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

{"title":"Telehealth and Digital Interventions for Type 2 Diabetes and Hypertension in Latin America and the Caribbean: A Systematic Review and Meta-Analysis.","authors":"Fabián Torres-Campoverde, Bolívar Torres-Campoverde","doi":"10.1177/15305627261497215","DOIUrl":"https://doi.org/10.1177/15305627261497215","url":null,"abstract":"<p><strong>Background: </strong>Telehealth, remote monitoring, and other digital interventions may support chronic disease management, but evidence from Latin America and the Caribbean (LAC) remains fragmented. We evaluated clinical effectiveness and characterized human support, clinical integration, and implementation.</p><p><strong>Methods: </strong>PubMed, Scopus, SciELO, and LILACS were searched through July 2026 for studies of digital interventions in adults with type 2 diabetes or hypertension in LAC. Random-effects meta-analyses were restricted to randomized trials and used restricted maximum likelihood estimation, Hartung-Knapp adjustment, and 95% prediction intervals (PIs). Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation.</p><p><strong>Results: </strong>Thirty-six studies (41 reports) from 12 countries were included: 15 randomized and 21 nonrandomized. Six trials (<i>n</i> = 689) showed lower HbA1c (mean difference [MD] -1.23 percentage points; 95% confidence interval [CI] -2.19 to -0.26; <i>I² =</i> 83.8%; PI: -3.64 to 1.18). Seven trials (<i>n</i> = 2,280) showed lower systolic blood pressure (SBP; MD: -4.97 mmHg; 95% CI: -7.15 to -2.79; <i>I² =</i> 26.1%; PI: -8.85 to -1.09), and five (<i>n</i> = 1,825) showed lower diastolic blood pressure (DBP; MD: -3.46 mmHg; 95% CI: -5.69 to -1.22; <i>I² =</i> 76.1%; PI: -9.24 to 2.33). Certainty was moderate for SBP and low for HbA1c and DBP. Professional support and clinical integration were common, whereas sustainability, scalability, interoperability, costs, and equity were inconsistently evaluated.</p><p><strong>Conclusions: </strong>Digitally enabled chronic care may improve glycemic and blood-pressure control in LAC, with the most consistent evidence for SBP. Heterogeneous intervention models and limited implementation evidence warrant comparative effectiveness-implementation studies.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261497215"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207500","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":"Looking Back and Looking Forward-A Windshield into the Future.","authors":"Charles R Doarn","doi":"10.1177/15305627261498503","DOIUrl":"https://doi.org/10.1177/15305627261498503","url":null,"abstract":"","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261498503"},"PeriodicalIF":2.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140394","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":"Remote Patient Monitoring for Neonates Discharged Home on Nasogastric Tube Feeds: A Multicenter Survey of Practices, Eligibility Criteria, and Implementation Barriers.","authors":"Sujir Pritha Nayak, Ahmed Syed, Abeer Azzuqa, John Chuo, Jeanne Zenge, Tavleen Sandhu, Abhishek Makkar","doi":"10.1177/15305627261495376","DOIUrl":"https://doi.org/10.1177/15305627261495376","url":null,"abstract":"<p><strong>Objective: </strong>To characterize institutional practices, eligibility criteria, monitoring strategies, and perceived barriers related to remote patient monitoring (RPM) for neonates discharged home on nasogastric tube (NGT) feeds across Children's Hospital Neonatal Consortium (CHNC) institutions.</p><p><strong>Methods: </strong>We conducted a cross-sectional, web-based survey of neonatal care providers across CHNC institutions. The survey assessed eligibility criteria for home NGT feeding, RPM implementation protocols, feeding regimens, follow-up practices, monitoring duration, outcomes tracked, and perceived barriers. Responses were collected anonymously via Research Electronic Data Capture and analyzed using descriptive statistics.</p><p><strong>Results: </strong>A total of 25 centers responded (50% response rate), with most respondents from neonatology (96%). Overall, 84% of centers reported discharging selected neonates home on NGT feeds, and 75% of centers without an established home NGT program planned implementation within 1-2 years. Medical stability (90.5%) and reliable caregiver involvement (85.7%) were commonly required, although eligibility criteria varied. Monitoring platforms, frequency, and duration were heterogeneous, with 61.9% continuing monitoring until NGT discontinuation. Fewer than half (47.6%) reported billing for home NGT monitoring services. Commonly tracked outcomes included growth (61.9%), gastrostomy tube placement (52.4%), and readmissions (47.6%). Major barriers included limited staffing support (66.7%), staff time commitment (57.1%), and reimbursement concerns (42.9%).</p><p><strong>Conclusions: </strong>Home NGT feeding is commonly practiced among the responding CHNC institutions; however, eligibility and monitoring practices vary considerably. Consensus-based eligibility criteria, standardized monitoring and outcome measures, and sustainable staffing and reimbursement models may improve consistency and facilitate evaluation of these programs.