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

{"title":"Telemedication Reviews to Optimize Medication Prescription for Older People in Nursing Homes.","authors":"Charlotte Berard,&nbsp;Thomas Di Mascio,&nbsp;Maeva Montaleytang,&nbsp;Anne Laure Couderc,&nbsp;Patrick Villani,&nbsp;Stephane Honoré,&nbsp;Aurelie Daumas,&nbsp;Florian Correard","doi":"10.1089/tmj.2021.0288","DOIUrl":"https://doi.org/10.1089/tmj.2021.0288","url":null,"abstract":"<p><p><b>Introduction:</b> Older people living in nursing homes (NH) are at a higher risk of preventable drug-related adverse events because of age-related physiological changes, polypathology, and polypharmacy. NH residents are particularly exposed to potentially inappropriate medications (PIMs). Many strategies have been developed to improve the quality and the safety of drug prescription in NH, including medication reviews (MRs). <b>Methods:</b> In the context of the application of telemedicine, we developed and are currently implementing a novel hospital expert-based MRs through tele-expertise (or \"telemedication review,\" telemedication reviews hereafter [TMR]) in French NH residents. The impact of these TMR on unplanned hospitalizations 3 months after implementation is assessed. TMR consider all available sociodemographic, clinical, biological, and pharmaceutical data pertaining to the patient and are performed in accordance with their health care objectives. <b>Results:</b> The preliminary results for the 39 TMRs performed to date (September 2021) showed that a total of 402 PIMs were detected, and all residents had at least one PIM. We also present the feasibility and the usefulness of this novel TMR for NH, illustrating these preliminary results with two concrete TMR experiences. Among the 39 TMR performed, the average acceptance rate of expert recommendations made to general practitioners (GP) working in NH was ∼33%. <b>Discussion and Conclusions:</b> The success of this novel TMR depends on how the proposed prescription adjustments made by the hospital expert team are subsequently integrated into health care practices. The low acceptance rate by GP highlights the need to actively involve these professionals in the process of developing TMR, with a view to encouraging them to act on proposed adjustments.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1225-1232"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39765097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine in Your Pocket: An Alternative Teleconsultation Tool in a Pandemic and in Resource-Poor Settings.","authors":"Shwetambara Malwade,&nbsp;Mallikarjun Marri,&nbsp;Rajendranath Gundamraj,&nbsp;Venkat Santosh Ramana Yerravalli,&nbsp;Raja Shekhar Bellamkonda,&nbsp;Acharyulu Gvrk,&nbsp;Ramaiah Itumalla,&nbsp;Shabbir Syed-Abdul","doi":"10.1089/tmj.2021.0443","DOIUrl":"https://doi.org/10.1089/tmj.2021.0443","url":null,"abstract":"<p><p><b>Introduction:</b> Owing to the coronavirus disease 2019 (COVID-19) pandemic, digitalization is booming in all sectors, including health care. This study provides evidence of using a social networking mobile app as a telemedicine tool during the pandemic in India. <b>Methods:</b> The data include telemedicine conversations of 318 COVID-19 patients who were consulted over WhatsApp during the period March 31 to April 16, 2021, and monitored during a quarantine period of 17 days. <b>Results:</b> In total, 2,089 consultations were made by these patients during the study period. Diagnostic reports and recommendations were suggested through WhatsApp 74 times, and 30 patients were advised to admit themselves to the hospital due to increasing symptom severity. <b>Conclusions</b>: WhatsApp efficiently helped remotely manage hundreds of patients, thereby avoiding unnecessary travel to hospitals. Future study implies the need to acquire information on patient satisfaction during the teleconsultations and further encourage applications of commonly used social networking apps as alternative tools for consultations during a pandemic situation.