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

{"title":"Providers at a Midwestern Academic System Report a Positive Experience with Telehealth During the COVID-19 Pandemic.","authors":"Jenna Berg,&nbsp;Kristy Carlson,&nbsp;Sarah Richards","doi":"10.1089/tmj.2021.0410","DOIUrl":"https://doi.org/10.1089/tmj.2021.0410","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Since the onset of the COVID-19 pandemic, there has been rapid expansion in the use of telehealth. As a result, many providers who had no prior experience using telehealth are now using it to provide patient care. The goal of this study was to survey health care providers on a wide range of telehealth topics including their experiences examining and connecting with patients digitally, identifying which types of patients may be best suited to telehealth, and identifying technical and logistical areas for improvement when using telehealth. <b><i>Methods:</i></b> Physicians and advanced practice providers (n = 944) at a large midwestern academic system were invited to complete an anonymous online survey during a 2-week period in October 2020. <b><i>Results:</i></b> Surveys, completed and analyzed (n = 178), indicated 86.6% of respondents felt confident in their clinical assessment, and 86.1% felt they formed an adequate personal connection with the patient in the majority of telehealth visits. A majority (58.5%) of providers felt telehealth was not effective for new patients, but 83% of providers felt it was effective for providing care to established patients. Respondents identified several areas for technological improvement including issues with video (27.5%) and audio (16.8%) quality. In 24.4% of visits, these technology issues were severe enough providers needed to convert an audiovisual appointment to telephone. <b><i>Conclusions:</i></b> Provider experience with telehealth has largely been positive at our institution. Although telehealth may not be appropriate for new patients, providers did feel it was an effective means of providing care for established patients. To continue improving the quality of telehealth, a multiteam approach should be considered, including members of technology and clinical operations teams working closely with those providers experienced in telehealth.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1379-1385"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39665371","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":"Access to Telepharmacy Services May Reduce Hospital Admissions in Outpatient Populations During the COVID-19 Pandemic.","authors":"Erik Hefti,&nbsp;Benjamin Wei,&nbsp;Kristen Engelen","doi":"10.1089/tmj.2021.0420","DOIUrl":"https://doi.org/10.1089/tmj.2021.0420","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Avoidable hospital admissions put increased pressure on already strained health care resources, causing emotional and financial distress for patients and their families while taxing the health system. Pharmacist involvement in patient care has been shown to improve health care outcomes. Telepharmacy allows for personalized interaction and access to pharmacy services in a flexible format. The primary aim of this report is to explore the impact that access to a personalized telepharmacy service has on the hospital admission rate in an outpatient population before and during the COVID-19 pandemic. <b><i>Materials and Methods:</i></b> A retrospective, double-arm cohort study was performed. Hospital admission rates were analyzed in two similarly aged groups; one group (<i>n</i> = 2,242) had access to telepharmacy services through their primary care provider and another group did not (<i>n</i> = 1,540), from 2019 to 2020. Statistical analysis was performed to explore hospitalization rates in both groups. <b><i>Results:</i></b> An increase in hospitalization rates was observed in both groups of patients from 2019 to 2020. The patient group that had access to the telepharmacy service demonstrated a reduced rise in hospitalization rates versus the group without access to the telepharmacy service (access group +12.9% vs. nonaccess group +40.2%, <i>p</i> < 0.05, Student's <i>t</i>-test). <b><i>Discussion:</i></b> The patient group with access to telepharmacy services demonstrated a reduced increase in hospitalizations versus the group without access in 2020. While this represents a preliminary investigation into the potential impacts of telepharmacy on hospitalization rates, telepharmacy services may have a role in improving patient outcomes and cost savings.