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Mathews D, Abernethy A, Butte AJ, Ginsburg P, Kocher B, Levy L, Novelli C, Sandy L, Smee J, Fabi R, Offodile AC, Sherkow JS, Sullenger RD, Freiling E, Balatbat C. Telehealth and Mobile Health: Case Study for Understanding and Anticipating Emerging Science and Technology. NAM Perspect 2023; 2023:202311e. [PMID: 38812841 PMCID: PMC11136501 DOI: 10.31478/202311e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
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Yap ET, Tan CL, Dumago MP, Jacomina LE, Yu KKL, Tapispisan JAR, Agas RAF, Co JL, Bacorro WR, Mejia MA, Sy Ortin TT. Teleconsultation Perceptions of Medical and Radiation Oncologists in the COVID-19 and Post-COVID-19 Era: A National Survey in the Philippines. JCO Glob Oncol 2023; 9:e2200370. [PMID: 37348036 PMCID: PMC10497274 DOI: 10.1200/go.22.00370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 04/01/2023] [Accepted: 05/09/2023] [Indexed: 06/24/2023] Open
Abstract
PURPOSE The study reports on the current perception of medical and radiation oncologists regarding teleconsultation in the Philippines. Before the COVID-19 pandemic, the adoption of telemedicine was not widespread. With movement restrictions imposed during the pandemic, physicians were compelled to use telemedicine. It is uncertain whether physicians will still adopt its use in practice in the post-COVID-19 era. This study gives insight into the possible adaptation of this mode of consultation in the future, especially in areas with limited health care resources. MATERIALS AND METHODS We conducted a national survey among medical oncologists and radiation oncologists in the Philippines. A 43-item online survey was developed, validated, and administered to the oncologists. The demographics and data from categorical questions were reported as frequencies and percentages. RESULTS A total of 142 responses were gathered from 82 medical oncologists and 60 radiation oncologists. There was agreement among participants that, during the pandemic, teleconsultation could be used for the first visit, diagnostic workup request, treatment explanation, follow-up care, and chronic disease management. There was disagreement whether cancer diagnosis disclosure and cancer prognosis revelation could be performed via teleconsultation, and there was agreement that emergency consultation and physical examination would warrant a face-to-face consultation. After the COVID-19 pandemic, 78.7% intend to continue using teleconsultation except for emergency consultations, first visits, physical examination, diagnosis disclosure, and cancer prognosis revelation. CONCLUSION Teleconsultation was perceived by oncologists as an acceptable method of providing cancer care during and after the COVID-19 pandemic. Oncologists also intend to use teleconsultation in the post-COVID-19 era in certain aspects of patient care.
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Affiliation(s)
- Eugene T. Yap
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Charmaine L. Tan
- Department of Medical Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Mark P. Dumago
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Luisa E. Jacomina
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Kelvin Ken L. Yu
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Julie Ann R. Tapispisan
- Department of Medical Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Ryan Anthony F. Agas
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Jayson L. Co
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Warren R. Bacorro
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Michael A. Mejia
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Teresa T. Sy Ortin
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
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Holtmann LC, Deuß E, Meyer M, Kaster F, Bastian T, Schleupner MC, Hagedorn E, Lang S, Arweiler-Harbeck D. Detection accuracy of soft tissue complications during remote cochlear implant follow-up. Cochlear Implants Int 2022; 23:249-256. [PMID: 35477412 DOI: 10.1080/14670100.2022.2067644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE After cochlear implantation (CI), long-term follow-up is obligatory. Remote-care options which provide a standard of care comparable to in-person consultations, could be an attractive addition to a cochlear implant centre's portfolio. The aim of this study was to evaluate the accuracy of photographs of the skin covering the implant to reliably detect skin irritations or soft tissue complications. METHODS During routine follow-up consultations, 109 CI patients were examined in person and asked to take a photograph of the skin covering the implant using their smartphones. Photographs were digitally and remotely evaluated by two CI physicians who were blinded to the findings during the in-person examination. RESULTS In nine cases, skin abnormalities were detected by the CI physician upon in-person examination, seven of which required immediate treatment. Both digital evaluators reliably detected all treatment-requiring conditions. Overall, more skin irritations were suspected digitally compared to in-person examination. Without additional information from the patients' medical record, sensitivity was 100% and specificity was 63%; with additional information provided, sensitivity was 100%, and specificity increased to 65.3%. CONCLUSION Digital photographic assessment of the skin covering the implant is a highly sensitive method to detect skin irritations and could reduce the number of necessary in-person consultations.
