Digital Technology-Based Telemedicine for the COVID-19 Pandemic

The Use of Telemedicine in an Interdisciplinary Pain Center in the Years 2020 and 2021 in Germany: Effects of the COVID-19 Pandemic

Introduction: COVID-19 changed the management of patients with chronic pain. The increased utilization of telemedicine was recommended as a solution. Telemedicine provides medical services by overcoming the geographical distance between practitioner and patient and makes it possible to continue treating the patients with a high level of safety for patients and staff. The aim of our study is to investigate the data on the use of telemedicine in an interdisciplinary pain center in the years 2020 and 2021. Methods: Every patient contact in 2020 and 2021 with the interdisciplinary pain center was registered. Dataset consists of 4,156 patient contacts (N = 1,996 in the year 2020; N = 2,160 in the year 2021). For each patient contact, we collected data on age, sex, place of residence, and the reason or type of the contact. In addition, the incidence rates were used as a data source for the COVID-19 development. Results: In 2020, there was a significant decrease in face-to-face contacts (85.0% to 59.4%) and a significant increase in telemedicine use (especially video calls 0.6% to 20.0%). The use of telemedicine had a temporary peak at the beginning of 2021 (first quarter of 2021: 41.2%). The trend generally reversed during 2021: face-to-face contacts increased again (25.5% to 58.9%) and telemedicine decreased (mainly video calls 41.2% to 25.9%). Conclusion: The results show that telemedicine was successfully implemented in an interdisciplinary pain center during 2020 and 2021. In addition to the software requirements and the data protection, the aspect of digital literacy appears to be relevant. There seems to be a need for an implementation plan in pain centers that includes guidelines for the use of telemedicine.

Unravelling the shift: exploring consumers' adoption or resistance of E-Pharmacy through behavioural reasoning theory

In the ever-evolving nature of the healthcare sector, the advent of electronic-Pharmacy introduces a dynamic shift in how consumers acquire and access medical and pharmaceutical products. The research utilized the behaviour reasoning theory. The study evaluated the reasons for adopting and against adopting electronic-Pharmacy. By employing the qualitative approach, this study unravels rich contextual and narrative insights, shedding light on the complexities of individual decision-making processes. The study received responses from 28 through an in-depth interview, and thematic data analysis was employed for the data analysis. The outcome of the research is summarized as follows. The respondents indicated that essential reasons for adopting electronic pharmacy services include convenience and accessibility, prescription management, cost and affordability, logistics, and timely delivery. On the other hand, the reasons against adoption include trust and security concerns, regulatory challenges and legal uncertainties, lack of internet access and privacy concerns. As technology changes healthcare delivery, this research closes the knowledge gap between theory and practice by offering crucial insights into the behavioural aspects influencing electronic-Pharmacy adoption or resistance. The findings are anticipated to significantly impact the academic discourse surrounding electronic-health and the practical implementation of strategies to enhance the integration of electronic-Pharmacy services into conventional healthcare systems.

The relationship between telemedicine tools and physician satisfaction, quality of care, and patient visits during the COVID-19 pandemic

OBJECTIVE

The objective of our study is to investigate the impacts of telemedicine technology and its specific tools on physicians' overall satisfaction, quality of care, and percentage of patient visits in ambulatory care settings after the COVID-19 lockdowns.

MATERIALS AND METHODS

Data for our analysis was sourced from the 2021 annual National Electronic Health Records Survey (NEHRS), which included 1,875 complete questionnaire responses from physicians in the 2021 NEHRS. We used regression models to test the effects of telemedicine on physicians' overall satisfaction, quality of care, and percentage of patients' visits.

RESULTS

We report that telemedicine technology has significant positive effects on physicians' satisfaction with telemedicine and quality of care evaluation, both at an aggregate level and at the disaggregate levels of individual telemedicine features, and partially significant effects on patients' telemedicine visits.

DISCUSSION

Telemedicine features that contributed significantly to physician satisfaction and quality of care evaluation were telephone, videoconferencing, standalone telemedicine platform, and telemedicine platform integrated with EHR, while only telephone and integrated telemedicine platform contributed significantly to patients' telemedicine visits.

CONCLUSION

For telemedicine research and practice, this study confirms that telemedicine improves physician satisfaction and quality of care perceptions and will therefore be preferred by physicians. However, telemedicine has a mixed impact on percentage of patient visits, which suggests that providers may have to work harder to regularize telemedicine acceptance among patients in the post-COVID era.

Telemedicine in nutritional management of children with severe neurological impairment: implication for quality of life

Children with severe neurological impairment (SNI) frequently present feeding problems requiring a close monitoring of their nutritional status. In addition to constant clinical monitoring of body composition and nutritional indexes in these patients, frequent reports of dietary intake and weight gain variations are useful to ensure proper nutritional management. Furthermore, non-oral feeding is often needed to avoid malnutrition or aspiration pneumonia, constantly necessitating medical assistance. Despite their necessity for frequent hospital accesses, these patients' disabilities represent an important obstacle to accessing care, generating anxiety and concern in children and their families. Telemedicine has proven to be a promising instrument for improving pediatric patients' healthcare in several fields. By breaking down geographical and temporal barriers, telehealth may represent a valuable tool to implement in clinical practice, in order to improve patients' outcomes and quality of life. The aim of this narrative review is to provide an overview of the main nutritional issues in children with SNI, the potential implications of telemedicine in their management and the available evidence regarding the effects and benefits of telehealth.

