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

{"title":"Bridging the Readiness-to-Practice Gap in Telemedicine: A Cross-Sectional Study of Outpatients at a Malaysian Public Tertiary Hospital.","authors":"Nurfarihah Zulkifli, Juhaida Daud, Ritzzaleena Rosli Mohd Rosli, Afiq Izzudin A Rahim","doi":"10.1177/15305627261477284","DOIUrl":"https://doi.org/10.1177/15305627261477284","url":null,"abstract":"<p><strong>Introduction: </strong>Telemedicine plays a key role in Malaysia's National Digital Health agenda, but the population's readiness at the national level in public tertiary hospitals remains poorly understood. Identifying gaps in knowledge, attitudes, and practices is crucial to ensuring fair and successful telemedicine implementation, especially in semiurban areas where digital skills vary widely.</p><p><strong>Methods: </strong>A cross-sectional study of 255 adult outpatients was conducted at a public tertiary hospital in North-East Malaysia, focusing on those who visited the family medicine, medical, orthopedic, and surgical outpatient clinics. Systematic random sampling was used to select participants. The study utilized a validated Bahasa Malaysia questionnaire to assess patients' knowledge, attitudes, and practices regarding telemedicine. Multivariable logistic regression analysis was conducted to identify sociodemographic factors predicting each readiness domain.</p><p><strong>Results: </strong>While 60.4% of participants demonstrated good knowledge and 75.7% held favorable attitudes, understanding how these readiness levels can guide targeted interventions remains limited. Only 16.9% had prior telemedicine experience, and 52.2% showed adequate practice readiness based on the composite score. Younger age was independently associated with greater knowledge (adjusted odds ratio [AOR] 0.95; 95% confidence interval [CI] 0.93-0.98), more favorable attitudes (AOR 0.95; 95% CI 0.92-0.97), and greater practice readiness (AOR 0.97; 95% CI 0.95-0.99). The strongest predictor of practice readiness was prior telemedicine exposure (AOR 3.11; 95% CI 1.42-7.43).</p><p><strong>Discussion: </strong>Our population faces a significant readiness-to-practice gap, mainly due to age-related digital barriers and limited experience. Addressing these challenges through structured onboarding can help ensure equitable access to health care for all, thereby encouraging collective action.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261477284"},"PeriodicalIF":2.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687471","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 Monitoring to Determine the Effect of Ramadan Fasting on Blood Pressure in Congestive Heart Failure Patients.","authors":"Malcolm Clarke, Hulya Gokalp, Omer Gedikli","doi":"10.1177/15305627261476425","DOIUrl":"https://doi.org/10.1177/15305627261476425","url":null,"abstract":"<p><strong>Objective: </strong>A prospective study to compare the mean blood pressure and mean weight of subjects with congestive heart failure (CHF) in the month before Ramadan, during the month of Ramadan, and in each of the two months following Ramadan to determine if fasting has any effect on health.</p><p><strong>Methods: </strong>Patients were given a blood pressure meter and weighing scale and instructed to take daily measurements. Data were transmitted wirelessly from the devices to a simple home gateway for automatic onward transmission to the data server without intervention from the subject. Subsets of data for blood pressure and weight were created for each of the months before Ramadan, during the month of Ramadan, and the two months following Ramadan for 2025 and 2026. The mean and standard deviation were determined for each patient, and comparison between successive months was performed for the cohort mean and standard deviation using <i>t-</i>test. Paired <i>t</i>-tests were performed for subgroups containing only patients participating in successive periods.</p><p><strong>Results: </strong>There was significant variation in the mean of an individual and in the mean of a cohort; however, the mean was consistent across the period with the value for the <i>t-</i>test between successive periods being greater than 0.25 (CI: 0.05). The value for the paired <i>t-</i>test was greater than 0.22 (CI: 0.05) for all periods except between post-Ramadan and 2 months post-Ramadan when the value was 0.10 (CI: 0.05), and some subjects were seen to exhibit significant changes.</p><p><strong>Conclusions: </strong>The <i>t-</i>test and paired <i>t-</i>test values show that there were no statistically significant differences between cohort means and paired comparisons for blood pressure and weight for all months, indicating there are no effects on health in patients with CHF due to fasting if appropriately clinically managed.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261476425"},"PeriodicalIF":2.