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

{"title":"Telehealth in Heart Failure Management: A Scoping Review.","authors":"Felipe Montes Pena, Lyana Reis de Moura, Ingrid Lopes da Silveira Vianna Corrêa, Tatiana Cabral da Silva Ramos, Renata Flávia Abreu da Silva, Cristiane Helena Gallasch, Raphael Chança, Magda Guimarães de Araujo Faria","doi":"10.1177/15305627261484375","DOIUrl":"https://doi.org/10.1177/15305627261484375","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) entails high morbidity, mortality, and health care costs. This scoping review maps and describes telehealth interventions for adult HF management, summarizing modalities, contexts, and reported outcomes (morbidity, mortality, and hospitalizations), and identifying evidence gaps, implementation challenges, and future trends. Our review question was: Which telemedicine interventions have been used in adult HF management, in which contexts, and what outcomes are reported for morbidity, mortality, and hospitalizations?</p><p><strong>Methods: </strong>We searched four electronic databases (MEDLINE via PubMed, Latin American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, and Scopus) and gray literature (DataBase of Theses and Dissertations, Brazil) through December 2023, using a Population, Concept, Context framework. Two independent reviewers screened and extracted data; discrepancies were resolved by a third reviewer.</p><p><strong>Results: </strong>Of 1,122 records, 81 studies were included. Evidence spans 12 thematic areas covering telemonitoring modalities, adherence, clinical indicators, early detection, symptom management, communication, satisfaction, cost considerations, comparative perspectives, public health contributions, and future trends. Reported outcomes were heterogeneous across study designs and settings. Evidence on effectiveness is mixed across modalities and settings. Signals of benefit appear in integrated, protocolized telemonitoring programs-particularly for reducing readmissions in selected contexts-while other modalities show neutral effects. Key gaps relate to standardization, data integration, and long-term sustainability.</p><p><strong>Conclusion: </strong>Telehealth is widely applied in HF care with diverse implementations; further rigorous and standardized evaluations are needed to clarify effectiveness across modalities and settings.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261484375"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876626","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 Assessment of the Attitudes of People Seeking Services from Family Medicine Units Toward Telemedicine Practices.","authors":"Tugba Balik Kozak, Aysima Bulca Acar","doi":"10.1177/15305627261450357","DOIUrl":"10.1177/15305627261450357","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to examine the attitudes of patients visiting family medicine units toward telemedicine services in order to assess the extent of social acceptance of digitalization in primary health care services.</p><p><strong>Methods: </strong>This cross-sectional and descriptive study included 333 individuals aged 18 years and older who visited the Family Medicine units at the Antalya Training and Research Hospital between April 1, 2025, and June 1, 2025. The \"Attitude Scale for the Use of Telemedicine Services\" developed by Yucel and Uyar, was administered to the participants through face-to-face interviews conducted by researchers, utilizing a 5-point Likert scale.</p><p><strong>Results: </strong>The mean scale score for participants was determined to be 61.46 ± 13.27, and a significant negative correlation was found between age and scale scores (<i>p</i> < 0.001). The overall scores rose notably, as the education level increased (<i>p</i> < 0.001). The attitude scores for those who used smartphones and computers, respectively, were significantly greater than for those who did not use them (<i>p</i> = 0.006, <i>p</i> = 0.001). A significant correlation was found between the lack of trust in treatment offered via telemedicine services and the willingness to use such services if information was provided by a family physician (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Our study demonstrated that, alongside demographic factors, contact with family physicians is a determining factor in shaping people's attitudes toward telemedicine services. The active involvement of family physicians in telemedicine practices could facilitate the integration of digital health care services into the community.