Journal of Telemedicine and Telecare最新文献

{"title":"Variation in telehealth use for endocrine care: Patterns and predictors under the \"new normal\".","authors":"Varsha G Vimalananda, Kevin Arao, Shirley Qian, Alison Leibowitz, Margaret F Zupa, Justin Benzer, B Graeme Fincke, Mark Zocchi, Mark Meterko, Dan Berlowitz, Kailyn E Sitter, Jolie B Wormwood","doi":"10.1177/1357633X231203144","DOIUrl":"10.1177/1357633X231203144","url":null,"abstract":"<p><p>IntroductionUse of telehealth for outpatient endocrine care remains common since onset of the COVID-19 pandemic, though the context for its use has matured. We aimed to describe the variation in telehealth use for outpatient endocrine visits under these \"new normal\" conditions and examine the patient, clinician-, and organization-level factors predicting use.MethodsRetrospective cross-sectional study using data from the U.S. Department of Veterans Affairs (VA) Corporate Data Warehouse on 167,017 endocrine visits conducted between 3/9/21 and 3/8/22. We used mixed effects logistic regression models to examine 1) use of telehealth vs. in-person care among all visits and 2) use of telephone vs. video among the subsample of telehealth visits.ResultsVisits were in person (58%), by telephone (29%), or by video (13%). Unique variability in telehealth use at each level of the analysis was 56% patient visit, 24% clinician, 18% facility. The strongest predictors were visit type (first vs. follow up) and clinician and facility characteristics. Among telehealth visits, unique variability in telephone (vs. video) use at each level was 44% patient visit, 24% clinician, 26% facility. The strongest predictors of telephone vs. video were visit type, patient age, and percent of the facility's population that was rural.ConclusionsWe found wide variation in use of telehealth for endocrinology under the \"new normal\". Future research should examine clinician and facility factors driving variation, as many may be amenable to influence by clinical leaders and leveraged to enhance the availability of telehealth for all clinically appropriate patients.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"592-600"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41218059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural safety in telehealth consultations with Indigenous people: A scoping review of global literature.","authors":"Kirsty Terrill, Hannah Woodall, Rebecca Evans, Tarun Sen Gupta, Raelene Ward, Kay Brumpton","doi":"10.1177/1357633X231203874","DOIUrl":"10.1177/1357633X231203874","url":null,"abstract":"<p><p>IntroductionTelehealth has become increasingly routine within healthcare and has potential to reduce barriers to care, including for Indigenous populations. However, it is crucial for practitioners to first ensure that their telehealth practice is culturally safe. This review aims to describe the attributes of culturally safe telehealth consultations for Indigenous people as well as strategies that could promote cultural safety.MethodsA scoping review was conducted on key features of cultural safety in telehealth for Indigenous people using the Johanna Briggs Institute (JBI) guidelines and PRISMA-ScR checklist. Five electronic databases were searched, and additional literature was identified through handsearching.ResultsA total of 649 articles were screened resulting in 17 articles included in the review. The central themes related to the provision of culturally safe telehealth refer to attributes of the practitioner: cultural and community knowledge, communication skills and the building and maintenance of patient-provider relationships. These practitioner attributes are modified and shaped by external environmental factors: technology, the availability of support staff and the telehealth setting.DiscussionThis review identified practitioner-led features which enhance cultural safety but also recognised the structural factors that can contribute, both positively and negatively, to the cultural safety of a telehealth interaction. For some individuals, telehealth is not a comfortable or acceptable form of care. However, if strategies are undertaken to make telehealth more culturally safe, it has the potential to increase opportunities for access to care and thus contribute towards reducing health inequalities faced by Indigenous peoples.