Reasons for Utilizing Telemedicine during and after the COVID-19 Pandemic: An Internet-Based International Study

The theory behind and factors influencing the use of telemedicine during the COVID-19 pandemic: A systematic review

A paradigm change in patient health care toward telemedicine services was necessary in 2020 due to the COVID-19 pandemic, which broke out at the end of 2019. Theories used in determining the determinants of telemedicine utilization are various theories. Research conducted on the use of telemedicine still has doubts about the basic theory used in analyzing the factors that influence telemedicine, especially during the Covid-19 pandemic. The goal of this study is to outline the fundamental principles of telemedicine utilization during the Covid-19 outbreak and the variables that affect it. This Literature Review uses the scoping review method with the tool procedure, namely PRISMA. Based on the conducted literature review, there are 12 scholarly papers addressing the variables that affect the utilization of telemedicine services. During the Covid 19 epidemic, more individuals in many nations used telemedicine services. Anderson's theory of health care use and the idea of technology adoption or acceptance serve as the foundational theories for forecasting the variables that affect the use of telemedicine. The utilization of telemedicine is influenced by 29 different factors that come from different theories. The desire for health, exposure to COVID 19, co-morbidities, social media usage, avoiding contamination, time efficiency, ease of use of services, social impact, and hedonic incentive are among the factors associated to the COVID 19 pandemic.

Impact of ChatGPT on Teleconsultants in Healthcare: Perceptions of Healthcare Experts in Saudi Arabia

Purpose

This study aims to investigate the impact of ChatGPT on teleconsultants in managing their operations and services.

Methods

A qualitative approach with focus groups is adopted in this study. A total of 54 participants with varying degrees of experience using AI such as ChatGPT in healthcare, including 11 physicians, 24 nurses, eight dieticians, six pharmacists, and five physiotherapists providing teleconsultations participated in this study.

Results

Twelve themes including informational support, diagnostic assistance, communication, enhancing efficiency, cost and time saving, personalizing care, multilingual support, assisting in medical research, decision-making, documentation, continuing education, and enhanced team collaboration reflecting positive impact were identified from the data analysis of seven focus groups. In addition, six themes including misdiagnosis and errors, issues in personalized care, ethical and legal issues, limited medical context/knowledge, communication challenges, and increased dependency reflecting negative impact were identified.

Conclusion

Although ChatGPT has several advantages for teleconsultants in the healthcare sector, it is associated with ethical issues.

Service user satisfaction with telemedicine in an occupational healthcare setting

BACKGROUND

Telemedicine has existed pre-pandemic and has been used in some healthcare settings with high patient satisfaction. The COVID-19 pandemic increased the use of telemedicine to help minimize transmission while maintaining service provision.

AIMS

To assess service user satisfaction with telephone assessment and to assess distance/time saved by telephone assessment as services users did not have to travel to their appointment.

METHODS

Prospective review of service users attending one occupational health clinic over a 1-month period. Service users were asked two questions regarding method of travel, and satisfaction with telephone review. All data captured were anonymous, and distances and times for travel were calculated for driving using Google Maps.

RESULTS

Seventy-three service users were recruited to the review. Ninety per cent were reviewed by telephone and 10% reviewed in person. Eighty-eight per cent of service users were satisfied with telephone review. Seventy-eight per cent of service users planned to drive to Dr Steevens' Hospital. In total, 4058.4 km (77 h 6 min) of commuting was saved with phone reviews, and 2753.2 km (54 h 16 min) driving was saved.

CONCLUSIONS

Service user satisfaction with telephone review was found to be high, and telephone review resulted in saving of both commuting time for the healthcare worker, reduced time away from the workplace, as well as having a positive environmental impact.

Patient's and Practionner's Experiences of a First Face-to-Face vs. Remote Orthodontic Consultation: A Randomized Controlled Trial

(1) Aim: The purpose of this study was to assess patients' and practitioners' reported experience measures (PREMs) following a first standard orthodontic consultation (face-to-face consultation) versus a first orthodontic teleconsultation (video-assisted remote orthodontic consultation).; (2) Materials and Methods: This study was designed as a randomized controlled trial in which 60 patients were randomly allocated to two groups. In the control group, patients received a first face-to-face consultation (n = 30) whereas, in the test group, patients received a first orthodontic teleconsultation (n = 30). Patients as well as the orthodontic practitioners completed questionnaires after the experience. (3) Results: From the patients' point of view, overall satisfaction was comparable between the control group and the test group (p = 0.23). Quality of communication with the clinician, understanding of the explanations provided and a sense of privacy were also comparable between the two groups. However, from the practitioners' perspective, overall satisfaction after the face-to-face consultation was significantly higher than after the first remote consultation (p < 0.01). (4) Conclusions: In the context of a first orthodontic consultation, teleorthodontics appears to be an interesting and complementary approach to a classical face-to-face appointment, but which should by no means become systematic.

