasized its importance. The constraints imposed by the pandemic breached regulatory, psychological, and organizational obstructions among both patients and caretakers. Community and hospital nursing services were forced to deal with a new reality, to provide remote care solutions for bedridden chronic patients, as the need for this grew exponentially. Despite the increase of telemedicine in recent years, so far no research in Israel has investigated the nursing staff's perceptions of the quality of the care provided through telenursing. OBJECTIVE To assess nurses' perceptions of the quality of the care provided through telenursing compared to face-to-face nursing. METHOD A quantitative cross-sectional study among 227 male and female nurses in Israel. The questionnaire included demographic questions, and the five measures of quality of care: concern and empathy for the patient, professional treatment, response to treatment, educated use of resources, and patients' sense of security. RESULTS Significant differences were found between nurses' perceptions of telenursing and face-to-face nursing. The quality of face-to-face nursing was perceived as more positive than that of telenursing, in general, as were the individual measures of care quality such as providing professional treatment, response to treatment, and patients' sense of security. CONCLUSIONS Although telemedicine has increased significantly in recent years, nursing staff still perceived the quality of care and follow-up of face-to-face nursing as more positive. It is important to continue to monitor nurses' perceptions and attitudes towards the strengths of these two treatment methods, not only in crisis situations, but among wider populations, and to investigate the factors that could influence these perceptions.
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Affiliation(s)
- Keren Grinberg
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek-Hefer 4025000, Israel;
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10
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Yap ET, Tan CL, Dumago MP, Jacomina LE, Yu KKL, Tapispisan JAR, Agas RAF, Co JL, Bacorro WR, Mejia MA, Sy Ortin TT. Teleconsultation Perceptions of Medical and Radiation Oncologists in the COVID-19 and Post-COVID-19 Era: A National Survey in the Philippines. JCO Glob Oncol 2023; 9:e2200370. [PMID: 37348036 PMCID: PMC10497274 DOI: 10.1200/go.22.00370] [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: 10/30/2022] [Revised: 04/01/2023] [Accepted: 05/09/2023] [Indexed: 06/24/2023] Open
Abstract
PURPOSE The study reports on the current perception of medical and radiation oncologists regarding teleconsultation in the Philippines. Before the COVID-19 pandemic, the adoption of telemedicine was not widespread. With movement restrictions imposed during the pandemic, physicians were compelled to use telemedicine. It is uncertain whether physicians will still adopt its use in practice in the post-COVID-19 era. This study gives insight into the possible adaptation of this mode of consultation in the future, especially in areas with limited health care resources. MATERIALS AND METHODS We conducted a national survey among medical oncologists and radiation oncologists in the Philippines. A 43-item online survey was developed, validated, and administered to the oncologists. The demographics and data from categorical questions were reported as frequencies and percentages. RESULTS A total of 142 responses were gathered from 82 medical oncologists and 60 radiation oncologists. There was agreement among participants that, during the pandemic, teleconsultation could be used for the first visit, diagnostic workup request, treatment explanation, follow-up care, and chronic disease management. There was disagreement whether cancer diagnosis disclosure and cancer prognosis revelation could be performed via teleconsultation, and there was agreement that emergency consultation and physical examination would warrant a face-to-face consultation. After the COVID-19 pandemic, 78.7% intend to continue using teleconsultation except for emergency consultations, first visits, physical examination, diagnosis disclosure, and cancer prognosis revelation. CONCLUSION Teleconsultation was perceived by oncologists as an acceptable method of providing cancer care during and after the COVID-19 pandemic. Oncologists also intend to use teleconsultation in the post-COVID-19 era in certain aspects of patient care.
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Affiliation(s)
- Eugene T. Yap
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Charmaine L. Tan
- Department of Medical Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Mark P. Dumago
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Luisa E. Jacomina
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Kelvin Ken L. Yu
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Julie Ann R. Tapispisan
- Department of Medical Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Ryan Anthony F. Agas
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Jayson L. Co
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Warren R. Bacorro
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Michael A. Mejia
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Teresa T. Sy Ortin
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
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11
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You W, Donnelly F. Although in shortage, nursing workforce is still a significant contributor to life expectancy at birth. Public Health Nurs 2023; 40:229-242. [PMID: 36527363 DOI: 10.1111/phn.13158] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 11/11/2022] [Accepted: 11/27/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Previous studies have not fully reported the strength and independency of the correlation of nursing workforce to life expectancy. This study advances that nursing workforce is a major independent contributor to life expectancy at birth (LEB) globally and regionally. DESIGN A cross-sectional study was conducted at population level. SAMPLE Ecological data were extracted from the United Nations agencies for 215 populations. Each population is considered a research subject. MEASUREMENTS The correlation between nursing workforce and LEB was analyzed with scatter plots, bivariate correlation, partial correlation, and multiple linear regression analyses, Analysis of Variance post hoc and independent T-test. Economic affluence, urban lifestyle and obesity were included as the potential confounders in this study. INTERVENTION Not applicable RESULTS: Nursing workforce correlated to LEB and this relationship remained regardless of the competition of economic affluence, urbanization, and obesity. Second to economic affluence, nursing workforce showed the greatest influence on LEB. In total, 64.50% of LEB was explained in this study. Nursing workforce was a determinant of regional variations of LEB. CONCLUSIONS Nursing workforce may be a significant contributor to LEB globally and regionally. This contribution was independent of the potential confounding effects of economic affluence, urbanization, and obesity.
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Affiliation(s)
- Wenpeng You
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia.,Acute and Urgent Care, Royal Adelaide Hospital, Adelaide, Australia.,Adelaide Medical School, the University of Adelaide, Adelaide, Australia
| | - Frank Donnelly
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia
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Mishra V, Sharma MG. Digital transformation evaluation of telehealth using convergence, maturity, and adoption. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Sodhi N, Weinstein RS, Stewart K, Doarn CR. Analysis of Telehealth Versus Telemedicine Terminology in the Telemedicine and e-Health Journal Between 2010 and 2020. Telemed J E Health 2022; 28:1861-1865. [PMID: 35417253 DOI: 10.1089/tmj.2022.0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction: The terms "telemedicine" and "telehealth" are similar, yet, carry different meanings and are often defined differently. Methods: A decadal longitudinal study analyzing the usage of these terms in the Telemedicine and e-Health Journal (TMJ) between 2010 and 2020 was conducted. Looking at the keywords assigned to the "Original Research" articles, "telemedicine" (34%) is used almost three times more than telehealth (12%). Although "other" keywords are assigned at a similar frequency as "telemedicine," a similar pattern is followed for the terms within the text. Results: "Telemedicine" and "other" terms are used the most (36%), while articles using both ("telemedicine" and "telehealth") (15%) or "telehealth" (14%) as terms throughout the article are less. This longitudinal study also analyzed the TMJs editorial board between 2010 and 2020. Most of the board is made up of physicians (MD or DO) (42) or PhDs (33), with 25 out the 75 having dual credentialing. Conclusions: Also, while there is international influence within the board (UK, India, France, Canada, etc.), most of the board is associated with an American organization (educational and/or corporate). Most of the board (34/75) has also been present between 10 and 11 years within the study period (a total of 11 years).
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Affiliation(s)
- Nandini Sodhi
- Arizona Telemedicine Program, University of Arizona, Tucson, Arizona, USA
| | - Ronald S Weinstein
- Arizona Telemedicine Program, University of Arizona, Tucson, Arizona, USA.,Department of Pathology, University of Arizona, Tucson, Arizona, USA
| | - Kristine Stewart
- Arizona Telemedicine Program, University of Arizona, Tucson, Arizona, USA
| | - Charles R Doarn
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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Maleka NH, Matli W. A review of telehealth during the COVID-19 emergency situation in the public health sector: challenges and opportunities. JOURNAL OF SCIENCE AND TECHNOLOGY POLICY MANAGEMENT 2022. [DOI: 10.1108/jstpm-08-2021-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to provide current state of knowledge on how the COVID-19 emergency situation necessitated the behaviour influencing use and acceptance of telehealth. This study interlinks the health belief model (HBM) and the unified theory of acceptance and use of technology (UTAUT) to highlight the challenges and opportunities as a result of the COVID-19 pandemic in the public health sector.
