Journal of Telemedicine and Telecare最新文献

{"title":"Using the Unified Theory of Acceptance and Use of Technology (UTAUT) to predict the behavioral intent of teledentistry utilization amongst United States adults.","authors":"Mercedes D VanDeWiele, Angela M Hastings, Michael D Evans, Megan S O'Connell, Priscilla M Flynn","doi":"10.1177/1357633X231182405","DOIUrl":"10.1177/1357633X231182405","url":null,"abstract":"<p><strong>Introduction: </strong>Teledentistry is an innovative health care delivery platform that can potentially improve oral health access and outcomes. The purpose of this study was to predict teledentistry utilization intentions of U.S. adults using the Unified Theory of Acceptance and Use of Technology (UTAUT) as a framework.</p><p><strong>Methods: </strong>This mixed-method, cross-sectional study surveyed 899 participants from two independent samples in August and September 2021. Convenience samples of Minnesota State Fair attendees and ResearchMatch volunteers completed electronic surveys to identify the behavioral intention (BI) for teledentistry use within the next 6 months. Independent variables were the UTAUT constructs of performance expectancy (PE), effort expectancy (EE), social influence (SI), and facilitating conditions (FC). Data were analyzed using univariate analysis and multiple linear regression adjusting for age, gender and educational level. Qualitative analysis used thematic analysis using UTAUT as a coding framework.</p><p><strong>Results: </strong>Univariate analysis showed statistical significance between each construct with BI (<i>P </i>< 0.0001). Adjusted multiple linear regression revealed statistical significance between PE and SI with BI (<i>P </i>< 0.0001). Qualitative responses corroborated quantitative results and revealed a lack of teledentistry knowledge.</p><p><strong>Conclusion: </strong>The majority of participants indicated an intention not to use teledentistry within the next 6 months. The lack of prior experience of telehealth or teledentistry use in addition to lack of knowledge regarding teledentistry may contribute to these results. Future interventions to improve the BI to use teledentistry may benefit from focusing on PE and SI constructs for educational and marketing strategies.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"286-296"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9867700","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":"Limb-saving emergent procedural sedation and joint reduction via telehealth.","authors":"Benjamin Powell, Clinton Gibbs","doi":"10.1177/1357633X251313593","DOIUrl":"https://doi.org/10.1177/1357633X251313593","url":null,"abstract":"<p><p>In this case report, we describe the performance of procedural sedation and emergent joint reduction via remote telehealth leadership for a patient with an acutely limb-threatening injury. The patient was a 33-year-old man who presented to a small rural hospital with a fracture dislocation of his ankle complicated by severe pain refractory to opiate analgesia and neurovascular compromise, including absent peripheral pulses and sensory changes. Due to aviation and resource limitation factors, immediate retrieval was not possible. While it was clear he needed urgent treatment, local staff expressed that they did not possess the training or requisite experience to undertake a procedural sedation and joint reduction. Following extensive discussions between the telehealth specialist and the local team, the telehealth doctor assumed clinical governance for the case, serving as team leader and coaching the local team through a ketamine procedural sedation and emergent joint reduction. Ultimately, these procedures were successful, with immediate improvement in limb neurovascular status. This case, along with prior work, demonstrates that High-Acuity Low-Occurrence (HALO) procedures can be facilitated by telehealth. Key learning points from the case include the choice of anaesthetic agent given limited local experience, delegating a separate telehealth clinician to monitor patient vital signs to cognitively offload local staff, and the importance of detailed pre-procedure discussions prior to completing HALO tasks.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251313593"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069058","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":"Effect of telemental health adoption on mental health services utilization in federally qualified health centers.","authors":"Khyathi Gadag, Kanika Arora, Whitney E Zahnd","doi":"10.1177/1357633X241307417","DOIUrl":"https://doi.org/10.1177/1357633X241307417","url":null,"abstract":"<p><strong>Introduction: </strong>Mental health issues disproportionately affect rural and low-income populations, where access to prevention and treatment is limited. Implementing telemental health services (TMHS) in Federally Qualified Health Centers (FQHCs) could improve accessibility to mental healthcare. This study assessed the effect of TMHS on mental health services utilization in FQHCs, comparing centers with and without TMHS and examined differences in TMHS effect between FQHCs that adopted TMHS before and during the pandemic.