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

{"title":"Portal Message Language Use Prior to Suicide, Suicide Attempts, and Hospitalization for Depression.","authors":"Michelle J Duvall,&nbsp;Nathaniel E Miller,&nbsp;Frederick North,&nbsp;William B Leasure,&nbsp;Jennifer L Pecina","doi":"10.1089/tmj.2021.0318","DOIUrl":"https://doi.org/10.1089/tmj.2021.0318","url":null,"abstract":"<p><p><b>Introduction:</b> Previous research suggests patients may be willing to communicate serious psychiatric concerns through patient portals. <b>Methods:</b> Retrospective chart review of portal messages sent by patients who had an emergency department (ED) visit or hospitalization for depression, self-harm, or suicidality or had a completed suicide (cases) was reviewed for content that was suggestive of depression or self-harm and language indicating emotional distress. Comparison with a randomly selected group (controls) was performed. <b>Results:</b> During the study period 420 messages were sent by 149 patients within 30 days of death by suicide, ED visit, and/or hospitalization related to depression, suicidality, or suicide attempt. Thirteen patients died by suicide but only 23% (3 of 13) sent one or more portal messages within 30 days before their death. None mentioned thoughts of self-harm. There were 271 messages sent by patients who were hospitalized, 142 messages by those who presented to the ED, and 56 messages patients who attempted suicide. Patient messages from cases were more likely than messages from controls to convey a depressed mood (17.1% vs. 3.1%, odds ratio 6.5; 95% confidence interval 3.6-11.9, <i>p</i> < 0.0001), thoughts of suicide or self-harm (4.8% vs. 0% <i>p</i> < 0.0001), or have a distressed tone (24.0% vs. 1.7%, odds ratio 18.7; 95% confidence interval 8.6-41, <i>p</i> < 0.0001). <b>Conclusions:</b> Patient portal messages from patients with subsequent hospitalizations for depression and suicidality do report thoughts of depression, distress, and thoughts of self-harm. However, portal use before completed suicide was not helpful at identifying at-risk patients although total numbers were small.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1143-1150"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39748171","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":"Orthopedic Asynchronous Teleconsultation for Primary Care Patients by a Large-Scale Telemedicine Service in Minas Gerais, Brazil.","authors":"Letícia Baião Silva,&nbsp;Daniella Nunes Pereira,&nbsp;Victor Schulthais Chagas,&nbsp;Cristiane Guimarães Pessoa,&nbsp;Kaíque Amancio Alvim Gouvea,&nbsp;Marco Antonio Percope de Andrade,&nbsp;Thiago Barbabela de Castro Soares,&nbsp;Milena Soriano Marcolino","doi":"10.1089/tmj.2021.0293","DOIUrl":"https://doi.org/10.1089/tmj.2021.0293","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine was implemented in Brazil as a way to support primary health care (PHC). Orthopedic complaints are common in PHC, and, because musculoskeletal diseases are the most frequent causes of chronic pain, it is important to explore knowledge gaps of PHC as well as to understand the teleconsultations' impact on reducing referrals to secondary care. <b>Materials and Methods:</b> Observational, retrospective study that analyzed consecutive orthopedic asynchronous teleconsultations from the Telehealth Network of Minas Gerais, a large-scale public telehealth service, performed from September 17, 2013 to June 18, 2020. Teleconsultations were analyzed based on the type of query. <b>Results:</b> Throughout the study, 1,174 teleconsultations from 254 municipalities were analyzed. Most requests for teleconsultations were from nurses (37.8%) and physicians (48.7%). In 58.3%, challenges could be solved by a general practitioner, meanwhile 38.4% needed referral to an orthopedic specialist. Most queries related to a specific case (assistencial teleconsultation, 66.0%), and the others were classified as educational (34%). With regard to the motivation for the assistencial teleconsultations, 72% approached treatment options, 49.5% surrounded possible diagnosis, and 20.1% discussed patient's rehabilitation. In addition, 95.5% of requests could be solved by teleconsultation, without the need for referral to in-person consultation with the specialist. <b>Conclusions:</b> Teleconsultations can help investigate the most frequent queries in PHC. Most of them were solved without the need for referral, showing the potential of teleconsultations in daily practice as a way to manage patients and guarantee better access to first-rate health care. As for the public health system, teleconsultations represent a way to overcome the distance barrier to health care access.