Design/methodology/approach
This study used three online databases (Emerald publishing, Science Direct and Taylor and Francis) that enabled the authors to access electronic journal articles. Search strategy was used to extract articles based on the relevance of this study.
Findings
The key findings from this study suggested that the COVID-19 emergency forced health-care workers and their patients to rapidly use and rely on telehealth to reduce the rate of COVID-19 transmissions. The key benefits of telehealth use highlighted an expansive cost effective and convenient access to health-care services irrespective of geographical local and levels of physical impairment. Moreover, telehealth inhibited in person human interaction, which was perceived as impersonal and not ideal for new patient consultations. The barriers outweighed the benefits; as a result, it is unlikely that there will be a wide use of telehealth beyond the COVID-19 emergency situation.
Practical implications
The research findings are limited to discussions drawn from available secondary data. The criteria within telehealth for policymakers to note the technology acceptance and use for both health-care and outpatient stakeholders and their health seeking behaviour. Health-care sectors (private and public) and government need to understand enablers of effective telehealth in policymaking to ease the barriers during an emergency situation like a pandemic.
Originality/value
This study contributes to the emerging literature on how COVID-19 pandemic has disrupted and accelerated telehealth by extending both the UTAUT and HBM theories. This study is expected to contribute and expand literature on telehealth during emergency situations, given the novice nature of COVID-19 and limited literature surrounding it.
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15
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Jackson LE, Edgil TA, Hill B, Owensby JK, Smith CH, Singh JA, Danila MI. Telemedicine in Rheumatology Care: A Systematic Review. Semin Arthritis Rheum 2022; 56:152045. [DOI: 10.1016/j.semarthrit.2022.152045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 12/14/2022]
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16
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Placing equity at the heart of eHealth implementation: a qualitative pilot study. Int J Equity Health 2022; 21:38. [PMID: 35303883 PMCID: PMC8931179 DOI: 10.1186/s12939-022-01640-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/25/2022] [Indexed: 12/24/2022] Open
Abstract
Background There is a growing urgency to tackle issues of equity and justice in the implementation of eHealth technologies. Methods Qualitative interviews were conducted with 19 multidisciplinary health professionals to explore the implementation and uptake of eHealth technologies in practice. The aim of this article was to examine in more detail issues of equity and justice in the implementation and uptake of eHealth technologies in practice. Results were analysed using Braun and Clarke’s six-step reflexive thematic analysis approach. Results Nancy Fraser’s concept of social justice is introduced as a novel framework for inquiry into the implementation of digital health services. Health professionals reported that eHealth offered their clients a greater sense of safety, convenience, and flexibility, allowing them to determine the nature and pace of their healthcare, and giving them more control over their treatment and recovery. However, they also expressed concerns about the use of eHealth with clients whose home environment is unsafe. Application of Fraser’s framework revealed that eHealth technologies may not always provide a secure clinical space in which the voices of vulnerable clients can be recognised and heard. It also highlighted critical systemic and cultural barriers that hinder the representation of clients’ voices in the decision to use eHealth technologies and perpetuate inequalities in the distribution of eHealth services. Conclusions To facilitate broad participation, eHealth tools need to be adaptable to the needs and circumstances of diverse groups. Future implementation science efforts must also be directed at identifying and addressing the underlying structures that hinder equitable recognition, representation, and distribution in the implementation of eHealth resources. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01640-5.
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deMayo R, Huang Y, Lin EJD, Lee JA, Heggland A, Im J, Grindle C, Chandawarkar A. Associations of Telehealth Care Delivery with Pediatric Health Care Provider Well-Being. Appl Clin Inform 2022; 13:230-241. [PMID: 35172372 PMCID: PMC8850009 DOI: 10.1055/s-0042-1742627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background
The rapid, large-scale deployment of new health technologies can introduce challenges to clinicians who are already under stress. The novel coronavirus disease 19 (COVID-19) pandemic transformed health care in the United States to include a telehealth model of care delivery. Clarifying paths through which telehealth technology use is associated with change in provider well-being and interest in sustaining virtual care delivery can inform planning and optimization efforts.
Objective
This study aimed to characterize provider-reported changes in well-being and daily work associated with the pandemic-accelerated expansion of telehealth and assess the relationship of provider perceptions of telehealth effectiveness, efficiency, and work–life balance with desire for future telehealth.
Methods
A cross-sectional survey study was conducted October through November 2020, 6 months after the outbreak of COVID-19 at three children's hospitals. Factor analysis and structural equation modeling (SEM) were used to examine telehealth factors associated with reported change in well-being and desire for future telehealth.
Results
A total of 947 nontrainee physicians, advanced practice providers, and psychologists were surveyed. Of them, 502 (53.0%) providers responded and 467 (49.3%) met inclusion criteria of telehealth use during the study period. Of these, 325 (69.6%) were female, 301 (65.6%) were physicians, and 220 (47.1%) were medical subspecialists. Providers were 4.77 times as likely (95% confidence interval [CI]: 3.29–7.06) to report improved versus worsened well-being associated with telehealth. Also, 95.5% of providers (95% CI: 93.2–97.2%) wish to continue performing telehealth postpandemic. Our model explains 66% of the variance in telehealth-attributed provider well-being and 59% of the variance for future telehealth preference and suggests telehealth resources significantly influence provider-perceived telehealth care effectiveness which in turn significantly influences provider well-being and desire to perform telehealth.
Conclusion
Telehealth has potential to promote provider well-being; telehealth-related changes in provider well-being are associated with both provider-perceived effectiveness of telemedicine for patients and adequacy of telehealth resources.
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Affiliation(s)
- Richelle deMayo
- Division of Clinical Informatics, Connecticut Children's Medical Center, Hartford, Connecticut, United States.,Division of Pain and Palliative Medicine, Connecticut Children's Medical Center, Hartford, Connecticut, United States.,Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, United States
| | - Yungui Huang
- Research Information Solutions and Innovation, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, United States
| | - En-Ju D Lin
- Research Information Solutions and Innovation, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, United States
| | - Jennifer A Lee
- Division of Clinical Informatics, Nationwide Children's Hospital, Columbus, Ohio, United States.,Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, United States.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States
| | - Andrew Heggland
- Division of Clinical Informatics, Connecticut Children's Medical Center, Hartford, Connecticut, United States.,Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, United States.,Division of Pediatric Emergency Medicine, Connecticut Children's Medical Center, Hartford, Connecticut, United States
| | - Jane Im
- Division of Clinical Informatics, Connecticut Children's Medical Center, Hartford, Connecticut, United States.,Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, United States.,Division of Pediatric Hospital Medicine, Connecticut Children's Medical Center, Hartford, Connecticut, United States
| | - Christopher Grindle
- Division of Clinical Informatics, Connecticut Children's Medical Center, Hartford, Connecticut, United States.,Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, United States.,Division of Otolaryngology, Connecticut Children's Medical Center, Hartford, Connecticut, United States
| | - Aarti Chandawarkar
- Division of Clinical Informatics, Nationwide Children's Hospital, Columbus, Ohio, United States.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States
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18
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Pooni R, Lee T. The Emerging Telehealth Landscape in Pediatric Rheumatology. Rheum Dis Clin North Am 2021; 48:259-270. [PMID: 34798951 DOI: 10.1016/j.rdc.2021.08.005] [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: 11/29/2022]
Abstract
This article provides an in-depth review of telemedicine and its use in pediatric rheumatology. Historical barriers to the use of telemedicine in pediatric chronic care are described, and recent policy changes that have supported the use of telemedicine are discussed. Future directions and suggestions for the evaluation of telemedicine in pediatric rheumatology care are provided with a special focus on clinical outcomes, its use in research, patient acceptability, and health equity.