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Affiliation(s)
- L C Holtmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - E Deuß
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - M Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - F Kaster
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - T Bastian
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - M C Schleupner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - E Hagedorn
- CIC Ruhr Acoustics Bagus, Essen, Germany
| | - S Lang
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - D Arweiler-Harbeck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
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Eum NJ, Kim SH. A Cross-Country Comparative Study on the Role of Information and Communication Technology Policy and Infrastructure to Curb the Spread of Novel Coronavirus. JMIR Public Health Surveill 2021; 8:e31066. [PMID: 34817392 PMCID: PMC8745697 DOI: 10.2196/31066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/25/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022] Open
Abstract
Background Despite worldwide efforts, control of COVID-19 transmission and its after effects is lagging. As seen from the cases of SARS-CoV-2 and influenza, worldwide crises associated with infections and their side effects are likely to recur in the future because of extensive international interactions. Consequently, there is an urgent need to identify the factors that can mitigate disease spread. We observed that the transmission speed and severity of consequences of COVID-19 varied substantially across countries, signaling the need for a country-level investigation. Objective We aimed to investigate how distancing-enabling information and communications technology (ICT) infrastructure and medical ICT infrastructure, and related policies have affected the cumulative number of confirmed cases, fatality rate, and initial speed of transmission across different countries. Methods We analyzed the determinants of COVID-19 transmission during the relatively early days of the pandemic by conducting regression analysis based on our data for country-level characteristics, including demographics, culture, ICT infrastructure, policies, economic status, and transmission of COVID-19. To gain further insights, we conducted a subsample analysis for countries with low population density. Results Our full sample analysis showed that implied telehealth policy, which refers to the lack of a specific telehealth-related policy but presence of a general eHealth policy, was associated with lower fatality rates when controlled for cultural characteristics (P=.004). In particular, the fatality rate for countries with an implied telehealth policy was lower than that for others by 2.7%. Interestingly, stated telehealth policy, which refers to the existence of a specified telehealth policy, was found to not be associated with lower fatality rates (P=.30). Furthermore, countries with a government-run health website had 36% fewer confirmed cases than those without it, when controlled for cultural characteristics (P=.03). Our analysis further revealed that the interaction between implied telehealth policy and training ICT health was significant (P=.01), suggesting that implied telehealth policy may be more effective when in-service training on ICT is provided to health professionals. In addition, credit card ownership, as an enabler of convenient e-commerce transactions and distancing, showed a negative association with fatality rates in the full sample analysis (P=.04), but not in the subsample analysis (P=.76), highlighting that distancing-enabling ICT is more useful in densely populated countries. Conclusions Our findings demonstrate important relationships between national traits and COVID-19 infections, suggesting guidelines for policymakers to minimize the negative consequences of pandemics. The findings suggest physicians’ autonomous use of medical ICT and strategic allocation of distancing-enabling ICT infrastructure in countries with high population density to maximize efficiency. This study also encourages further research to investigate the role of health policies in combatting COVID-19 and other pandemics.
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Affiliation(s)
- Nam Ji Eum
- Yonsei University, 50 Yonsei-ro, Sinchon-dong, Seodaemun-gu, Seoul, KR
| | - Seung Hyun Kim
- Yonsei University, 50 Yonsei-ro, Sinchon-dong, Seodaemun-gu, Seoul, KR
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Haleem A, Javaid M, Singh RP, Suman R. Telemedicine for healthcare: Capabilities, features, barriers, and applications. SENSORS INTERNATIONAL 2021; 2:100117. [PMID: 34806053 PMCID: PMC8590973 DOI: 10.1016/j.sintl.2021.100117] [Citation(s) in RCA: 135] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 12/14/2022] Open
Abstract
Regular hospital visits can be expensive, particularly in rural areas, due to travel costs. In the era of the Covid-19 Pandemic, where physical interaction becomes risky, people prefer telemedicine. Fortunately, medical visits can be reduced when telemedicine services are used through video conferencing or other virtual technologies. Thus, telemedicine saves both the patient's and the health care provider time and the cost of the treatment. Furthermore, due to its fast and advantageous characteristics, it can streamline the workflow of hospitals and clinics. This disruptive technology would make it easier to monitor discharged patients and manage their recovery. As a result, it is sufficient to state that telemedicine can create a win-win situation. This paper aims to explore the significant capabilities, features with treatment workflow, and barriers to the adoption of telemedicine in Healthcare. The paper identifies seventeen significant applications of telemedicine in Healthcare. Telemedicine is described as a medical practitioner to diagnose and treat patients in a remote area. Using health apps for scheduled follow-up visits makes doctors and patients more effective and improves the probability of follow-up, reducing missing appointments and optimising patient outcomes. Patients should have an accurate medical history and show the doctor any prominent rashes, bruises, or other signs that need attention through the excellent quality audio-video system. Further, practitioners need file management and a payment gateway system. Telemedicine technologies allow patients and doctors both to review the treatment process. However, this technology supplements physical consultation and is in no way a substitute for a physical consultation. Today this technology is a safe choice for patients who cannot go to the doctor or sit at home, especially during a pandemic.
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Affiliation(s)
- Abid Haleem
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Ravi Pratap Singh
- Department of Industrial and Production Engineering, Dr B R Ambedkar National Institute of Technology, Jalandhar, Punjab, India
| | - Rajiv Suman
- Department of Industrial & Production Engineering, G.B. Pant University of Agriculture & Technology, Pantnagar, Uttarakhand, India
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Cannon P, Lumsden L, Wass V. An innovative and authentic way of learning how to consult remotely in response to the COVID-19 pandemic. EDUCATION FOR PRIMARY CARE 2021; 33:53-58. [PMID: 33913401 DOI: 10.1080/14739879.2021.1920476] [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: 10/21/2022]
Abstract
Medical students preparing to undertake general practice (GP) placements need to be equipped with the unique skills required to successfully utilise and adapt to current and emerging remote consultation modalities used in primary care and integrate this into their day-to-day clinical practice. Medical educators needed to flexibly and quickly cater learning to the evolving landscape.A three-hour teaching session was devised to be delivered to 50 students online via Microsoft Teams™ and facilitated by five general practice tutors in groups of 10, prior to students' GP placements. In pre-assigned pairs, students undertook two role-play scenarios for the main remote modalities of telephone and video-consultations. E-consultations were explored via discussion of simulated encounters. The authentic technology pertinent to each modality was used; this included a training version of NHS Scotland's Near Me IT platform for video-consultations, the students' own mobile phones for telephone consultations and simulated PDFs generated using the e-consultation facility. Teaching was evaluated via a student focus group pre and post placement.Student feedback was positive. The session prepared them for their placement and increased their confidence. They suggested this teaching be incorporated earlier in the medical school curriculum. They appreciated learning with the same IT platforms used on placement. Some students had no prior experience of remote consultations and subsequently were expected to undertake independent remote consultations almost immediately upon arrival.Careful design of challenging scenarios mirroring common GP presentations via remote modalities can increase student preparedness and confidence prior to GP placements during the COVID-19 pandemic.