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"954-960"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944753","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":"Evaluation of a Brief Telepsychotherapy Service Offered in a Brazilian Capital.","authors":"Nuria Ananda Parron Giacomelli Pereira, Paula Soares Brandão, Bianca Cristina Ciccone Giacon, Magda Faria","doi":"10.1177/15305627261450354","DOIUrl":"10.1177/15305627261450354","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate a brief telepsychotherapy service within the Brazilian Unified Health System in a Brazilian capital (April 2024-April 2025), analyzing its functioning, outcomes, and contribution to access in primary health care (PHC).</p><p><strong>Methods: </strong>A quantitative descriptive study using secondary data from the service's regulatory system and records. Individuals ≥18 years of age with a therapeutic outcome during the period were included. Descriptive, bivariate (chi-square, Welch's <i>t</i>, and Mann-Whitney), and binary logistic regression analyses were performed.</p><p><strong>Results: </strong>One hundred and ninety-three users participated, predominantly women (88.1%) and adults aged 25-59 years (80.3%). The outcome was discharge in 37.8% and discontinuation in 62.2%. Reasons for discontinuation included absences (30.6%), unsuitability (13.5%), at the patient's request (12.4%), and referral to the psychosocial care center (5.7%). In the regulatory system, \"Mental and behavioral disorders\" (ICD F00-F99; <i>n</i> = 126) predominated, with frequent use of ICD Z codes, suggesting diagnostic difficulties in PHC. Most teleconsultations occurred in urban units (97.2%), with 77.7% of requests coming from units with multiprofessional teams in primary health care (eMULTI); the average attendance rate was 58.75%. In bivariate analyses, the outcome was associated with the presence of eMULTI (<i>p</i> = 0.0398) and the ICD chapter (<i>p</i> = 0.0056). The attendance rate differed significantly between high-level and low-level attendance (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Telepsychology is a relevant strategy to expand access and reduce unmet demand in PHC. However, challenges regarding adherence and continuity persist. Effectiveness depends on clear workflows, qualified teams, and engagement and integration strategies between PHC and specialized services.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"948-953"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877241","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":"Telehealth Utilization Patterns Among Patients with Chronic Conditions Across Age, Gender, Geography, and Insurance in Arkansas.","authors":"Roberto Bravo, Kelsey Owsley, Michele Longo, Lizheng Shi, Bertha Hidalgo, Brigham Walker","doi":"10.1177/15305627261450303","DOIUrl":"10.1177/15305627261450303","url":null,"abstract":"<p><strong>Background: </strong>Telehealth utilization patterns have been variably studied across diabetes, hyperlipidemia, and asthma settings. This study aims to evaluate telehealth patterns in these disease settings through the COVID-19 pandemic across age, gender, geography, and insurance dimensions.</p><p><strong>Methods: </strong>We identified patients with asthma, diabetes, or hyperlipidemia aged 18-64 with commercial or Medicaid insurance between 2017 and 2022 using Arkansas All-Payer Claims Database (APCD) data. The primary outcome variable was an indicator for any telehealth use. We plotted telehealth visits by quarter for each disease state by age, gender, rurality, and insurance strata. We also conducted linear regression analyses to associate telehealth use with each year relative to 2019 while controlling for patient characteristics.</p><p><strong>Results: </strong>Telehealth was seldom used pre-pandemic but sharply increased during the pandemic, reaching 11.8% in asthma, 9.1% in diabetes, and 9.0% in hyperlipidemia. Following the pandemic (2020-2022), females, urban residents, and younger patients were generally more likely to utilize telehealth. In adjusted analyses, relative to 2019, telehealth use sharply increased in 2020 between 12.7 and 15.1 percentage points (all <i>p</i> < 0.05) across the conditions. Utilization dipped in later years but remained much higher than prepandemic levels with the largest increases being among patients with asthma.</p><p><strong>Conclusion: </strong>These findings suggest that differences in telehealth adoption are not solely and uniformly attributable to observable patient characteristics but may also reflect structural and clinical factors particular to patient demographics and the specific disease setting. Ongoing efforts should support clinically-appropriate, even, and sustained access across groups.