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Affiliation(s)
- Rajdeep Pooni
- Division of Allergy, Immunology and Rheumatology, Department of Pediatric Rheumatology, Stanford Children's Health, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA 94304, USA.
| | - Tzielan Lee
- Division of Allergy, Immunology and Rheumatology, Department of Pediatric Rheumatology, Stanford Children's Health, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA 94304, USA
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19
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Grundstein MJ, Fisher C, Titmuss M, Cioppa-Mosca J. The Role of Virtual Physical Therapy in a Post-Pandemic World: Pearls, Pitfalls, Challenges, and Adaptations. Phys Ther 2021; 101:6294522. [PMID: 34106273 DOI: 10.1093/ptj/pzab145] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/07/2021] [Accepted: 05/15/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To keep patients healthy and safe during the pandemic, payers and the federal government temporarily relaxed restrictions, expanded the eligible provider list for providing telehealth services, and developed a reimbursement structure. Physical therapists were uniquely challenged during the pandemic, requiring a reassessment of techniques and strategies in order to best support patients. The purpose of this case report is to describe a musculoskeletal institution's experience with implementing telehealth physical therapy. METHODS Previous telehealth experience enabled the infrastructure of a wide-scale adoption across institutions to respond to the COVID-19 pandemic. However, to fill in training gaps for Hospital for Special Surgery (HSS) outpatient physical therapists, HSS Rehabilitation developed a robust education and implementation program. This training was influenced by clinician and patient surveys as well as the development of a published HSS Rehabilitation telehealth guide. Prior to performing telehealth physical therapist visits, clinicians were required to complete all training material to ensure comfortability and confidence. RESULTS The adoption of telehealth among clinicians was born out of necessaity; however, the speed with which HSS Rehabilitation pivoted was critical to avoid lapses in care. In a 4-week period after the New York City shelter in-place orders, 173 therapists were trained and performing virtual visits. HSS Rehabilitation determined telehealth physical therapy had quicker access to care, similar patient satisifaction, and increased geographical outreach compared with in-person care. CONCLUSION The transition to telehealth physical therapy included a multi-step process that provided clinician training, established protocols and guidelines, and obtained a better understanding of the patient experience. Telehealth physical therapy has shown early benefits such as improving patient access to care and better continuity of care for traveling patients. Even after the current public health emergency, there is a place for high-value telehealth physical therapy in caring for patients with musculoskeletal conditions.
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20
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Shouman S, Emara T, Saber HG, Allam MF. Awareness and attitude of healthcare workers towards Telehealth in Cairo, Egypt. Int J Clin Pract 2021; 75:e14128. [PMID: 33650177 DOI: 10.1111/ijcp.14128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/26/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Telehealth is delivering health care services remote from health-care facilities using telecommunications. Egypt is aiming for Universal Health Coverage; this increases the demand for telehealth in routine health services. OBJECTIVE To measure the awareness of telehealth health care workers of primary health care units and to evaluate the effect of an orientation programme on primary health care workers' awareness and acceptance of the application of telehealth. METHODOLOGY This was an intervention study amongst health care workers. A self-administrated valid questionnaire for health care workers was designed, the questionnaire consists of different domains of knowledge in addition to advantages, disadvantages, security and necessity perceptions. Each domain consists of Likert scale questions of 5 points. The questions were scored as the worst answer (1) and the best (5). A total of 109 questionnaires were filled by participants who spent at least 6 months in primary health care units. Then the health care workers attended an orientation programme and the questionnaire was re-filled once more. A total of 104 was recollected. Ethical issues were considered. RESULTS 50.5% of the health care workers were aware of telehealth; 66.7% of health care workers with master's degree were aware of telehealth in comparison to 31.8% amongst those with a diploma, 64.3% of physicians were aware of telehealth, while 29.6 of nurses were aware [Correction added on 08 April 2021 after first online publication: '9.6%' has been amended to '29.6%' in the preceding sentence]. The score of knowledge and attitude increased from 130 ± 23.538 to 156.49 ± 18.456 after the educational programme. CONCLUSION Half of the health care workers were aware of telehealth; the orientation improved the Healthcare Workers' knowledge and attitude.
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Affiliation(s)
- Sara Shouman
- Faculty of Medicine, Family Medicine, Ain Shams University, Cairo, Egypt
| | - Tamer Emara
- Faculty of Medicine, Neurology, Ain Shams University, Cairo, Egypt
| | - Heba Gamal Saber
- Faculty of Medicine, Geriatrics and Gerontology, Ain Shams University, Cairo, Egypt
| | - Mohamed Farouk Allam
- Faculty of Medicine, Family Medicine, Ain Shams University, Cairo, Egypt
- Preventive Medicine and Public Health, Universidad de Cordoba, Cordoba, Spain
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21
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Chen PV, Helm A, Fletcher T, Wassef M, Hogan J, Amspoker A, Cloitre M, Lindsay J. Seeing the Value of Video: A Qualitative Study on Patient Preference for Using Video in a Veteran Affairs Telemental Health Program Evaluation. TELEMEDICINE REPORTS 2021; 2:156-162. [PMID: 35720740 PMCID: PMC8812285 DOI: 10.1089/tmr.2021.0005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 05/30/2023]
Abstract
Background: As the use of telemental health-mental health care delivered through video or phone-has increased in the era of COVID, it is important to understand patients' preferences and perspectives regarding the use of video for telehealth visits. A new web-based treatment program for veterans uses video visits with mental health experts to supplement its online cognitive behavioral therapy to treat clinically significant symptoms of depression and/or post-traumatic stress disorder. Objective: As part of the program evaluation, Veterans were asked, "How important was it for you to be able to physically see your provider through video telehealth?" to understand whether they thought using video was important and why it may or may not be important. Materials and Methods: The study uses data from the program's exit survey and exit interview. The surveys and interviews were conducted over a 19-month period. Surveys and interviews were conducted over the phone with note taking. Matrix and content analyses were used to analyze the qualitative data-predetermined themes and emergent themes were analyzed and inform findings. Results: Seventy-three veterans completed a survey. Of these, 64 completed an interview. The majority of veterans surveyed (75%) said that it was "very important" to physically see their provider through video telehealth, 23% said that it was at least "somewhat important" or "not at all important." This study highlights three main themes found in the qualitative data: patients discuss (1) advantages of using video, (2) why they dislike video, and (3) technological barriers to using video. Conclusions: Being able to visually see a provider, and be seen by a provider, has distinct benefits for care and relationship building that are difficult to achieve over the phone. This has important implications for the future delivery of telemental health care and deserves consideration as patients and providers decide whether to use phone or video for remotely delivered care.