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261495376"},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130242","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":"Disparities in Virtual Outpatient Mental Health Care Utilization Among Commercially Insured Children and Adults, 2023-2025.","authors":"Dena M Bravata, James M Hudson, Severin Kibby, Jonathan Cantor, Christopher Whaley, Nicole M Benson","doi":"10.1177/15305627261493347","DOIUrl":"10.1177/15305627261493347","url":null,"abstract":"<p><strong>Introduction: </strong>Early COVID-19 pandemic-era studies documented rapid adoption of telemental health, but current utilization patterns and disparities, particularly among children and young adults, remain poorly characterized since the COVID-19 Public Health Emergency ended in May 2023. The objective of this work was to characterize current utilization of virtual versus in-person outpatient mental health care in a large national cohort of commercially insured children and adults and to assess variation by patient, provider, clinical, and geographic characteristics.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed 28,844,298 outpatient mental health visits delivered to 1,843,439 commercially insured patients aged 6-64 years between January 2023 and December 2025. The primary outcome was the percentage of visits delivered virtually, compared across age, gender, provider type, diagnosis, state, urbanicity, and social vulnerability index.</p><p><strong>Results: </strong>Overall, 77.6% of visits were delivered virtually, declining from 79.7% (2023) to 76.2% (2025). Children aged 6-12 years had substantially lower telehealth utilization than young adults aged 18-24 years (37.1% vs. 77.0%, <i>p</i> < 0.001), a disparity more pronounced for psychotherapy than psychiatry. Virtual care was highest for attention-deficit/hyperactivity disorder, anxiety, and depressive disorders, and higher among prescribers than psychotherapists (90.4% vs. 75.7%). Rural patients used virtual care less than urban patients (70.3% vs. 77.5%), whereas utilization was higher among patients in areas of greater social vulnerability.</p><p><strong>Conclusions: </strong>In this large national cohort, virtual mental health care remained widely used but unevenly distributed. Persistent disparities by age, geography, clinical need, and social vulnerability highlight the need for hybrid care models and policies addressing digital access barriers.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261493347"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122863","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":"<i>Letter:</i> Entropy, Energy, and Organization in Telemedicine.","authors":"Jonghoon Kang","doi":"10.1177/15305627261495382","DOIUrl":"https://doi.org/10.1177/15305627261495382","url":null,"abstract":"","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261495382"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122860","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":"Advancing Neonatal Tele-Resuscitation in Community Settings: Effects of Targeted Workshops on Provider Perception and Procedural Confidence.","authors":"Tavleen Sandhu, Lise DeShea, Jennifer L Fang, Rachel Umoren, Abhishek Makkar","doi":"10.1177/15305627261461861","DOIUrl":"10.1177/15305627261461861","url":null,"abstract":"<p><strong>Background: </strong>Approximately 50,000 neonates weighing under 1,500 grams are born annually in the United States, with 15-20% delivered in smaller community hospitals without a neonatal intensive care unit. These \"outborn\" infants face higher risks of adverse outcomes due to limited resources. Implementing tele-resuscitation services with targeted training workshops may enhance providers' technical skills, confidence, and perceptions of feasibility and acceptability.</p><p><strong>Methods: </strong>In January 2023, Oklahoma Children's Hospital launched a tele-resuscitation program offering real-time, audio-video support to community hospital staff. This service targeted neonates ≤32 weeks' gestation, <1,500 g, and those >32 weeks requiring advanced resuscitation. Workshops were hosted to give community hospital providers a first hand experience with the technology, and it included background on tele-resuscitation, technical skills training, and neonatal resuscitation simulations incorporating telemedicine. Pre- and postworkshop surveys with Likert scale questions assessed attendees' confidence in advanced resuscitation and feasibility of integrating tele-resuscitation into practice.</p><p><strong>Results: </strong>Briefly, 20 community providers attended two interprofessional workshops, including 5 physicians (25%), 11 nurses (55%), and 4 respiratory therapists (20%). One-quarter of attendees reported prior experience with telemedicine, and one attendee reported prior experience with tele-resuscitation. Following the workshops, participant confidence in performing tasks such as intubation, umbilical line placement, needle thoracentesis, and debriefing increased significantly (<i>p</i> < 0.001 for all procedures). While ratings for the appeal and applicability of telemedicine to their practice showed no significant changes (<i>p</i> = 0.267 and <i>p</i> = 0.056, respectively), the perceived feasibility of tele-resuscitation significantly improved after the workshop (<i>p</i> = 0.029).