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"515-522"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Declining trends in telehealth utilization in the ongoing COVID-19 pandemic.","authors":"David Shilane, Ting'an Heidi Lu","doi":"10.1177/1357633X231202284","DOIUrl":"10.1177/1357633X231202284","url":null,"abstract":"<p><p>IntroductionTelehealth is an important complement to in-person healthcare, with opportunities to overcome barriers to healthcare and improve health equity. Telehealth utilization increased sharply at the onset of the COVID-19 pandemic. This study assessed trends in telehealth utilization for the years 2020 through 2022, both overall and in subgroups.MethodsWe gathered data from the 2020-2022 National Health Interview Survey. The rates of telehealth utilization were calculated overall and within subgroups based on demographic factors, health conditions, healthcare utilization, challenges of ability, and social needs. Adjusted multivariable logistic regression models of telehealth utilization assessed the yearly trends. We also analyzed the ratios of subgroup utilization relative to the overall rates.ResultsA total of 69,581 patients were identified with complete information. The overall rates of telehealth utilization were 36.2% for 2020, 38.9% for 2021, and 31.3% for 2022. The reduction in telehealth utilization for 2022 was large and statistically significant (OR: 0.64 (95% CI: 0.62-0.67), <i>p</i> < 0.001). Subgroup analyses showed corresponding reductions in 2022 for essentially all patient subgroups. Telehealth was utilized at higher rates by patients with chronic conditions, challenges of ability, and other kinds of medical utilization. Ratio analyses showed evidence of widening disparities for patients of older age, in rural areas, and by geographic region, limited education, and of low income.DiscussionThe study demonstrates declining rates of telehealth utilization are occurring with widening gaps among patient subgroups. Addressing these disparities may be critical to improving equity in telehealth and healthcare overall.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"563-571"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth competencies for allied health professionals: A scoping review.","authors":"Krithika Anil, Adam R Bird, Kate Bridgman, Shane Erickson, Jennifer Freeman, Carol McKinstry, Christie Robinson, Sally Abey","doi":"10.1177/1357633X231201877","DOIUrl":"10.1177/1357633X231201877","url":null,"abstract":"<p><p>IntroductionTelehealth has become one of the main methods of delivering allied health professional services world-wide, yet many professionals do not have sufficient training to deliver high-quality telehealth services. This review aims to identify what competencies allied health professionals require for effective telehealth service delivery.MethodsThis scoping review used the Population Concept Context framework and searched the following databases: MEDLINE, CINAHL, PsychInfo, Cochrane, EMBASE, Web of Science, PEDro, United Kingdom Health Forum, WHO, Health Education England, and all UK and Australian AHP professional bodies.ResultsA total of 37 articles were included out of 92,525 identified by the literature search. Competencies were related to two areas: (1) delivery of the telehealth consultation and (2) service management of telehealth consultations. The first area included the following competency themes: clinical reasoning, communication, effectively using technology, person-centred care, practice-based assessment and intervention knowledge/behaviour/skills, privacy, security, and patient safety, professionalism, and setting up the technical environment. The second area included the following competency themes: digital infrastructure, informing practice, and management. Although findings emphasised the importance of telehealth competencies, none have been implemented within education. One-third of the articles were from the discipline of psychology.ConclusionThis is the first scoping review to combine telehealth competencies reported across allied health disciplines. Although there were a vast range of competencies, they need implementation into teaching and learning to be practically useful. Most competencies were from psychology, but potentially applicable for other allied health professionals. A shared and adaptable standard for telehealth competencies would be useful to ensure high-quality practice across all allied health professionals.