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1324-1331"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9508445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39813632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Satisfaction and Interest in Telemedicine Visits Following Total Knee and Hip Replacement Surgery.","authors":"Michael R Moore,&nbsp;Matthew S Galetta,&nbsp;Ran Schwarzkopf,&nbsp;James D Slover","doi":"10.1089/tmj.2021.0439","DOIUrl":"https://doi.org/10.1089/tmj.2021.0439","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Telemedicine is the practice of caring for patients remotely when the patient and provider are not physically present at the same location. Within orthopedic surgery, telemedicine offers care without the typical obstacles of an in-person appointment such as difficulty ambulating following surgery and patient wait times. In this study, we evaluated patient interest and satisfaction in postoperative telemedicine visits following hip or knee arthroplasty surgery. <b><i>Materials and Methods:</i></b> Patients were offered either a traditional in-person or a remote telemedicine postoperative visit following surgery. Patients were asked to complete a satisfaction survey following their postoperative visit regarding their experience. Patient-survey responses as well as patient-reported outcome metrics were captured using a mobile and web-based electronic patient rehabilitation application. <b><i>Results:</i></b> A total of 766 patients were included in this study with 360 offered postoperative telemedicine visits and 402 offered traditional in-person visits. Two hundred fifty-nine patients reported satisfaction levels with their telemedicine visit, with 58.3% of patients characterizing their feelings with the visit as \"extremely satisfied,\" 32.0% as \"satisfied,\" 8.9% as \"neutral,\" 0.3% as \"dissatisfied,\" and 0.3% as \"extremely dissatisfied.\" A total of 713 patients reported how the COVID-19 pandemic effected their feelings toward telemedicine with 12.9% of patients characterizing the affect as \"extremely positively,\" 33.1% of patients as \"positively,\" 48.9% of patients as \"neutral,\" 3.6% of patients as \"negatively,\" and 1.4% of patients as \"extremely negatively.\" There were no significant differences in the change between preoperative Hip disability and Osteoarthritis Outcome Scores/Knee Injury and Osteoarthritis Outcome Score Joint Replacement, or Veterans RAND 12 Physical and Mental components and these values at 12 weeks follow-up and 1-year follow-up, respectively, in patients who had telemedicine visits versus those who had traditional in-person visits. <b><i>Discussion:</i></b> The results of this study demonstrate that the patients who decided to have a telemedicine visit during their postoperative visit were satisfied with their experience. Overall, COVID-19 had a positive influence on patient's feelings toward telemedicine visits.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1309-1316"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39889305","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 for Cranial Radiosurgery Patients in a Rural U.S. Population: Patterns and Predictors of Patient Utilization.","authors":"Daniel T Cifarelli,&nbsp;Joshua S Weir,&nbsp;Jenifer D Slusser,&nbsp;Tanya M Smith,&nbsp;Rebecca DeWitt,&nbsp;Christopher P Cifarelli","doi":"10.1089/tmj.2021.0519","DOIUrl":"https://doi.org/10.1089/tmj.2021.0519","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Telemedicine retains potential for increasing access to specialty providers in underserved and rural communities. COVID-19 accelerated adoption of telehealth beyond rural populations, serving as a primary modality of patient-provider encounters for many nonemergent diagnoses. <b><i>Methods:</i></b> From 2020 to 2021, telemedicine was incorporated in management of stereotactic radiosurgery patients. Retrospective data on diagnoses, demographics, distance to primary clinic, and encounter type were captured and statistically analyzed using descriptive measures and Cox proportional regression modeling. Graphical representation of service areas was created using geo-mapping software. <b><i>Results:</i></b> Patients (<i>n</i> = 208) completed 331 telemedicine encounters over 12 months. Metastases and meningiomas comprised 60% of diagnoses. Median age was 62 years with median household income and residential population of $44,752 and 7,634 people. The one-way mean and median travel distances were 74.6 and 66.3 miles. The total potential road mileage for all patients was 44,596 miles. A total of 118 (57%) patients completed video visits during the first encounter, whereas 90 (43%) opted for telephone encounters. At 12 months, 138 patients (66%) utilized video visits and 70 (34%) used telephone visits. Predictors of video visit use were video-enabled visit during the first encounter (hazard ratio [HR] 2.806, <i>p</i> < 0.001), total potential distance traveled (HR 1.681, <i>p</i> < 0.05), and the need for more than one visit per year (HR 2.903, <i>p</i> < 0.001). <b><i>Discussion:</i></b> Telemedicine can be effective in radiosurgery practice with predictors of video-enabled use being pre-existing patient comfort levels with videoconferencing, total annual travel distance, and number of visits per year. Age, rural population status, and household income did not impact telemedicine use in our patient cohort.