</p><p><strong>Methods: </strong>The study utilized FQHC-level data from Uniform Data Systems annual performance reports (<i>N</i> = 9540 FQHC-year) and county-level demographic, health status, and provider characteristic data from 2016 to 2022. A two-way fixed effects model was applied to examine the effect of TMHS on mental health visit rates, supplemented by the Sun and Abraham difference-in-differences estimator. The analysis included both pre-COVID and during-COVID TMHS adopters.</p><p><strong>Results: </strong>FQHCs offering TMHS showed 1.04 times increase in overall mental health visit rates compared to those without TMHS. Centers serving higher proportions of Medicaid-insured (1.07 times) and low-income (below 200% FPL; 1.05 times) populations showed even higher visit rates. During-COVID TMHS adopters showed a significant increase (1.05 times), particularly in urban areas, whereas rural adopters did not see significant changes.</p><p><strong>Conclusion: </strong>FQHCs offering TMHS showed increased mental health visit rates, especially among low-income and Medicaid-insured populations. FQHCs that adopted TMHS during the pandemic experienced a marked rise in mental health visits, but rural-urban disparities persist, highlighting the ongoing challenges in expanding access to mental healthcare in rural settings.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X241307417"},"PeriodicalIF":3.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030171","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":"Innovative telehospitalist model optimizes medical triage in collaboration with community emergency departments: A cross-sectional study.","authors":"Adam T Koch, Rachel L Keuseman, Riddhi Parikh, Sean R Legler, Shant Ayanian, Renu Bhargavi Boyapati, Karen M Fischer, Donna K Lawson, Sagar B Dugani, M Caroline Burton, Sandeep R Pagali","doi":"10.1177/1357633X241311957","DOIUrl":"https://doi.org/10.1177/1357633X241311957","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal hospital bed utilization requires innovative patient care models. We studied a novel hospitalist model utilizing telemedicine to facilitate collaboration with affiliated emergency departments (EDs) and support medical triage and care of ED patients with high likelihood of hospital admission.</p><p><strong>Methods: </strong>Telehospitalists based at a tertiary care facility collaborated with four community EDs in the same healthcare network between January 1, 2022, and April 30, 2023. Telehospitalists supported ED clinicians in medical care decisions and facilitated patient disposition. Emergency department length of stay (LOS) and disposition were evaluated, as were hospital LOS, 30-day readmission, and in-hospital mortality. For patients discharged from the ED, 7-day ED readmission and subsequent hospitalization were evaluated.</p><p><strong>Results: </strong>Telehospitalists discussed 550 \"admit-likely\" patients with ED clinicians: 105 patients (19.1%) discharged from the ED and avoided admission; 322 patients (58.5%) were admitted to local or nearby community hospitals; 123 patients (22.4%) transferred to the tertiary care facility. Emergency department LOS differed significantly among disposition groups, including patients discharged home (10.2 h), admitted to local hospitals (12.6 h), and transferred to tertiary care hospitalist services (14.9 h; <i>p</i> < 0.001). Hospital LOS and in-hospital mortality were not significantly different among disposition groups. Patients admitted locally had lower 30-day readmission compared to those transferred to tertiary care facility (odds ratio = 0.59 [0.36, 0.99], <i>p</i> = 0.048).</p><p><strong>Discussion: </strong>Telehospitalists as triage clinicians is an innovative approach to support local ED clinicians and patients. Telehospitalists optimized hospital bed utilization and healthcare system resources by facilitating safe discharges to home and expediting tertiary care transfers when necessary.