Sacroiliac Joint Dysfunction in Endurance Runners Using Wearable Technology as a Clinical Monitoring Tool: Systematic Review

BACKGROUND

In recent years, researchers have delved into the relationship between the anatomy and biomechanics of sacroiliac joint (SIJ) pain and dysfunction in endurance runners to elucidate the connection between lower back pain and the SIJ. However, the majority of SIJ pain and dysfunction cases are diagnosed and managed through a traditional athlete-clinician arrangement, where the athlete must attend regular in-person clinical appointments with various allied health professionals. Wearable sensors (wearables) are increasingly serving as a clinical diagnostic tool to monitor an athlete's day-to-day activities remotely, thus eliminating the necessity for in-person appointments. Nevertheless, the extent to which wearables are used in a remote setting to manage SIJ dysfunction in endurance runners remains uncertain.

OBJECTIVE

This study aims to conduct a systematic review of the literature to enhance our understanding regarding the use of wearables in both in-person and remote settings for biomechanical-based rehabilitation in SIJ dysfunction among endurance runners. In addressing this issue, the overarching goal was to explore how wearables can contribute to the clinical diagnosis (before, during, and after) of SIJ dysfunction.

METHODS

Three online databases, including PubMed, Scopus, and Google Scholar, were searched using various combinations of keywords. Initially, a total of 4097 articles were identified. After removing duplicates and screening articles based on inclusion and exclusion criteria, 45 articles were analyzed. Subsequently, 21 articles were included in this study. The quality of the investigation was assessed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) evidence-based minimum set of items for reporting in systematic reviews.

RESULTS

Among the 21 studies included in this review, more than half of the investigations were literature reviews focusing on wearable sensors in the diagnosis and treatment of SIJ pain, wearable movement sensors for rehabilitation, or a combination of both for SIJ gait analysis in an intelligent health care setting. As many as 4 (19%) studies were case reports, and only 1 study could be classified as fully experimental. One paper was classified as being at the "pre" stage of SIJ dysfunction, while 6 (29%) were identified as being at the "at" stage of classification. Significantly fewer studies attempted to capture or classify actual SIJ injuries, and no study directly addressed the injury recovery stage.

CONCLUSIONS

SIJ dysfunction remains underdiagnosed and undertreated in endurance runners. Moreover, there is a lack of clear diagnostic or treatment pathways using wearables remotely, despite the availability of validated technology. Further research of higher quality is recommended to investigate SIJ dysfunction in endurance runners and explore the use of wearables for rehabilitation in remote settings.

Internet hospital response to the COVID-19 pandemic in a tertiary hospital in China: Perspectives based on a mixed-methods

Objective

This study aimed to summarize the characteristics of the Internet hospital services of the Seventh Affiliated Hospital of Sun Yat-sen University (SAHSYSU), describe diagnosis and treatment patterns in each department, determine SAHSYSU Internet hospital's role in pandemic control, and explore development strategies in non-pandemic situations.

Methods

Mixed-methods was used in this study. Qualitative organizational behavior analysis was conducted on hospital meeting records and semi-structured interview records to determine the research analysis indicators. We quantitatively analyzed online consultation record data of SAHSYSU Internet hospital from January to December 2020, and conduct classification analysis on departmental case studies using K-means clustering algorithm.

Results

29,944 patient data items were retrieved. Internet hospital services synchronized with COVID-19 pandemic development in China and Guangdong province. The service volume peaked during the period of January to March, which coincided with the height of the pandemic. Out of the total visits, 58.90% were conducted during office hours while 41.10% were conducted during non-office hours. The majority of the patients came from Guangdong (19.67%) and Hubei (9.09%) provinces. The cluster analysis identified three clusters, each with different change rates and magnitudes of change for various departments.

Conclusion

Internet hospitals complemented conventional medical services, providing crucial medical care during the COVID-19 pandemic. Internet hospitals are the future trend of medical services and should be improved based on each department's treatment characteristics.

Greenway of Digital Health Technology During COVID-19 Crisis: Bibliometric Analysis, Challenges, and Future Perspective

Digital health has transformed the healthcare landscape by leveraging technology to improve patient outcomes and access to medical services. The COVID-19 pandemic has highlighted the urgent need for digital healthcare solutions that can mitigate the impact of the outbreak while ensuring patient safety. In this chapter, we delve into how digital health technologies such as telemedicine, mobile apps, and wearable devices can provide personalized care, reduce healthcare provider burden, and lower healthcare costs. We also explore the creation of a greenway of digital healthcare that safeguards patient confidentiality, enables efficient communication, and ensures cost-effective payment systems. This chapter showcases the potential of digital health to revolutionize healthcare delivery while ensuring patient well-being and medical staff satisfaction.

Use of Simulated Telenursing With Standardized Patients to Enhance Prelicensure Nursing Education

BACKGROUND

Telenursing is a growing field in health care but remains underutilized as a clinical learning opportunity in the prelicensure nursing curriculum.