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Affiliation(s)
- Philip Cannon
- Year 5 MBChB Student, University of Aberdeen Medical School, U.K
| | | | - Valerie Wass
- Professor of Medical Education in Primary Care, University of Aberdeen Medical School, U.K
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Matsumoto RA, England BR, Mastarone G, Richards JS, Chang E, Wood PR, Barton JL. Rheumatology Clinicians' Perceptions of Telerheumatology Within the Veterans Health Administration: A National Survey Study. Mil Med 2021; 185:e2082-e2087. [PMID: 32789463 DOI: 10.1093/milmed/usaa203] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION The Department of Veterans Affairs Veterans Health Administration (VA) Strategic Plan (Fiscal Year 2018-2024) identified four priorities for care including easy access, timely and integrated care, accountability, and modernization, all of which can be directly or indirectly impacted by telemedicine technologies. These strategic goals, coupled with an anticipated rheumatology workforce shortage, has created a need for additional care delivery methods such as clinical video telehealth application to rheumatology (ie, telerheumatology). Rheumatology clinician perceptions of clinical usefulness telerheumatology have received limited attention in the past. The present study aimed to evaluate rheumatologists' perceptions of and experiences with telemedicine, generally, and telerheumatology, specifically, within the VA. MATERIALS AND METHODS A 38-item survey based on an existing telehealth providers' satisfaction survey was developed by two VA rheumatologists with experience in telemedicine as well as a social scientist experienced in survey development and user experience through an iterative process. Questions probed VA rheumatology clinician satisfaction with training and information technology (IT) supports, as well as barriers to using telemedicine. Additionally, clinician perceptions of the impact and usefulness of and appropriate clinical contexts for telerheumatology were evaluated. The survey was disseminated online via VA REDCap to members of the VA Rheumatology Consortium (VARC) through a LISTSERV. The study protocol was approved by the host institution IRB through expedited review. Survey responses were analyzed using descriptive statistics. RESULTS Forty-five anonymous responses (20% response rate) were collected. Of those who responded, 47% were female, 98% were between 35 and 64 years old, 71% reported working at an academic center, and the majority was physician-level practitioners (98%). Respondents generally considered themselves to be tech savvy (58%). Thirty-six percent of the sample reported past experience with telemedicine, and, of those, 29% reported experience with telerheumatology specifically. Clinicians identified the greatest barrier to effective telerheumatology as the inability to perform a physical exam (71%) but agreed that telerheumatology is vital to increasing access to care (59%) and quality of care (40%) in the VA. Overall, regardless of experience with telemedicine, respondents reported that telerheumatology was more helpful for management of rheumatologic conditions rather than initial diagnosis. CONCLUSIONS While the majority of rheumatology clinicians did not report past experience with telerheumatology, they agreed that it has potential to further the VA mission of improved access and quality of care. Rheumatology clinicians felt the suitability of telerheumatology is dependent on the phase of care. As remote care technologies continue to be rapidly adopted into clinic, clinician perceptions of and experiences with telemedicine will need to be addressed in order to maintain high-quality and clinician- and patient-centric care within VA rheumatology.
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Affiliation(s)
- Rachel A Matsumoto
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd., Portland, OR 97239
| | - Bryant R England
- VA Nebraska-Western Iowa Health Care System & University of Nebraska Medical Center, Omaha, NE
| | - Ginnifer Mastarone
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd., Portland, OR 97239
- Department of Communication, College of Liberal Arts & Sciences, Portland State University, 1825 SW Broadway, Portland, OR 97201
| | - J Steuart Richards
- Pittsburgh VA Medical Center & University of Pittsburgh, University Drive C, Pittsburgh, PA 15213
| | - Elizabeth Chang
- Phoenix VA Health Care System, 650 E Indian School Rd., Phoenix, AZ 85012
| | - Patrick R Wood
- Rocky Mountain Regional VA Medical Center & University of Colorado School of Medicine, 1700 N Wheeling St., Aurora, CO 80045
| | - Jennifer L Barton
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd., Portland, OR 97239
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239
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Quinzi V, Paskay LC, Manenti RJ, Giancaspro S, Marzo G, Saccomanno S. Telemedicine for a Multidisciplinary Assessment of Orofacial Pain in a Patient Affected by Eagle’s Syndrome: A Clinical Case Report. Open Dent J 2021. [DOI: 10.2174/1874210602115010102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background:
Orofacial pain has a broad range of origins and a multidisciplinary approach occupies a relevant role.
Objective:
The aim of this study was to review the literature regarding the evolution of telemedicine and orofacial pain related to a case report of a patient affected by Eagle's syndrome.
Materials and Methods:
Two authors (RJM and SG) independently reviewed the literature up to March 2020. A case report was developed by including the interdisciplinary assessment and initial treatment of orofacial pain in a 38-year-old female patient affected by Eagle’s syndrome. The patient was interviewed by two different specialists (from Rome, Italy and Los Angeles, California) through an online meeting platform in order to evaluate her complex situation, demonstrating the possibilities that telemedicine offered during the COVID-19 pandemic.