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1172-1177"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39688898","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":"Digital Health Technology for Remote Care in Primary Care During the COVID-19 Pandemic: Experience from Dubai.","authors":"Mahera AbdulRahman,&nbsp;Fatema Al-Tahri,&nbsp;Mouza Khalifa AlMehairi,&nbsp;Frederick Robert Carrick,&nbsp;Alia Mohammad Rafi Aldallal","doi":"10.1089/tmj.2021.0459","DOIUrl":"https://doi.org/10.1089/tmj.2021.0459","url":null,"abstract":"<p><p><b>Introduction:</b> We aimed to provide an insight on the feasibility and impact of telemedicine use among primary health care (PHC) providers and on nonurgent health care delivery during the coronavirus disease 2019 (COVID-19) outbreak in the United Arab Emirates (UAE). <b>Methods:</b> This observational study was conducted using telemedicine data from Dubai Health Authority from January 2020 to July 2021. <b>Results:</b> Of 123,944 individuals who booked an appointment for the telemedicine service, 106,408 (86%) showed up. Most patients were 19-59 years old, UAE nationals, female, and having government insurance. The telemedicine care volume grew from 188 visits in January 2020 to 11,757 in April 2020. The most common diagnosis was general health consultation (55,672; 52%), followed by COVID-19-related consultation (18,523; 17%) and laboratory test requests (11,064; 10%). Around 4,997 (5%) telemedicine consultations were for a medication refill. A multiple linear regression model predicting the types of diagnosis-related telemedicine needs by age and the interaction of gender and nationality was statistically significant for dermatology (<i>p</i> = 0.0000), respiratory (<i>p</i> = 0.0000), and cardiovascular (<i>p</i> = 0.0000) diseases. <b>Conclusions:</b> Virtual care services in PHC clinics have been highly successful in meeting the needs of patients during the COVID-19 pandemic. Telemedicine has enabled clinicians to continue providing care to patients while maintaining the necessary public health measures adopted in the fight against COVID-19. However, will the switch to telemedicine be sustainable in the long term and what will be the level and degree of telemedicine adoption beyond COVID-19? This requires more studies to explore how the PHC organizations will provide further support and guidance on the suitability of telemedicine in various circumstances and clinical conditions.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1100-1108"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39896442","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":"From Office-Based Treatment to Telehealth: Comparing Clinical Outcomes and Patient Participation in a Psychiatric Intensive Outpatient Program with a Large Transdiagnostic Sample.","authors":"Jessica M Gannon,&nbsp;Jaspreet S Brar,&nbsp;Susanna Zawacki,&nbsp;Tiffany Painter,&nbsp;Kelly O'Toole,&nbsp;K N Roy Chengappa","doi":"10.1089/tmj.2021.0421","DOIUrl":"https://doi.org/10.1089/tmj.2021.0421","url":null,"abstract":"<p><p><b>Introduction:</b> Patient participation and clinical outcomes of a precoronavirus disease 2019 (COVID-19) office-based transdiagnostic psychiatric intensive outpatient program (IOP) were compared with those of telehealth IOP during COVID-19. <b>Materials and Methods:</b> Weeks of enrollment, Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) assessments, and sociodemographic and clinical factors (including group track and diagnosis) were collected during pre-COVID-19 (n = 191) and during COVID-19 (<i>n</i> = 200). Continuous and categorical measures of GAD-7 and PHQ-9 were analyzed; potential sociodemographic and clinical covariates to scores were also explored. <b>Results:</b> There were no statistically significant differences in participation between time periods. Associations were observed between PHQ-9/GAD-7 score improvement and number of assessments. Significant score reductions occurred in both periods, and differences in change scores were not significant. Sociodemographic and clinical factors were not significantly different between time periods. Patients with commercial insurance had significantly higher improvement in both mean and categorical PHQ-9 scores (<i>t</i> = 2.77, <i>p</i> = 0.006; χ² = 10.47, df = 1, <i>p</i> = 0.001) and GAD-7 scores (<i>t</i> = 2.29, <i>p</i> = 0.023; χ² = 8.58, df = 1, <i>p</i> = 0.003) than those with public insurance. Patients with anxiety disorders had significantly greater improvements (<i>F</i> = 4.49, <i>p</i> = 0.004; χ² = 9.15, df = 3, <i>p</i> = 0.027) in GAD-7 during COVID-19. <b>Discussion:</b> Significant improvements in PHQ-9/GAD-7 scores and measures of participation were not significantly different between telehealth and office-based IOP, nor were they greatly influenced by clinical or sociodemographic factors. Further study is needed of possible care disparities for publicly insured patients. <b>Conclusion:</b> Despite some limitations, telehealth IOP appears to be a clinically appropriate option for a diverse sociodemographic and diagnostically heterogeneous psychiatric population.