PROBLEM

Prelicensure nursing students need exposure to telenursing as an educational modality, which can serve as an alternative opportunity for clinical hours where facilities and resources are limited.

APPROACH

Using standardized patients and a web-based videoconferencing platform, faculty developed an innovative, simulated telenursing encounter to expose nursing students to virtual patient care scenarios. The effectiveness of this learning experience was evaluated through student-teacher satisfaction debriefing and student performance on content-related examinations.

OUTCOMES

Students scored higher on targeted examination questions than students from the same cohort who did not participate in the telenursing encounter. In addition, students voiced increased comfort and confidence with conducting patient interviews, providing patient education, and debriefing.

CONCLUSION

Using a simulated telenursing encounter is useful in prelicensure nursing education by exposing students to patient interaction outside of traditional clinical settings and reinforcing essential nursing concepts.

Strengths and weaknesses of telemedicine: Survey analysis in a single center bariatric surgery program

BACKGROUND

Despite Telemedicine being considered by most patients as the preferred follow-up method, bariatric surgery programs that include virtual consults still exhibit high attrition rates. This study analyzed the strengths and weaknesses of telemedicine in a single-center bariatric surgery program.

METHODS

We developed a 5-minute, 10-question online survey via Qualtrics and examined the results between 108 patients under telehealth visits by the bariatric team at the University of Illinois at Chicago from August to November 2022.

RESULTS

Most patients reported telehealth utilization was easy (91%). Virtual visits were chosen as the preferred method for follow-up (88%), while avoidance of having to take time off work/school was mentioned as the leading reason. However, a small fraction (6%) considered that connecting with the bariatric team took some time/effort.

CONCLUSION

Telemedicine is a fundamental tool to overcome several barriers that hinder access to obesity treatment among patients. Understanding its weaknesses will increase compliance with bariatric surgery programs.

Management of hospital admission, patient information and education, and immediate preoperative care

An increasing proportion of surgical procedures involves elderly and frail patients in high-income countries, leading to an increased risk of postoperative complications. Complications significantly impact patient outcomes and costs, due to prolonged hospitalization and loss of autonomy. Consequently, it is crucial to evaluate preoperative functional status in older patients, to tailor the perioperative plan, and evaluate risks. The hospital environment often exacerbates cognitive impairments in elderly and frail patients, also increasing the risk of infection, falls, and malnutrition. Thus, it is essential to work on dedicated pathways to reduce hospital readmissions and favor discharges to a familiar environment. In this context, the use of wearable devices and telehealth has been promising. Telemedicine can be used for preoperative evaluations and to allow earlier discharges with continuous monitoring. Wearable devices can track patient vitals both preoperatively and postoperatively. Preoperative education of patient and caregivers can improve postoperative outcomes and is favored by technology-based approach that increases flexibility and reduce the need for in-person clinical visits and associated travel; moreover, such approaches empower patients with a greater understanding of possible risks, moving toward shared decision-making principles. Finally, caregivers play an integral role in patient improvement, for example, in the prevention of delirium. Hence, their inclusion in the care process is not only advantageous but essential to improve perioperative outcomes in this population.

The femtech revolution-A new approach to pregnancy management: Digital transformation of maternity care-The hybrid e-health perinatal clinic addressing the unmet needs of low- and middle-income countries

Prenatal care and infant mortality rates are crucial indicators of healthcare quality. However, millions of women in low-income countries lack access to adequate care. Factors such as high-risk pregnancies and unmanaged diet increase the risk of developing complications during pregnancy, highlighting the need for continuous monitoring of maternal health. The increasing burden of non-communicable diseases represents a significant threat to fragile health systems. The lack of access to appropriate prenatal care and poor maternal and newborn health outcomes are major concerns in low- and middle-income countries (LMICs). It emphasizes the need for innovative, integrative approaches to healthcare delivery, especially in pregnant women. The health services need to be reorganized holistically and effectively, focusing on factors that directly impact maternal, neonatal, and infant mortality, resulting in improved access to maternity services and survival of "at-risk" mothers and their offspring in many LMICs. Based on the FIGO (the International Federation of Gynecology & Obstetrics) recommendations of extending preconception care to the postpartum stage, the authors of this review have developed a new model of care-PregCare-based on the triple-intervention-based holistic and multidisciplinary maternal and fetal medicine model for low-risk pregnancies. This model will help transform the traditional model's high visitation frequency into a safe and reduced office visit, while increasing virtual connections, point of care and self-care with doctors, nurses, and community-based providers of self-care. This shall be based on a sophisticated central PregCare call center powered by innovative technologies combined with experienced personnel in perinatal management (doctors and nurses/midwives).