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Affiliation(s)
- Patricia V. Chen
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
- Margaret M. and Albert B Alkek Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Ashley Helm
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
- VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas, USA
| | - Terri Fletcher
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
- VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Miryam Wassef
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
- VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas, USA
| | - Julianna Hogan
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
- VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Amy Amspoker
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
- Margaret M. and Albert B Alkek Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas, USA
| | | | - Jan Lindsay
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
- VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
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22
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Gonzalez JN, Axiotakis LG, Yu VX, Gudis DA, Overdevest JB. Practice of Telehealth in Otolaryngology: A Scoping Review in the Era of COVID-19. Otolaryngol Head Neck Surg 2021; 166:417-424. [PMID: 34003046 DOI: 10.1177/01945998211013751] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has spurred widespread adoption and advancement in telehealth activities, representing a marked change in otolaryngology practice patterns. The present study undertakes a scoping review of research focused on telehealth in otolaryngology (teleotolaryngology) to identify key themes and commonly utilized outcome measures that will assist future development in this growing field. DATA SOURCES PubMed, Embase, and Cochrane databases and reference review. REVIEW METHODS Per guidelines of the PRISMA Extension for Scoping Reviews, we performed database queries using a comprehensive search strategy developed in collaboration with research librarians at the Columbia University Irving Medical Center. We identified 596 unique references to undergo title and abstract review by 2 independent reviewers, leaving 439 studies for full-text review. RESULTS We included 285 studies for extraction of notable findings, leaving 262 unique studies after accounting for content overlap. We identified core outcome measures, including patient and provider satisfaction, costs and benefits, quality of care, feasibility, and access to care. Publication volume increased markedly over time, though only 4% of studies incorporated randomized study group assignment. Using an iterative approach to thematic development, we organized article content across 5 main themes: (1) exploration of teleotolaryngology evolution, (2) role in virtual clinical encounters, (3) applications in interdisciplinary care and educational initiatives, (4) emerging and innovative technologies, and (5) barriers to implementation. CONCLUSION This scoping review of teleotolaryngology documents its evolution and identifies current use cases, limitations, and emerging applications, providing a foundation from which to build future studies, inform policy decision making, and facilitate implementation where appropriate.
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Affiliation(s)
- Joseph N Gonzalez
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Lucas G Axiotakis
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Victoria X Yu
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA
| | - David A Gudis
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Jonathan B Overdevest
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA
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23
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Cross S, Kurmas N, Byrne C, Julius M, Burant C, Utech A, Aoun A. Diabetes Self-Management Education Support Healthy Teaching Kitchen Cooking Classes Delivered Using a Telehealth Technology. Sci Diabetes Self Manag Care 2021; 47:199-206. [PMID: 34000912 DOI: 10.1177/26350106211004887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the study was to evaluate the effectiveness of diabetes self-management education and support (DSMES) among veterans with diabetes using the Healthy Teaching Kitchen (HTK) by means of telehealth communication. METHODS A retrospective chart review collected data from veterans with type 2 diabetes (T2DM) that participated in the DSMES-HTK program at 2 Veterans Affairs Northeast Ohio Healthcare System facilities between February 2013 and December 2018. A factorial design was used to compare A1C data and use of clinical video telehealth from main hub to satellite site. Statistical analyses were performed using SPSS (Version 25). Repeated measures analysis of variance (RMANOVA) were performed to compare mean A1C in veterans that attended HTK at the main site versus a telehealth site. RMANOVA was also used to compare mean A1C in veterans that attended at least 1 hands-on class versus those that attended at least 1 demonstration class. RESULTS A1C values of all groups improved over time and were sustained regardless of DSMES-HTK delivery method or location. CONCLUSIONS Sustained improvement in A1C was observed in patients that participated in both DSMES-HTK in person and via clinical video telehealth classes conducted by hub site facilitator with RDN, CDCES credential. The use of a clinical video telehealth strategy for DSMES-HTK capitalizes on limited, highly skilled, credentialed instructional team members.
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Affiliation(s)
- Samantha Cross
- VA Northeast Ohio Healthcare System, Cleveland, Ohio.,Orangetheory Fitness, Lakewood, Ohio
| | - Neal Kurmas
- VA Northeast Ohio Healthcare System, Cleveland, Ohio
| | - Cally Byrne
- VA Northeast Ohio Healthcare System, Cleveland, Ohio
| | - Mary Julius
- VA Northeast Ohio Healthcare System, Cleveland, Ohio
| | - Christopher Burant
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
| | - Anne Utech
- Department of Veterans Affairs, Central Office, Washington, DC.,Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Arianna Aoun
- VA Northeast Ohio Healthcare System, Cleveland, Ohio
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24
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Diegel-Vacek L, Cotler K, Reising V, Corbridge SJ. Transition of Nurse Practitioner Faculty Practice and Student Clinicals to Telehealth: Response to the COVID-19 Pandemic. J Nurse Pract 2021; 17:317-321. [PMID: 33746647 PMCID: PMC7954268 DOI: 10.1016/j.nurpra.2020.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic forced the US health care system to evaluate alternative care delivery strategies to reduce the risk of coronavirus transmission to patients and health care providers. Telehealth modalities are a safe and effective alternative to face-to-face visits for primary and psychiatric care. Federal policy makers approved changes to telehealth reimbursement coverage and allowed flexibility of location for patients and providers. This article describes the transition of patient visits to telehealth by nurse practitioner faculty at an academic medical center to maintain continuity of care of underserved patient populations. This pivot facilitated resumption of clinical learning experiences for nurse practitioner students.
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25
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Bhatia R. Telehealth and COVID-19: Using technology to accelerate the curve on access and quality healthcare for citizens in India. TECHNOLOGY IN SOCIETY 2021; 64:101465. [PMID: 33814651 PMCID: PMC8008321 DOI: 10.1016/j.techsoc.2020.101465] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/01/2020] [Accepted: 11/25/2020] [Indexed: 05/06/2023]
Abstract
The current COVID-19 pandemic has reinstated the importance of telehealth as a business model for accelerating the accessibility of healthcare and improving the quality of healthcare for citizens of a country. Telehealth service has a tremendous potential in a developing country like India where the healthcare facilities in India are heavily concentrated in urban cities while their majority (67%) of the population resides in rural areas. At the same time, a high teledensity of almost 90% supports telehealth overall reach. However, the growth of telehealth in India till now has been sluggish but the corona virus (COVID-19) crisis has redefined the telehealth ecosystem by reducing the risk of infection through person-to-person contact. In this study, we explore the perception of healthcare users towards telehealth services and analyze the key enablers for the telehealth services in the current scenario. We collected data from 1170 participants through personal interview. The results of the study shows a considerable segment of the population is having high healthcare need, have aspirations for accessing better healthcare for themselves and their family members and use ICT to a significant extent. At the same time, they have positive attitude towards telehealth and socio-demographic factors like age, geographical location, educational qualification, family size affects the attitude towards telehealth services. The results of the study shows there is a significant market for telehealth services in India to be explored by the technology firms, hospitals and other healthcare stakeholders and going forward it has an enormous capability to transform the complete healthcare ecosystem, especially in developing countries like India post the COVID-19 crisis.
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Affiliation(s)
- Ridhi Bhatia
- Faculty of Management Studies, Manav Rachna International Institute of Research and Studies, India
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26
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DeGuzman PB, Jain N, Loureiro CG. Public Libraries as Partners in Telemedicine Delivery: A Review and Research Agenda. PUBLIC LIBRARY QUARTERLY 2021. [DOI: 10.1080/01616846.2021.1877080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Pamela B. DeGuzman
- Associate Professor, University of Virginia School of Nursing, Charlottesville, Virginia, USA
| | - Neha Jain
- Undergraduate Student, University of Virginia School of Nursing, Charlottesville, Virginia, USA
| | - Christine G. Loureiro
- Graduate Student, University of Virginia School of Nursing, Charlottesville, Virginia, USA
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27
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Almojaibel AA, Munk N, Goodfellow LT, Fisher TF, Miller KK, Comer AR, Bakas T, Justiss MD. Health Care Practitioners' Determinants of Telerehabilitation Acceptance. Int J Telerehabil 2020; 12:43-50. [PMID: 32983367 PMCID: PMC7502808 DOI: 10.5195/ijt.2020.6308] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Pulmonary rehabilitation is a multidisciplinary patient-tailored intervention that aims to improve the physical and psychological condition of people with chronic respiratory diseases. Providing pulmonary rehabilitation (PR) services to the growing population of patients is challenging due to shortages in health care practitioners and pulmonary rehabilitation programs. Telerehabilitation has the potential to address this shortage in practitioners and PR programs as well as improve patients' participation and adherence. This study's purpose was to identify and evaluate the influences of intention of health care practitioners to use telerehabilitation. Methods: Data were collected through a self-administered Internet-based survey. Results: Surveys were completed by 222 health care practitioners working in pulmonary rehabilitation with 79% having a positive intention to use telerehabilitation. Specifically, perceived usefulness was a significant individual predictor of positive intentions to use telerehabilitation. Conclusion: Perceived usefulness may be an important factor associated with health care providers' intent to use telerehabilitation for pulmonary rehabilitation.
