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Abstract
Passive remote monitoring is a relatively new technology that may support older adults to age in place. However, current knowledge about the effectiveness of this technology in extending older adults' independence is lacking. Therefore, we conducted a scoping review of studies examining passive remote monitoring to systematically synthesize evidence about the technology's effectiveness as an intervention. Our initial search of Embase, CINAHL, PubMed, and Scopus databases identified 486 unique articles. Of these, 14 articles met our inclusion criteria. Results show that passive remote monitoring technologies are being used in innovative and diverse ways to support older adults aging in place and their caregivers. More high-quality research on this topic is needed.
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Levine S, Gupta R, Alkwatli K, Almoushref A, Cherian S, Jimenez DF, Cordero Baez GN, Hart A, Weinstock C. Telehealth Perceptions among US Immigrant Patients: a cross-sectional study within an academic internal medicine practice (Preprint). JMIR Hum Factors 2022; 9:e36069. [PMID: 35947438 PMCID: PMC9403821 DOI: 10.2196/36069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/10/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background The use of telemedicine has increased dramatically through the COVID-19 pandemic. Although data are available about patient satisfaction with telemedicine, little is known about immigrant patients’ experience. Objective We sought to investigate patients’ experiences with telehealth compared to in- person visits between immigrants and nonimmigrants. We wanted to identify and describe next visit preferences within the Farmington University of Connecticut Internal Medicine practice to ultimately guide suggestions for more equitable use and accessibility of visit options. Methods A total of 270 patients including 122 immigrants and 148 nonimmigrants were seen by 4 Internal Medicine providers in an in-person (n=132) or telemedicine (n=138) university practice setting. Patients were queried between February and April 2021, using an adaptation of a previously validated patient satisfaction survey that contained standard questions developed by the Consumer Assessment of Healthcare Providers and Systems Program. Patients seen via in-person visits completed a paper copy of the survey. The same survey was administered by a follow-up phone call for telemedicine visits. Patients surveyed spoke English, Spanish, or Arabic and were surveyed in their preferred language. For televisits, the same survey was read to the patient by a certified translator. The survey consisted of 10 questions on a Likert scale of 1-5. Of them, 9 questions assessed patient satisfaction under the categories of access to care, interpersonal interaction, and quality of care. An additional question asked patients to describe and explain the reasons behind next visit preferences. Survey question responses were compared by paired t tests. Results Across both immigrant and nonimmigrant patient populations, satisfaction with perceived quality of care was high, regardless of visit type (P=.80, P=.60 for televisits and P=.76, P=.37 for in-person visits). During televisits, immigrants were more likely to feel providers spent sufficient time with them (P<.001). Different perceptions were noted among nonimmigrant patients. Nonimmigrants tended to perceive more provider time during in-person visits (P=.006). When asked to comment on reasons behind next televisit preference, nonimmigrant patients prioritized convenience, whereas immigrants noted not having to navigate office logistics. For those who chose in-person visits, both groups prioritized the need for a physical exam. Conclusions Although satisfaction was high for both telemedicine and in-person visits across immigrant and nonimmigrant populations, significant differences in patient priorities were identified. Immigrants found televisits desirable because they felt they spent more time with providers and were able to avoid additional office logistics that are often challenging barriers for non-English speakers. This suggests opportunities to use information technology to provide cultural and language-appropriate information throughout immigrants’ in-person and telemedicine visit experience. A focus on diminishing these barriers will help reduce health care inequities among immigrant patients.