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"895-902"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045457","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":"Diagnostic Performance of an Artificial Intelligence Model for Retinal Abnormalities in Primary Health Care: A Real-World Teleophthalmology Study.","authors":"Alan Cristian Marinho Ferreira, Mariana Abreu Caporali de Freitas, Rosangela Durso Perillo, Carlos Eduardo Menezes Amaral, Alaneir de Fátima Santos","doi":"10.1177/15305627261454208","DOIUrl":"10.1177/15305627261454208","url":null,"abstract":"<p><strong>Introduction: </strong>Timely access to ophthalmological care is a challenge in primary health care (PHC). Teleophthalmology and artificial intelligence (AI) are tools to expand access, but real-world evidence remains limited. This study evaluates the diagnostic performance of an AI model for detecting retinal abnormalities in PHC, analyzing variability across clinical and demographic subgroups.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 2,158 initial retinal exams, resulting in a final paired sample of 824 retinographies for accuracy analysis. The exams were conducted within a teleophthalmology workflow in the PHC of six municipalities in Minas Gerais, Brazil. A commercial AI model based on a convolutional neural network (Eyer Maps^®) evaluated the images and was compared with classifications performed by an ophthalmologist, considered the reference standard. Cluster analysis was performed, and sensitivity, specificity, positive and negative predictive values, Cohen's Kappa coefficient, and area under the receiver operating characteristic curve (AUC) were calculated.</p><p><strong>Results: </strong>The AI model demonstrated almost perfect agreement with the human specialist (Kappa = 0.819; <i>p</i> < 0.001). In the global sample, sensitivity was 83.0%, specificity was 98.0%, positive predictive value was 98.0%, negative predictive value was 86.0%, and AUC was 0.91. Eight distinct clusters were identified, in which the model maintained high specificity (96.0-100.0%), with sensitivity varying only in one specific subgroup.</p><p><strong>Conclusions: </strong>In a real-world teleophthalmology context within PHC, AI showed robust diagnostic performance and a high capacity for confirming retinal abnormalities, minimizing unnecessary referrals. The findings reinforce its potential as a supportive tool for organizing ophthalmological care and optimizing assistance workflows in PHC.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"932-939"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990764","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":"Population-Level Teleretinal Screening Bulk Orders to Improve Diabetic Retinopathy Screening Rates: A Randomized Quality Improvement Trial.","authors":"Sarah W Takimoto, Matthew Freeby, Maria Han, Sitaram Vangala, Jeffrey Fujimoto, Anna Dermenchyan, Sylvia Lambrechts","doi":"10.1177/15305627261450353","DOIUrl":"10.1177/15305627261450353","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a leading cause of blindness; however, many patients with type 2 diabetes (T2DM) are not up to date with screening guidelines. This study explored the impact of teleretinal screening bulk orders on the DR screening completion rate.</p><p><strong>Methods: </strong>In this randomized controlled trial, eligible patients with T2DM due for DR screening were randomly assigned to receive a teleretinal screening bulk order at one of four monthly time points, following a stepped-wedge design. Teleretinal screening bulk orders are placed by a centralized provider for a defined patient cohort. They include a retinal fundus photo order and an associated electronic patient education message. Logistic regression at the patient-month level, with errors clustered at the patient level, was used to evaluate the effect of bulk orders on DR screening completion rate. Two-stage least squares was used to evaluate the effects of opening the message, using random assignment as an instrument.</p><p><strong>Results: </strong>A total of 5,665 eligible patients were identified for this study. At six months from the first bulk order, the overall DR screening completion rate was 17.5% (<i>n</i> = 994). Receiving a bulk order increased odds of completing screening (odds ratio [OR]: 1.78; confidence interval [CI] 95%: 1.49, 2.14; <i>p</i> < 0.001). 