Pathophysiologic Basis of Connected Health Systems

Since the start of the COVID-19 pandemic, there has been a rapid transition to telehealth across the United States, primarily involving virtual clinic visits. Additionally, the proliferation of consumer technologies related to health reveals that for many people health and care in the contemporary world extends beyond the boundaries of a clinical interaction and includes sensors and devices that facilitate health in personal environments. The ideal connected environment is networked and intelligent, personalized to promote health and prevent disease. The combination of sensors, devices, and intelligence constitutes a connected health system around an individual that is optimized to improve and maintain health, deliver care, and predict and reduce risk of illness. Just as modern medicine uses the pathophysiology of disease as a framework for the basis of pharmacologic therapy, a similar clinically reasoned approach can be taken to organize and architect technological elements into therapeutic systems. In this work, we introduce a systematic methodology for the design of connected health systems grounded in the pathophysiologic basis of disease. As the digital landscape expands with the ubiquity of health devices, it is pivotal to enable technology-agnostic clinical reasoning to guide the integration of technological innovations into systems of health and care delivery that extend beyond the boundaries of a clinical interaction. Applying clinical reasoning in a repeatable and systematic way to organizing technology into therapeutic systems can yield potential benefits including expanding the study of digital therapeutics from individual devices to networked technologies as therapeutic interventions; empowering physicians who are not technological experts to still play a significant role in using clinical reasoning for architecting therapeutic networks of sensors and devices; and developing platforms to catalog and share combinations of technologies that can form therapeutic networks and connected health systems.

Relatives' experiences of visiting restrictions during the COVID-19 pandemic's first wave: a PREMs study in Valais Hospital, Switzerland

BACKGROUND

During the COVID-19 pandemic, most countries introduced temporary visiting restrictions on the relatives of acute care hospital patients, whether or not they were infected with SARS-CoV-2. This affected relatives' psychological and emotional states and how closely they could be involved in their loved one's hospitalization.

STUDY AIMS

Investigate relatives' experiences of visiting restrictions during the COVID-19 pandemic's first wave and the support offered by Valais Hospital's healthcare staff.

METHODS

Relatives and patients who had been discharged between February 28 and May 13, 2020, were asked to complete a patient-reported experience measures (PREMs) questionnaire, whether or not they had been infected by SARS-CoV-2. Relatives were asked about how visiting restrictions had affected them, their perceptions of the severity of the COVID-19 pandemic, the quality of communication concerning their loved ones' health status during their hospitalization, and the information received from healthcare staff. Descriptive and inferential statistics were computed.

RESULTS

Of 866 PREMs questionnaires returned, 818 were analyzable, and 543 relatives had experienced visiting restrictions to their loved ones: 92 relatives (87%) of COVID-19 patients and 451 relatives (66%) of non-infected patients, with heterogenous effects on their psychological and affective status. Overall, whether or not relatives were subjected to visiting restrictions, they perceived themselves to be well treated, well informed, and that communication with hospital healthcare staff was satisfactory. However, relatives subjected to visiting restrictions reported significantly lower scores on the quality of communication than other relatives. The relatives of patients in gynecology/obstetrics and internal medicine wards were significantly more affected by visiting restrictions than were the relatives of patients in other wards. Numerous relatives subjected to visiting restrictions reported regular communication with their loved ones or with healthcare staff, at least once a day (n = 179), either via videoconferences using FaceTime®, WhatsApp®, Zoom®, or Skype® or via mobile phone text messages.

CONCLUSION

Visiting restrictions affected relatives differently depending on the wards their loved ones were hospitalized. Healthcare institutions should investigate the utility of visiting restrictions on patients, how they affect relatives, and how to improve personalized patient-relative communications. Future research should attempt to develop reliable, validated measurement instruments of relatives' experiences of acute-care visiting restrictions during pandemics.

Telehealth Talk on Reddit: Understanding How Language Use About Telemedicine Evolved Throughout the COVID-19 Pandemic

The COVID-19 health pandemic acted as a punctuated event that spurred rapid change in healthcare delivery, pushing us to adopt new socio-cultural norms and ways of communicating. The pandemic also altered several long-standing structures within healthcare organizations. To better understand peoples' perceptions of how the pandemic shifted technological structures within healthcare, this study examines a telemedicine (TM) Reddit forum. Analyzing language use on Reddit offered a bottom-up means of examining the public's feelings, understandings, and conceptualizations of TM. Studying language use provides rich insight into how people experience and make sense of the world around them. We specifically examined three time periods: (1) prior to the COVID-19 outbreak, (2) the two years at the center of the outbreak, wherein TM coverage increased-high-risk COVID, and (3) the point at which COVID-19 community risk levels largely diminished -low-risk COVID. Using LIWC, we studied around 1500 conversations posted in the TM forum from 2015 to 2022. Results reveal how people's language use and emotions surrounding TM meaningfully shifted over-time, along with the pandemic stages. Specifically, negative emotion language significantly increased and positive emotion language significantly decreased during Time 3-low-risk COVID. Use of body and health words increased throughout the time periods, and there were no significant differences in cognitive processing words use-which were used very frequently across all time periods. Theoretical and practical implications are offered.

Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities

BACKGROUND

The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP).

METHODS

This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

RESULTS

The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits.

CONCLUSIONS

Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.