</p><p><strong>Conclusions: </strong>Neonatal tele-resuscitation workshops improved providers' perceptions of this service and increased their acceptance of such a program. Additionally, the skill sessions and simulated resuscitations increased their confidence with procedures commonly performed during advanced neonatal resuscitation.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1067-1073"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280837","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":"Resilience of Pediatric Telemedicine: Therapeutic Alliance and Practice-Level Experience During a Pandemic-Driven System Transformation.","authors":"Joann Ramezanzadeh, Dimitrios Zikos","doi":"10.1177/15305627261461867","DOIUrl":"10.1177/15305627261461867","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic caused a sudden transition from in-person to virtual pediatric care, creating a natural experiment to evaluate patient experience with telemedicine under operational stress. As hybrid care models mature, understanding perceptions during this disruption can inform durable delivery strategies, particularly regarding the therapeutic alliance and practice-level experience.</p><p><strong>Purpose: </strong>To determine whether family experience with telemedicine was comparable to or differed from in-person care during the COVID-19 transition and to assess how delivery modality, pandemic phase, and patient characteristics were associated with experience outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional secondary analysis of 18,452 patient and family experience surveys linked to ambulatory pediatric encounters at a large academic medical center between January 1 and September 30, 2020. Encounters were categorized into pre-COVID, early COVID rapid deployment, and later COVID hybrid stabilization phases. Surveys reflected both in-person and synchronous video-based telemedicine visits; telemedicine accounted for approximately 30% of responses during the study period. Independent-samples <i>t</i> tests and multiple linear regression models evaluated associations among visit modality, experience metrics, and demographic characteristics. Primary outcomes were Overall Rating of Provider and Recommend Office.</p><p><strong>Results: </strong>During Early COVID, telemedicine visits demonstrated significantly higher provider ratings than in-person visits, indicating preservation of the therapeutic alliance during rapid system change, although the absolute difference was small. In the later COVID phase, telemedicine was associated with higher unadjusted office recommendation scores; however, this effect was not independently associated with delivery modality in adjusted models. Telemedicine remained an independent predictor of higher provider ratings.</p><p><strong>Conclusions: </strong>Telemedicine sustained clinician-level experience outcomes comparable to, and in some contexts higher than, in-person care across pandemic phases. Findings support institutionalizing hybrid pediatric care models, strengthening clinician virtual communication skills, and advancing digital equity efforts.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1003-1011"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280813","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":"Disparities in Initial Usage of Direct-to-Patient Teledermatology: A Retrospective Observational Study.","authors":"Sara B Peracca, Daniel J Sturgeon, Rebecca P Lamkin, E David Zepeda, David C Mohr, Olevie Lachica, Heather A King, George L Jackson, Isis J Morris, Allen L Gifford, John D Whited, Martin A Weinstock, Dennis H Oh","doi":"10.1177/15305627261458160","DOIUrl":"10.1177/15305627261458160","url":null,"abstract":"<p><strong>Background: </strong>While telehealth has potential to enhance patients' access to care, uneven implementation may limit its impact. My VA Images (<i>MVAI</i>), a clinician-gated, patient-facing asynchronous teledermatology application developed by the Department of Veterans Affairs (VA) was piloted at three VA facilities, and then sequentially offered to groups of seven facilities every 3 months for 1 year. We characterized patients who were exposed to and used <i>MVAI</i> and we identified associated characteristics.</p><p><strong>Methods: </strong>We used VA's mobile health and administrative databases to examine <i>MVAI</i> activity and dermatology patient demographics over a 17-month period during 2019 and 2020.</p><p><strong>Results: </strong>At 11 VA facilities, 494 established dermatology patients were invited to a follow-up visit using <i>MVAI</i>. Invitees were more likely than Non-Invitees to be White and urban, have shorter drive times to specialty care, and have more outpatient and dermatology visits before and after <i>MVAI</i> use. Forty-eight percent of Invitees successfully used <i>MVAI</i> and were most likely to do so in the 8-30 day interval. Successful Users were more likely than Unsuccessful Users to be younger and have a dermatology visit 1 year after <i>MVAI</i> use. Patients requiring multiple attempts before successfully using <i>MVAI</i> were older than initially Successful Users, though younger than Unsuccessful Users.</p><p><strong>Conclusions: </strong>Not all patients benefited equally during the initial rollout of <i>MVAI</i>. Disparities in VA where other forms of patient-facing telehealth are already common illustrate challenges for health care organizations in equitably implementing direct-to-patient teledermatology. Specific groups may benefit from targeted outreach or support.