2,763 patients (48.7%) opened the electronic patient message. Opening the message increased completion rates by 8.5% (95% CI; 6.0%, 11.1%; <i>p</i> < 0.001) and retinal fundus photo appointments scheduled by 19.1% (95% CI; 16.8%, 21.3%; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Teleretinal screening bulk orders were associated with a significant increase in DR screening. Population-level interventions should be implemented to improve diabetes preventative care.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"903-911"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148160396","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":"High Patient Satisfaction in a Telemedicine-Based Virtual-First Hospital-at-Home Program: A Large Real-World Cohort Study.","authors":"María Mir Montero, Maria Nieves Martín Alonso, Gabriela Peña Y Lillo Echevarría, Eva María Arroyo Urea, Laura Laguna García, Luis Soto Medina, Cristina Úbeda García, Raquel Rubio Parra, Sandra Hernández Muñoz, Maria Oliva González Ruiz, Carlos Bibiano Guillén","doi":"10.1177/15305627261450347","DOIUrl":"10.1177/15305627261450347","url":null,"abstract":"<p><strong>Background: </strong>Hospital-at-Home (HaH) programs supported by telemedicine have emerged as a promising alternative to conventional hospitalization. However, evidence on patient experience in large-scale, real-world virtual-first models remains limited. The objective of this research was to evaluate patient experience and satisfaction in a telemedicine-based, virtual-first HaH program.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study, including adult patients admitted to a virtual-first HaH program at a tertiary hospital in Madrid, Spain, between October 2020 and May 2025. Patient experience was assessed at discharge using a routinely implemented digital questionnaire. A set of 18 common items across questionnaire versions was analyzed, covering communication, perceived safety, professional competence, and overall satisfaction. Responses were standardized and dichotomized using a top-box approach.</p><p><strong>Results: </strong>A total of 887 patients were included (median age 64 years; median length of stay 9 days). Patient experience was highly positive, with satisfaction rates exceeding 95% across most domains. Perceived safety was reported by 98.98% of patients, and 97.06% indicated that telemedicine was easily integrated into daily life. Overall satisfaction reached 96.50%, and the same proportion would choose the HaH model again.</p><p><strong>Conclusions: </strong>A telemedicine-based, virtual-first HaH program achieved very high levels of patient satisfaction and perceived safety in a large real-world cohort. These findings support the feasibility and acceptability of virtual-first models for acute hospital care, demonstrating consistent patient experience across diverse clinical profiles, age groups, and lengths of stay.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"940-947"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937314","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-Enabled Surgical Outreach across the Surgical Continuum to Bridge the Gap in Low- and Middle-Income Countries: Lessons from the COVID-19 Era and Applications Beyond.","authors":"Eslam Abdelhady, Mohamed Abdo Khalafallah, Husam Alddin Alkajah, Reem Reda Elmahadi, Brittany L Willer, Joseph D Tobias","doi":"10.1177/15305627261453274","DOIUrl":"10.1177/15305627261453274","url":null,"abstract":"<p><strong>Introduction: </strong>Telemedicine has revolutionized health care delivery globally, reducing health care costs, increasing patient satisfaction, and improving surgical outcomes. Innovation is often born out of necessity, and during the Coronavirus disease 2019 (COVID-19) pandemic, there was a surge of telemedicine initiatives both in surgical education and surgical care delivery. This has been well documented in high-income countries, but there has been less evaluation of the use and potential application of telemedicine in low- and middle-income countries (LMICs) to support surgical outreach efforts. This review seeks to describe telemedicine-enabled surgical outreach across the surgical continuum that emerged from the COVID-19 era in LMICs and provide recommendations for future practices.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Identified studies on telemedicine indexed in PubMed, Web of Science, Scopus, and Embase from January 2020 to February 2025 were aggregated. The search terms included \"telemedicine,\" \"surgery,\" \"COVID-19,\" \"SARS-CoV-2,\" \"e-learning,\" \"remote,\" \"tele-simulation,\" and \"LMICs.\" Of 713 papers, 15 eligible studies were found. Data were summarized by study type, intervention type, and outcomes. Themes of accessibility, efficacy, and user satisfaction were analyzed. Key implementation challenges were reviewed. Summary recommendations for future directions are provided.