Telemedicine journal and e-health : the official journal of the American Telemedicine Association最新文献

{"title":"Lessons Learned from a Vitreoretinal Virtual Service in a Tertiary Referral Center.","authors":"Bence Tasnadi, Anthony Gigon, Huda Al-Hayouti, Shohista Saidkasimova","doi":"10.1089/tmj.2025.0042","DOIUrl":"https://doi.org/10.1089/tmj.2025.0042","url":null,"abstract":"<p><p><b>Background:</b> We present our experience in telemedicine in a tertiary referral hospital covering the west of Scotland, from November 29, 2021, to June 27, 2022. We piloted vitreoretinal virtual clinics where patients were directly referred by community optometrists or by general ophthalmologists. Most patients were referred with an accompanying Optical Coherence Tomography (OCT) scan. A consultant vitreoretinal surgeon reviewed the scans with any accompanying-colored pictures and conducted a telephone consultation with the patients. This study aimed to analyze the efficacy of this virtual service to improve delivery of future care. <b>Methods</b>: This was a retrospective audit study. All patients booked into the virtual telephone clinics for one consultant were identified through the electronic referral pathway and health care records. The total number of patients booked into these virtual clinics was 284, of which 258 attended. Each patient's referral letter and clinic letter were reviewed. Patients were also sent a questionnaire to assess their experience accessing the virtual clinic. <b>Results</b>: Of the 258 patients who attended the virtual clinic, 55 patients were listed for surgical intervention, 6 were sent for outpatient treatment, 38 were invited for a face-to-face consultation, 10 were offered surgery but declined, and 149 were discharged from the clinic. Our patient questionnaire found that 86% of attendees were satisfied with the accessibility of the appointment and 63% were confident in the quality of care provided. <b>Conclusions</b>: The combination of patients requiring no further treatment and those declining treatment demonstrated a 62% reduction in the number of face-to-face hospital appointments required. We believe the use of imaging such as OCT and wide-field colored fundus photography proves to be an excellent tool for assessment of patients in combination with a telephone discussion of symptomatology and management plans. This approach can also prove cost-effective for both the health care systems and the patients.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine in the Management of Patients with Obstructive Sleep Apnea: Evidence from the Literature and Practical Issues. A Consensus Document from the Task Force for Telemedicine in Respiratory Diseases, Part of the Italian Society of Telemedicine.","authors":"Lucia Spicuzza, Antonino Attinà, Elisabetta Bignamini, Marta Cilla, Jessica De Bortoli, Loreta Di Michele, Antonio Foresi, Emanuela Malorgio, Luigi Marino, Alberto Rocca, Domenico Maurizio Toraldo, Antonio Sanna","doi":"10.1089/tmj.2024.0573","DOIUrl":"https://doi.org/10.1089/tmj.2024.0573","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a high prevalent condition associated with relevant cardiovascular morbidity and mortality, determining the consume of a great amount of health care resources. Diagnosis and treatment of OSA are generally performed in OSA Units (OUs). However, although the large expansion of OUs in western countries, these still fail to cope with the increasing number of patients requiring care. Since long time, well before the COVID-19 pandemic, telemedicine (TM) has been explored as a tool to monitor both physiological parameters during sleep and treatment outcomes. Recently, the availability of wireless data transmission technology and new TM solutions has given an impetus to the spread of TM services. Nowadays, these find application throughout the diagnosis, treatment and follow-up of patients with OSA and the management of these patients is recognized as the most promising TM application among chronic disorders. A Task Force of experts in respiratory diseases, within the Italian Society of Telemedicine, has recently produced a document on distance management of OSA. Here, we present a revision of literature discussed by the TF and the document produced focusing on how to integrate TM services into the traditional routine care of patients with OSA.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provider Perspectives of Providing Clinically Appropriate Care with Telemedicine.","authors":"Anne R Links, Lauren Claus, Helen K Hughes, Michele A Manahan","doi":"10.1089/tmj.2025.0040","DOIUrl":"https://doi.org/10.1089/tmj.2025.0040","url":null,"abstract":"<p><p><b>Background:</b> Following the initial resurgence of telemedicine during the COVID-19 pandemic, higher levels of virtual ambulatory care utilization continue. This study aimed to identify factors that contribute to providers' perspectives about the utility of telemedicine across various medical and surgical clinical contexts within a single academic health system. <b>Methods:</b> A cross-sectional survey including an open-response question about the clinical appropriateness of telemedicine was distributed to Johns Hopkins Medicine clinical sites, including 6 hospitals and 40 ambulatory clinics in Maryland, the Washington, D.C., Capital Region, and Florida. Modified grounded theory was used to code responses about the clinical appropriateness of telemedicine. Responses from providers who perform >50% of both new patient and follow-up care via