Conclusion:
An interdisciplinary approach can be performed for future follow ups on patients as various advantages were found by the patient and by the clinicians themselves.
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James HM, Papoutsi C, Wherton J, Greenhalgh T, Shaw SE. Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework. J Med Internet Res 2021; 23:e23775. [PMID: 33434141 PMCID: PMC7837451 DOI: 10.2196/23775] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/27/2020] [Accepted: 12/17/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND COVID-19 has thrust video consulting into the limelight, as health care practitioners worldwide shift to delivering care remotely. Evidence suggests that video consulting is acceptable, safe, and effective in selected conditions and settings. However, research to date has mostly focused on initial adoption, with limited consideration of how video consulting can be mainstreamed and sustained. OBJECTIVE This study sought to do the following: (1) review and synthesize reported opportunities, challenges, and lessons learned in the scale-up, spread, and sustainability of video consultations, and (2) identify transferable insights that can inform policy and practice. METHODS We identified papers through systematic searches in PubMed, CINAHL, and Web of Science. Included articles reported on synchronous, video-based consultations that had spread to more than one setting beyond an initial pilot or feasibility stage, and were published since 2010. We used the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability (NASSS) framework to synthesize findings relating to 7 domains: an understanding of the health condition(s) for which video consultations were being used, the material properties of the technological platform and relevant peripherals, the value proposition for patients and developers, the role of the adopter system, organizational factors, wider macro-level considerations, and emergence over time. RESULTS We identified 13 papers describing 10 different video consultation services in 6 regions, covering the following: (1) video-to-home services, connecting providers directly to the patient; (2) hub-and-spoke models, connecting a provider at a central hub to a patient at a rural center; and (3) large-scale top-down evaluations scaled up or spread across a national health administration. Services covered rehabilitation, geriatrics, cancer surgery, diabetes, and mental health, as well as general specialist care and primary care. Potential enablers of spread and scale-up included embedded leadership and the presence of a telehealth champion, appropriate reimbursement mechanisms, user-friendly technology, pre-existing staff relationships, and adaptation (of technology and services) over time. Challenges tended to be related to service development, such as the absence of a long-term strategic plan, resistance to change, cost and reimbursement issues, and the technical experience of staff. There was limited articulation of the challenges to scale-up and spread of video consultations. This was combined with a lack of theorization, with papers tending to view spread and scale-up as the sum of multiple technical implementations, rather than theorizing the distinct processes required to achieve widespread adoption. CONCLUSIONS There remains a significant lack of evidence that can support the spread and scale-up of video consulting. Given the recent pace of change due to COVID-19, a more definitive evidence base is urgently needed to support global efforts and match enthusiasm for extending use.
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Affiliation(s)
- Hannah M James
- Department of Knowledge Integration, University of Waterloo, Waterloo, ON, Canada
| | - Chrysanthi Papoutsi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Joseph Wherton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Sara E Shaw
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Tauben DJ, Langford DJ, Sturgeon JA, Rundell SD, Towle C, Bockman C, Nicholas M. Optimizing telehealth pain care after COVID-19. Pain 2020; 161:2437-2445. [PMID: 32826752 PMCID: PMC7566302 DOI: 10.1097/j.pain.0000000000002048] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/23/2022]
Affiliation(s)
- David J. Tauben
- Departments of Anesthesiology & Pain Medicine
- Medicine, University of Washington, Seattle, WA, United States
| | | | | | - Sean D. Rundell
- Departments of Rehabilitation Medicine
- Health Services, University of Washington, Seattle, WA, United States
| | - Cara Towle
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Christina Bockman
- Department of Pharmacy, University of Washington, Harborview Medical Center, Seattle, WA, United States
| | - Michael Nicholas
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Schimmer R, Orre C, Öberg U, Danielsson K, Hörnsten Å. Digital Person-Centered Self-Management Support for People With Type 2 Diabetes: Qualitative Study Exploring Design Challenges. JMIR Diabetes 2019; 4:e10702. [PMID: 31538941 PMCID: PMC6754678 DOI: 10.2196/10702] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/19/2019] [Accepted: 07/21/2019] [Indexed: 01/20/2023] Open
Abstract
Background Self-management is a substantial part of treatment for patients with type 2 diabetes (T2D). Modern digital technology, being small, available, and ubiquitous, might work well in supporting self-management. This study follows the process of developing a pilot implementation of an electronic health (eHealth) service for T2D self-management support in primary health care. The use of digital health, or eHealth, solutions for supporting self-management for patients with T2D is increasing. There are good examples of successful implementations that can serve as guides in the development of new solutions. However, when adding person-centered principles as a requirement, the examples are scarce. Objective The objective of this study was to explore challenges that could impact the design of a person-centered eHealth service for T2D self-management support. The study included data collection from multiple sources, that is, interviews, observations, focus groups, and a Mentimeter (interactive presentation with polling) survey among stakeholders, representing various perspectives of T2D. Methods A user-centered design approach was used to exploratively collect data from different sources. Data were collected from a workshop, interviews, and observations. The different data sources enabled a triangulation of data. Results Results show that user needs related to an eHealth service for person-centered T2D self-management support are multifaceted and situated in a complex context. The two main user groups, patients and diabetes specialist nurses, express needs that both diverge and converge, which indicates that critical design decisions have to be made. There is also a discrepancy between the needs expressed by the potential users and the current work practice, suggesting more attention toward changing the organization of work to fully support a new eHealth service. Conclusions A total of three overarching challenges—flexible access, reducing administrative tasks, and patient empowerment—each having a significant impact on design, are discussed. These challenges need to be considered and resolved through careful design decisions. Special attention has to be given to the patient user group that could greatly impact current work practice and power structures at the primary care unit. A need for further studies investigating patient needs in everyday life is identified to better support the implementation of technology that does not give specific attention to organizational perspectives but instead approach design with the patient perspective in focus.