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674975","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":"Short-Term Impact of Remote Patient Monitoring on Total Cost of Care Among High-Acuity Medicare Beneficiaries: A Retrospective Pre-Post Cohort Analysis.","authors":"Wesley Smith, Angela Orsky, Joseph A Ewing, Craig Flanagan","doi":"10.1177/15305627261475507","DOIUrl":"https://doi.org/10.1177/15305627261475507","url":null,"abstract":"<p><strong>Background: </strong>High-acuity Medicare beneficiaries with annual expenditures exceeding $12,000 disproportionately drive the total cost of care (TCOC) through preventable acute utilization and are natural candidates for value-based and shared savings arrangements. Whether remote patient monitoring (RPM) produces near-term TCOC reductions in this cost-stratified population has been insufficiently evaluated in real-world practice.</p><p><strong>Methods: </strong>A retrospective pre-post cohort analysis was conducted among 597 Medicare beneficiaries enrolled for at least 5 months in a technology-enabled RPM program, each with annualized preenrollment TCOC ≥$12,000. Patients received a cellular-enabled blood pressure monitor linked to a HIPAA-compliant platform staffed by licensed care navigators. The primary outcome was change in annualized TCOC over the 12 months before and after program initiation. Given right-skewed cost distribution (skewness = 4.47), the Wilcoxon signed-rank test was the primary inferential procedure. Secondary outcomes included per-1,000-patient rates of emergency department (ED) visits, inpatient hospitalizations, and 30-day readmissions.</p><p><strong>Results: </strong>The mean age was 76.6 ± 8.2 years; 55.6% were female. The median annualized TCOC declined from $25,956 to $11,792, a reduction of $10,932 per patient (Wilcoxon <i>p</i> < 0.001; rank-biserial r = 0.47). The mean TCOC fell from $39,291 to $27,255 (<i>p</i> < 0.001). ED visits declined 19.9% (<i>p</i> < 0.001) and inpatient hospitalizations 40.9% (<i>p</i> < 0.001). Reductions were significant across all four baseline cost quartiles. Baseline TCOC was the dominant predictor of postenrollment costs (β = 0.50; <i>p</i> < 0.001; <i>R</i>² = 0.23). At $100 per member per month, estimated net savings were $6.47 million (ROI: 9.0:1).</p><p><strong>Conclusion: </strong>Short-term RPM participation was associated with substantial reductions in TCOC and acute utilization among high-acuity Medicare beneficiaries, supporting RPM as a viable intervention to advance this population toward value-based care models. Prospective controlled evaluation is warranted to establish causal attribution.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261475507"},"PeriodicalIF":2.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702955","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":"Conversational Capacity in Triadic Telemedicine: A Conceptual Framework and Evidence Synthesis.","authors":"Alexander Gamus, Gabriel Chodick, Yoram Blachar, Tamar Shalom","doi":"10.1177/15305627261473017","DOIUrl":"https://doi.org/10.1177/15305627261473017","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine is conventionally modeled as a dyadic clinician-patient encounter, yet a third party-caregiver, community health worker, nurse, or increasingly an artificial intelligence (AI) conversational agent-frequently participates. No principled basis exists for determining when such a third party is a genuine facilitator versus an instrument of one party, rendering cross-study comparison incommensurable and deployment decisions poorly grounded.</p><p><strong>Methods: </strong>We conducted a narrative synthesis of literature spanning triadic clinical communication, shared decision-making, and AI-mediated interaction to derive a technology-neutral conceptual framework and classification model.</p><p><strong>Results: </strong>We propose conversational capacity, operationalized through four functions (interpret, translate, advocate, adapt), as the minimum criterion for triadic facilitation. The framework defines a structural boundary separating genuine triadic architectures (Modes A and B) from augmented dyadic models (Mode C); a five-level Conversational Capacity Spectrum classifying human and AI facilitators; and a Clinical Situation Matrix mapping architecture to morbidity complexity, patient vulnerability, and decision complexity. Advocacy emerges as the discriminating function AI is least able to perform, making it the current limiting dimension of AI facilitation. The framework generates three testable hypotheses and identifies an equity paradox whereby high-vulnerability populations most in need of human facilitation are those most likely to be assigned AI on resource grounds.</p><p><strong>Conclusions: </strong>Triadic telemedicine should be defined by conversational capacity rather than mere third-party presence. Replacing the binary triadic-versus-dyadic distinction with two gradable, measurable constructs is a prerequisite for cumulative research and responsible AI deployment in clinical consultations.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261473017"},"PeriodicalIF":2.