telemedicine were evaluated. <b>Results:</b> Analysis of 567 comments revealed domains of advantage/disadvantages to telemedicine including clinical factors (e.g., physical exam, interventions, testing), process factors (e.g., logistics, technology), information-sharing (teaching, history-taking), communication (e.g., rapport), patient factors (e.g., patient preference, child attention), clinician factors (e.g., clinician preference, reimbursement), and overall appropriateness. Domains of clinical and process factors were most commonly discussed. <b>Conclusion:</b> This study identifies features of telemedicine that may affect the provision of clinically appropriate care across medical and surgical fields. As health care spending continues to be assessed, traditional delivery models may adapt. Proactive identification of opportunities for additional virtual care implementation may assist systems in nimble responsiveness to changing landscapes.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of the Effectiveness of Audio-Only Telemedicine for Chronic Disease Management.","authors":"Brett Moran,&nbsp;Travis Frazier,&nbsp;Larry Steven Brown,&nbsp;Molly Case,&nbsp;Srinivas Polineni,&nbsp;Lonnie Roy","doi":"10.1089/tmj.2021.0285","DOIUrl":"https://doi.org/10.1089/tmj.2021.0285","url":null,"abstract":"<p><p><b><i>Background:</i></b> The clinical effectiveness of audio-only telemedicine has not been fully quantified. The pandemic afforded a unique situation to retrospectively observe clinical outcomes of care for three disease cohorts within three care models, including audio-only telemedicine. <b><i>Methods:</i></b> Patients were classified into three care models: audio-only telemedicine, in-person, and hybrid. Each model was compared with an aggregate group before the onset of the pandemic and within each group during the pandemic. Each disease cohort was evaluated in cross-sectional and paired analyses. <b><i>Results:</i></b> Patients (<i>n</i> = 52,720) were grouped within one of three care models. A majority (<i>n</i> = 48,335) of patients qualified for the \"pre\" group comparison. The audio-only telemedicine care model showed similar control of renal disease, hypertension control, and diabetes management than in-person and hybrid care models. <b><i>Conclusions:</i></b> Audio-only telemedicine appears to be noninferior to in-person or hybrid models for chronic disease management for the diseases studied. In all instances, it had similar control compared with the in-person care model. We acknowledge the limitations of this study, including convenience sampling and a limited observation timeframe. Audio-only telemedicine should be considered a viable care model modality that can be integrated into options for patient care. Further study and investment are warranted, as it provides efficacy and convenience to health systems (Clinical Registration Number # 32449).</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1280-1284"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39814680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Effectiveness of Telemedicine in Reproductive and Neonatal Health in Rural and Low-Income Areas in India.","authors":"Siddhartha S Peri,&nbsp;Ann D Bagchi,&nbsp;Alok Baveja","doi":"10.1089/tmj.2021.0481","DOIUrl":"https://doi.org/10.1089/tmj.2021.0481","url":null,"abstract":"<p><p>A systematic review of four relevant databases for articles about the use of telemedicine to expand access to neonatal and reproductive health in rural India was conducted. The objective of this review was to identify initiatives with evidence for potential public health benefits through large-scale implementation. Of 3,098 records from the initial search, 1,415 records were selected for further review after removing duplicates. Eight reports that met the eligibility and inclusion criteria were included in the final review. Selected studies included two types of interventions, direct telemedicine interventions with patients and indirect telemedicine interventions through frontline health care workers. Among studies involving direct telemedicine interventions, 22.4% of the collective health and knowledge outcomes (n = 49) showed statistically significant improvement in the intervention group, whereas 38.0% of the collective health and knowledge outcomes (n = 50) in the studies involving indirect telemedicine intervention showed statistically significant improvement. This systematic review suggested that the use of telemedicine interventions may have a statistically significant effect through educational impacts. There were certain limitations around the use of technology and training that may have undermined the effects of some of the outcomes. This systematic review did not receive any funding.