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1012-1020"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261330","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 Preferences for Virtual Versus In-Person Care in Inflammatory Bowel Disease: A Cross-Sectional Study.","authors":"Ahmed Alghamdi, Sultan Alshahrani, Hesham Almuaili, Abdullah Alhassoun, Alrayuf Alothri, Hamoud Alfawzan, Abdulkareem Alyousef, Bader Alhammad, Bandar Alazmi, Hatim Karhan, Renad Alharbi, Abeer Alhuraibi, Thamer Alotaibi, Abdullah Bawazir","doi":"10.1177/15305627261467001","DOIUrl":"10.1177/15305627261467001","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine adoption in gastroenterology has accelerated rapidly in recent years. Virtual interventions offer disease activity control comparable to standard in-person care. However, factors determining patient satisfaction and personal perceptions of virtual clinics remain poorly explored. This study identifies the clinical, demographic, and socioeconomic predictors of clinic format preference among patients with inflammatory bowel disease.</p><p><strong>Methods: </strong>We conducted a cross-sectional observational study at King Fahad Medical City in Riyadh, Saudi Arabia. The study included adult patients diagnosed with Crohn's disease or ulcerative colitis. Authors collected demographic parameters, clinical covariates, and patient experience ratings using a structured questionnaire. A multivariable binary logistic regression model was employed to isolate independent predictors of virtual clinic preference.</p><p><strong>Results: </strong>The cohort comprised 1,005 patients. Overall, 55.6% preferred in-person appointments and 44.4% preferred virtual clinics. Prior telehealth exposure served as the strongest predictor for future virtual care (odds ratio [OR] = 4.10; 95% confidence interval [CI]: 2.90, 5.82). Patients utilizing subcutaneous injections (OR = 2.02) or oral medications (OR = 1.81) demonstrated significantly higher odds of selecting virtual care. Conversely, an ulcerative colitis diagnosis predicted a preference for physical visits (OR = 0.63). Prioritizing ease of access (OR = 1.47) and the use of technology (OR = 2.14) underpinned virtual choices. Strict privacy concerns (OR = 0.57) and inadequate physician communication (OR = 0.05) deterred patients from the remote clinic.</p><p><strong>Conclusion: </strong>Prior telehealth experience and the use of home-based therapies drive virtual clinic adoption. Disease phenotype, reliance on intravenous treatments, and privacy concerns may necessitate accessible in-person care. Health care systems must abandon uniform digital strategies and implement tailored, hybrid care models to optimize resource allocation.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1039-1051"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379589","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":"Characterization of Clinical Diagnoses at a Community Telehealth Platform in Uganda.","authors":"Flavian Otieno, Daniel Mwanga, Ashiraf Mawanda, Louis Kamulegeya, John Mark Bwanika, Damazo Kadengye, Agnes Kiragga","doi":"10.1177/15305627261464772","DOIUrl":"10.1177/15305627261464772","url":null,"abstract":"<p><strong>Background: </strong>Rocket Health Africa (formerly The Medical Concierge Group) pioneered telehealth in Uganda by integrating technology with personalized care, providing consultations, diagnostics, pharmacy services, laboratory services, clinics, and vaccination services on a single platform.</p><p><strong>Methods: </strong>This study examined the diagnostic and demographic profiles captured through Rocket Health's digital health platform from 2019 to 2023, across the prepandemic, pandemic, and postpandemic periods, using descriptive statistics.</p><p><strong>Results: </strong>A total of 2,677 users were recorded on the telehealth platform during the prepandemic period, 47,072 during the pandemic, and 99,904 during the postpandemic period. Male users accounted for the largest proportion of platform users across all three periods. Married individuals constituted the largest proportion by marital status categories, while users aged 25-34 accounted for the highest proportion within the age group distribution. A range of diagnostic categories was documented across the study period. Diseases of the respiratory system, such as acute upper respiratory infection, were the most frequently recorded diagnostic category, followed by symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified, including fever, headache, and cough. Certain infectious and parasitic diseases, such as coronavirus infection, candidiasis of the vulva and vagina, and <i>Plasmodium falciparum</i> malaria, constituted the third most frequently recorded diagnostic category.</p><p><strong>Conclusions: </strong>Telehealth utilization in Uganda was documented across diverse demographic groups and diagnostic categories over three distinct periods. These findings inform future telehealth policy and planning in Uganda and sub-Saharan Africa.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1021-1028"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355009","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}