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Affiliation(s)
| | - Niki Munk
- School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Lynda T Goodfellow
- Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | - Thomas F Fisher
- Dwyer College of Health Sciences, Iu South Bend, Indiana, USA
| | - Kristine K Miller
- School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Amber R Comer
- School of Health and Human Sciences, Indiana University, Indianapolis, IN, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Michael D Justiss
- School of Applied Health Sciences, Brooks Rehabilitation College of Healthcare Sciences Jacksonville University, Jacksonville, FL, USA
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Boström E, Ali L, Fors A, Ekman I, Andersson AE. Registered nurses' experiences of communication with patients when practising person-centred care over the phone: a qualitative interview study. BMC Nurs 2020; 19:54. [PMID: 32577097 PMCID: PMC7304080 DOI: 10.1186/s12912-020-00448-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/12/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To explore registered nurses' (RNs') experiences of practising person-centred care (PCC) by telephone with people diagnosed with chronic obstructive pulmonary disease and/or chronic heart failure. METHODS Qualitative interview study. Four RNs were individually interviewed before, during, and after participating in an intervention practising PCC by telephone. The interviews were analysed using qualitative content analysis. RESULTS The results reflect three categories of their experience: realize the complexity of practising PCC by distance, gain insight into what PCC communication meant to RNs and their approach, and develop the professional role by practising PCC theory and ethics. CONCLUSIONS PCC over the telephone facilitate healthcare and support patients. Through careful listening, the RNs (1) created space for the individual patients to express their thoughts and feelings and (2) emphasized each patient's capabilities and resources. The RNs also gained an understanding of PCC and what it means to patients and to themselves as practitioners. Potential implications are that it is important for RNs practising PCC by telephone to remould their role, to listen carefully, and to communicate as equals in conversations that respect both parties' knowledge and expertise. Health professionals need supervision and support to fully understand the person-centred approach and provide communications that support it.
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Affiliation(s)
- Eva Boström
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30 Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30 Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Närhälsan Research and Development Primary Health Care, Region Västra, Götaland, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30 Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Annette Erichsen Andersson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30 Gothenburg, Sweden
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Sikka N, Gross H, Joshi AU, Shaheen E, Baker MJ, Ash A, Hollander JE, Cheung DS, Chiu AR, Wessel CB, Robinson M, Lowry G, Guyette FX. Defining emergency telehealth. J Telemed Telecare 2019; 27:527-530. [PMID: 31825766 DOI: 10.1177/1357633x19891653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The American College of Emergency Physicians Emergency Telehealth Section was charged with development of a working definition of emergency telehealth that aligns with the College's definition of emergency medicine. A modified Delphi method was used by the section membership who represented telehealth providers in both private and public health-care delivery systems, academia and industry, rural and urban settings. Presented in this manuscript is the final definition of emergency telehealth developed with an additional six clarifying statements to address the context of the definition. Emergency telehealth is a core domain of emergency medicine and is inclusive of remotely providing all types of care for acute conditions of any kind requiring expeditious care irrespective of any prior relationship. The development of this definition is important to the global community of emergency physicians and all patients seeking acute care to ensure that appropriately trained clinicians are providing the highest quality of emergency services via the telehealth modality. We recommend implementing emergency telehealth in a manner that ensures appropriate qualifications of providers, appropriate/parity reimbursement for telehealth services and, most importantly, the delivery of quality care to patients in a safe, efficient, timely and cost-effective manner.
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Affiliation(s)
- Neal Sikka
- Department of Emergency Medicine, The George Washington University, USA
| | - Hartmut Gross
- Medical College of Georgia at Augusta University, USA
| | - Aditi U Joshi
- Department of Emergency Medicine, Thomas Jefferson University Hospital, USA
| | - Edward Shaheen
- Shaheen Consulting, a division of On Call Specialists, Inc., USA
| | | | - Adam Ash
- Progressive Emergency Physicians, USA
| | | | | | - Alexander R Chiu
- Faculty, Health + Hospitals/Coney Island Hospital, USA.,State University of New York Downstate College of Medicine, USA.,mHealth Technology and Distance Learning SIG, American Telemedicine Association, USA
| | | | | | - Gregory Lowry
- Department of Emergency Medicine, University of Pittsburgh
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HIV telehealth: framing the dialog and debate for reaching community consensus. HEALTH AND TECHNOLOGY 2019. [DOI: 10.1007/s12553-019-00310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Alverson DC, Krupinski EA, Erps KA, Rowe NS, Weinstein RS. The Third National Telemedicine & Telehealth Service Provider Showcase Conference: Advancing Telehealth Partnerships. Telemed J E Health 2018; 25:332-340. [PMID: 29851367 PMCID: PMC6482893 DOI: 10.1089/tmj.2018.0096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Introduction:As telemedicine and telehealth services are experiencing increasing rates of adoption, industry leaders and healthcare service providers are becoming increasingly focused on human resource issues encountered in the delivery of a broad range of telehealth services. To create a forum for the discussion of many interrelated elements of telehealth service industry, a national conference entitled “Telemedicine & Telehealth Service Provider Showcase” (SPS) Conference was established in 2014, and repeated in 2016 and 2017, in Arizona. These SPS Conferences include thought leaders, telehealth service providers, government administrators, and academicians from leading programs addressing service provider workforce issues. Methods:This report summarizes the content of SPS 2017 conference, held in Phoenix, AZ, October 2–3, 2017. The topics covered at SPS 2017 include using telehealth services as a strategic asset; development of appropriate effective partnerships; direct-to-consumer initiatives; important reimbursement, legislative, and regulatory issues (i.e., Centers for Medicare & Medicaid Services [CMS] approaches, financial models, and return on investment [ROI]); marketing; evaluation and applied metrics; remote monitoring and sensors; integration with electronic health records; and overall lessons learned. Results:The content of SPS 2017 is summarized in the body of this report. The SPS 2017 program evaluators included attendees, speakers, and exhibitors. The knowledge attendees gained at SPS 2017 was characterized, by all three groups, as forward-looking and practical. Conclusion:SPS 2017 succeeded in identifying, and focusing on, solutions for issues, challenges, and barriers impacting the rapidly expanding telehealth service segment of the healthcare industry. The growing interest in this annual SPS Conference series apparently reflects, in part, the program committee's successes in identifying practical issues and their potential solutions.