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1317-1323"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39858456","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":"Identifying the Factors Influencing Patients' Telehealth Visit Satisfaction: Survey Validation Through a Structural Equation Modeling Approach.","authors":"Mounika Guntu,&nbsp;En-Ju D Lin,&nbsp;Emre Sezgin,&nbsp;Megan E Gregory,&nbsp;Yungui Huang,&nbsp;Simon Lin Linwood","doi":"10.1089/tmj.2021.0372","DOIUrl":"https://doi.org/10.1089/tmj.2021.0372","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The COVID-19 pandemic accelerated the adoption of telehealth as an alternative to in-person hospital visits. To understand the factors impacting the quality of telehealth services, there is a need for validated survey instruments and conceptual frameworks. The objective of this study is to validate a telehealth patient satisfaction survey by structural equation modeling (SEM) and determine the relationship between the factors in the proposed telehealth patient satisfaction model (TPSM). <b><i>Methods:</i></b> We conducted a cross-sectional survey of pediatric patients and families receiving care from a comprehensive pediatric hospital in the Midwest between September 2020 and January 2021. In total, 2,039 usable responses were collected. We used an SEM approach by performing confirmatory factor analysis with Diagonally Weighted Least Squares modeling and Partial Least Squares-Path Modeling to establish the structural validity and examined the relationships among the constructs of \"Admission Process\" (AP), \"Perceived Quality of Service\" (PQS), and \"Telehealth Satisfaction\" (TS). <b><i>Results:</i></b> Participants were predominantly White (75%) and English-speaking (95%) parents (85%) of patients (mean age of patients was 10.2 years old). The survey responses were collected from patients visiting 43 department specialties, whereas 50% were behavioral and occupational therapy patients. The structural model showed that the admission process (AP) had a strong positive impact on perceived quality of service (PQS) (<i>p</i> = 0.67, <i>t</i> = 36.1, <i>p</i> < 0.001). The PQS had a strong positive impact on telehealth satisfaction (TS) (<i>p</i> = 0.66, <i>t</i> = 31.8, <i>p</i> < 0.001). The AP had a low positive direct impact on TS (<i>p</i> = 0.16, <i>t</i> = 7.46, <i>p</i> < 0.05). Overall, AP and PQS explained 61% variances (<i>R</i>²) <i>of TS.</i> <b><i>Conclusions:</i></b> We validated a newly proposed TS assessment model by using SEM. The TPSM will inform researchers to better understand the influencing factors in TS and help health care systems to improve telehealth patient satisfaction through a validated model.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1261-1269"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39835385","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":"What Do Physicians Think About the Use of Telemedicine to Recruit and Assess Participants in mHealth-Related Clinical Studies as a Consequence of the COVID-19 Pandemic?","authors":"Ana Margarida Pereira,&nbsp;Rute Almeida,&nbsp;Rita Amaral,&nbsp;Magna Alves-Correia,&nbsp;Sandra Mendes,&nbsp;João Almeida Fonseca,&nbsp;Cristina Jácome","doi":"10.1089/tmj.2021.0462","DOIUrl":"https://doi.org/10.1089/tmj.2021.0462","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To evaluate physician's opinion and availability to participate in mHealth-related clinical studies with patient recruitment and assessment via telemedicine and to identify characteristics associated with the willingness to participate. <b><i>Methods:</i></b> Cross-sectional, observational study, based on an anonymous web survey conducted in May-Jun of 2020 to 237 physicians, from Portugal and Spain that collaborated with an asthma mHealth project (INSPIRERS). <b><i>Results:</i></b> Response rate was 51% (<i>n</i> = 120). Most (74%, <i>n</i> = 89) physicians were available to participate in such studies, but 62% anticipated lower recruiting capacity and 40% increased difficulty in obtaining quality data. Physicians aged ≤40 years, from secondary care (vs. general practitioners) and that used apps in personal life or clinical practice were more likely to be available. <b><i>Conclusions:</i></b> Three-quarters of the physicians were available to participate in mHealth-related clinical studies with patient recruitment and assessment through telemedicine. Age group, medical specialty, and app use were associated with the willingness to participate.