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1251-1260"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39925835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative Use of a Mobile Web Application to Remotely Monitor Nonhospitalized Patients with COVID-19.","authors":"Rebekah L Gardner,&nbsp;Jacqueline Haskell,&nbsp;Brenda Jenkins,&nbsp;Lauren F Capizzo,&nbsp;Emily L Cooper,&nbsp;Blake Morphis","doi":"10.1089/tmj.2021.0429","DOIUrl":"https://doi.org/10.1089/tmj.2021.0429","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Most patients with COVID-19 do not require hospitalization but may need close monitoring, which can strain primary care practices. Our objective was to describe the implementation of a mobile web application to monitor COVID-19 signs and symptoms among nonhospitalized primary care patients and to assess the feasibility and acceptability of the application. <b><i>Study Design:</i></b> Retrospective analysis of (1) mobile web application data from March through December 2020 and (2) cross-sectional surveys administered in June 2020. <b><i>Materials and Methods:</i></b> We enrolled nonhospitalized patients and staff from nine New England primary care practices across 29 sites. Outcomes included feasibility and acceptability of the application as measured by the proportion of texts that resulted in a response, proportion of patients who agreed using the application was easy, and proportion of practice staff who agreed the application reduced outreach burden and that they would recommend use. <b><i>Results:</i></b> Five thousand five hundred thirty-two patients used the mobile web application, with 26,466 total responses. Overall, 78% of the daily texts resulted in a response from patients. Most patients agreed that responding to texts was easy (95%) and that they would be willing to participate in other texting programs (78%). Most staff agreed that the program reduced burden of outreach (94%) and that they would recommend use to other practices (100%). <b><i>Conclusions:</i></b> Use of a COVID-19 symptom tracking application was feasible and acceptable to patients and primary care practice staff. Outpatient practices should consider use of mobile web applications to monitor nonhospitalized patients with other acute illnesses.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1285-1292"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39676065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Preferences for Current and Planned Future Use of Telemedicine.","authors":"Ayane Rossano,&nbsp;Tom Crijns,&nbsp;David Ring,&nbsp;Jason Reichenberg","doi":"10.1089/tmj.2021.0486","DOIUrl":"https://doi.org/10.1089/tmj.2021.0486","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Many clinicians and patients tried telemedicine for the first time during the COVID-19 pandemic. In a prior survey, we found that clinicians who were adaptable and willing to incorporate technology into their clinical practice are more likely to utilize telemedicine. Seeking factors associated with current and future use of telemedicine, and identifying its relative advantages and drawbacks, may help determine the role of telemedicine after the pandemic. <b><i>Questions/Purposes:</i></b> We asked (1) which demographic factors and personal preferences are associated with current and planned future use of telemedicine, (2) what factors are associated with telemedicine utilization, and (3) what are clinician-reported advantages and disadvantages of telemedicine? <b><i>Materials and Methods:</i></b> Approximately 750 clinicians within a national multispecialty hospital group were invited to complete an online survey assessing telemedicine use and preferences, self-reported technology proficiency, and personal characteristics. A total of 284 clinicians started the survey, and 259 complete responses were analyzed using bivariate analysis and multivariable regression. <b><i>Results:</i></b> More frequent current telemedicine use was associated with being a nonsurgeon clinician, not primarily practicing in an inpatient setting, preferring either telemedicine or having no preference for discussing sensitive topics, and greater self-reported technological proficiency. Planned future telemedicine use was associated with greater self-reported troubleshoot ability and less desire for a hands-on physical examination. Clinicians reported that the top benefits of telemedicine are decreased barriers for patients and convenience for clinicians, and disadvantages are technical difficulties for both patients and clinicians. <b><i>Conclusions:</i></b> Telemedicine continues to be widely utilized by clinicians, particularly those who are confident in their ability to examine patients over video, and who can troubleshoot issues that arise on the platform. With continued reimbursement, telemedicine is likely to remain a convenient and effective method of caring for patients.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1293-1299"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39680207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance of Telehealth Therapy to Replace In-Person Therapy for Autism Treatment During COVID-19 Pandemic: An Assessment of Patient Variables.","authors":"Jenna Aranki,&nbsp;Patricia Wright,&nbsp;Paula Pompa-Craven,&nbsp;Amin D Lotfizadeh","doi":"10.1089/tmj.2021.0397","DOIUrl":"https://doi.org/10.1089/tmj.2021.0397","url":null,"abstract":"<p><p><b><i>Importance:</i></b> Children with autism achieve improved behavioral outcomes with applied behavior analytic (ABA) interventions. Typically, ABA is delivered in a participant's home or in a clinic setting. At the onset of COVID-19, treatment in these environments was not available due to health exposure concerns. A large social service organization in California rapidly pivoted to the delivery of ABA intervention through telehealth. Access disparity for telehealth has been a historical concern in health care delivery, particularly for disenfranchised populations within the autistic participant population. <b><i>Objective:</i></b> This study evaluated the demographic and behavioral variables associated with the acceptance or declination of telehealth by the pediatric participants' caregivers at the onset of the