Barriers to Telemedicine Adoption during the COVID-19 Pandemic in Taiwan: Comparison of Perceived Risks by Socioeconomic Status Correlates

Telemedicine is the use of technology to deliver healthcare services from a distance. In some countries, telemedicine became popular during the COVID-19 pandemic. Its increasing popularity provides new research opportunities to unveil users' perceptions toward its adoption and continued use. Existing studies have provided limited information and understanding of Taiwanese users and the various sociodemographic factors that influence their intention to use telemedicine services. Thus, the goals of this study were twofold: identifying the dimensions of perceived risks of telemedicine services in Taiwan and providing specific responses to those perceptions as well as determining strategies to promote telemedicine to local policymakers and influencers by providing a better understanding of the perceived risks in relation to socioeconomic status. We collected 1000 valid responses using an online survey and found performance risk to be the main barrier, which was followed by psychological, physical, and technology risks. Older adults with lower levels of education are less likely to use telemedicine services compared to other categories because of multiple perceived risks, including social and psychological concerns. Understanding the differences in perceived risks of telemedicine services by socioeconomic status may aid in identifying the actions required to overcome barriers and may consequently improve adoption of the technology and user satisfaction.

Nurses' view of benefits, enablers and constraints to the use of digital health tools with patients: A cross-sectional study

Introduction

Digital literacy helps patients to be more informed in order to make decisions about their health. Patient empowerment in the digital realm is a duty for all healthcare professionals, but nurses are the most numerous professionals in all healthcare systems worldwide. In addition, they have an important role in health education and patient follow-up. Therefore, the use of digital tools, by nurses to empower and help patients know more about their health, is crucial.

Objective

This study was conducted to identify nurses' views on the benefits as well as constraints nurses encounter when using digital resources to empower and educate their patients. We sought to identify enablers that could help nurses use technology with their patients as a means to reinforce the care and advice they offer them.

Methods

An online ad hoc questionnaire was answered by 848 currently employed Spanish nurses on the benefits of using digital media with their patients, as well as on the constraints and enablers during implementation.

Results

The majority of the nurses considered that reliable digital information would reduce unnecessary consultations. In addition, they think that at least 50% of their patients could benefit from consulting information online. Among the constraints, nurses mainly pointed out the older age and low educational level of their patients. Younger nurses are the most likely nurses to see patient age as a problem. As for enablers, nurses pointed out the training offered to patients as well as digital tools being user-friendly for patients.

Conclusions

It is crucial to work while following a lifelong learning strategy, with training from university education as well as training from healthcare institutions to reduce the digital gap that affects patients' digital empowerment.

Changes in Older Adults' Frequency of Going Outside between 2020 and 2021: Associations with Health Status and Environmental Factors

OBJECTIVES

To examine the changes in the frequency of going outside among U.S. older adults between 2020 and 2021 (post-COVID vaccine) and correlates of those changes.

METHODS

We used the 2019-2021 National Health and Aging Trend Study (NHATS) (N = 3,063, age 70+) and multinomial logistic regression to analyze associations of increased and decreased frequencies in going outside with physical, psychosocial, and cognitive health, environmental (COVID concerns and transportation) factors, and social media use as the independent variables.

RESULTS

In 2021 compared to 2020, 13% and 16% of those age 70+ reported increased and decreased frequencies, respectively. Increased frequency was associated with social media use. Decreased frequency was associated with poor physical health, depression/anxiety, and perceived memory decline. COVID concerns and transportation problems, as well as female gender, age 90+, and being non-Hispanic Black, were also significant correlates of decreased frequency.

CONCLUSIONS

Most U.S. adults age 70+ appear to have resumed their 2019 level of frequency of going outside in 2021 after the COVID vaccines became available; however, 16% reported decreased frequency of going outside in 2021 compared to 2020.

CLINICAL IMPLICATIONS

Older adults with physical, mental, and cognitive health challenges need help to increase their frequency of going outside.