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1386-1392"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39790094","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":"Impact of Hearing Loss on Communication During Remote Health Care Encounters.","authors":"Gabrielle H Saunders,&nbsp;Francesca Oliver","doi":"10.1089/tmj.2021.0490","DOIUrl":"https://doi.org/10.1089/tmj.2021.0490","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Satisfaction with telemedicine is generally high; however, it can lead to communication problems for people with hearing loss (HL), especially when encounters are conducted by telephone, because of the inability to see the face and lips on which many people with HL rely. Despite acknowledgement that HL might affect telemedicine outcomes, no studies have directly examined this. The primary aims of this study were to determine whether and how HL impacts patient satisfaction and willingness to use telemedicine. <b><i>Methods:</i></b> Opinions about telemedicine were assessed in a survey of 383 members of the general public. Data regarding reported hearing ability, use of hearing assistive technology, and preferred form of communication (oral/aural vs. sign language) were also collected; people with HL were intentionally oversampled. Survey items included closed set and open-ended responses. <b><i>Results:</i></b> People with HL declined the offer of telemedicine appointments, rated telemedicine outcomes significantly less positively, and had stronger preferences for in person care than did people without HL. Explanations provided for this were directly associated with hearing-related difficulties or the indirect consequences of those difficulties. HL resulted in concerns about communication during the appointment, a lack of privacy when an intermediary helped with communication during the appointment, worries that critical information has been misheard/missed, and anxiety/stress. <b><i>Conclusions:</i></b> The needs of people with HL during telemedicine encounters must be addressed to ensure equitable access. Health care providers should take responsibility to communicate clearly with people with HL and individuals with HL should be willing to advocate for their needs and use special access tools during telemedicine appointments.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1350-1358"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39815807","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":"Eye Movement Desensitization and Reprocessing in a Primary Care Setting: Assessing Utility and Comparing Efficacy of Virtual Versus In-Person Methods.","authors":"Harris Liou,&nbsp;Colton Lane,&nbsp;Crystal Huang,&nbsp;Martina Mookadam,&nbsp;Malin Joseph,&nbsp;Jennifer Hecker DuVal","doi":"10.1089/tmj.2021.0454","DOIUrl":"https://doi.org/10.1089/tmj.2021.0454","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Eye movement desensitization and reprocessing (EMDR) is an evidence-based psychotherapy method designed to treat distress associated with traumatic memories. The COVID-19 pandemic has challenged providers to shift EMDR to telehealth platforms. <b><i>Objectives:</i></b> This research had to aims. (1) To compare EMDR in conjunction with cognitive behavioral therapy (CBT) with CBT alone for treatment of a patient population with prevalent anxiety and (2) to compare the efficacy of virtual EMDR with that of in-person EMDR in the primary care setting. <b><i>Methods:</i></b> Retrospective chart review of all adult patients seen by a single therapist at a primary care center was conducted from January 2018 to December 2020. Charts were reviewed for demographics, psychiatric diagnoses, number of visits, number and type of EMDR treatments, and patient health questionnaire (PHQ)-9 and general anxiety disorder (GAD-7) scores pre- and post-treatment. <b><i>Results:</i></b> Patients who underwent EMDR with CBT demonstrated greater decreases in PHQ-9 and GAD-7 scores than patients who had only CBT (2.4, 2.5 vs. 0.9, 1.1). However, after adjusting for total number of sessions, post-traumatic stress disorder, grief, and pain, the adjusted mean differences of change in PHQ-9 and GAD-7 scores between those who underwent EMDR with CBT and CBT-exclusive patients were not statistically significant. Similarly, the adjusted mean differences of change in PHQ-9 and GAD-7 scores between those who underwent virtual EMDR and those who had in-person EMDR were not statistically significant. <b><i>Conclusions:</i></b> To our knowledge, this is the first study describing the use of virtual EMDR in a primary care setting. Although our data did not provide evidence for the superiority of EMDR with CBT over CBT alone, we demonstrate that both in-person and virtual EMDR led to significantly improved GAD-7 scores.