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148672040","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":"Assessing the Quality of Telehealth Services in Latin America Using ISO/TS 13131:2021.","authors":"Mariana Abreu Caporali de Freitas, Yibran Alejandro Hernández Montoya, Adrián Pacheco López, Bernardette Isabel Cotrina Urteaga, Styp Bill Roy Canto Rondon, Maurizio Mattoli Chiavarelli, Angélica Avendaño Veloso, César Macieira, Carlos Eduardo Menezes Amaral, Raphael Augusto Teixeira de Aguiar, Alaneir de Fátima Dos Santos","doi":"10.1177/15305627261443158","DOIUrl":"10.1177/15305627261443158","url":null,"abstract":"<p><strong>Introduction: </strong>Telehealth has emerged as a fundamental component for improving health efficiency and access in Latin America. In this regard, it is essential to investigate the quality of the services offered and structure best practices for their implementation, monitoring, and evaluation. This study aims to evaluate the quality of 15 telehealth services from 4 Latin American countries across 3 dimensions.</p><p><strong>Methods: </strong>An instrument for evaluating the quality of telehealth services was developed and validated by Latin American experts, based on the Service Planning, Risk Management, and Technology Management domains of ISO/TS 13131:2021. After validation, data from 15 services in Brazil, Mexico, Chile, and Peru were analyzed. The following tests were applied: Content Validation Index, Shapiro-Wilk, Analysis of Variance, Kruskal-Wallis, and Fisher to validate content and verify associations between countries and service quality, classified into low, medium, and high levels.</p><p><strong>Results: </strong>The instrument showed S-CVI for Relevance = 0.96; Clarity = 0.86; General = 0.91. There was no statistically significant association between countries and service quality. Overall, 60% of services were classified as low (46.67%) or medium quality (13.33%), while 40% presented high quality. Mean scores were 9.8/15 for Service Planning, 8.5/12 for Risk Management, and 21.5/35 for Technology Management, resulting in a general mean of 39.8/62 points.</p><p><strong>Conclusion: </strong>The results highlight gaps in the quality of the evaluated telehealth services. The instrument's validation confirms its applicability as a tool for telehealth quality assessment.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"836-844"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849231","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 Role of Telehealth in Decreasing Barriers in Accessing Primary and Specialized Care Services in U.S. Rural and Underserved Communities: A Scoping Review.","authors":"Diana Lobaina, Cheila Llorens, Nada Eldawy, George Kosseifi, Avanthi Puvvala, Megha Srivastav, Erik Miron, Mindy Frishman, Melodie Nasr, Vama Jhumkhawala, Samantha Jimenez, Madison Etzel, Michelle Knecht, Maria Mejia, Lea Sacca","doi":"10.1177/15305627261443159","DOIUrl":"10.1177/15305627261443159","url":null,"abstract":"<p><strong>Background: </strong>Telehealth has emerged as a promising strategy to mitigate access barriers, particularly following rapid expansion during the COVID-19 pandemic; however, evidence on its role across care settings and populations remains fragmented. This scoping review synthesizes United States (U.S.)-based evidence on the role of telehealth in improving access to primary and specialized medical care for underserved, rural, and hard-to-reach adult populations.</p><p><strong>Methods: </strong>Guided by the Arksey and O'Malley framework and PRISMA-ScR guidelines, peer-reviewed studies were identified through PubMed, Embase, and the Cochrane Library. Eligible studies examined telehealth use in adult U.S. populations and reported outcomes related to health care access, social determinants of health (SDoH), or implementation strategies. Data were charted and synthesized narratively, with implementation approaches categorized using the ERIC framework.</p><p><strong>Results: </strong>Of 9,212 records identified, 242 studies met inclusion criteria. Telehealth was associated with comparable or improved access and clinical outcomes across primary care, specialty care, behavioral health, palliative care, and perioperative settings. Commonly addressed SDoH and demographic characteristics included age, race/ethnicity, socioeconomic status, insurance coverage, geography, and digital access. While telehealth reduced barriers related to transportation, travel burden, and scheduling flexibility, disparities persisted for older adults, individuals with limited English proficiency, and those with low digital literacy or broadband access. Implementation strategies most frequently involved adapting interventions to local context, iterative evaluation, and clinician support, whereas financial and infrastructure-level strategies were less commonly reported.