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Affiliation(s)
| | - Elizabeth A Krupinski
- 2 Emory University , Atlanta, Georgia .,3 Arizona Telemedicine Program, The University of Arizona , Tucson, Arizona
| | - Kristine A Erps
- 3 Arizona Telemedicine Program, The University of Arizona , Tucson, Arizona
| | - Nancy S Rowe
- 3 Arizona Telemedicine Program, The University of Arizona , Tucson, Arizona
| | - Ronald S Weinstein
- 3 Arizona Telemedicine Program, The University of Arizona , Tucson, Arizona.,4 Department of Pathology, The University of Arizona , Tucson, Arizona
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Bashir A, Bastola DR. Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study. JMIR Med Inform 2018; 6:e35. [PMID: 29802089 PMCID: PMC5993972 DOI: 10.2196/medinform.9080] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 03/18/2018] [Accepted: 04/05/2018] [Indexed: 11/27/2022] Open
Abstract
Background Telehealth nursing, or the delivery, management, and coordination of nursing care services provided via telecommunications technology, is one of the methods of delivering health care to patients in the United States. It is important to assess the service quality of the involved health professionals as well as the telehealth nursing process. The focus of this study is the innovative model of telehealth care delivery by nurses for managing patients with chronic disease while they are living in their own residence. Objective The primary objective of this pilot study was to examine whether telehealth technology impacts the perceived level of internal service quality delivered by nurses within a telehealth organization. To address this research goal, the notion of telehealth nursing service quality (TNSQ) is empirically tested and validated with a survey instrument. Methods Data were collected from nurses belonging to a home care agency based on interview questions inquiring about facilitators and inhibitors to TNSQ. A survey to measure TNSQ based on the SERVQUAL instrument was completed by adjusting descriptions of the original instrument to suit the context. Follow-up interviews were conducted to validate questions on the revised instrument. Results The findings of this survey research were positive, based on mean differences between expectations and perceptions of TNSQ. This indicates satisfaction with TNSQ and shows that the quality of the service is higher than what the respondents expect. The Wilcoxon signed-rank test using the P value for the test, which is .35, did not show a statistically significant change between the median differences of perception and expectation. The total number of respondents was 13. Results indicate that overall perceived service quality is a positive value (0.05332). This means the perceptions of the level of service are slightly higher than what they expect, indicating there is satisfaction with TNSQ. Conclusions The responses to the interview questions and data gathered from the survey showed overall satisfaction with TNSQ. The SERVQUAL instrument was a good framework to assess TNSQ. In a nutshell, the study highlighted how the telehealth process provides daily monitoring of patient health, leading to the benefits of immediate feedback for patients, family, and caregivers as well as convenience of scheduling.
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Affiliation(s)
- Ayisha Bashir
- Department of Clinical and Translational Science, Creighton University, Omaha, NE, United States
| | - Dhundy R Bastola
- School of Interdisciplinary Informatics, Information Science and Technology, University of Nebraska, Omaha, NE, United States
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Warner MM, Kelly JT, Reidlinger DP, Hoffmann TC, Campbell KL. Reporting of Telehealth-Delivered Dietary Intervention Trials in Chronic Disease: Systematic Review. J Med Internet Res 2017; 19:e410. [PMID: 29229588 PMCID: PMC5742660 DOI: 10.2196/jmir.8193] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/26/2017] [Accepted: 11/04/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Telehealth-delivered dietary interventions are effective for chronic disease management and are an emerging area of clinical practice. However, to apply interventions from the research setting in clinical practice, health professionals need details of each intervention component. OBJECTIVE The aim of this study was to evaluate the completeness of intervention reporting in published dietary chronic disease management trials that used telehealth delivery methods. METHODS Eligible randomized controlled trial publications were identified through a systematic review. The completeness of reporting of experimental and comparison interventions was assessed by two independent assessors using the Template for Intervention Description and Replication (TIDieR) checklist that consists of 12 items including intervention rationale, materials used, procedures, providers, delivery mode, location, when and how much intervention delivered, intervention tailoring, intervention modifications, and fidelity. Where reporting was incomplete, further information was sought from additional published material and through email correspondence with trial authors. RESULTS Within the 37 eligible trials, there were 49 experimental interventions and 37 comparison interventions. One trial reported every TIDieR item for their experimental intervention. No publications reported every item for the comparison intervention. For the experimental interventions, the most commonly reported items were location (96%), mode of delivery (98%), and rationale for the essential intervention elements (96%). Least reported items for experimental interventions were modifications (2%) and intervention material descriptions (39%) and where to access them (20%). Of the 37 authors, 14 responded with further information, and 8 could not be contacted. CONCLUSIONS Many details of the experimental and comparison interventions in telehealth-delivered dietary chronic disease management trials are incompletely reported. This prevents accurate interpretation of trial results and implementation of effective interventions in clinical practice.
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Affiliation(s)
- Molly M Warner
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Jaimon T Kelly
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | | | - Tammy C Hoffmann
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Katrina L Campbell
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
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Shaw J, Jamieson T, Agarwal P, Griffin B, Wong I, Bhatia RS. Virtual care policy recommendations for patient-centred primary care: findings of a consensus policy dialogue using a nominal group technique. J Telemed Telecare 2017; 24:608-615. [PMID: 28945161 DOI: 10.1177/1357633x17730444] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The development of new virtual care technologies (including telehealth and telemedicine) is growing rapidly, leading to a number of challenges related to health policy and planning for health systems around the world. Methods We brought together a diverse group of health system stakeholders, including patient representatives, to engage in policy dialogue to set health system priorities for the application of virtual care in the primary care sector in the Province of Ontario, Canada. We applied a nominal group technique (NGT) process to determine key priorities, and synthesized these priorities with group discussion to develop recommendations for virtual care policy. Methods included a structured priority ranking process, open-ended note-taking, and thematic analysis to identify priorities. Results Recommendations were summarized under the following themes: (a) identify clear health system leadership to embed virtual care strategies into all aspects of primary and community care; (b) make patients the focal point of health system decision-making; (c) leverage incentives to achieve meaningful health system improvements; and (d) building virtual care into streamlined workflows. Two key implications of our policy dialogue are especially relevant for an international audience. First, shifting the dialogue away from technology toward more meaningful patient engagement will enable policy planning for applications of technology that better meet patients' needs. Second, a strong conceptual framework on guiding the meaningful use of technology in health care settings is essential for intelligent planning of virtual care policy. Conclusions Policy planning for virtual care needs to shift toward a stronger focus on patient engagement to understand patients' needs.
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Affiliation(s)
- James Shaw
- 1 Scientist Institute for Health System Solutions and Virtual Care Women's College Hospital, Toronto, ON, Canada
| | - Trevor Jamieson
- 2 Institute for Health System Solutions and Virtual Care Women's College Hospital Toronto, ON, Canada
| | - Payal Agarwal
- 2 Institute for Health System Solutions and Virtual Care Women's College Hospital Toronto, ON, Canada
| | - Bailey Griffin
- 2 Institute for Health System Solutions and Virtual Care Women's College Hospital Toronto, ON, Canada
| | - Ivy Wong
- 2 Institute for Health System Solutions and Virtual Care Women's College Hospital Toronto, ON, Canada
| | - R Sacha Bhatia
- 2 Institute for Health System Solutions and Virtual Care Women's College Hospital Toronto, ON, Canada
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Satou GM, Rheuban K, Alverson D, Lewin M, Mahnke C, Marcin J, Martin GR, Mazur LS, Sahn DJ, Shah S, Tuckson R, Webb CL, Sable CA. Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association. Circulation 2017; 135:e648-e678. [PMID: 28193604 DOI: 10.1161/cir.0000000000000478] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Cameron JD, Ramaprasad A, Syn T. An ontology of and roadmap for mHealth research. Int J Med Inform 2017; 100:16-25. [PMID: 28241934 DOI: 10.1016/j.ijmedinf.2017.01.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 12/05/2016] [Accepted: 01/07/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE Mobile health or mHealth research has been growing exponentially in recent years. However, the research on mHealth has been ad-hoc and selective without a clear definition of the mHealth domain. Without a roadmap for research we may not realize the full potential of mHealth. In this paper, we present an ontological framework to define the mHealth domain and illuminate a roadmap. METHODS We present an ontology of mHealth. The ontology is developed by systematically deconstructing the domain into its primary dimensions and elements. We map the extent research on mHealth in 2014 onto the ontology and highlight the bright, light, and blind/blank spots which represent the emphasis of mHealth research. FINDINGS The emphases of mHealth research in 2014 are very uneven. There are a few bright spots and many light spots. The research predominantly focuses on individuals' use of mobile devices and applications to capture or obtain health-related data mostly to improve quality of care through mobile intervention. CONCLUSIONS We argue that the emphases can be balanced in the roadmap for mHealth research. The ontological mapping plays an integral role in developing and maintaining the roadmap which can be updated periodically to continuously assess and guide mHealth research.