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"487-499"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of interactive cardiac rehabilitation web applications versus usual care on programme completion in patients with cardiovascular disease: A systematic review and meta-analysis of randomised controlled trials.","authors":"Katie Nesbitt, Stephanie Champion, Vincent Pearson, Lemlem G Gebremichael, Hila Dafny, Joyce S Ramos, Orathai Suebkinorn, Maria A Pinero de Plaza, Aarti Gulyani, Huiyun Du, Robyn A Clark, Alline Beleigoli","doi":"10.1177/1357633X231201874","DOIUrl":"10.1177/1357633X231201874","url":null,"abstract":"<p><p>IntroductionAlthough available evidence demonstrates positive clinical outcomes for patients attending and completing cardiac rehabilitation, the effectiveness of interactive cardiac rehabilitation web applications on programme completion has not been systematically examined.MethodsThis JBI systematic review of effects included studies measuring effectiveness of interactive cardiac rehabilitation web applications compared to telephone, and centre-based programmes. Outcome data were pooled under programme completion and clinical outcomes (body mass index, low-density lipoproteins, and blood pressure). Databases including MEDLINE (via Ovid), Cochrane Library, Scopus (via Elsevier) and CINAHL (via EBSCO) published in English were searched. Articles were screened and reviewed by two independent reviewers for inclusion, and the JBI critical appraisal tool and Grading of Recommendations Assessment, Development and Evaluation tool were applied to appraise and assess the certainty of the findings of the included studies. A meta-analysis of the primary and secondary outcomes used random effects models.ResultsIn total, nine studies involving 1175 participants who participated in web-based cardiac rehabilitation to usual care were identified. The mean critical appraisal tool score was 76 (standard deviation: 9.7) with all (100%) studies scoring >69%, and the certainty of evidence low. Web-based programmes were 43% more likely to be completed than usual care (risk ratio: 1.43; 95% confidence interval: 0.96, 2.13) There was no difference between groups for clinical outcomes.DiscussionDespite the relatively small number of studies, high heterogeneity and the limited outcome measures, the results appeared to favour web-based cardiac rehabilitation with regard to programme completion.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"475-486"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth access, willingness, and barriers during the COVID-19 pandemic among a nationally representative diverse sample of U.S. adults with and without chronic health conditions.","authors":"Randy Le, Izabelle Mendez, Stephanie A Ponce, Alexis Green, Sherine El-Toukhy, Anna M Nápoles, Paula D Strassle","doi":"10.1177/1357633X231199522","DOIUrl":"10.1177/1357633X231199522","url":null,"abstract":"<p><p>IntroductionDuring the COVID-19 pandemic, telehealth services represented a critical tool in maintaining continuity and access to care for adults in the USA. However, despite improvements in access and utilization during the pandemic, disparities in telehealth utilization have persisted. It is unclear what role access and willingness to use telehealth play in telehealth disparities.MethodsWe used data from the nationally representative COVID-19's Unequal Racial Burden (CURB) survey, an online survey conducted between December 2020 and February 2021, <i>n</i> = 5500. Multivariable Poisson regression was used to estimate the prevalence of perceived telehealth access and willingness to use telehealth services among adults with and without chronic conditions.ResultsOverall, 60.1% of adults with and 38.7% of adults without chronic conditions reported having access to telehealth. After adjustment, adults with chronic conditions were more likely to report telehealth access (adjusted prevalence ratio [aPR] = 1.35, 95% confidence interval [CI] = 1.21-1.50). Most adults with and without chronic conditions reported being willing to use telehealth services (85.1% and 79.8%, respectively), and no significant differences in willingness were observed across chronic condition status (aPR = 1.03, 95% CI = 0.95-1.13). Perceived telehealth access appeared to be a predictor of telehealth willingness in both groups (chronic conditions: aPR = 1.22, 95% CI = 0.97-1.54; no chronic conditions: aPR = 1.37, 95% CI = 1.22-1.54). The prevalence of perceived barriers to telehealth was low, with the majority reporting no barriers (chronic conditions = 51.4%; no chronic conditions = 61.4%).DiscussionPerceived access to telehealth was associated with telehealth willingness. Investing in approaches that increase telehealth accessibility and awareness is needed to improve access to telehealth for adults with and without chronic conditions.