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Affiliation(s)
- Susan Levine
- UConn Health, University of Connecticut, Farmington, CT, United States
| | - Richa Gupta
- UConn Health, University of Connecticut, Farmington, CT, United States
| | - Kenda Alkwatli
- UConn Health, University of Connecticut, Farmington, CT, United States
| | - Allaa Almoushref
- UConn Health, University of Connecticut, Farmington, CT, United States
| | - Saira Cherian
- UConn Health, University of Connecticut, Farmington, CT, United States
| | | | | | - Angela Hart
- UConn Health, University of Connecticut, Farmington, CT, United States
| | - Clara Weinstock
- UConn Health, University of Connecticut, Farmington, CT, United States
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Wang J, Ying M, Li Y. Home Health Agencies With More Socially Vulnerable Patients Have Poorer Experience of Care Ratings. J Appl Gerontol 2021; 41:661-670. [PMID: 34937402 DOI: 10.1177/07334648211053859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Examine the relationships between dual eligibility and race/ethnicity characteristics of Medicare-Certified Home Health Agencies (CHHAs) and experience of care ratings. METHODS Analysis of 2017 national Consumer Assessment of Healthcare Providers and Systems and matched datasets of 10,906 CHHAs. RESULTS CHHAs with higher concentrations of dual-eligible patients were less likely to have high experience of care ratings for all three domains (e.g., for care delivery, quartile 4 vs. 1: odds ratio [OR] = 0.622, p < .001); CHHAs with higher concentrations of racial/ethnic minorities generally were less likely to have high experience of care ratings in care delivery (e.g., Black: quartile 4 vs. 1: OR = 0.418, p<0.001), communication (e.g., Black: quartile 4 vs. 1: OR = 0.316, p<0.001), and specific care issues (e.g., Hispanic: quartile 4 vs. 1: OR = 0.397, p < .001). DISCUSSION CHHAs with greater concentrations of dual-eligible patients and racial/ethnic minorities were more likely to have poor experience of care ratings.
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Affiliation(s)
- Jinjiao Wang
- Elaine Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester, Rochester, NY, USA
| | - Meiling Ying
- Department of Public Health Sciences, University of Rochester, NY, USA
| | - Yue Li
- Department of Public Health Sciences, University of Rochester, NY, USA
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Kintzle S, Rivas WA, Castro CA. Satisfaction of the Use of Telehealth and Access to Care for Veterans During the COVID-19 Pandemic. Telemed J E Health 2021; 28:706-711. [PMID: 34551276 DOI: 10.1089/tmj.2021.0262] [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: 11/13/2022] Open
Abstract
Background: While many health care providers have shifted toward telehealth services in response to the COVID-19 pandemic, little is known about the perception and acceptance of such services, particularly among vulnerable populations. Veterans, who are at increased risk of physical and mental health needs, may benefit from the use and availability of telehealth services. Materials and Methods: Cross sectional survey data related to telehealth use, satisfaction, and access were collected through an online survey. Participants from previous research studies and veterans receiving care at a national veteran behavioral health organization were invited to participate. Results: A total of 404 veterans participated. Before the pandemic, many veterans had never used telehealth for physical (72%) or mental (76%) health care. Since the start of the pandemic, 62% of participants reported they received some care through telehealth services. Most participants found telehealth valuable and helpful (82%), indicated the technology was well explained (77%), and felt that issues were resolved quickly and easily (67%). Access to care was limited among participants who utilize massage therapy (64%), dental care (53%), routine checkups (50%), acupuncture (50%), and physical therapy (48%). Discussion: These findings showed an increase in the use of telehealth services and overwhelming satisfaction among veterans. Despite this, some veterans indicated barriers to receiving physical and mental health care. Conclusions: This provides an opportunity to expand the use of telehealth services to meet the health care needs of veterans. Barriers to care should be addressed to minimize the impact on the well-being of veterans.
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Affiliation(s)
- Sara Kintzle
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Wilmer A Rivas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Carl A Castro
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
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Zahoransky MA, Lape JE. Telehealth and Home Health Occupational Therapy: Clients' Perceived Satisfaction with and Perception of Occupational Performance. Int J Telerehabil 2020; 12:105-124. [PMID: 33520099 PMCID: PMC7757652 DOI: 10.5195/ijt.2020.6327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Home health care agencies are restructuring service delivery models to address quality of care and client satisfaction while containing costs. New regulatory changes and the public health emergency due to the COVID-19 pandemic precipitated an immediate need for alternative care models. Telehealth has been recognized as a feasible delivery model to provide health care. This quasi-experimental pretest-posttest study examined the feasibility of performing occupational therapy telehealth visits as an adjunct to on-site visits for homebound clients (N=9). The Outcomes and Assessment Information Set (OASIS) data collection set, Canadian Occupational Performance Measure (COPM), and a survey were used to collect data. This combination of visits resulted in clinically and statistically significant improvements in client perception of performance and satisfaction with activities of daily living. Findings showed that participants favorably perceived this service delivery model met their therapy needs and they would recommend it to others. Results of this study warrant a larger study involving physical and speech therapy services.