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X241311957"},"PeriodicalIF":3.5,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025570","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":"A time series analysis of Medicare-reimbursed telepsychiatry consultations across Australian states and territories before and after telehealth item expansion: Enabling policy can improve access to care.","authors":"Luke Sy-Cherng Woon, Paul A Maguire, Rebecca E Reay, David Smith, Tarun Bastiampillai, Jeffrey Cl Looi","doi":"10.1177/1357633X241311623","DOIUrl":"https://doi.org/10.1177/1357633X241311623","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to examine the associations of telepsychiatry consultations with the Medicare Benefits Schedule (MBS) telehealth policy changes (pandemic-related expansion and subsequent consolidation).</p><p><strong>Methods: </strong>We performed a time series analysis of MBS telepsychiatry usage (January 2016-December 2023) using state/territory-level Medicare panel data. Linear regression analyses with panel-corrected standard error and autocorrelation were performed for telepsychiatry consultations (overall and age and sex subgroups). Telehealth policies, rural psychiatrist availability (rural psychiatrists per 100,000 population) and their interaction were the independent variables. The models were adjusted for pandemic lockdown severity (Stringency Index) and population size.</p><p><strong>Results: </strong>Telehealth expansion and consolidation were associated with substantial increases in telepsychiatry consultations, with larger increases in the consolidation phase. Given the telehealth policy changes, lower per capita rural psychiatrists were associated with more telepsychiatry consultations. Males and older people (>65 years) showed greater relative consultation increases. Policy change-related telepsychiatry increases varied amongst states and territories.</p><p><strong>Discussion: </strong>There was sustained telepsychiatry usage when it became more readily available, beyond the direct impact of acute pandemic lockdowns. Telehealth-enabling policies may contribute to fulfilling unmet mental health needs and improving access to psychiatric care amongst Australians. Further in-depth research in this area is needed.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X241311623"},"PeriodicalIF":3.5,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015128","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":"Trauma-focused evidence-based psychotherapy for post-traumatic stress disorder delivered via video telehealth in the Veterans Health Administration.","authors":"Nicholas Holder, Adam Batten, Brian Shiner, Shira Maguen","doi":"10.1177/1357633X241304072","DOIUrl":"https://doi.org/10.1177/1357633X241304072","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma-focused evidence-based psychotherapy (EBP) is the recommended treatment for post-traumatic stress disorder (PTSD). During and after the COVID-19 pandemic, veterans began to initiate general mental health services delivered via video telehealth at high rates. Our goal in the current project was to describe the percentage as well as the demographic, military, and clinical characteristics of veterans receiving PTSD EBPs via video telehealth versus in-person.</p><p><strong>Methods: </strong>Using data from the VA electronic health record, we identified a national cohort of all-era veterans who received individual PTSD EBP between April 2022 and April 2023 (<i>n </i>= 24,447). We used multivariable hierarchical Bayesian logistic regression to model the probability of receiving at least 50% of their EBP care via video telehealth.</p><p><strong>Results: </strong>In our sample, 74.4% of veterans who received PTSD EBP used video telehealth for at least one EBP session and 66.8% of veterans received at least half of their EBP sessions by video telehealth. Female veterans, younger veterans, and veterans with fewer mental health comorbidities were more likely to have received their PTSD EBP via video telehealth. Additional strong interaction effects for Black female veterans, Hispanic female veterans, female officer veterans, and Black officer veterans.</p><p><strong>Discussion: </strong>Video telehealth delivery of PTSD EBPs was more common than in-person delivery of PTSD EBPs. Consistent with underlying trends in telehealth services, female veterans, and particularly female, racial/ethnic minority veterans were more likely to receive PTSD EBP via video telehealth. Future research designed to contextualize the observed differences in video telehealth delivery of PTSD EBPs should consider the role of social determinants of health.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X241304072"},"PeriodicalIF":3.