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1359-1366"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39899222","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":"Satisfaction with and Feasibility of Prenatal Counseling via Telemedicine: A Prospective Cohort Study.","authors":"Kathrin Oelmeier,&nbsp;Ralf Schmitz,&nbsp;Mareike Möllers,&nbsp;Janina Braun,&nbsp;Daniela Deharde,&nbsp;Marina Sourouni,&nbsp;Helen Ann Köster,&nbsp;Gunita Apsite,&nbsp;Maria Eveslage,&nbsp;Karen Fischhuber,&nbsp;Michael Storck,&nbsp;Franziska Emming,&nbsp;Jan Wohlmann,&nbsp;Christian Juhra","doi":"10.1089/tmj.2021.0309","DOIUrl":"https://doi.org/10.1089/tmj.2021.0309","url":null,"abstract":"<p><p><b>Introduction:</b> Telemedicine has become increasingly important over the past decade. With the pressure of the COVID-19 pandemic, demands for remote health care solutions have seen an unprecedented rise. However, many questions regarding the feasibility and benefits of telemedicine remain. The aim of our study was to evaluate both the technical feasibility and patient satisfaction with video consultations in a tertiary center for obstetric care. <b>Materials and Methods:</b> This prospective single-center trial was part of the larger open Video Service project on telemedicine at the Department of Gynecology and Obstetrics at the University of Münster. Patients requiring prenatal or prepregnancy counseling were included. A questionnaire was designed for the evaluation of patient satisfaction and filled in by both patient and health care provider at the end of the video consultation. <b>Results:</b> Of 80 eligible cases, 75 video consultations were carried out and data from the questionnaire were collected. Overall patient satisfaction was high (95%, 71/75) although technical problems occurred in 37% (29/75) of the appointments. Health care providers' satisfaction was equally high and in 88% (66/75) of cases, remote consultations avoided an in-house visit without effect on health care quality. <b>Conclusions:</b> Remote consultations are feasible and yield high satisfaction rates even in a medical field as sensitive as perinatal medicine. Further research is necessary to determine the cost-effectiveness and effects on perinatal outcome. Health care systems should be offered clear guidance on medicolegal issues and funding of remote consultations to integrate telemedicine into routine health care.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1193-1198"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39689314","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":"The Utilization and Impact of Live Interactive and Store-and-Forward Teledermatology in a Veterans Affairs Medical Center During the COVID-19 Pandemic.","authors":"Francine Castillo,&nbsp;Sara Peracca,&nbsp;Dennis H Oh,&nbsp;Amanda R Twigg","doi":"10.1089/tmj.2021.0275","DOIUrl":"https://doi.org/10.1089/tmj.2021.0275","url":null,"abstract":"<p><p><b>Introduction:</b> Teledermatology has emerged as a promising method of continuing dermatologic care during the coronavirus 2019 (COVID-19) pandemic, including in the Department of Veterans Affairs (VA). Analysis of the utilization and impact of teledermatology within the San Francisco Veterans Affairs Health Care System (SFVAHCS) may elucidate the ways that teledermatology programs can continue to be optimized. <b>Methods:</b> We conducted a retrospective analysis of live interactive encounters, Veterans Affairs Video Connect (VVC), store-and-forward telehealth (SFT), and face-to-face (FTF) consultations, performed within the SFVAHCS from March 2020 to December 2020. To assess utilization, we analyzed numbers of encounters throughout 2020. To assess impact, we analyzed primary diagnoses for each encounter and rates of recommendations for medications and lesion biopsies. Additionally, we assessed diagnostic accuracy associated with each teledermatology type by measuring concordance between teledermatologists' clinical diagnoses and histopathological diagnoses. <b>Results:</b> Two thousand two hundred fifty FTF, 347 VVC, and 470 SFT encounters were conducted from March to December 2020. More female patients utilized VVC, and patients who utilized VVC were younger than SFT and FTF users (<i>p</i> < 0.01). SFT was utilized more by patients from rural areas (<i>p</i> < 0.01). Diagnoses addressed were significantly different between VVC and SFT. A majority of VVC encounters involved referrals for inflammatory conditions; primary diagnoses associated with SFT consultations were most frequently neoplasms. Comparison of VVC and SFT outcomes showed that more VVC visits resulted in a medication recommendation, while more SFT consultations resulted in a biopsy recommendation. <b>Conclusions:</b> Teledermatology contributed to meeting patient needs throughout 2020 and created an impact on clinical management. Patient characteristics, diagnoses, and type of impact associated with encounters varied between SFT and VVC. This analysis provides insight into teledermatology utilization within the VA system and can contribute to efforts to improve the quality of teledermatology care for veterans.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1186-1192"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39734369","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}