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1215-1219"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39836566","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":"Telepsychology May Improve Treatment Adherence in Patients with Psychogenic Nonepileptic Seizures.","authors":"Becky Bikat S Tilahun,&nbsp;Nicolas R Thompson,&nbsp;Jocelyn F Bautista,&nbsp;Lauren R Sankary,&nbsp;Susan Stanton,&nbsp;Vineet Punia","doi":"10.1089/tmj.2021.0463","DOIUrl":"https://doi.org/10.1089/tmj.2021.0463","url":null,"abstract":"<p><p><b>Introduction:</b> Access to mental health care is a significant challenge in patients with psychogenic nonepileptic seizures (PNES). Telepsychology can curb the access barriers and improve adherence but the role of telepsychology in improving adherence has not been well investigated. The current study examines the utility of telepsychology during the COVID-19 pandemic and treatment adherence in PNES patients. <b>Materials and Methods:</b> Patients with PNES admitted to a 12-week counseling program were offered two visit types: telepsychology and in-office. Visit type, visit status, and demographic information were obtained from department database. Follow-up visits in 6 months were used to examine the effect of visit type on visit status. Adherence to treatment was measured by higher attendance of scheduled visits and less cancellation and no-show rates. <b>Results:</b> Two hundred fifty-seven (<i>n</i>) patients who scheduled virtual or telepsychology visits were included in the study. After adjusting for demographic variables, and accounting for repeated measures, telepsychology visits were significantly more likely to be attended (odds ratio [OR] = 2.40, 95% confidence interval [CI] = 1.69-3.41, <i>p</i> < 0.001) and were significantly less likely to be canceled (OR = 0.43, 95% CI = 0.29-0.64, <i>p</i> < 0.001). The regression model showed patients in the telepsychology visit group attended more than three times as many visits as in-office patients (incidence rate ratios = 3.16, 95% CI = 2.13-4.73, <i>p</i> < 0.001). <b>Conclusions:</b> Patients with PNES have logistical and psychological barriers that can impede their ability to attend counseling treatment. Receiving care remotely may have been associated with higher engagement with mental health treatment compared to having to travel to counseling clinics. Considering the symptom-related restrictions patients with PNES have and the barriers presented by the COVID-19 pandemic, telepsychology played a key role for continuation of mental health treatment.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1159-1165"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39857171","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":"Current Status and Challenges of the Dissemination of Telemedicine in Japan After the Start of the COVID-19 Pandemic.","authors":"Shotaro Kinoshita,&nbsp;Taishiro Kishimoto","doi":"10.1089/tmj.2021.0336","DOIUrl":"https://doi.org/10.1089/tmj.2021.0336","url":null,"abstract":"Background: The use of telemedicine is expanding worldwide in response to the COVID-19 pandemic, and deregulation is occurring even in countries with strict regulations, such as Japan. Methods: We conducted a narrative review of the activities and initiatives undertaken by the government and professional organizations to promote the use of telemedicine in Japan from January 2020, when the COVID-19 pandemic began, to September 2021. Results: In Japan, where before the pandemic the spread of telemedicine had been limited, various recommendations and deregulations have now been made, resulting in the expanded use of telemedicine. In particular, the government's overall policy direction has become a catalyst for deregulation. Conclusions: With the COVID-19 pandemic, telemedicine is now moving toward widespread use. However, further activities and initiatives, including policy changes such as reimbursement and the establishment of evidence to show the effectiveness of telemedicine in Japan, are needed to properly disseminate telemedicine.","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1220-1224"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39596217","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":"An Observational Study of Disparities in Telemedicine Utilization in Primary Care Patients Before and During the COVID-19 Pandemic.","authors":"Veronica M Pagán,&nbsp;Katie S McClung,&nbsp;Carol J Peden","doi":"10.1089/tmj.2021.0412","DOIUrl":"https://doi.org/10.1089/tmj.2021.0412","url":null,"abstract":"<p><p><b>Background:</b> The rapid scale up of telemedicine due to the COVID-19 pandemic may have disadvantaged patients less able to use technology. <b>Objectives:</b> We tested the hypothesis that certain patient groups may have been disadvantaged in accessing primary care using telemedicine. <b>Design:</b> We compared visit type and patient characteristics for April-May 2019 with April-May 2020 at a large urban academic medical center. Variables of interest included age, gender, race, ethnicity, language, visit type, visit status, insurance type, and zip code to approximate average income. <b>Results</b>: There was a 5% increase in patient visits in the observation period from 2019 to 2020. Care shifted from 100% in person to 83% telemedicine, 60% of which occurred through video and 23% by telephone. In 2020, there was a significant increase in the