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958009","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":"Effectiveness of a telerehabilitation tablet app in combination with face-to-face physiotherapy for people with wrist, hand or finger injuries: A pragmatic multicentre clinical trial.","authors":"Alejandro Suero-Pineda, Ángel Oliva-Pascual-Vaca, Manuel Rodríguez-Piñero Durán, Pablo Rodríguez Sánchez-Laulhé, María Ángeles García-Frasquet, Jesús Blanquero","doi":"10.1177/1357633X231172245","DOIUrl":"10.1177/1357633X231172245","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether, in patients with trauma and soft tissue injuries of the wrist, hand and/or fingers, an exercise program performed on a touchscreen tablet-based app reduces the consumption of face-to-face resources and improves clinical recovery, compared to a conventional home exercise program prescribed on paper.</p><p><strong>Design: </strong>Pragmatic, multicentre, parallel, two-group, controlled clinical trial with blinded assessor.</p><p><strong>Participants and setting: </strong>Eighty-one patients with traumatic bone and/or soft tissue injuries of the hand, wrist and/or fingers recruited in four hospitals of the Andalusian Public Health System.</p><p><strong>Interventions: </strong>The experimental group received a home exercise program using a touchscreen tablet application and the control group received a home exercise program on paper. Both groups received the same treatment of face-to-face physiotherapy.</p><p><strong>Primary outcome: </strong>Number of physiotherapy sessions. Secondary outcomes were the duration of physiotherapy and clinical variables such as functional ability, grip strength, pain and manual dexterity.</p><p><strong>Results: </strong>The experimental group required fewer physiotherapy sessions (MD -11,5 sessions; 95% CI -21.4 to -1.4), showed a shorter duration of physiotherapy (MD -3.8 weeks, 95% CI -7 to -1) and had better recovery of grip strength, pain and dexterity compared to the control group.</p><p><strong>Conclusions: </strong>In patients with trauma and soft tissue injuries of the wrist, hand and/or fingers, an exercise program performed on a touchscreen tablet-based app in combination with face-to-face physiotherapy reduces the consumption of face-to-face resources and improves clinical recovery, compared to conventional home exercise program prescribed on paper.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"29-40"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9489136","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":"Perceptions of telehealth among older U.S. adults during the COVID-19 pandemic: A national survey.","authors":"Kathleen Y Li, Liz B Marquis, Preeti N Malani, Erica Solway, Matthias Kirch, Dianne Singer, Jeffrey T Kullgren, Melissa A Plegue, Lorraine R Buis","doi":"10.1177/1357633X231166031","DOIUrl":"10.1177/1357633X231166031","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 necessitated a shift from in-person to virtual care for all patients, particularly older adults. It is unknown how older individuals' views of telehealth changed during this time and how this may affect their future use of telehealth services.</p><p><strong>Methods: </strong>We used data from a cross-sectional online survey of a nationally representative sample of 2074 U.S. adults ages 50-80 who were participants in the National Poll on Healthy Aging. We performed a descriptive and multivariable analysis of individuals' perspectives on past and future telehealth visits, sociodemographics, and health status.</p><p><strong>Results: </strong>Before March 2020, 5.8% of respondents had used telehealth, compared to 32.0% by June 2020. Of telehealth users, 36.1% indicated their most recent telehealth visit used audio-only (i.e., without video) technology. In multivariable analysis, those who never used video technology compared to those who were \"very comfortable\" (average marginal effect (AME) 49%, 95% CI: 36-63), identified as Hispanic (AME 19% vs White, non-Hispanic, 95% CI: 5-32), or were female (AME 9%, 95% CI: 1-17) were more likely to report audio-only use. Concerns remained about the inability to conduct physical exams (75%) and telehealth quality of care (67%), though most (64%) older adults indicated an interest in future telehealth visits.</p><p><strong>Discussion: </strong>Telehealth use increased substantially among older U.S. adults during the early months of the COVID-19 pandemic; however, many reported using audio-only telehealth, an important consideration for policymakers and providers. Addressing older adults' concerns about and barriers to telehealth visits is needed to ensure telehealth does not exacerbate disparities in their care.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"55-63"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080170/pdf/10.1177_1357633X231166031.