Digital Transformation in Toxicology: Improving Communication and Efficiency in Risk Assessment

Toxicology is undergoing a digital revolution, with mobile apps, sensors, artificial intelligence (AI), and machine learning enabling better record-keeping, data analysis, and risk assessment. Additionally, computational toxicology and digital risk assessment have led to more accurate predictions of chemical hazards, reducing the burden of laboratory studies. Blockchain technology is emerging as a promising approach to increase transparency, particularly in the management and processing of genomic data related with food safety. Robotics, smart agriculture, and smart food and feedstock offer new opportunities for collecting, analyzing, and evaluating data, while wearable devices can predict toxicity and monitor health-related issues. The review article focuses on the potential of digital technologies to improve risk assessment and public health in the field of toxicology. By examining key topics such as blockchain technology, smoking toxicology, wearable sensors, and food security, this article provides an overview of how digitalization is influencing toxicology. As well as highlighting future directions for research, this article demonstrates how emerging technologies can enhance risk assessment communication and efficiency. The integration of digital technologies has revolutionized toxicology and has great potential for improving risk assessment and promoting public health.

Perceptions, Satisfaction, and Barriers to Telemedicine Use: A Community-Based Study From Jeddah, Saudi Arabia

Background Telemedicine has expanded significantly, driven by technology and the necessity for accessible healthcare. However, users' knowledge, attitudes, and perceived barriers determine its application. This study aimed to assess these factors among patients in Jeddah, Saudi Arabia. Methodology We conducted a cross-sectional study on 403 participants from Ministry of Health centers in Jeddah from February to May 2023. A structured questionnaire was used for data collection, and subsequent analysis was performed using SPSS version 28.0 (IBM Corp., Armonk, NY, USA). Results Most participants (93.1%) agreed that telehealth services have improved healthcare accessibility and expressed willingness to participate in future telemedicine consultations. However, 73.7% felt potential embarrassment or discomfort due to camera and equipment presence. Remarkably, 76.2% of participants believed telemedicine suits all medical conditions, and 95% recommended its use. Barriers to telemedicine use were identified, including the need to travel to access healthcare services in the absence of telemedicine and the associated inconvenience and cost. The overall satisfaction score was 4.56 ± 0.78, with the highest satisfaction reported for the ability to talk freely over telemedicine (4.64 ± 0.76) and the ease of registration/scheduling (4.63 ± 0.82). Significant differences (p < 0.001) in satisfaction scores were found across various age groups, gender, nationality, employment status, and education level. Patients aged >55 years and those who used telemedicine services for the first time were associated with a significantly increased risk of poor satisfaction (odds ratio (OR) = 8.068, p = 0.011 and OR = 8.919, p = 0.005, respectively). Conclusions The findings suggest high satisfaction and positive attitudes toward telemedicine services in Jeddah, Saudi Arabia, despite identifiable barriers such as potential discomfort from camera presence. Patient age and familiarity with telemedicine services significantly influenced satisfaction levels, indicating areas that require attention for the successful implementation and expansion of telemedicine in Saudi Arabia.

From Polio to COVID-19: Examining the Impact of Pandemics on Childhood Vaccination Programs

This review article aims to examine the impact of pandemics on childhood vaccination programs, specifically looking at the examples of polio and coronavirus disease 2019 (COVID-19). The article provides a comprehensive overview of the history of polio vaccination programs, including the challenges of eradicating the disease and the barriers to vaccine uptake. The article also looks at the global efforts to eradicate polio, such as the Global Polio Eradication Initiative, and the progress made in reducing the number of polio cases worldwide. The article reviews the impact of the COVID-19 pandemic on childhood vaccination programs and how the pandemic has disrupted routine vaccination services. Lockdowns and travel restrictions have contributed to this, which has reduced access to medical facilities and vaccine uptake. The article also explores how the prioritization of COVID-19 vaccines has led to a diversion of resources away from routine childhood immunization programs. The article highlights the need to address these challenges to prevent a resurgence of vaccine-preventable diseases. Furthermore, the article discusses the lessons learned from these pandemics, such as the importance of global collaboration, vaccine equity, addressing vaccine hesitancy, pandemic preparedness, and embracing technology. The article emphasizes the need to prioritize vaccine equity and ensure that vulnerable populations have access to vaccines. Additionally, the article stresses the importance of addressing vaccine hesitancy and providing effective communication and education about vaccines. The article also advocates for pandemic preparedness, emphasizing the need to invest in research and development of vaccines for emerging infectious diseases. Finally, the article suggests embracing technology as a means to improve vaccine accessibility and distribution.

The Use of Telemedicine in Medical Education and Patient Care

The COVID-19 pandemic has accelerated and expanded the adoption of telemedicine globally. This allowed telemedicine to engage medical students in patient care and ensured continuity of care for vulnerable patients. In this review, the history of telemedicine and some of its applications in medical education were reviewed. Furthermore, we also shed light on how to incorporate telemedicine into several curricula and the strategies used to include it. The article also explored how to evaluate telemedicine and the major facilitators and barriers any medical and educational institution must address when using telemedicine. At the end of the review, we explored the future promises telemedicine has for medical education.