percentage of older patients, patients of lower income, patients whose preferred language was not English, and patients without commercial insurance who accessed care. For patients who completed a telemedicine visit, racial minority status, Hispanic/Latino ethnicity, older age, and non-English language preference significantly increased the likelihood of a telephone visit compared with younger adult, white, non-Hispanic/Latino and English-preference patients. <b>Conclusions:</b> The increase in visits in 2020 and particularly visits by older, non-English preference and lower income patients, demonstrates that the telemedicine scale-up increased access and reached patients regardless of age, language, and income. However, varied usage of televideo and telephone visits for certain groups suggests the need to explore the differences between these modalities to ensure quality telemedicine care for all patients.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1117-1125"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623890","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":"COVID-19 Home Monitoring: An Institutional Approach to Bridging Care During a Pandemic.","authors":"Gregory J Wong,&nbsp;Katherine Douglas,&nbsp;Stephen Fuest,&nbsp;Peter J McDonnell,&nbsp;Nickole Forget","doi":"10.1089/tmj.2021.0317","DOIUrl":"https://doi.org/10.1089/tmj.2021.0317","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Coronavirus disease 2019 (COVID-19) has widened patient care gaps and created gaps in medical student clinical training. The care gaps are often most obvious in primary care medicine clinics (PCMCs) where residents and medical students care for a vulnerable population. <b><i>Materials and Methods:</i></b> We designed an outpatient telehealth program to support and monitor PCMC patients who had been diagnosed or were suspected to have COVID-19 and were confined to their homes due to public health mandated isolation. To support the program, we recruited medical student volunteers. We recruited patients from our institution's primary care clinic who were recently diagnosed with COVID-19 and were currently not hospitalized. Feasibility of the home monitoring program (HMP) was assessed and mortality data for all patients were collected. <b><i>Results:</i></b> Over 800 monitoring phone calls were placed during the 8-month study period to 296 patients, with an average of 2.79 calls per patient. A total of 30 medical students participated. A total of four patients died during the study period. <b><i>Conclusions:</i></b> Our institution was able to rapidly design and implement a COVID-19 HMP integrated with our primary care clinic to ensure continued access to care during a pandemic.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1044-1049"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39808285","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 Implementation and Acceptability of a Combined Mobile Application with a COVID-19 at-Home Test Kit.","authors":"Adrian H Zai,&nbsp;Molly Caffrey,&nbsp;Conor S O'Brien,&nbsp;Dawei Jiang,&nbsp;Remona Kanyat,&nbsp;Sara Silacci","doi":"10.1089/tmj.2021.0487","DOIUrl":"https://doi.org/10.1089/tmj.2021.0487","url":null,"abstract":"<p><p><b><i>Introduction</i></b>: Testing facilities for COVID-19 were stood up around the country during the pandemic, but could not handle the demand. This study aimed to combine a mobile application (App) with an at-home test kit to facilitate home-based testing. <b><i>Methods</i></b>: After integrating an App with an at-home testing service, we measured the time between sample collection and notification of results. We recruited 92 volunteers to utilize the platform. <b><i>Results</i></b>: Sixty-one percent (55/92) responded to the survey. Median sample collection-to-result time was 2.2 days (IQR = 1.3-3.2). Eighty-two percent (45/55) found the self-test kit and App easy to use. Eighty-four percent agreed that the combined solution is an acceptable way to receive health care services. <b><i>Discussion</i></b>: Decreasing testing time and providing timely test results improve care access and decrease the risk of infection. Combining a tailored App with an at-home testing service is a feasible solution to reaching that goal.