</p><p><strong>Conclusions: </strong>Extant literature suggests that telehealth has broad and firm support for its role in reducing access barriers and improving health outcomes across a wide range of conditions and populations. Therefore, future community-based approaches should focus on integrating telehealth into existing care delivery systems, tailoring interventions to the needs and preferences of different populations, and addressing structural barriers such as digital access, health literacy, and reimbursement to ensure sustained implementation.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"811-826"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795866","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 Telepharmacy on Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.","authors":"Kansak Boonpattharatthiti, Garin Ruenin, Patipan Arsa, Teerapon Dhippayom","doi":"10.1177/15305627261443195","DOIUrl":"10.1177/15305627261443195","url":null,"abstract":"<p><strong>Background: </strong>Pharmacists play a vital role in optimizing therapy and supporting glycemic control in patients with type 2 diabetes (T2D). Telepharmacy extends these services remotely. However, previous meta-analyses often combined telepharmacy with other interventions, limiting the clarity of their conclusions. This study aimed to evaluate the effect of telepharmacy on glycemic control in patients with T2D.</p><p><strong>Methods: </strong>PubMed, Cochrane Library, Embase, CINAHL, and EBSCO Open Dissertations were searched from inception to March 2026. Randomized controlled trials (RCTs) investigating the effect of telepharmacy in patients with T2D and reporting glycated hemoglobin (HbA1c) outcomes were included. Study quality was assessed using the Risk of Bias (RoB) 2 tool. The mean difference (MD) in HbA1c with 95% confidence intervals (CI) was pooled using a random-effects model. Heterogeneity was assessed using the <i>I</i>² statistic. The certainty of the evidence was evaluated using the GRADE approach. PROSPERO (CRD420251105397).</p><p><strong>Results: </strong>Three RCTs (487 participants) were included. Telepharmacy interventions shared similar contexts, focusing on adherence improvement, lifestyle improvement, and diabetes education. Telepharmacy was associated with a statistically significant reduction in HbA1c compared with usual care (MD -0.64; 95% CI -0.93 to -0.35) with no heterogeneity observed (<i>I² =</i> 0%). All trials were rated as having \"some concerns\" in RoB. The certainty of the evidence was rated as low due to RoB and imprecision.</p><p><strong>Conclusions: </strong>Telepharmacy significantly improved glycemic control in patients with T2D. It may be considered a supportive strategy to enhance access to care and promote patient self-management, particularly among individuals facing barriers to health care access.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"803-810"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702022","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":"Availability of Telehealth Services for Total Knee Arthroplasty at Orthopaedic Surgery Practices.","authors":"Wei Shao Tung, Chloe C Dlott, Laurie C Yousman, Sanjana Jain, Anchal Bahel, Aarush Kalia, Sohani Das, Daniel H Wiznia","doi":"10.1177/15305627261440758","DOIUrl":"10.1177/15305627261440758","url":null,"abstract":"<p><strong>Background: </strong>For patients in lower socioeconomic groups who are unable to take time off from work, afford transportation to a clinic, or who live in rural locations, telehealth appointments have been found to improve access to care. Given how knee osteoarthritis disproportionately impacts patients in lower socioeconomic groups, we sought to evaluate the availability of telehealth appointments in orthopaedic surgery practices for patients with knee osteoarthritis with private or public (Medicaid) insurance.</p><p><strong>Methods: </strong>A secret shopper methodology was utilized for a scenario designed to measure access to telehealth appointments for patients with knee osteoarthritis. The caller asked questions regarding the availability and wait times for telehealth and in-person appointments for both new visits and follow-up visits. Separate calls were made for private and public insurance. Descriptive characteristics and univariate tests were used for analysis.</p><p><strong>Results: </strong>For initial new patient consults, 4.3% (13/304) of practices accepting private insurance offered telehealth and 3.6% (7/196) of practices accepting Medicaid offered telehealth. For follow-up visits, 39.8% (121/304) of practices accepting private insurance offered telehealth, and 40.3% (79/196) of practices accepting Medicaid offered telehealth. No differences were found in the availability of telehealth services for patients with Medicaid compared to patients with private insurance.</p><p><strong>Discussion: </strong>Telehealth is an underutilized but viable option for patients who are considering knee arthroplasty, especially for follow-up appointments. Implementing telehealth follow-up appointments can be beneficial to patients and surgeons. Further research should examine the barriers that limit the availability of telehealth in arthroplasty clinics and how a lack of musculoskeletal telehealth services, especially for patients of lower socioeconomic status, may affect access to osteoarthritis care.