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"547-557"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10937324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10297114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an algorithm-driven home telemonitoring system on the metabolic control and self-care behaviour of Asian adults with type-2 diabetes mellitus: A randomised controlled trial.","authors":"Ngiap Chuan Tan, Shilpa Tyagi, Cia Sin Lee, Eileen Yi Ling Koh, Kuan Liang Shawn Goh, Pei Pei Gong, Seng Bin Ang, Choon Huat Gerald Koh","doi":"10.1177/1357633X231203490","DOIUrl":"10.1177/1357633X231203490","url":null,"abstract":"<p><p>AimHealthcare professionals are leveraging on telehealth to manage patients with type-2 diabetes mellitus (T2DM). This study aimed to determine the clinical outcomes of patients using a novel tele-monitoring system (OPTIMUM) as compared to the standard of care.MethodsAn open-labelled randomised controlled trial involving 330 Asian patients with T2DM, aged 26-65 years, and suboptimal glycaemic control (HbA1c = 7.5-10%) was conducted in a Singapore public primary care clinic. The patients were assigned in a 1:1 ratio by block randomization to the intervention group to receive: in-app video-based tele-education, tele-monitoring of the blood pressure (BP), capillary glucose and weight via Bluetooth devices and mobile application, followed by algorithm-based tele-management by the OPTIMUM telehealth care team for abnormal parameters. Patients received usual care in the control group. Clinical assessments and self-care-related questionnaires were administered for both groups at baseline and 6 months.ResultsComplete data of 159 (intervention) and 160 (control) patients with comparable demographic profiles were analysed. Those in the intervention group showed significantly lower HbA1c by 0.34% (95%CI = -0.57 to -0.11; <i>p</i> = 0.004); first measurement of systolic BP decreased by 2.98 mmHg (95%CI:-5.8 to -0.08; <i>p</i> = 0.044) and diastolic BP by 4.24 mmHg (95%CI = -6.0 to -2.47; <i>p</i> = 0.001); and total cholesterol by 0.18 mmol/L (95%CI:  -0.34 to -0.01; <i>p</i> = 0.040) compared to the control group, after adjusting for baseline variables. Questionnaire scores showed significant improvements in medication adherence and self-care behaviour in the intervention group. No significant weight change was noted between groups.ConclusionThe OPTIMUM tele-monitoring system improved the glycaemic, BP and total cholesterol control in patients with suboptimal T2DM control by enhancing their medication adherence and self-care over 6 months.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"523-533"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41150580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tele-assessment of trunk control in children with cerebral palsy: Intra- and inter-rater reliability, and validity of the trunk control measurement scale.","authors":"Sefa Üneş, Merve Tunçdemir, Cemil Özal, Kivanç Delioğlu, Kübra Seyhan Bıyık, Mintaze Kerem Günel","doi":"10.1177/1357633X251336009","DOIUrl":"https://doi.org/10.1177/1357633X251336009","url":null,"abstract":"<p><p>IntroductionThe aim of the study was to evaluate the intra- and inter-rater reliability, and validity of the Trunk Control Measurement Scale (TCMS) for tele-assessment in children with cerebral palsy (CP).MethodA cross-sectional study was conducted with 36 children aged 4-18 years, diagnosed with hemiplegic CP. Participants underwent four TCMS assessments: in-person assessment, tele-assessment via videoconferencing, and two video-based tele-assessments scored by same rater and by a second rater. Reliability was analyzed using intraclass correlation coefficients (ICC). Discriminant validity was assessed by comparing TCMS tele-assessment scores between children with Gross Motor Function Classification System (GMFCS) levels I and II, while criterion validity was evaluated by examining the correlation between face-to-face and tele-assessment TCMS scores.ResultsExcellent reliability was observed between face-to-face and tele-assessment (ICC: 0.91; 95%CI: 0.83-0.95). TCMS tele-assessment also demonstrated excellent intra-rater reliability (ICC: 0.90, 95%CI: 0.80-0.94) and high inter-rater reliability (ICC: 0.82, 95%CI: 0.66-0.90). Criterion validity was confirmed by strong correlations between face-to-face and tele-assessment scores (<i>r</i> = 0.925, and <i>r</i> = 0.892, <i>p</i> < 0.001 for rater-1 and rater-2, respectively). The TCMS successfully discriminated children by functional levels, demonstrating discriminative validity (<i>p</i> = 0.002). Bland-Altman analysis revealed minimal systematic error, with internal consistency remaining high across all assessments (>0.88).DiscussionTCMS is a valid and reliable tool for teleassessing trunk control in children with hemiplegic CP. These results may pave the way for developing child-specific, targeted telerehabilitation programs, bringing telerehabilitation closer to its primary aim of ensuring equal opportunities.This study was registered as a clinical trial (NCT06707831). https://clinicaltrials.gov/study/NCT06707831.