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1126-1133"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39770587","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 Use Before and During the COVID-19 Pandemic Among Children with Sickle Cell Anemia.","authors":"Sarah L Reeves,&nbsp;Pooja N Patel,&nbsp;Brian Madden,&nbsp;Sophia Ng,&nbsp;Susan E Creary,&nbsp;Dominic Smith,&nbsp;Chad Ellimoottil","doi":"10.1089/tmj.2021.0132","DOIUrl":"https://doi.org/10.1089/tmj.2021.0132","url":null,"abstract":"<p><p><b>Introduction:</b> Sickle cell anemia (SCA) is a genetic condition that predominantly affects minority populations in the United States. A lack of access to care is strongly associated with poor outcomes and quality of care among children and adolescents with SCA. The use of telehealth, which has rapidly expanded during the COVID-19 pandemic, has been shown to improve access to care for many conditions. However, the adoption of telehealth among children and adolescents with SCA is unknown. <b>Methods:</b> We identified children 1-17 years old with SCA continuously enrolled in Michigan Medicaid from January 2019 to December 2020. The number of in-person and telehealth outpatient visits (both urgent and routine) were summarized prepandemic (January 2019-February 2020) and during the pandemic (March 2020-December 2020); National Provider Identifier was used to identify provider specialty for telehealth visits. <b>Results:</b> The study population comprised 493 children with SCA with a mean age of 8.7 (±4.9) years at study entry. Prepandemic, there were 4,367 outpatient visits; 4,348 (99.6%) were in-person and 19 (0.4%) were telehealth. During the pandemic, there were 2,307 outpatient visits; 2,059 (89.3%) were in-person and 248 (10.7%) were telehealth. Telehealth visits peaked in April 2020 and declined thereafter. The majority of telehealth visits were to hematology (49%), followed by adult subspecialists (27%) and pediatrics/family medicine (14%). <b>Discussion/Conclusions:</b> While the overall number of outpatient visits declined during the initial months of the pandemic compared with 2019, use of telehealth rapidly increased among children and adolescents with SCA. Additional research is needed to understand patient and provider preferences for telehealth and the roles that federal and state policies can play in facilitating telehealth adoption among children and adolescents with SCA.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1166-1171"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39899297","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":"Teletherapy Versus In-Person Psychotherapy for Depression: A Meta-Analysis of Randomized Controlled Trials.","authors":"Annaleis K Giovanetti,&nbsp;Stephanie E W Punt,&nbsp;Eve-Lynn Nelson,&nbsp;Stephen S Ilardi","doi":"10.1089/tmj.2021.0294","DOIUrl":"https://doi.org/10.1089/tmj.2021.0294","url":null,"abstract":"<p><p><b>Introduction:</b> The recent surge in telehealth service delivery represents a promising development in the field's ability to address access gaps in health care across underserved populations. Telehealth also carries the potential to help reduce the societal burden of mental illnesses such as major depression, which often go untreated. There is now a sufficiently large corpus of randomized controlled trials to examine the comparative effectiveness of teletherapy and in-person services meta-analytically. <b>Methods:</b> We searched the PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for articles from January 1, 2000 to February 1, 2021 to identify randomized head-to-head trials of video-based versus in-person delivery of psychotherapy to reduce depressive symptoms. We conducted a random-effects meta-analysis to evaluate potential differences in efficacy rates. We calculated and meta-analyzed odds ratios to examine differential attrition rates between video and in-person conditions. Finally, we conducted subgroup analyses based on the primary treatment focus (depression or another condition) of each