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Affiliation(s)
- Robyn Schimmer
- Department of Informatics, Umeå University, Umeå, Sweden
| | - Carljohan Orre
- Department of Computer Science and Media Technology, Malmö University, Malmö, Sweden
| | - Ulrika Öberg
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
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Grassl N, Nees J, Schramm K, Spratte J, Sohn C, Schott TC, Schott S. A Web-Based Survey Assessing the Attitudes of Health Care Professionals in Germany Toward the Use of Telemedicine in Pregnancy Monitoring: Cross-Sectional Study. JMIR Mhealth Uhealth 2018; 6:e10063. [PMID: 30089606 PMCID: PMC6105866 DOI: 10.2196/10063] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/12/2018] [Accepted: 06/18/2018] [Indexed: 01/03/2023] Open
Abstract
Background The demand for fetal monitoring and constant reassurance is high in pregnant women. Consequently, pregnant women use various health apps and are more likely to visit emergency departments due to subjective but nonurgent complaints. However, electronic health (eHealth) and mobile health (mHealth) solutions are rarely used to prevent nonurgent emergency consultations. To implement modern care solutions, a better understanding of the attitudes, fears, and hopes of health care professionals toward eHealth and mHealth is needed. Objective The aim of this study was to investigate the attitudes of health care professionals in obstetrics toward telemedicine. Methods A quantitative Web-based survey on health care professionals in obstetrics in Germany was conducted. The participants included nurses, midwives, and physicians of all age groups and job positions working in hospitals that provide various levels of health care. The questionnaire comprised 24 questions about the characteristics of the study population, views about emergency consultations in obstetrics, attitude toward telemedicine, job satisfaction, and sleeping behavior. Results In total, 244 health care professionals participated in the Web-based survey. In general, health care professionals were skeptical (170/233, 72.9%) about the use of telemedicine in obstetrics; however, 55.8% (130/233) recognized its potential. Moreover, 72% (62/86) of physicians were optimistic in using apps for pregnancy monitoring, whereas 36.1% (47/130) of nonphysicians (P<.001) were not. Significantly, more nonphysicians rejected such developments (75/130, 57.7% rejected) compared with physicians (24/86, 28%; P<.001). We also found that obstetricians with more than 10 years of work-experience are more skeptical; however, approximately 49% (18/37) of them believed that telemedicine could reduce nonurgent emergency consultations, whereas 73.2% (106/145) of obstetricians with less than 5 years of experience (P=.01) thought otherwise. Our survey revealed a high job satisfaction and a prevalence of regular sleeping problems of 45.9% (91/198) among health care professionals in obstetrics. Surprisingly, both job satisfaction and sleeping problems were independent from the number of night shifts per month (P=.77 and P=.99, respectively). Yet, 56.6% (112/198) of the survey participants thought they would be happier with their job if they had to work fewer night shifts per month. Conclusions Our study reveals an ambivalent attitude toward the use of telemedicine among health care professionals in obstetrics in Germany at the moment. Efforts to promote the use of telemedicine should focus on nurses and midwives because these groups are the most skeptical. By contrast, particularly young physicians recognize the potential of apps in patient care and would like to use such technology in pregnancy monitoring.
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Affiliation(s)
- Niklas Grassl
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Juliane Nees
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Katharina Schramm
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Julia Spratte
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Christof Sohn
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Timm C Schott
- Centre of Dentistry, Department of Orthodontics and Orofacial Orthopedics, University of Tuebingen, Tuebingen, Germany
| | - Sarah Schott
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
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13
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Granja C, Janssen W, Johansen MA. Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature. J Med Internet Res 2018; 20:e10235. [PMID: 29716883 PMCID: PMC5954232 DOI: 10.2196/10235] [Citation(s) in RCA: 274] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 04/09/2018] [Indexed: 01/18/2023] Open
Abstract
Background eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Objective Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. Methods We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Results Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow disruption (n=6), alignment with clinical processes (n=2), and staff turnover (n=1). Conclusions The reviewed literature suggested that, to increase the likelihood of success of eHealth interventions, future research must ensure a positive impact in the quality of care, with particular attention given to improved diagnosis, clinical management, and patient-centered care. There is a critical need to perform in-depth studies of the workflow(s) that the intervention will support and to perceive the clinical processes involved.