A survey on connected healthcare beyond COVID in India: clinical perspectives

The COVID-19 pandemic has seen the advent of novel medical devices and practices. Demand for quality healthcare services rose exponentially which eventually led to accessibility becoming a major issue of concern. In addition to this, in-person consultations and various other conventional treatment methods were proven to be problematic. Limitations of traditional health care systems such as in-person consultations were highlighted, and conventional treatment methods have proven to be problematic. As an alternative approach, telehealth services are now gaining recognition due to their high efficiency, ease of use, and state-of-the-art technology. In this article, trends of telemedicine and its evolving popularity across the medical community due to the pandemic and beyond are studied and highlighted. An online survey form was circulated to 42 medical practitioners and interns to analyse the growing interest in telemedicine. The questionnaire covered the physicians' perspectives, preferences, experiences, and other important aspects of home-based teleconsultation. Based on the responses collected from doctors and medical interns, 14.2% disapproved, whereas 38.1% favoured and 47.6% showed a neutral response to the teleconsultation. More than 50% of the respondents claim the process to be time-consuming and 42% of them perceived it to be the other way round. 4.8% of the doctors preferred it to be only through computers whereas 45.2% per cent preferred consultation through smartphones and 50% of them preferred it be both ways. More than half (59.5%) of the doctors preferred the pandemic scenario and the remaining for its continued usage post-pandemic. Although India has the world's second-largest online market, a major population in India is digitally illiterate according to the Digital Foundation of India. Thus, it is important to devise telehealth technology that is simplest to use to reach also the economically backward patient communities.

Smart healthcare: A prospective future medical approach for COVID-19

COVID-19 has greatly affected human life for over 3 years. In this review, we focus on smart healthcare solutions that address major requirements for coping with the COVID-19 pandemic, including (1) the continuous monitoring of severe acute respiratory syndrome coronavirus 2, (2) patient stratification with distinct short-term outcomes (eg, mild or severe diseases) and long-term outcomes (eg, long COVID), and (3) adherence to medication and treatments for patients with COVID-19. Smart healthcare often utilizes medical artificial intelligence (AI) and cloud computing and integrates cutting-edge biological and optoelectronic techniques. These are valuable technologies for addressing the unmet needs in the management of COVID. By leveraging deep learning/machine learning capabilities and big data, medical AI can perform precise prognosis predictions and provide reliable suggestions for physicians' decision-making. Through the assistance of the Internet of Medical Things, which encompasses wearable devices, smartphone apps, internet-based drug delivery systems, and telemedicine technologies, the status of mild cases can be continuously monitored and medications provided at home without the need for hospital care. In cases that develop into severe cases, emergency feedback can be provided through the hospital for rapid treatment. Smart healthcare can possibly prevent the development of severe COVID-19 cases and therefore lower the burden on intensive care units.

A systematic review of digital health technologies for the care of older adults during COVID-19 pandemic

Objective

During the Coronavirus Disease 2019 (COVID-19) pandemic, digital health technologies (DHTs) became increasingly important, especially for older adults. The objective of this systematic review was to synthesize evidence on the rapid implementation and use of DHTs among older adults during the COVID-19 pandemic.

Methods

A structured, electronic search was conducted on 9 November 2021, and updated on 5 January 2023, among five databases to select DHT interventional studies conducted among older adults during the pandemic. The bias of studies was assessed using Version 2 of the Cochrane Risk-of-Bias Tool for randomized trials (RoB 2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I).

Results

Among 20 articles included in the review, 14 (70%) focused on older adults with chronic diseases or symptoms, such as dementia or cognitive impairment, type 2 diabetes, and obesity. DHTs included traditional telehealth interventions via telephone, video, and social media, as well as emerging technologies such as Humanoid Robot and Laser acupuncture teletherapy. Using RoB 2 and ROBINS-I, four studies (20%) were evaluated as high or serious overall risk of bias. DHTs have shown to be effective, feasible, acceptable, and satisfactory for older adults during the COVID-19 pandemic compared to usual care. In addition, some studies also highlighted challenges with technology, hearing difficulties, and communication barriers within the vulnerable population.

Conclusions

During the COVID-19 pandemic, DHTs had the potential to improve various health outcomes and showed benefits for older adults' access to health care services.

Digital health: trends, opportunities and challenges in medical devices, pharma and bio-technology

Digital health interventions refer to the use of digital technology and connected devices to improve health outcomes and healthcare delivery. This includes telemedicine, electronic health records, wearable devices, mobile health applications, and other forms of digital health technology. To this end, several research and developmental activities in various fields are gaining momentum. For instance, in the medical devices sector, several smart biomedical materials and medical devices that are digitally enabled are rapidly being developed and introduced into clinical settings. In the pharma and allied sectors, digital health-focused technologies are widely being used through various stages of drug development, viz. computer-aided drug design, computational modeling for predictive toxicology, and big data analytics for clinical trial management. In the biotechnology and bioengineering fields, investigations are rapidly growing focus on digital health, such as omics biology, synthetic biology, systems biology, big data and personalized medicine. Though digital health-focused innovations are expanding the horizons of health in diverse ways, here the development in the fields of medical devices, pharmaceutical technologies and biotech sectors, with emphasis on trends, opportunities and challenges are reviewed. A perspective on the use of digital health in the Indian context is also included.