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1064-1069"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39807710","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":"Can Remote Patient Monitoring Be the New Standard in Primary Care of Chronic Diseases, Post-COVID-19?","authors":"Ashley Elizabeth Muller,&nbsp;Rigmor C Berg,&nbsp;Patricia Sofia Jacobsen Jardim,&nbsp;Trine Bjerke Johansen,&nbsp;Sari Susanna Ormstad","doi":"10.1089/tmj.2021.0399","DOIUrl":"https://doi.org/10.1089/tmj.2021.0399","url":null,"abstract":"<p><p><b><i>Background:</i></b> One lesson from the current COVID-19 pandemic is the need to optimize health care provision outside of traditional settings, and potentially over longer periods of time. An important strategy is remote patient monitoring (RPM), allowing patients to remain at home, while they transmit health data and receive follow-up services. <b><i>Materials and Methods:</i></b> We conducted an overview of the latest systematic reviews that had included randomized controlled trials with adult patients with chronic diseases. We summarized results and displayed these in forest plots, and used GRADE (Grading of Recommendations Assessment, Development, and Evaluation) to assess our certainty of the evidence. <b><i>Results:</i></b> We included 4 systematic reviews that together reported on 11 trials that met our definition of RPM, each including patients with diabetes and/or hypertension. RPM probably makes little to no difference on HbA1c levels. RPM probably leads to a slight reduction in systolic blood pressure, with questionable clinical meaningfulness. RPM probably has a small negative effect on the physical component of health-related quality of life, but the clinical significance of this reduction is uncertain. We have low confidence in the finding that RPM makes no difference to the remaining five primary outcomes. <b><i>Conclusion:</i></b> Most of our findings are consistent with reviews of other, broader definitions of RPM. The type of RPM examined in this review is as effective as standard treatment for patients with diabetes/hypertension. If this or other types of RPM are to be used for \"long covid\" patients or for other chronic disease groups post-pandemic, we need to understand why RPM may negatively affect quality of life.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"942-969"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39531016","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":"Measuring Telehealth Visit Length and Schedule Adherence Using Videoconferencing Data.","authors":"Xu Zhang,&nbsp;Yungui Huang,&nbsp;Jennifer Lee,&nbsp;Rajesh Ganta,&nbsp;Aarti Chandawarkar,&nbsp;Simon Lin Linwood","doi":"10.1089/tmj.2021.0382","DOIUrl":"https://doi.org/10.1089/tmj.2021.0382","url":null,"abstract":"<p><p><b><i>Background:</i></b> The ability to measure clinical visit length is critical for operational efficiency, patient experience, and accurate billing. Despite the unprecedented surge in telehealth use in 2020, studies on visit length and schedule adherence in the telehealth setting are nonexistent in the literature. This article aims to demonstrate the use of videoconferencing data to measure telehealth visit length and schedule adherence. <b><i>Materials and Methods:</i></b> We used data from telehealth video visits at four clinical specialties at Nationwide Children's Hospital, including behavioral health (BH), speech pathology (SP), physical therapy/occupational therapy (PT/OT), and primary care (PC). We combined videoconferencing timestamp data with visit scheduling data to calculate the total visit length, examination length, and patient wait times. We also assessed schedule adherence, including patient on-time performance, examination on-time performance, provider schedule deviations, and schedule length deviations. <b><i>Results:</i></b> The analyses included a total of 175,876 telehealth video visits. On average, children with BH appointments spent a total of 57.2 min for each visit, followed by PT/OT (50.8 min), SP (42.1 min), and PC (25.0 min). The average patient wait times were 4.1 min (BH), 2.7 min (PT/OT), 2.8 min (SP), and 3.1 min (PC). The average examination lengths were 48.8 min (BH), 44.5 min (PT/OT), 34.9 min (SP), and 16.6 min (PC). Regardless of clinical specialty, actual examination lengths of most visits were shorter than the scheduled lengths, except that appointments scheduled for 15 min tended to run overtime. <b><i>Conclusions:</i></b> Videoconferencing data provide a low-cost, accurate, and readily available resource for measuring telehealth visit length and schedule adherence.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"976-984"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39599994","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":"Flies in the Castle Today-Walking the Line.","authors":"Charles R Doarn","doi":"10.1089/tmj.2022.29078.editorial","DOIUrl":"https://doi.org/10.1089/tmj.2022.29078.editorial","url":null,"abstract":"","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"917-918"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40577853","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}