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"863-867"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680240","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":"Exploring Telemedicine Needs and Barriers in Women with Osteoporosis: A Cross-Sectional Study.","authors":"Selkin Yilmaz Muluk, Erhan Muluk, Sevcan Ugur","doi":"10.1177/15305627261443207","DOIUrl":"10.1177/15305627261443207","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine (TM) offers opportunities for disease management; however, patient-centered expectations, priorities, and barriers remain insufficiently characterized.</p><p><strong>Methods: </strong>A questionnaire assessed TM desire, expected benefits, topic preferences, and perceived barriers among women with osteoporosis. A telemedicine need score (TNS) was constructed based on living alone, inability to drive, and the presence of chronic illness. Associations were examined using chi-square and nonparametric tests and logistic regression.</p><p><strong>Results: </strong>Among 197 women (mean age 65.2 years), the most frequently reported health-care-system challenges were difficulty obtaining appointments and limited time with physicians. More than half of the participants wanted to use TM, and most believed it could improve quality of life. The most frequently requested topics were medication-related information overall, and fracture prevention and risk factors for older ones (<i>p</i> = 0.040; odds ratio [OR] = 2.30). Older adults reported more barriers (limited internet/device access (<i>p</i> < 0.001; OR = 3.96) and difficulty using devices (<i>p</i> = 0.003; OR = 2.61)), and they were less ready/confident to engage in TM services (<i>p</i> < 0.001). A high TNS was more common among older adults (<i>p</i> < 0.001; OR = 2.91). In multivariable analysis, age ≥ 65 years (OR = 2.79) and unmarried status (OR = 1.86) were independently associated with higher odds of high TM need.</p><p><strong>Conclusions: </strong>TM may address key gaps in osteoporosis care by supporting medication-related counseling and fracture-prevention education; however, age-related digital barriers may limit uptake. Osteoporosis-oriented TM programs should prioritize usability support and targeted education, particularly for adults aged ≥65 years.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"845-853"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694603","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 Competency Evaluation Tools: A Scoping Review.","authors":"Kelli Garber, Heather Jones, Cynthia Chew, Jeanne Moore, Carolyn Rutledge, Annie Boehning, Matthew Sorenson, Ayaba Logan, Katherine Chike-Harris","doi":"10.1177/15305627261440779","DOIUrl":"10.1177/15305627261440779","url":null,"abstract":"<p><strong>Introduction: </strong>Telehealth is an integral part of healthcare. Exposure to telehealth education is essential for both students and health care professionals to support its effective adoption and appropriate utilization. This scoping review aims to explore whether and which telehealth competencies are being assessed and the methods used to evaluate them among health care professionals and students.</p><p><strong>Methods: </strong>An electronic literature search was performed using six electronic databases between January 2024 and February 2025. We included studies where telehealth competencies or their components were evaluated by some type of tool (validated or researcher created). Strict inclusion and exclusion criteria were used, and each article was evaluated by at least two reviewers.</p><p><strong>Results: </strong>Out of 1,217 articles screened by title and abstract, 75 met inclusion criteria, with 36 of those selected for inclusion in this review. Participants were evaluated mostly by researcher-created tools that lacked psychometric properties or adapted nontelehealth evaluation tools. Few validated/reliable tools directly measured telehealth competencies.</p><p><strong>Discussion: </strong>The results of this review illustrate there exists a lack of available validated/reliable evaluation tools to appraise telehealth competencies. Few studies included an evaluation of all telehealth competencies but rather focused only on communication and technology proficiency; none evaluated the appropriate use of telehealth or digital disparities.</p><p><strong>Conclusions: </strong>More research is needed to develop validated telehealth evaluation tools that can be used across disciplines and encompass all telehealth competencies. Additionally, true research methods are needed to adequately assess the impact of telehealth education on the performance and confidence of learners.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"785-802"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680188","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}