Expanding Quality by Design Principles to Support 3D Printed Medical Device Development Following the Renewed Regulatory Framework in Europe

The vast scope of 3D printing has ignited the production of tailored medical device (MD) development and catalyzed a paradigm shift in the health-care industry, particularly following the COVID pandemic. This review aims to provide an update on the current progress and emerging opportunities for additive manufacturing following the introduction of the new medical device regulation (MDR) within the EU. The advent of early-phase implementation of the Quality by Design (QbD) quality management framework in MD development is a focal point. The application of a regulatory supported QbD concept will ensure successful MD development, as well as pointing out the current challenges of 3D bioprinting. Utilizing a QbD scientific and risk-management approach ensures the acceleration of MD development in a more targeted way by building in all stakeholders' expectations, namely those of the patients, the biomedical industry, and regulatory bodies.

Public interest in the digital transformation accelerated by the COVID-19 pandemic and perception of its future impact

BACKGROUND/AIMS

The coronavirus disease 2019 (COVID-19) pandemic has accelerated digital transformation (DT). We investigated the trend of the public interest in technologies regarding the DT and Koreans' experiences and their perceptions of the future impact of these technologies.

METHODS

Using Google Trends, the relative search volume (RSV) for topics including "coronavirus," "artificial intelligence," "cloud," "big data," and "metaverse" were retrieved for the period from January 2020 to January 2022. A survey was conducted to assess the population's knowledge, experience, and perceptions regarding the DT.

RESULTS

The RSV for "metaverse" showed an increasing trend, in contrast to those for "cloud," "big data," and "coronavirus." The RSVs for DT-related keywords had a negative correlation with the number of new weekly COVID-19 cases. In our survey, 78.1% responded that the positive impact of the DT on future lives would outweigh the negative impact. The predictors for this positive perception included experiences with the metaverse (4.0-fold) and virtual reality (VR)/augmented reality (AR) education (3.8-fold). Respondents predicted that the biggest change would occur in the healthcare sector after transportation/ communication.

CONCLUSION

Koreans' search interest for "metaverse" showed an increasing trend during the COVID-19 pandemic. Koreans believe that DT will bring about big changes in the healthcare sector. Most of the survey respondents have a positive outlook about the impact of DT on future life, and the predictors for this positive perception include the experiences with the metaverse or VR/AR education. Healthcare professionals need to accelerate the adoption of DT in clinical practice, education and training.

Complete Telehealth for Multidisciplinary Preoperative Workup Does Not Delay Time to Metabolic and Bariatric Surgery: a Pilot Study

Purpose

The COVID-19 pandemic accelerated implementation of telehealth throughout the US healthcare system. At our institution, we converted a fully integrated multidisciplinary bariatric clinic from face-to-face visits to entirely telehealth video/telephone visits. We hypothesized telehealth would increase the number of provider/patient encounters and therefore delay time to surgery.

Methods

This is a retrospective review of consecutive patients who underwent total telehealth preoperative workup. Demographics, comorbidities, and surgical characteristics were compared to the same number of consecutive patients who underwent a face-to-face approach 12 months prior, using a Wilcoxon test for continuous variables and chi-square or Fisher’s exact test for categorical variables. Differences between time and surgery were compared using inverse probability of treatment-weighted estimates and number of preoperative visits using Poisson regression with distance to hospital as a confounder. Noninferiority margin for time to surgery was set to 60 days, and the number of visits was set to 2 visits.

Results

Between March of 2020 and December of 2021, 36 patients had total telehealth workup, and were compared to 36 patients in the traditional group. Age, sex, body mass index, and comorbidities did not differ between groups. The average number of days to surgery was 121.1 days shorter in the telehealth group (90% bootstrap CI [− 160.4, − 81.8]). Estimated shift in the total number of visits was additional .76 visits in the traditional group (90% CI [.64, .91).

Conclusions

The total telehealth approach to preoperative bariatric multidisciplinary workup did not delay surgery and decreased number of total outpatient visits and time to surgery.

Graphical abstract

Usage of mobile health interventions among overweight/obese PCOS patients undergoing assisted reproductive technology treatment during the COVID-19 pandemic

Objective: In the context of the coronavirus disease 2019 (COVID-19) pandemic, telemedicine is a promising tool for providing clinical care for patients. Since the first-line treatment for infertile women with polycystic ovarian syndrome (PCOS) is lifestyle modification, a mobile-based service that provides lifestyle modification education would be helpful in the treatment of PCOS patients. In this observational study, the effect of a mobile Health (mHealth) application for lifestyle modification on PCOS patients undergoing assisted reproductive technology (ART) treatment was evaluated.Methods: A total of 79 overweight/obese patients (40 in the paper group and 39 in the WeChat application group) with PCOS from the First Affiliated Hospital of University of Science and Technology of China were enrolled in the study. The changes in the outcomes of BMI and ART treatment were analyzed between the two groups.Results: After three months of intervention, the BMIs in the control and mHealth groups were 24.5 ± 3.3 and 23.7 ± 3.1, respectively. The percentage of patients who lost weight was higher in the WeChat group than in the control group (87.2% vs. 67.5%). Furthermore, PCOS patients in the WeChat group were found to have a higher live birth rate than those in the control group (p = 0.005).Conclusion: Lifestyle modifications for PCOS patients undergoing ART treatment using the WeChat application improved weight loss and oocyte quality. Infertile patients with PCOS were more likely to make lifestyle modifications based on the usage of mobile applications during the COVID-19 pandemic.