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Affiliation(s)
- Conceição Granja
- Future Journal, Norwegian Centre for E-health Research, Tromsø, Norway
| | - Wouter Janssen
- Telemedicine and E-health Research Group, University of Tromsø-The Artic University of Norway, Tromsø, Norway
| | - Monika Alise Johansen
- Future Journal, Norwegian Centre for E-health Research, Tromsø, Norway.,Telemedicine and E-health Research Group, University of Tromsø-The Artic University of Norway, Tromsø, Norway
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14
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Kolltveit BCH, Thorne S, Graue M, Gjengedal E, Iversen MM, Kirkevold M. Telemedicine follow-up facilitates more comprehensive diabetes foot ulcer care: A qualitative study in home-based and specialist health care. J Clin Nurs 2018; 27:e1134-e1145. [PMID: 29193527 DOI: 10.1111/jocn.14193] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2017] [Indexed: 12/20/2022]
Abstract
AIMS AND OBJECTIVES To investigate the application of a telemedicine intervention in diabetes foot ulcer care, and its implications for the healthcare professionals in the clinical field. BACKGROUND Contextual factors are found to be important when applying technology in health care and applying telemedicine in home-based care has been identified as particularly complex. DESIGN AND METHODS We conducted field observations and individual interviews among healthcare professionals in home-based care and specialist health care in a diabetes foot care telemedicine RCT (Clin.Trial.gov: NCT01710774) during 2016. This study was guided by Interpretive Description, an inductive qualitative methodology. RESULTS Overall, we identified unequal possibilities for applying telemedicine in diabetes foot ulcer care within the hospital and home care contexts. Different circumstances and possibilities in home-based care made the application of telemedicine as intended more difficult. The healthcare professionals in both care contexts perceived the application of telemedicine to facilitate a more comprehensive approach towards the patients, but with different possibilities to enact it. CONCLUSIONS Application of telemedicine in home-based care was more challenging than in the outpatient clinic setting. Introducing more updated equipment and minor structural adjustments in consultation time and resources could make the use of telemedicine in home-based care more robust. RELEVANCE TO CLINICAL PRACTICE Application of telemedicine in diabetes foot ulcer follow-up may enhance the nursing staff's ability to conduct comprehensive assessment and care of the foot ulcer as well as the patient's total situation. Access to adequate equipment and time, particularly in home-based care, is necessary to capitalise on this new technology.
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Affiliation(s)
- Beate-Christin Hope Kolltveit
- Faculty of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sally Thorne
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Marit Graue
- Faculty of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Eva Gjengedal
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Faculty of Health and Social Care, Molde University College, Molde, Norway
| | - Marjolein M Iversen
- Faculty of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway.,Section of Endocrinology, Department of Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Marit Kirkevold
- Faculty of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway
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15
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Alami H, Gagnon MP, Wootton R, Fortin JP, Zanaboni P. Exploring factors associated with the uneven utilization of telemedicine in Norway: a mixed methods study. BMC Med Inform Decis Mak 2017; 17:180. [PMID: 29282048 PMCID: PMC5745591 DOI: 10.1186/s12911-017-0576-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Norway has a long history of using telemedicine, especially for geographical reasons. Despite the availability of promising telemedicine applications and the implementation of national initiatives and policies, the sustainability and scaling-up of telemedicine in the health system is still far from accomplished. The main objective of this study was to explore and identify the multi-level (micro, meso and macro) factors affecting telemedicine utilization in Norway. METHODS We used a mixed methods approach. Data from a national registry were collected to analyze the use of outpatient visits and telemedicine contacts in Norway from 2009 to 2015. Interviews with key stakeholders at national, regional and local level helped complete and contextualize the data analysis and explore the main issues affecting the use of telemedicine by health authorities and hospitals. Relevant national documents were also used to support, contradict, contextualize or clarify information and data. RESULTS Telemedicine use in Norway from 2009 to 2015 remained very low, not exceeding 0.5% of total outpatient activity at regional level and 0.1% at national level. All four regions used telemedicine. Of the 29 hospitals, 24 used it at least once over the 7-year period. Telemedicine was not used regularly everywhere, with some hospitals using it sporadically. Telemedicine was mostly used in selected specialties, including rehabilitation, neurosurgery, skin and venereal diseases. Three major themes affecting implementation and utilization of telemedicine in Norway emerged: (i) governance and strategy; (ii) organizational and professional dimensions; (iii) economic and financial dimensions. For each theme, a number of factors and challenges faced at different health care levels were identified. CONCLUSIONS This study allowed shedding light on multi-level and interdependent factors affecting utilization of telemedicine in Norway. The identification of the main implementation and utilization challenges might support decision makers and practitioners in the successful scaling-up of telemedicine. This work provides a knowledge base useful to other countries which intend to implement telemedicine or other digital health services into their healthcare systems.