Tele-Exercise in Non-Hospitalized versus Hospitalized Post-COVID-19 Patients

The purpose of our study was to investigate the effect of tele-exercise (TE) performed for 4 consecutive weeks on fitness indicators in hospitalized post-COVID-19 patients versus non-hospitalized patients. Forty COVID-19 survivors were included, and divided into two groups: non-hospitalized versus hospitalized. Body composition, anthropometric characteristics, pulmonary function tests, single-breath diffusing capacity for carbon monoxide, 6-min walk tests (6MWT) and handgrip strength tests were recorded before and after a TE regimen (3 sessions per week, 60 min each session, warm-up and cool-down with mobility exercises, aerobic exercise such as walking outdoors, and multi-joint strength exercises). Following TE, the 6-min walk distance and handgrip were increased in both groups, with a greater observed response in the non-hospitalized group (6MWT: 32.9 ± 46.6% vs. 18.5 ± 14.3%, p < 0.001; handgrip: 15.9 ± 12.3% vs. 8.9 ± 7.6%, p < 0.001). Self-assessed dyspnea and leg fatigue were reduced in both groups, while a higher percentage of reduction was observed in the non-hospitalized group (dyspnea: 62.9 ± 42.5% vs. 37.5 ± 49.0%, p < 0.05; leg fatigue: 50.4 ± 42.2% vs. 31.7 ± 45.1%, p < 0.05). Post- vs. pre-TE arterial blood pressure decreased significantly in both groups, with the hospitalized group exhibiting more prominent reduction (p < 0.001). Both groups benefited from the TE program, and regardless of the severity of the disease the non-hospitalized group exhibited a potentially diminished adaptative response to exercise, compared to the hospitalized group.

Factors Associated with Using Telemedicine in the Primary Care Clinics during the COVID-19 Pandemic in Israel

BACKGROUND

The COVID-19 pandemic generated an extraordinary need for telemedicine.

OBJECTIVE

To identify the factors and multi-way interactions associated with telemedicine use in primary healthcare during the COVID-19 pandemic.

METHODS

This population-based study included all members (2,722,773) aged ≥18 years of the largest healthcare organization in Israel who used primary care clinic services between 1 March 2020 and 31 December 2021. Individuals were classified as telemedicine users (≥1 phone/video visits or asynchronous encounters) or non-telemedicine users (only in-person encounter/s).

RESULTS

Ethnicity was the most discriminative variable associated with telemedicine use, with 85% and 52% users among Jews and Arabs, respectively. Higher odds for telemedicine utilization were observed among women, residents of urban areas, those confined to home, individuals with high level of technology literacy, residents of the central area (in Jews only), young Jews, and older Arabs. Based on decision tree analysis, the segments of the population with the lowest telemedicine use were characterized by lower primary care needs and comorbidities, as well as low technology literacy. The proportion of telemedicine use in these groups was 56% and 27% in Jews and in Arabs, respectively.

CONCLUSION

A proactive intervention program should be applied among populations who are less likely to use telemedicine in the primary care clinics, including Arabs, Jews who live in the distant periphery, and individuals with low technology literacy.

Is Telemedicine in Primary Care a Good Option for Polish Patients with Visual Impairments Outside of a Pandemic?

With the proliferation of telemedicine during the COVID-19 pandemic, attention began to turn to the risk of health disparities associated with its use among people with disabilities. Therefore, the present study investigates the level of interest in using teleconsultations (TCs) in primary healthcare among people with visual impairments (PVIs) and identifies their motivations and needs. A total of 219 Polish PVIs were surveyed using a combination of closed and open questions. About 50% of the respondents expressed interest in using TCs. The factor most closely related to the willingness to use TCs was age. The predominant reason for using TCs was to obtain a prescription or referral, and the most highlighted need was the possibility to choose between a TC and an in-person visit. The blind and poor-sighted participants differed in some regards. Our study indicates that TCs, under some conditions, may be a beneficial option for PVIs, and provides some directions for its effective implementation.

The Consult Station® innovation for primary care: a proof-of-concept study for the generalisation of teleconsultation devices (Preprint)

Background

Telemedicine technology is a growing field, especially in the context of the COVID-19 pandemic. Consult Station (Health for Development) is the first telemedicine device enabling completely remote medical consultations, including the concurrent collection of clinical parameters and videos.

Objective

Our aim was to collect data on the multisite urban and suburban implementation of the Consult Station for primary care and assess its contribution to health care pathways in areas with a low density of medical services.

Methods

In a proof-of-concept multisite prospective cohort study, 2134 consecutive patients had teleconsultations. Consultation characteristics were analyzed from both the patient and practitioner perspective.

Results

In this study, the main users of Consult Station were younger women consulting for low-severity seasonal infections. Interestingly, hypertension, diabetes, and preventive medical consultations were almost absent, while they accounted for almost 50% of consultations with a general practitioner (GP). We showed that for all regions where the Consult Station was implemented, the number of consultations increased as GP density decreased. The study of practitioner characteristics showed GPs from metropolitan areas are motivated to work with this device remotely, with a high level of technology acceptability.

Conclusions

The multisite implementation of Consult Station booths is suitable for primary care and could also address the challenge of “medical deserts.” In addition, further studies should be performed to evaluate the possible contribution of Consult Station booths to limiting work absenteeism.