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283104","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":"Shifting behavioral intervention research to virtual methods: Challenges and solutions in practice, during and after the COVID-19 pandemic.","authors":"Kylie M Steinhilber, Reena S Chabria, Amy Clara, Jennifer S Temel, Joseph A Greer, Lara Traeger, Jamie M Jacobs","doi":"10.1177/1357633X231167899","DOIUrl":"10.1177/1357633X231167899","url":null,"abstract":"<p><p>Behavioral medicine researchers have rapidly adapted study procedures and interventions to telehealth modalities during the pandemic. We rely heavily on telehealth research methods to avoid study delays and mitigate risk to chronically ill patients our studies aim to support. We implemented methods to virtually recruit, enroll, and retain patients and their families on clinical trials, and virtually deliver study interventions. These adaptations are likely to become permanent amid ongoing virus variants and surges in cases. However, little has been written about how remote methods apply in practice. This paper documents these processes to maximize efficiency across our research studies and systems and highlights the strengths and challenges of transitioning our research protocols to telehealth. We outline solutions to using remote methods across the entire span of the research process, including study recruitment, data collection, and intervention delivery. We offer insight into the implications of these transitions on research staff and interventionists. In providing a transparent review of the advantages and challenges of implementing remote methods, we encourage discourse around remote methods implementation, share the lessons we learned, and inform the design of future trials. Further research is needed to review the clinical feasibility and acceptability of these procedures.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"134-139"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130932/pdf/10.1177_1357633X231167899.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9400166","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":"Implementation of the Good Life with osteoArthritis in Denmark (GLA:D^®) program via telehealth in Australia: A mixed-methods program evaluation.","authors":"Allison M Ezzat, Joanne L Kemp, Joshua J Heerey, Marcella F Pazzinatto, Danilo De Oliveira Silva, Karen Dundules, Matthew Francis, Christian J Barton","doi":"10.1177/1357633X231167620","DOIUrl":"10.1177/1357633X231167620","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate the implementation of the Good Life with osteoArthritis in Denmark (GLA:D^®) program via telehealth in Australia using Reach, Effectiveness, Adoption, Implementation, and Maintenance Qualitative Evaluation for Systematic Translation framework.</p><p><strong>Methods: </strong>Using a convergent mixed-methods design, semi-structured one-on-one interviews with physiotherapist adopters and nonadopters of GLA:D^® via telehealth were analyzed thematically alongside the examination of registry data (1 March 2020-10 February 2022) from patients with hip or knee osteoarthritis completing GLA:D^® via telehealth (telehealth-only) or combined with in-person care (hybrid). Effectiveness was determined as changes from baseline to 3-month follow-up (mean differences, 95% confidence intervals, effect size) for Knee injury and Osteoarthritis Outcome Score (KOOS-12)/Hip disability and Osteoarthritis Outcome Score-12 (HOOS-12), and chair stand test. Group- and individual-level changes were compared to published minimally clinically important change scores.</p><p><strong>Results: </strong>Twenty-three interviews (12 adopters, 11 nonadopters) found key barriers/facilitators to reach and adoption, high perceived effectiveness, and strategies to support sustainability. Of 2612 registered patients, 85 (3%) and 115 (4%) completed GLA:D^® via telehealth-only or hybrid model, respectively. Most effectiveness outcomes were associated with moderate-large improvements. Group-level changes exceeded minimally clinically important change values for KOOS/HOOS-quality of life and chair stand test. Nearly two out of three patients reached a minimally clinically important change for KOOS/HOOS-quality of life. With telehealth-only and hybrid delivery, 99% (<i>n</i> = 82) and 85% (<i>n</i> = 97) were satisfied/very satisfied. Physiotherapist adoption was limited (<i>n</i> = 128, 6%).</p><p><strong>Discussion: </strong>GLA:D^® delivered via telehealth is effective, had high patient satisfaction, and was perceived positively by physiotherapist adopters. Addressing low reach and adoption requires further implementation strategies to facilitate greater telehealth opportunities for patients and physiotherapists.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"104-120"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9391525","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}