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Law T, Cronin C, Schuller K, Jing X, Bolon D, Phillips B. Conceptual Framework to Evaluate Health Care Professionals' Satisfaction in Utilizing Telemedicine. ACTA ACUST UNITED AC 2020; 119:435-445. [PMID: 31233109 DOI: 10.7556/jaoa.2019.080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Context Several advantages of telemedicine have been reported, such as improved patient satisfaction, reduced costs, and broader access to specialists. However, most studies have focused on patient satisfaction with telemedicine services. A literature gap exists in evaluating health care professionals' (both referring and performing professionals) satisfaction in delivering telemedicine services. A clear picture of professionals' telemedicine satisfaction has the potential to improve care quality, care accessibility, and telemedicine adoption and to reduce overall health care costs. Objectives To develop a framework to evaluate health care professionals' satisfaction in delivering telemedicine services and to articulate the factors that can contribute to their satisfaction. Methods We developed an initial conceptual framework based on existing literature and the research team's expertise. The initial framework was validated by a convenience group of 12 osteopathic and allopathic physicians, and the framework was further revised and refined according to their input. Results The refined framework includes 5 main components (professionals' demographics, care settings, motivations, experiences, and overall satisfaction) that can contribute to health care professionals' satisfaction or dissatisfaction in delivering telemedicine services. Detailed itemization is provided under each component, including hierarchical organizations of the items, definitions, and potential value sets. Conclusions The refined conceptual framework may provide a comprehensive evaluation reference for measuring professionals' satisfaction in delivering telemedicine. Further customization according to the specific setting of telemedicine services is needed. This refined conceptual framework can also be used to identify areas that can be improved and to ultimately improve telemedicine services and care quality.
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Serwe KM, Schloer L, Vigna S. Increasing Caregiver Access to Programming: A Qualitative Exploration of Caregivers' Experience of a Telehealth Powerful Tools for Caregivers Program. Home Healthc Now 2019; 37:273-280. [PMID: 31483359 DOI: 10.1097/nhh.0000000000000783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Family caregivers can benefit from education-based wellness programs, but many face barriers to attending such programs. The purpose of this research was to explore telehealth as a delivery format for an education-based caregiver wellness program. This qualitative research examined the caregiver experience of a specific program called Powerful Tools for Caregivers (PTC). The traditionally in-person program was delivered via telehealth in four states. Twelve caregivers participated in focus groups the week after completing the telehealth PTC program. Three major themes emerged from the focus groups: Knowledge Gained, Interrelatedness, and Technology Pros and Cons. All affirmed a positive experience of the telehealth delivered PTC program. Participants expressed gratitude for the opportunity to participate in the program and knowledge gained including relaxation techniques, communication skills, resources to support caregiving, and goal setting for self-care. Furthermore, participants were appreciative of the opportunity to connect with other caregivers from the comfort of their home.
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Affiliation(s)
- Katrina M Serwe
- Katrina M. Serwe, PhD, OTR/L, is an Associate Professor, Occupational Therapy Department, Concordia University, Mequon, Wisconsin. Latasha Schloer, OTS, is a Master of Occupational Therapy Student, Concordia University, Mequon, Wisconsin. Sara Vigna, OTS, is a Master of Occupational Therapy Student, Concordia University, Mequon, Wisconsin
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Rising KL, Ward MM, Goldwater JC, Bhagianadh D, Hollander JE. Framework to Advance Oncology-Related Telehealth. JCO Clin Cancer Inform 2018; 2:1-11. [DOI: 10.1200/cci.17.00156] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Purpose As telehealth is increasingly used across the clinical care spectrum to provide patient-centered care, it is important to have robust measures to assess its impact on patient outcomes and care processes. The National Quality Forum (NQF) developed a Telehealth Framework to organize measures and inform target areas for measure development that includes the following four domains: access to care, financial impact or cost, experience, and effectiveness. Our goal is to identify and categorize within the NQF domains currently existing measures of telehealth applicable to oncology to detect priority areas for future research and measure development. Methods We reviewed telehealth-related measures applied to oncology care reported in systematic reviews and identified NQF-endorsed quality measures related to oncology care potentially amenable to telehealth. We organized identified measures by the NQF domains to inform suggestions for advancing the care of patients with cancer through telehealth. Results We identified 12 systematic reviews representing 183 studies reporting telehealth-related oncology research. Most studied outcomes related to diagnosis and treatment or user experience and symptom monitoring. Clinical effectiveness measures were most frequently reported (38%), and most were psychosocial. Patient, family, and/or caregiver experience was the next most frequently reported measure. There were only a few other cancer-related clinical effectiveness measures (eg, morbidity). Most NQF-endorsed oncology measures amenable to telehealth applied to the domains of access to care and effectiveness, with a lack of measures informing financial impact or cost and experience. Conclusion Overall, there has been a lack of quality measures to assess use of telehealth for the care of oncology patients. Future work should focus on developing measures within each of the NQF-identified domains, with special attention to the financial impact or cost domain.