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Affiliation(s)
- H. Alami
- Research Center on Healthcare and Services in Primary Care, Institute of Health and Social Services in Primary Care. Laval University (CERSSPL-UL). CIUSSS-CN, Pavillon Landry-Poulin, 2525, chemin de la canardiere, Quebec, QC G1J 0A4 Canada
- Research Centre of the CHU de Quebec-Universite Laval, Hopital St-François d’Assise, Edifice D, 45, rue Leclerc, Quebec, QC G1L 2G1 Canada
| | - M. P. Gagnon
- Research Center on Healthcare and Services in Primary Care, Institute of Health and Social Services in Primary Care. Laval University (CERSSPL-UL). CIUSSS-CN, Pavillon Landry-Poulin, 2525, chemin de la canardiere, Quebec, QC G1J 0A4 Canada
- Research Centre of the CHU de Quebec-Universite Laval, Hopital St-François d’Assise, Edifice D, 45, rue Leclerc, Quebec, QC G1L 2G1 Canada
- Faculty of Nursing Science, Laval University. Pavillon Ferdinand-Vandry, 1050, avenue de la Medecine, Quebec, QC G1V 0A6 Canada
| | - R. Wootton
- Norwegian Centre for E-health Research, University Hospital of North Norway, P.O. Box 35, 9038 Tromso, Norway
| | - J. P. Fortin
- Research Center on Healthcare and Services in Primary Care, Institute of Health and Social Services in Primary Care. Laval University (CERSSPL-UL). CIUSSS-CN, Pavillon Landry-Poulin, 2525, chemin de la canardiere, Quebec, QC G1J 0A4 Canada
- Faculty of Medicine, Laval University Pavillon Ferdinand-Vandry, 1050, avenue de la Medecine, Quebec, QC G1V 0A6 Canada
| | - P. Zanaboni
- Norwegian Centre for E-health Research, University Hospital of North Norway, P.O. Box 35, 9038 Tromso, Norway
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16
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Adenuga KI, Iahad NA, Miskon S. Towards reinforcing telemedicine adoption amongst clinicians in Nigeria. Int J Med Inform 2017; 104:84-96. [PMID: 28599820 DOI: 10.1016/j.ijmedinf.2017.05.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 11/29/2022]
Abstract
Telemedicine systems have been considered as a necessary measure to alleviate the shortfall in skilled medical specialists in developing countries. However, the obvious challenge is whether clinicians are willing to use this technological innovation, which has aided medical practice globally. One factor which has received little academic attention is the provision of suitable encouragement for clinicians to adopt telemedicine, in the form of rewards, motivation or incentives. A further consideration for telemedicine usage in developing countries, especially sub-Saharan Africa and Nigeria in particular, are to the severe shortage of available practising clinicians. The researchers therefore explore the need to positively reinforce the adoption of telemedicine amongst clinicians in Nigeria, and also offer a rationale for this using the UTAUT model. Data were collected using a structured paper-based questionnaire, with 252 physicians and nurses from six government hospitals in Ondo state, Nigeria. The study applied SmartPLS 2.0 for analysis to determine the relationship between six variables. Demographic moderating variables, age, gender and profession, were included. The results indicate that performance expectancy (p<0.05), effort expectancy (p<0.05), facilitating condition (p<0.01) and reinforcement factor (p<0.001) have significant effects on clinicians' behavioural intention to use telemedicine systems, as predicted using the extended UTAUT model. Our results showed that the use of telemedicine by clinicians in the Nigerian context is perceived as a dual responsibility which requires suitable reinforcement. In addition, performance expectancy, effort expectancy, facilitating condition and reinforcement determinants are influential factors in the use of telemedicine services for remote-patient clinical diagnosis and management by the Nigerian clinicians.
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Affiliation(s)
- Kayode I Adenuga
- Department of Information Systems, Universiti Teknologi Malaysia, Skudai Johor Bahru, Malaysia.
| | - Noorminshah A Iahad
- Department of Information Systems, Universiti Teknologi Malaysia, Skudai Johor Bahru, Malaysia.
| | - Suraya Miskon
- Department of Information Systems, Universiti Teknologi Malaysia, Skudai Johor Bahru, Malaysia.
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17
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Zanaboni P, Wootton R. Adoption of routine telemedicine in Norwegian hospitals: progress over 5 years. BMC Health Serv Res 2016; 16:496. [PMID: 27644324 PMCID: PMC5028940 DOI: 10.1186/s12913-016-1743-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 09/13/2016] [Indexed: 11/25/2022] Open
Abstract
Background Although Norway is well known for its early use of telemedicine to provide services for people in rural and remote areas in the Arctic, little is known about the pace of telemedicine adoption in Norway. The aim of the present study was to explore the statewide implementation of telemedicine in Norwegian hospitals over time, and analyse its adoption and level of use. Methods Data on outpatient visits and telemedicine consultations delivered by Norwegian hospitals from 2009 to 2013 were collected from the national health registry. Data were stratified by health region, hospital, year, and clinical specialty. Results All four health regions used telemedicine, i.e. there was 100 % adoption at the regional level. The use of routine telemedicine differed between health regions, and telemedicine appeared to be used mostly in the regions of lower centrality and population density, such as Northern Norway. Only Central Norway seemed to be atypical. Twenty-one out of 28 hospitals reported using telemedicine, i.e. there was 75 % adoption at the hospital level. Neurosurgery and rehabilitation were the clinical specialties where telemedicine was used most frequently. Despite the growing trend and the high adoption, the relative use of telemedicine compared to that of outpatient visits was low. Conclusions Adoption of telemedicine is Norway was high, with all the health regions and most of the hospitals reporting using telemedicine. The use of telemedicine appeared to increase over the 5-year study period. However, the proportion of telemedicine consultations relative to the number of outpatient visits was low. The use of telemedicine in Norway was low in comparison with that reported in large-scale telemedicine networks in other countries. To facilitate future comparisons, data on adoption and utilisation over time should be reported routinely by statewide or network-based telemedicine services.
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Affiliation(s)
- Paolo Zanaboni
- Norwegian Centre for E-health Research, University Hospital of North Norway, P.O. Box 35, 9038, Tromsø, Norway.