Application of 5G network combined with AI robots in personalized nursing in China: A literature review

The medical and healthcare industry is currently developing into digitization. Attributed to the rapid development of advanced technologies such as the 5G network, cloud computing, artificial intelligence (AI), and big data, and their wide applications in the medical industry, the medical model is shifting into an intelligent one. By combining the 5G network with cloud healthcare platforms and AI, nursing robots can effectively improve the overall medical efficacy. Meanwhile, patients can enjoy personalized medical services, the supply and the sharing of medical and healthcare services are promoted, and the digital transformation of the healthcare industry is accelerated. In this paper, the application and practice of 5G network technology in the medical industry are introduced, including telecare, 5G first-aid remote medical service, and remote robot applications. Also, by combining application characteristics of AI and development requirements of smart healthcare, the overall planning, intelligence, and personalization of the 5G network in the medical industry, as well as opportunities and challenges of its application in the field of nursing are discussed. This paper provides references to the development and application of 5G network technology in the field of medical service.

Singular Spectrum Analysis of Tremorograms for Human Neuromotor Reaction Estimation

Singular spectrum analysis (SSA) is a method of time series analysis and is used in various fields, including medicine. A tremorogram is a biological signal that allows evaluation of a person’s neuromotor reactions in order to infer the state of the motor parts of the central nervous system (CNS). A tremorogram has a complex structure, and its analysis requires the use of advanced methods of signal processing and intelligent analysis. The paper’s novelty lies in the application of the SSA method to extract diagnostically significant features from tremorograms with subsequent evaluation of the state of the motor parts of the CNS. The article presents the application of a method of singular spectrum decomposition, comparison of known variants of classification, and grouping of principal components for determining the components of the tremorogram corresponding to the trend, periodic components, and noise. After analyzing the results of the SSA of tremorograms, we proposed a new algorithm of grouping based on the analysis of singular values of the trajectory matrix. An example of applying the SSA method to the analysis of tremorograms is shown. Comparison of known clustering methods and the proposed algorithm showed that there is a reasonable correspondence between the proposed algorithm and the traditional methods of classification and pairing in the set of periodic components.

Effect of telemedicine via videoconference on provider fatigue and empathy: Implications for the Quadruple Aim

Telemedicine via videoconferencing rapidly deployed during the COVID-19 pandemic reduces contact and opportunity for virus transmission, with Quadruple Aim benefits of improved population health and associated cost avoidance of COVID-related illness. Patient experience of telemedicine has generally been positive, but widespread use of videoconferencing outside of healthcare has brought growing recognition of associated mental fatigue. Experience in telepsychiatry shows attending to non-verbal communication and maintaining empathic rapport requires increased mental effort, making provider experience more sensitive to cumulative fatigue effects. Since empathy and therapeutic alliance are foundational to all physician-patient relationships, these telepsychiatry findings have implications for telehealth generally. Health leaders and providers planning for sustainable incorporation of videoconferencing into ongoing healthcare delivery should consider the potential for unintended negative effects on provider experience and burnout.

Telehealth and Artificial Intelligence Insights into Healthcare during the COVID-19 Pandemic

Soon after the coronavirus disease 2019 pandemic was proclaimed, digital health services were widely adopted to respond to this public health emergency, including comprehensive monitoring technologies, telehealth, creative diagnostic, and therapeutic decision-making methods. The World Health Organization suggested that artificial intelligence might be a valuable way of dealing with the crisis. Artificial intelligence is an essential technology of the fourth industrial revolution that is a critical nonmedical intervention for overcoming the present global health crisis, developing next-generation pandemic preparation, and regaining resilience. While artificial intelligence has much potential, it raises fundamental privacy, transparency, and safety concerns. This study seeks to address these issues and looks forward to an intelligent healthcare future based on best practices and lessons learned by employing telehealth and artificial intelligence during the COVID-19 pandemic.

Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era

The COVID-19 pandemic has led to the implementation of policies that mandate various restrictions on daily life, including social distancing, the closure of public services and schools, and movement limitations. Even though these restrictive measures decreased the COVID-19 spread, they may have detrimental effects on various lifestyle components such as physical inactivity, sedentary behavior, and dietary habits, influencing the maintenance of weight and contributing to obesity among children and adolescents. The coexistence of childhood obesity and COVID-19 and changes in the bioecological environment have put children and adolescents at increased risk for developing obesity and exacerbating the severity of this disorder. The use of telehealth technology is a modern approach useful for the delivery of health care services by health care professionals, where distance is a critical factor. Telehealth is effective in promoting increased self-monitoring and behavioral change, and provides the opportunity to perform online nutritional support and exercise training programs to promote a healthy lifestyle and reduce sedentary behaviors in children and adolescents. Telehealth, including tele-exercise and tele-nutrition, has the potential to address many of the key challenges in providing health services, including in patients with obesity during the COVID-19 outbreak. This narrative review aims to describe the role of telehealth as an opportunity in the management of pediatric obesity in the COVID-19 era, and to deliver nutrition and exercise programs for the maintenance of health.