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Affiliation(s)
- Kristin L. Rising
- Kristin L. Rising, Thomas Jefferson University; Judd E. Hollander, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; Marcia M. Ward, Rural Telehealth Research Center, University of Iowa; Divya Bhagianadh, University of Iowa, Iowa City, IA; and Jason C. Goldwater, National Quality Forum, Washington, DC
| | - Marcia M. Ward
- Kristin L. Rising, Thomas Jefferson University; Judd E. Hollander, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; Marcia M. Ward, Rural Telehealth Research Center, University of Iowa; Divya Bhagianadh, University of Iowa, Iowa City, IA; and Jason C. Goldwater, National Quality Forum, Washington, DC
| | - Jason C. Goldwater
- Kristin L. Rising, Thomas Jefferson University; Judd E. Hollander, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; Marcia M. Ward, Rural Telehealth Research Center, University of Iowa; Divya Bhagianadh, University of Iowa, Iowa City, IA; and Jason C. Goldwater, National Quality Forum, Washington, DC
| | - Divya Bhagianadh
- Kristin L. Rising, Thomas Jefferson University; Judd E. Hollander, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; Marcia M. Ward, Rural Telehealth Research Center, University of Iowa; Divya Bhagianadh, University of Iowa, Iowa City, IA; and Jason C. Goldwater, National Quality Forum, Washington, DC
| | - Judd E. Hollander
- Kristin L. Rising, Thomas Jefferson University; Judd E. Hollander, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; Marcia M. Ward, Rural Telehealth Research Center, University of Iowa; Divya Bhagianadh, University of Iowa, Iowa City, IA; and Jason C. Goldwater, National Quality Forum, Washington, DC
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Kao HY, Wei CW, Yu MC, Liang TY, Wu WH, Wu YJ. Integrating a mobile health applications for self-management to enhance Telecare system. TELEMATICS AND INFORMATICS 2018. [DOI: 10.1016/j.tele.2017.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Powell RE, Henstenburg JM, Cooper G, Hollander JE, Rising KL. Patient Perceptions of Telehealth Primary Care Video Visits. Ann Fam Med 2017; 15:225-229. [PMID: 28483887 PMCID: PMC5422083 DOI: 10.1370/afm.2095] [Citation(s) in RCA: 282] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/14/2016] [Accepted: 10/22/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Telehealth is a care delivery model that promises to increase the flexibility and reach of health services. Our objective is to describe patient experiences with video visits performed with their established primary care clinicians. METHODS We constructed semistructured, in-depth qualitative interviews with adult patients following video visits with their primary care clinicians at a single academic medical center. Data were analyzed with a content analysis approach. RESULTS Of 32 eligible patients, 19 were successfully interviewed. All patients reported overall satisfaction with video visits, with the majority interested in continuing to use video visits as an alternative to in-person visits. The primary benefits cited were convenience and decreased costs. Some patients felt more comfortable with video visits than office visits and expressed a preference for receiving future serious news via video visit, because they could be in their own supportive environment. Primary concerns with video visits were privacy, including the potential for work colleagues to overhear conversations, and questions about the ability of the clinician to perform an adequate physical examination. CONCLUSIONS Primary care video visits are acceptable in a variety of situations. Patients identified convenience, efficiency, communication, privacy, and comfort as domains that are potentially important to consider when assessing video visits vs in-person encounters. Future studies should explore which patients and conditions are best suited for video visits.
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Affiliation(s)
- Rhea E Powell
- Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.,National Academic Center for Telehealth, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jeffrey M Henstenburg
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Grace Cooper
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Judd E Hollander
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.,National Academic Center for Telehealth, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kristin L Rising
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania .,National Academic Center for Telehealth, Thomas Jefferson University, Philadelphia, Pennsylvania
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Grant LA, Rockwood T, Stennes L. Client Satisfaction with Telehealth in Assisted Living and Homecare. Telemed J E Health 2015; 21:987-91. [DOI: 10.1089/tmj.2014.0218] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Leslie A. Grant
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Todd Rockwood
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Leif Stennes
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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