trial. <b>Results:</b> Primary study analyses yielded evidence that video-based psychotherapy is roughly comparable in efficacy with in-person psychotherapy for reducing depressive symptoms (<i>g</i> = 0.04, 95% confidence interval [CI = -0.12 to 0.20], <i>p</i> = 0.60, <i>I</i>² = 5%). Likewise, attrition rates between the two conditions were not significantly different (odds ratio = 1.07, 95% CI = [0.78 to 1.49], <i>p</i> = 0.63, <i>I</i>² = 25%). Finally, we did not observe significant subgroup differences in either efficacy (<i>p</i> = 0.38) or attrition (<i>p</i> = 0.94). <b>Conclusions:</b> The present findings suggest that video-based teletherapy may be a feasible and effective alternative to in-person services for reducing depressive symptoms. Continued research on the effectiveness of telehealth in clinically depressed samples, and further elucidation of the access barriers entailed by each delivery modality, can help the field better determine which patients will derive the greatest benefit from each mode of intervention.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1077-1089"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39665373","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 Most Important Telemedicine Patient Satisfaction Dimension: Patient-Centered Care.","authors":"Andrew N Mason","doi":"10.1089/tmj.2021.0322","DOIUrl":"https://doi.org/10.1089/tmj.2021.0322","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine provider success requires patient satisfaction. The SERVQUAL model was used to identify the most salient telemedicine patient satisfaction dimensions. <b>Materials and Methods:</b> The author surveyed 440 telemedicine patients using Likert items to examine satisfaction levels. Four performance dimensions of telemedicine service were identified and examined. Factor analysis was used to validate the telemedicine performance dimensions measured, and regression analysis was used to test the effects of the service performance dimensions on telemedicine patient satisfaction. <b>Results:</b> The SERVQUAL model provided reliable measures of satisfaction dimensions. Four dimensions of satisfaction were identified, and patient-centered care was shown to be the most significant dimension. Patient perceptions of health benefits received from the telemedicine service were also found to impact patient satisfaction. The other two dimensions, monetary and non-monetary costs, did not have a significant effect on patient satisfaction. <b>Discussion:</b> Patient satisfaction was effectively measured as a multidimensional construct by using the service-marketing SERVQUAL model. The value that patients place on provider \"soft skills\" (i.e., bedside manner) during provider-patient interactions was demonstrated. Therefore, health care providers could develop and embrace patient-centered communication, such as having an empathetic and caring attitude, showing responsiveness to the emotional needs of the patient, and providing assurance to the patient to improve telemedicine patient satisfaction. <b>Conclusions:</b> The SERVQUAL model is useful to create a comprehensive, multidimensional construct for telemedicine patient satisfaction, which can lead to improved telemedicine patient satisfaction. The multidimensional approach highlights satisfaction dimensions where targeted improvements are most appropriate and, thus, can provide more focused practice guidance to providers.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1206-1214"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39817963","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 Is the True Value of Peer-Reviewed Literature in Telemedicine?","authors":"Charles R Doarn","doi":"10.1089/tmj.2022.29079.editorial","DOIUrl":"https://doi.org/10.1089/tmj.2022.29079.editorial","url":null,"abstract":"","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1075-1076"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40624451","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":"Cardiovascular Disease Risk Stratification in Wrist Wearable Devices and e-Health App Users: A Large-Scale Retrospective Study.","authors":"Erdong Chen,&nbsp;Jie Jiang,&nbsp;Jing Zhou,&nbsp;Hui Wang,&nbsp;Guangxin Sun,&nbsp;Rui Zhou,&nbsp;Rui Su,&nbsp;Sainan Zhu,&nbsp;Yong Huo","doi":"10.1089/tmj.2021.0347","DOIUrl":"https://doi.org/10.1089/tmj.2021.0347","url":null,"abstract":"<p><p><b>Introduction:</b> Wearable devices, including smart wristbands and watches, are often used with e-health applications (apps). The users' characteristics of wrist wearable devices currently lack description, and the cardiovascular disease (CVD) high-risk rate of users remains unknown. <b>Purpose:</b> This study aimed to (1) describe the basic characteristics and habits of users of the \"Amazfit Health\" app and Huami wrist wearable devices and (2) analyze the proportion and define the population characteristics of users with a high risk of developing CVD. <b>Subjects and Methods:</b> This study included users >18 years of age, residing in mainland China, using the \"Amazfit Health\" app and Huami wearable devices. Devices data and users' self-reported information were collected in the app. The risk stratification was based on WHO/ISH cardiovascular risk prediction charts for the Western Pacific Region. Subjects with CVD history, total cholesterol ≥8 mmol/L, or ≥10% predicted CVD risk and those with <10% predicted CVD risk were considered to be at high and low risk of developing CVD, respectively. <b>Results:</b> Data were obtained from 80,098 (total users) and 10,866 users (subjects) for risk stratification. The age of the total users and subjects were 45.6 ± 15.4 and 50.7 ± 14.0 years, respectively. The number of male and female users was 50,024, and 30,074 in total users, and 7,284, and 3,582 in subjects, respectively. The body mass index of total users and subjects was 24.0 ± 4.6 kg/m² and 24.6 ± 3.8 kg/m², respectively. By classifying users' residences into first-tier cities, municipalities and provincial capitals, and other areas, the numbers of total users were 20,179, 28,213, and 31,137, and subjects were 2,587, 3,966, and 4,269, respectively. The number of subjects with high CVD risk was 1,161, accounting for 10.7% of all subjects. <b>Conclusions:</b> Users with high CVD risk only accounted for a small proportion of the population of wearable devices users.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1151-1158"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39747751","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":"Development of a Telemedicine Screening Program During the COVID-19 Pandemic.","authors":"Eileen J Kim,&nbsp;Inna Kaminecki,&nbsp;Emily A Gaid,&nbsp;Michael Lopez,&nbsp;Megha Kalia,&nbsp;Jesse Zheng,&nbsp;Alexander Oliver,&nbsp;Hongyan Xu,&nbsp;Thomas J Kim,&nbsp;Desiree Seeyave,&nbsp;Phillip Coule,&nbsp;Matt Lyon","doi":"10.1089/tmj.2021.0313","DOIUrl":"https://doi.org/10.1089/tmj.2021.0313","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine use increased during the COVID-19 pandemic due to concerns for patient and provider safety. Given the lack of testing resources initially and the large geographical range served by Augusta University (AU), a telemedicine platform with up-to-date screening guidelines was implemented for COVID-19 testing in March 2020. Our objective was to understand the level of adherence to telemedicine screening guidelines for COVID-19. <b>Methods:</b> The study population included health care providers and population who participated in an encounter in the AU Health Express Care virtual care program from March 22 to May 21, 2020. All encounters were intended to be for COVID-19 screening, free, and available 24 h per day, 7 days per week. Screening guidelines were developed by AU based on information from the Centers for Disease Control and Prevention and the Georgia Department of Public Health. <b>Results:</b> Among 17,801 total encounters, 13,600 were included in the final analysis. Overall adherence to screening guidelines was 71% in the adult population and 57% in the pediatric population. When providers did not follow guidelines, 72% determined that the patient should have a positive screen. Guidelines themselves determined that only 52% of encounters should have a positive screen. Providers' specialty significantly correlated with guideline adherence (<i>p</i> = 0.002). Departments with the highest adherence were psychiatry, neurology, and ophthalmology. No significant correlation was found between guideline adherence and provider degree/position. <b>Conclusions:</b> This study provides proof of concept of a free telehealth screening platform during an ongoing pandemic. Our screening experience was effective and different specialties participated. Our patient population lived in lower than average income zip codes, suggesting that our free telemedicine screening program successfully reached populations with higher financial barriers to health care. Early training and a posteriori knowledge of telemedicine was likely key to screening guideline adherence.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1199-1205"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39747989","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}