pandemic. <b><i>Design, Setting, Participants:</i></b> A non-experimental design was used, and archival data were compared for a random sample of 100 participants with autism who accepted telehealth interventions with 100 participants who declined it. <b><i>Main Outcomes and Measures:</i></b> Socioeconomic data, gender, age, ethnicity, language, and household size were compared. Clinical data were compared for treatment dosage, standardized Vineland Adaptive Behavior Scales scores, and Verbal Behavior Milestones Assessment and Placement Program scores. <b><i>Results:</i></b> None of the demographic variables were statistically significant in a participant's acceptance or declination of telehealth, but there were moderate differences in treatment dosage across the groups. <b><i>Conclusions:</i></b> It is concerning that a large portion of participants initially declined intervention via telehealth, resulting in these participants experiencing a gap in intervention during the pandemic. As intervention is imperative for pediatric autism participants, it is untenable that ∼40% of the population initially declined telehealth at the start of the pandemic.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1342-1349"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39765852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Satisfaction of Telemedicine Remote Patient Monitoring: A Systematic Review.","authors":"Parker A Rhoden,&nbsp;Heather Bonilha,&nbsp;Jillian Harvey","doi":"10.1089/tmj.2021.0434","DOIUrl":"https://doi.org/10.1089/tmj.2021.0434","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> To examine the variety of patient satisfaction instruments (i.e., measures, methods, and scales) used within telemedicine remote patient monitoring (RPM) services; and to assess the quality of RPM patient satisfaction instruments. <b><i>Methods:</i></b> Three databases were searched for articles that used survey instrumentation to assess patient satisfaction of RPM services: (1) Healthcare Administration Database (PROQUEST), (2) Cumulative Index to Nursing and Allied Health Literature (CINAHL), and (3) PubMed (MEDLINE). The quality of survey instrumentation methods was assessed based on validity and reliability using the Terwee et al. framework. <b><i>Results:</i></b> Nine studies were included in the final review. For internal consistency, seven out of nine studies received an \"indeterminant\" quality rating; six out of nine of the studies received a \"positive\" quality rating for measurement error. For content validity, seven out of nine studies received a \"positive\" quality rating. <b><i>Discussion:</i></b> There are several RPM surveys that are used to assess patient satisfaction. This review suggests wide variation among the quality, reliability, and validity of the surveys currently used in practice. Assessing patient satisfaction of RPM services by organizations, researchers, and practitioners should be done through use of reliable instrumentation.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1332-1341"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39831216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Development of a Telehealth Patient Satisfaction Survey Using a Multi-Stakeholder Approach.","authors":"En-Ju D Lin,&nbsp;Mounika Guntu,&nbsp;Emre Sezgin,&nbsp;Laura McLaughlin,&nbsp;Rajesh Ganta,&nbsp;Jennifer Lee,&nbsp;Ujjwal Ramtekkar,&nbsp;Yungui Huang,&nbsp;Simon Lin Linwood","doi":"10.1089/tmj.2021.0371","DOIUrl":"https://doi.org/10.1089/tmj.2021.0371","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The COVID-19 pandemic has hastened the adoption of telehealth and the drastic shift to an unfamiliar process may impose significant impact to the quality-of-care delivery. Many providers are interested in understanding the quality of their telehealth services from the patients' experience. <b><i>Materials and Methods:</i></b> A telehealth patient satisfaction survey (TPSS) was developed by using an iterative stakeholder-centered design approach, incorporating elements from validated telemedicine and customer service survey instruments, and meeting the operational needs and constraints. A cross-sectional study design was employed to collect survey responses from patients and families of a large pediatric hospital. Finally, we performed exploratory factor analysis (EFA) to extract latent constructs and factor loadings of the survey items to further explain relationships. <b><i>Results:</i></b> A 22-item TPSS closely matched the existing in-person patient satisfaction survey and mapped to a revised SERVPERF conceptual model that was proposed by the interdisciplinary committee. Survey was implemented in the HIPAA-compliant online platform REDCap^® with survey link embedded in an automated Epic MyChart (Verona, WI) visit follow-up message. In total, 2,394 survey responses were collected between July 7, 2020, and September 2, 2020. EFA revealed three constructs (with factor loadings >0.30): admission process, perceived quality of services, and telehealth satisfaction. <b><i>Conclusions:</i></b> We reported the development of TPSS that met the operational needs of compatibility with existing data and possible comparison to in-person survey. The survey is short and yet covers both the clinical experience and telehealth usability, with acceptable survey validity.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1270-1279"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39836009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}