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251336009"},"PeriodicalIF":3.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translatability of physical examination to teleconsultation in primary care setting.","authors":"Kate Sy Tong, Moomna Waheed, Tim M Jackson, Takashi Sota, Annie Ys Lau","doi":"10.1177/1357633X251333899","DOIUrl":"https://doi.org/10.1177/1357633X251333899","url":null,"abstract":"<p><p>BackgroundTelehealth has been widely accepted and investigated however little is known about virtual physical examination (VPE) in primary care settings. In order to understand and improve patient and clinician experience during VPE, we need to analyse the physical examination during in-person general practitioner (GP) consultations.ObjectiveWe aim to analyse the characteristics of physical examination (PE) during in-person GP consultations including topics of consultations, types of physical examinations, equipment used and body area examined. We then evaluate how translatable these PE are over telehealth.MethodsEligible consultations were extracted from a dataset archive named HaRI, which contains 281 in-person GP consultations in de-identified transcript and video format. Eligible consultations were processed with data extracted. Finally, an evidence-based scoring system was used on each PE, determining its likelihood of being translated to telehealth.ResultsWe analysed 169 in-person GP consultations, in which 79% (133 out of 169) required physical examination (PE). A total of 307 physical examinations, 224 counts of equipment and 331 counts of body parts were observed. Out of 52 physical examination components we have observed, 79% were translatable but only 8% of these were deemed easily translatable over telehealth. 21% of the physical examinations were considered 'untranslatable over telehealth'.ConclusionOver half (54%) of the physical examinations were at least moderately translatable, especially for vital signs, musculoskeletal, neurological and cardiovascular exams. However, more research is warranted to increase the accuracy, reliability and translatability of virtual physical examinations and when VPE is not feasible, safety netting should be applied.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251333899"},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the telemedicine facilitators scale: A novel measure of telemedicine facilitators and use.","authors":"Jack D Watson, Alexandra L Silverman, Bridget Xia, Rea Pillai, Rajesh Balkrishnan, Bradford S Pierce, Paul B Perrin","doi":"10.1177/1357633X251333534","DOIUrl":"https://doi.org/10.1177/1357633X251333534","url":null,"abstract":"<p><p>The COVID-19 pandemic resulted in a dramatic increase in the use of telemedicine, with heightened rates of use persisting postpandemic. This change in use created a need for a valid and reliable scale to assess telemedicine use and facilitators impacting its uptake. The current study developed and validated the Telemedicine Facilitators Scale (TFS), a novel measure for assessing facilitators of telemedicine uptake. A sample of 228 physicians completed 13 items for the TFS along with an index of telemedicine use for convergent validity. We conducted two confirmatory factor analysis (CFA) models testing a four-factor structure (Positive Attitudes, Facilitating Infrastructure, Organizational Support, and External Policies) and a bifactor model in which all items loaded onto to a single telemedicine facilitators factor and the previous four factors. Both the four-factor CFA and bifactor models demonstrated acceptable fit for χ²/degrees of freedom, comparative fit index, and incremental fit index. The correlations among subscales showed that each subscale, while related, measured independent constructs. Both the general telemedicine facilitators factor and all four subfactors were positively correlated with telemedicine use, evidencing good convergent validity. Results suggest that the TFS may be used as a four-factor scale, a unidimensional scale, or a scale composed of both an overarching construct and four subconstructs. The TFS represents a useful tool for researchers, clinicians, and healthcare administrators who wish to study, use, or facilitate the use and evolution of telemedicine.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251333534"},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}