| | - Richard Wootton
- Norwegian Centre for E-health Research, University Hospital of North Norway, P.O. Box 35, 9038, Tromsø, Norway.,Faculty of Health Sciences, The Arctic University of Norway, Langnes, P.O. Box 6050, 9037, Tromsø, Norway
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18
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Edirippulige S, Armfield NR. Education and training to support the use of clinical telehealth: A review of the literature. J Telemed Telecare 2016; 23:273-282. [DOI: 10.1177/1357633x16632968] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Despite a growing literature base, substantial investment, and policy changes within governments, the integration of telehealth into routine clinical care has been limited. The availability of appropriate systematic education and training for practitioners has been highlighted as necessary for strong adoption. However, the availability and nature of telehealth-related education and training for practitioners is not understood. By reviewing the literature, we aimed to describe the delivery of education and training in telehealth, with particular focus on content, modes of delivery, types of institutions, and target clinician groups. Methods We performed searches using PubMed, Scopus, Embase, Web of Science, PsycINFO, the Cochrane Library, and ERIC. We included studies that were focused on the delivery of telehealth-related academic or vocational education and training. We extracted information pertaining to country, programs and their participants, and tabulated the results. Results Altogether 388 articles were identified, of which nine studies were selected for final review. Programs from five countries were represented and articles were spread across telemedicine and clinically oriented journals. Education and training in telehealth has been provided as both university level and vocational courses using conventional classroom based delivery methods and e-learning. Reported curriculum items included terminology, clinical applications, the evidence-base, and technological aspects. Conclusions Published evidence in peer-reviewed literature on telehealth education and training is limited. According to this review, a number of topics relating to telehealth have been covered by existing education programs both within tertiary and professional development levels.
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Affiliation(s)
- S Edirippulige
- Centre for Online Health, The University of Queensland, Australia
| | - NR Armfield
- Centre for Online Health, The University of Queensland, Australia
- Centre for Children’s Health Research, Australia
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19
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Jury SC, Kornberg AJ. Data review of an ongoing telehealth programme in a tertiary paediatric hospital. J Telemed Telecare 2015; 20:384-90. [PMID: 25399999 DOI: 10.1177/1357633x14552375] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Royal Children's Hospital (RCH) in Melbourne has been providing teleconsultations since 2011 using web-based videoconferencing. We reviewed telehealth activity over the first 30 months of the programme. The average consultation rate was 14 per month in 2012, 39 in 2013 and 49 per month in the first half of 2014. One-third of all activity (265 out of 852 consultations) was provided by only two departments: neurology and respiratory medicine. By June 2014, 92% of departments (n = 34) had provided one or more video-consultations. Most telehealth activity was provided by just a few clinicians. A review of actual and billed activity between July 2013 and April 2014 showed that 36% of booked telehealth appointments (n = 144 of 395) were not billed to Medicare; financial and other processes have since been streamlined. A snapshot of telehealth activity over a two-month period was used to estimate the revenue from telehealth. Approximately 65 billed telehealth appointments per month would be required to fund a 0.6 FTE coordinator's post. Overall, the findings have been valuable in planning the future expansion of telehealth at the RCH.
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Affiliation(s)
- Susan C Jury
- Telehealth Department, Royal Children's Hospital, Melbourne, Australia
| | - Andrew J Kornberg
- Neurology Department, Royal Children's Hospital, Melbourne, Australia
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20
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van den Berg N, Schmidt S, Stentzel U, Mühlan H, Hoffmann W. Telemedizinische Versorgungskonzepte in der regionalen Versorgung ländlicher Gebiete. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 58:367-73. [DOI: 10.1007/s00103-015-2134-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Sørensen T, Dyb K, Rygh E, Salvesen R, Thomassen L. A qualitative description of telemedicine for acute stroke care in Norway: technology is not the issue. BMC Health Serv Res 2014; 14:643. [PMID: 25523241 PMCID: PMC4276053 DOI: 10.1186/s12913-014-0643-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 12/09/2014] [Indexed: 11/10/2022] Open
Abstract
Background To assist small hospitals in providing advanced stroke treatment, the Norwegian Directorate of Health has recommended telemedicine services. Telestroke enables specialists to examine patients via videoconferencing supplemented by teleradiology and to provide decision support to local health care personnel. There is evidence that telestroke increases thrombolysis rates. In Norway, telemedicine has mainly been used in non-critical situations. The first telestroke trials took place in 2008. The aim of this paper is to present an overview of telestroke trials and today’s status with telestroke in Norway. Based on the divergent experience from two health regions in Norway, the paper discusses crucial factors for the integration of telestroke in clinical practice. Methods This is a descriptive study based on multiple methods to obtain an overview of the practice and experience with telestroke in Norway. A Web and literature search for ‘telestroke in Norway’ was performed and compared with a survey of telemedicine services at the country's largest hospitals. These findings were supplemented by interviews with key personnel involved in telestroke in two of four health regions, as well as hospital field observations and log data of telestroke transmissions from five of the hospitals involved. Results In Norway, experience in telemedicine for acute stroke care is limited. At the beginning of 2014, three of four regional health authorities were working with telestroke projects and services. Integration of the service in practice is challenging, with varying experience. The problems are not attributed to the technology in itself, but to organization (availability of staff on duty 24/7 and surveillance of the systems), motivation of staff, logistics (patient delay), and characteristics of the buildings (lack of space). Conclusions Prerequisites for successful integration of telestroke in clinical practice include realization of the collaboration potential in the technology with consistent procedures for training and triage, availability of the equipment, and providing advice beyond questions concerning thrombolysis.
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Affiliation(s)
- Tove Sørensen
- Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038, Tromsø, Norway.
| | - Kari Dyb
- Norwegian Centre for Integrated Care and Telemedicine, PO Box 35, NO-9038, Tromsø, Norway.
| | - Ellen Rygh
- Norwegian Centre for Integrated Care and Telemedicine, Kirkeveien 9, NO-4816, Kolbjørnsvik, Norway.
| | - Rolf Salvesen
- Nordland Hospital, NO-8092, Bodø, Norway. .,University of Tromsø, 9038, Tromsø, Norway.
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