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Affiliation(s)
- Joshua D Cameron
- Miller School of Medicine, University of Miami, 1600 NW 10th Avenue #1140, Miami, FL, USA.
| | - Arkalgud Ramaprasad
- Department of Information and Decision Sciences, University of Illinois at Chicago, 601 S Morgan Street (MC 294), Chicago, IL, USA.
| | - Thant Syn
- Division of International Business and Technology Studies, Texas A&M International University, 5201 University Boulevard, Laredo, TX, USA.
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Kalankesh LR, Pourasghar F, Nicholson L, Ahmadi S, Hosseini M. Effect of Telehealth Interventions on Hospitalization Indicators: A Systematic Review. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2016; 13:1h. [PMID: 27843425 PMCID: PMC5075236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Telehealth has been defined as the remote delivery of healthcare services using information and communication technology. Where resource-limited health systems face challenges caused by the increasing burden of chronic diseases and an aging global population, telehealth has been advocated as a solution for changing and improving the paradigm of healthcare delivery to cope with these issues. The aim of this systematic review is to investigate the effect of telehealth interventions on two indicators: hospitalization rate and length of stay. MATERIALS AND METHODS The reviewers searched the PubMed, ScienceDirect, and Springer electronic databases from January 2005 to November 2013. A search strategy was developed using a combination of the following search keywords: impact, effect, telehealth, telemedicine, telecare, hospitalization, length of stay, and resource utilization. Both randomized controlled trials and observational studies were included in the review. To be included in the review, articles had to be written in English. The results of study were compiled, reviewed, and analyzed on the basis of the review aims. RESULTS This systematic review examined 22 existing studies with a total population of 19,086 patients. The effect of telehealth on all-cause hospitalization was statistically significant in 40 percent of the related studies, whereas it was not statistically significant in 60 percent. Similarly, the effect of telehealth on the all-cause length of stay was statistically significant in 36 percent of the studies and nonsignificant in 64 percent. CONCLUSION Considering the fact that hospitalization rate and length of stay can be confounded by factors other than telehealth intervention, studies examining the effect of the intervention on these indicators must take into account all other factors influencing them. Otherwise any judgment on the effect of telehealth on these indicators cannot be valid.
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Affiliation(s)
- Leila R Kalankesh
- Medical informatics and health information technology in School of Management and Medical Informatics and researcher at Tabriz Health Services Management Research Center in Tabriz, Iran
| | - Faramarz Pourasghar
- Medical informatics in School of Management and Medical Informatics at the Tabriz University of Medical Sciences in Tabriz, Iran
| | - Lorraine Nicholson
- IFHIMA (2007-2010), Independent HIM Consultant, Rochdale OL11 2XE, Lancashire, UK
| | - Shamim Ahmadi
- Health information technology at Iran University of Medical Sciences in Tehran, Iran
| | - Mohsen Hosseini
- Health information technology at the School of Management and Medical Informatics at Tabriz University of Medical Sciences in Tabriz, Iran
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Haluza D, Naszay M, Stockinger A, Jungwirth D. Prevailing Opinions on Connected Health in Austria: Results from an Online Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080813. [PMID: 27529261 PMCID: PMC4997499 DOI: 10.3390/ijerph13080813] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/01/2016] [Accepted: 08/05/2016] [Indexed: 12/22/2022]
Abstract
New technological developments affect almost every sector of our daily lives, including the healthcare sector. We evaluated how connected health applications, subsumed as eHealth and telemedicine, are perceived in relation to socio-demographic characteristics. The current cross-sectional, online survey collected self-reported data from a non-probability convenience sample of 562 Austrian adults (58.9% females). The concept of eHealth and telemedicine was poorly established among the study population. While most participants already used mobile devices, they expressed a quite low desirability of using various telemedicine applications in the future. Study participants perceived that the most important overall benefits for implementing connected health technology were better quality of healthcare, location-independent access to healthcare services, and better quality of life. The respective three top-ranked overall barriers were data security, lack of acceptance by doctors, and lack of technical prerequisites. With regard to aging societies, healthcare providers, and users alike could take advantage of inexpensive, consumer-oriented connected health solutions that address individual needs of specific target groups. The present survey identified issues relevant for successful implementation of ICT-based healthcare solutions, providing a compilation of several areas requiring further in-depth research.
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Affiliation(s)
- Daniela Haluza
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria.
| | - Marlene Naszay
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria.
| | - Andreas Stockinger
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria.
| | - David Jungwirth
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria.
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Davis TL, DiClemente R, Prietula M. Taking mHealth Forward: Examining the Core Characteristics. JMIR Mhealth Uhealth 2016; 4:e97. [PMID: 27511612 PMCID: PMC4997001 DOI: 10.2196/mhealth.5659] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 07/02/2016] [Accepted: 07/20/2016] [Indexed: 01/21/2023] Open
Abstract
The emergence of mobile health (mHealth) offers unique and varied opportunities to address some of the most difficult problems of health. Some of the most promising and active efforts of mHealth involve the engagement of mobile phone technology. As this technology has spread and as this technology is still evolving, we begin a conversation about the core characteristics of mHealth relevant to any mobile phone platform. We assert that the relevance of these characteristics to mHealth will endure as the technology advances, so an understanding of these characteristics is essential to the design, implementation, and adoption of mHealth-based solutions. The core characteristics we discuss are (1) the penetration or adoption into populations, (2) the availability and form of apps, (3) the availability and form of wireless broadband access to the Internet, and (4) the tethering of the device to individuals. These collectively act to both enable and constrain the provision of population health in general, as well as personalized and precision individual health in particular.
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Rojahn K, Laplante S, Sloand J, Main C, Ibrahim A, Wild J, Sturt N, Areteou T, Johnson KI. Remote Monitoring of Chronic Diseases: A Landscape Assessment of Policies in Four European Countries. PLoS One 2016; 11:e0155738. [PMID: 27195764 PMCID: PMC4873167 DOI: 10.1371/journal.pone.0155738] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/03/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Remote monitoring (RM) is defined as the surveillance of device-transmitted outpatient data. RM is expected to enable better management of chronic diseases. The objective of this research was to identify public policies concerning RM in four European countries. METHODS Searches of the medical literature, the Internet, and Ministry of Health websites for the United Kingdom (UK), Germany, Italy, and Spain were performed in order to identify RM policies for chronic diseases, including end stage renal disease (ESRD), chronic pulmonary obstructive disease (COPD), diabetes, heart failure, and hypertension. Searches were first performed in Q1 2014 and updated in Q4 2015. In addition, in depth interviews were conducted with payers/policymakers in each country. Information was obtained on existing policies, disease areas and RM services covered and level of reimbursement, other incentives such as quality indicators, past/current assessments of RM technologies, diseases perceived to benefit most from RM, and concerns about RM. RESULTS Policies on RM and/or telemedicine were identified in all four countries. Pilot projects (mostly in diabetes, COPD, and/or heart failure) existed or were planned in most countries. Perceived value of RM was moderate to high, with the highest rating given for heart failure. Interviewees expressed concerns about sharing of medical information, and the need for capital investment. Patients recently discharged from hospital, and patients living remotely, or with serious and/or complicated diseases, were believed to be the most likely to benefit from RM. Formal reimbursement is scarce, but more commonly available for patients with heart failure. CONCLUSIONS In the four European countries surveyed, RM has attracted considerable interest for its potential to increase the efficiency of healthcare for chronic diseases. Although rare at this moment, incentives to use RM technology are likely to increase in the near future as the body of evidence of clinical and/or economic benefit grows.