</p><p><strong>Results: </strong>The 15 studies identified provide evidence for the feasibility and effectiveness of a variety of surgical teleinterventions within LMICs. The majority of the qualifying research consisted of prospective cohort studies that involved physicians, surgical residents, and patients. The primary findings include improvements in surgical skills, positive perception by participants, and high satisfaction with tele-simulation and e-learning. Key implementation challenges identified were technical issues, insufficient infrastructure, and unreliable internet.</p><p><strong>Conclusion: </strong>Preliminary experience suggests that telemedicine applications during the COVID-19 pandemic proved to be effective tools for both surgical education and patient care. These initiatives may hold promise for augmenting surgical outreach efforts in a more sustainable fashion to facilitate both surgeon training and improved care delivery for underserved communities in LMICs. However, numerous challenges must be addressed to ensure long-term effectiveness and sustainability.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"875-886"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008487","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":"Real-World Use, Usability, and User Experience of a Teledentistry Platform for Oral Lesion Screening in the Brazilian Public Health System.","authors":"Caroline Miranda Pernambuco, Hélder Domiciano Dantas Martins, Livian Isabel de Medeiros Carvalho, Eduarda Gomes Onofre de Araújo, Livia Maris Ribeiro Paranaíba Dias, Edson Hilan Gomes de Lucena, Paulo Rogerio Ferreti Bonan, Leonardo Amaral Dos Reis","doi":"10.1177/15305627261453253","DOIUrl":"10.1177/15305627261453253","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the real-world use of the TeleEstomato-MG platform, an asynchronous teledentistry system designed for oral lesion screening within the Brazilian Unified Health System, with a focus on user profile, distribution across levels of care, usability, and satisfaction.</p><p><strong>Methods: </strong>This retrospective observational study analyzed data from 601 dental professionals registered on the TeleEstomato-MG platform. Variables included sex, age, specialist status, and level of care. Usability and satisfaction were assessed using a structured questionnaire completed by a subset of users (<i>n</i> = 90). Descriptive statistics were performed, and the association between specialist status and level of care was evaluated using the chi-square test, with Cramér's <i>V</i> used to assess effect size.</p><p><strong>Results: </strong>Most professionals were female (<i>n</i> = 417; 69.4%), with a mean age of 38.6 ± 11.0 years. The majority worked in primary health care (<i>n</i> = 424; 70.2%), followed by private practice (<i>n</i> = 119; 19.7%), secondary care (<i>n</i> = 34; 5.8%), tertiary care (<i>n</i> = 12; 2.0%), and educational institutions (<i>n</i> = 14; 2.3%). Specialists accounted for 56.4% (<i>n</i> = 339) of users, and a significant association was observed between specialist status and level of care (χ² = 56.58; <i>p</i> < 0.001; Cramér's <i>V</i> = 0.31). Usability results indicated high acceptance, with most users reporting willingness to use the platform frequently (<i>n</i> = 84; 93.4%), ease of use (<i>n</i> = 84; 93.3%), confidence (<i>n</i> = 82; 91.1%), rapid learnability (<i>n</i> = 77; 85.5%), and a low need for technical support (<i>n</i> = 64; 71.1%). Satisfaction was also high, with 87.7% (<i>n</i> = 79) rating the platform as excellent or very good and 90.0% (<i>n</i> = 81) considering it highly necessary.</p><p><strong>Conclusions: </strong>The TeleEstomato-MG platform is predominantly used in primary health care and demonstrates high usability and user satisfaction in a real-world public health context. These findings support asynchronous teledentistry as a scalable strategy to enhance oral lesion screening, improve access to specialist support, and strengthen integration across levels of care.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"923-931"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020392","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":"Seventeen Seconds to Success or Disaster: Failure Is Not an Option.","authors":"Charles R Doarn","doi":"10.1177/15305627261475506","DOIUrl":"10.1177/15305627261475506","url":null,"abstract":"","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"873-874"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650495","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}