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Affiliation(s)
- Katherine Rojahn
- Baxter Healthcare Corporation, Deerfield, IL, United States of America
- * E-mail:
| | - Suzanne Laplante
- Baxter Healthcare Corporation, Deerfield, IL, United States of America
| | - James Sloand
- Baxter Healthcare Corporation, Deerfield, IL, United States of America
| | - Claire Main
- Baxter Healthcare Ltd, Compton, United Kingdom
| | | | - Janet Wild
- Baxter Healthcare Ltd, Compton, United Kingdom
| | - Nicky Sturt
- Baxter Healthcare Ltd, Compton, United Kingdom
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Heckemann B, Wolf A, Ali L, Sonntag SM, Ekman I. Discovering untapped relationship potential with patients in telehealth: a qualitative interview study. BMJ Open 2016; 6:e009750. [PMID: 26936904 PMCID: PMC4785285 DOI: 10.1136/bmjopen-2015-009750] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/23/2015] [Accepted: 12/31/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To explore factors that influence relationship building between telehealth professionals and patients with chronic illness over a distance, from a telehealth professional's perspective. DESIGN 4 focus group interviews were conducted in June 2014. Digital recordings were transcribed verbatim and qualitative content analysis was performed using an iterative process of 3 coding rounds. PARTICIPANTS 20 telehealth professionals. SETTING A telehealth service centre in the south of Germany that provided care for 12,000 patients with chronic heart failure across Germany. RESULTS Non-video telehealth technology creates an atmosphere that fosters sharing of personal information and a non-judgemental attitude. This facilitates the delivery of fair and equal healthcare. A combination of a protocol-driven service structure along with shared team and organisational values provide a basis for establishing long-term healthcare relationships. However, each contact between a telehealth professional and a patient has an uncertain outcome and requires skillful negotiation of the relationship. Although care provision was personalised, there was scope to include the patients as 'experts on their own illness' to a greater extent as advocated by person-centred care. Currently, provision of person-centred care is not sufficiently addressed in telehealth professional training. CONCLUSIONS Telehealth offers a viable environment for the delivery of person-centred care for patients with long-standing disease. Current telehealth training programmes may be enhanced by teaching person-centred care skills.
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Affiliation(s)
- Birgit Heckemann
- CAPHRI, School for Public Health and Primary Care, UM/CAPHRI, Maastricht, The Netherlands
| | - Axel Wolf
- The Gothenburg Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lilas Ali
- The Gothenburg Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Inger Ekman
- The Gothenburg Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Dinesen B, Nonnecke B, Lindeman D, Toft E, Kidholm K, Jethwani K, Young HM, Spindler H, Oestergaard CU, Southard JA, Gutierrez M, Anderson N, Albert NM, Han JJ, Nesbitt T. Personalized Telehealth in the Future: A Global Research Agenda. J Med Internet Res 2016; 18:e53. [PMID: 26932229 PMCID: PMC4795318 DOI: 10.2196/jmir.5257] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 12/26/2015] [Accepted: 01/03/2016] [Indexed: 12/15/2022] Open
Abstract
As telehealth plays an even greater role in global health care delivery, it will be increasingly important to develop a strong evidence base of successful, innovative telehealth solutions that can lead to scalable and sustainable telehealth programs. This paper has two aims: (1) to describe the challenges of promoting telehealth implementation to advance adoption and (2) to present a global research agenda for personalized telehealth within chronic disease management. Using evidence from the United States and the European Union, this paper provides a global overview of the current state of telehealth services and benefits, presents fundamental principles that must be addressed to advance the status quo, and provides a framework for current and future research initiatives within telehealth for personalized care, treatment, and prevention. A broad, multinational research agenda can provide a uniform framework for identifying and rapidly replicating best practices, while concurrently fostering global collaboration in the development and rigorous testing of new and emerging telehealth technologies. In this paper, the members of the Transatlantic Telehealth Research Network offer a 12-point research agenda for future telehealth applications within chronic disease management.
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Affiliation(s)
- Birthe Dinesen
- Laboratory of Assistive Technologies - Telehealth & Telerehabilitation, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
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Daniel H, Sulmasy LS. Policy recommendations to guide the use of telemedicine in primary care settings: an American College of Physicians position paper. Ann Intern Med 2015; 163:787-9. [PMID: 26344925 DOI: 10.7326/m15-0498] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Telemedicine-the use of technology to deliver care at a distance-is rapidly growing and can potentially expand access for patients, enhance patient-physician collaboration, improve health outcomes, and reduce medical costs. However, the potential benefits of telemedicine must be measured against the risks and challenges associated with its use, including the absence of the physical examination, variation in state practice and licensing regulations, and issues surrounding the establishment of the patient-physician relationship. This paper offers policy recommendations for the practice and use of telemedicine in primary care and reimbursement policies associated with telemedicine use. The positions put forward by the American College of Physicians highlight a meaningful approach to telemedicine policies and regulations that will have lasting positive effects for patients and physicians.
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Affiliation(s)
- Hilary Daniel
- From American College of Physicians, Washington, DC, and Philadelphia, Pennsylvania
| | - Lois Snyder Sulmasy
- From American College of Physicians, Washington, DC, and Philadelphia, Pennsylvania
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Gee PM, Greenwood DA, Paterniti DA, Ward D, Miller LMS. The eHealth Enhanced Chronic Care Model: a theory derivation approach. J Med Internet Res 2015; 17:e86. [PMID: 25842005 PMCID: PMC4398883 DOI: 10.2196/jmir.4067] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/21/2015] [Accepted: 02/07/2015] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Chronic illnesses are significant to individuals and costly to society. When systematically implemented, the well-established and tested Chronic Care Model (CCM) is shown to improve health outcomes for people with chronic conditions. Since the development of the original CCM, tremendous information management, communication, and technology advancements have been established. An opportunity exists to improve the time-honored CCM with clinically efficacious eHealth tools. OBJECTIVE The first goal of this paper was to review research on eHealth tools that support self-management of chronic disease using the CCM. The second goal was to present a revised model, the eHealth Enhanced Chronic Care Model (eCCM), to show how eHealth tools can be used to increase efficiency of how patients manage their own chronic illnesses. METHODS Using Theory Derivation processes, we identified a "parent theory", the Chronic Care Model, and conducted a thorough review of the literature using CINAHL, Medline, OVID, EMBASE PsychINFO, Science Direct, as well as government reports, industry reports, legislation using search terms "CCM or Chronic Care Model" AND "eHealth" or the specific identified components of eHealth. Additionally, "Chronic Illness Self-management support" AND "Technology" AND several identified eHealth tools were also used as search terms. We then used a review of the literature and specific components of the CCM to create the eCCM. RESULTS We identified 260 papers at the intersection of technology, chronic disease self-management support, the CCM, and eHealth and organized a high-quality subset (n=95) using the components of CCM, self-management support, delivery system design, clinical decision support, and clinical information systems. In general, results showed that eHealth tools make important contributions to chronic care and the CCM but that the model requires modification in several key areas. Specifically, (1) eHealth education is critical for self-care, (2) eHealth support needs to be placed within the context of community and enhanced with the benefits of the eCommunity or virtual communities, and (3) a complete feedback loop is needed to assure productive technology-based interactions between the patient and provider. CONCLUSIONS The revised model, eCCM, offers insight into the role of eHealth tools in self-management support for people with chronic conditions. Additional research and testing of the eCCM are the logical next steps.
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Affiliation(s)
- Perry M Gee
- School of Nursing, Division of Health Sciences, Idaho State University, Pocatello, ID, United States.
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