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

{"title":"The COVID-19 Pandemic as an Opportunity to Improve Health Care Through a Nurse-Coordinated Multidisciplinary Model in a Headache Specialist Center: The Implementation of a Telemedicine Protocol.","authors":"Valeria Caponnetto,&nbsp;Raffaele Ornello,&nbsp;Eleonora De Matteis,&nbsp;Sara Consilia Papavero,&nbsp;Andrea Fracasso,&nbsp;Giovanni Di Vito,&nbsp;Loreto Lancia,&nbsp;Fabrizio Massimo Ferrara,&nbsp;Simona Sacco","doi":"10.1089/tmj.2021.0414","DOIUrl":"https://doi.org/10.1089/tmj.2021.0414","url":null,"abstract":"<p><p><b><i>Background:</i></b> Due to coronavirus disease-19 (COVID-19) pandemic, Italian outpatient clinics were suspended in March-April 2020 and subsequently slowed down. Telemedicine was shown to be useful in headache clinics, despite absence of a detailed protocol for its development. <b><i>Objective:</i></b> To describe the implementation of a structured telemedicine protocol during COVID-19 pandemic. <b><i>Materials and Methods:</i></b> Since May 2020, we performed a quality improvement study in a Headache Specialist Center in central Italy. We involved patients who had in-person follow-up visits scheduled during suspension and initial reopening of clinics. Patients had two appointments with a nurse specialized in headache care and a headache physician, respectively, using Microsoft Teams^®. The service is still active. We collected sociodemographic and clinical characteristics of patients, technical details of telemedicine visits, patient feedback, medical judgment about complexity of clinical decisions, and need for in-person re-evaluation. We also performed a Strengths-Weaknesses-Opportunities-Threats analysis to provide a realistic picture of the service. <b><i>Results:</i></b> We performed 207 telemedicine visits involving 100 patients with a median age of 44 (interquartile range [IQR]: 35-56) years; 76.0% were women and lived at a median of 68 (IQR: 24-109) km from the Center. Thirty-nine (39.0%) were visited for migraine without aura. Patients mostly used a computer (68.1% visits) with high audio-video quality in 93.2% of visits. First and second appointments lasted in median 20 (IQR: 14-25) minutes and 9 (IQR: 7-13) minutes, respectively. Interacting with patients was very easy in 66.7% of visits. Patients reported no difficulty in sharing documents and high satisfaction in 78.6% and 93.5% of visits, respectively. Perceived complexity of clinical decisions was generally low (86.5%), whereas 8.2% of cases required in-person re-evaluation. <b><i>Conclusions:</i></b> Telemedicine facilitated follow-ups, ensuring multidisciplinary care and high patient satisfaction, justifying its wider adoption in headache care.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1016-1022"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39606337","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":"Telemental Health Collaborative Care Medication Management: Implementation and Outcomes.","authors":"Smita Das,&nbsp;Jane Wang,&nbsp;Shih-Yin Chen,&nbsp;Connie E Chen","doi":"10.1089/tmj.2021.0401","DOIUrl":"https://doi.org/10.1089/tmj.2021.0401","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Access to quality mental health medication management (MM) in the United States is limited, even among those with employment-based health insurance. This implementation, feasibility, and outcome study sought to design and evaluate an evidence-based telemental health MM service using a collaborative care model (CoCM). <b><i>Materials and Methods:</i></b> CoCM MM was available to adult employees/dependents through their employer benefits, in addition to therapy. Outcomes included Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) collected at baseline and throughout participation. This analysis was not deemed to be human subjects research by the Western Institutional Review Board. <b><i>Results:</i></b> Over 17 months, 212 people enrolled and completed >2 assessments; the enrollees were 58.96% female with average age of 32.00 years (standard deviation [SD] = 7.38). In people with moderate to severe depression or anxiety, PHQ-9 and GAD-7 scores reduced by an average of 7.27 (SD = 4.80) and 6.71 (SD = 5.18) points after at least 12 ± 4 weeks in the program. At 24 ± 4 weeks, the PHQ-9 and GAD-7 reductions were on average 7.17 (SD = 5.00) and 6.03 (SD = 5.37), respectively. Approximately 65.88% of participants with either baseline depression or anxiety had a response on either the PHQ-9 or GAD-7 at 12 ± 4 weeks and 44.71% of participants experienced remission; at 24 ± 4 weeks, 56.41% had response and 41.03% experienced remission. <b><i>Conclusions:</i></b> An evidence-based CoCM telemedicine service within an employee behavioral health benefit is feasible and effective in reducing anxiety and depression symptoms when using measurement-based care. Widespread implementation of a benefit like this could expand access to evidence-based mental health MM.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1035-1043"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39751489","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":"Ease in Emergency Hospital Visits Due to Covid-19 Following Implementation of a Telemedicine Service in Ceará, Brazil.","authors":"Antonia Célia de Castro Alcântara,&nbsp;Hermano Alexandre Lima Rocha,&nbsp;Caroline Calisto da Silva,&nbsp;Sabrina Gabriele Maia Oliveira Rocha,&nbsp;Danielle Leite Cunha de Queiroz,&nbsp;Flavio Lucio Pontes Ibiapina,&nbsp;Elias Bezerra Leite,&nbsp;Francisco Airton Castro da Rocha","doi":"10.1089/tmj.2021.0327","DOIUrl":"https://doi.org/10.1089/tmj.2021.0327","url":null,"abstract":"<p><p><b><i>Background:</i></b> We assessed the impact of implementing a virtual emergency room (VER) in easing emergency room (ER) visits in patients suspected of having COVID-19. <b><i>Materials and Methods:</i></b> Retrospective observational cohort study conducted in May 2020 and in March 2021, during the first and second waves in Brazil. Patients could choose to either visiting ER or using the VER (implemented in March 2021). Medical records were revised for demographic and clinical data. The primary outcome was the number of visits. <b><i>Results:</i></b> A total of 32,822 visits were evaluated. HR was more than three times less in the VER group with <10% VER clients going to ER. The trend and volume of use of the emergency sector in the periods did not show a statistically significant difference, despite the higher number of cases in the second period. <b><i>Conclusion:</i></b> This telemedicine strategy led to a reduction in visits to the ER. Also, our results suggest the safety of this intervention.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1058-1063"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39581913","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 Association Between e-Health Literacy and Willingness to Deprescribe Among Patients with Chronic Diseases: A Cross-Sectional Study from Jordan.","authors":"Rawand A Khasawneh,&nbsp;Mohammad B Nusair,&nbsp;Rasha M Arabyat,&nbsp;Reema Karasneh,&nbsp;Sayer Al-Azzam","doi":"10.1089/tmj.2021.0331","DOIUrl":"https://doi.org/10.1089/tmj.2021.0331","url":null,"abstract":"<p><p><b><i>Background:</i></b> Deprescribing refers to the partnered discontinuation of chronic medications to limit the negative impacts of polypharmacy. Polymedicated patients play a key role in the success of deprescribing efforts. eHealth literacy reflects patients' ability to appraise electronically available health-related information to make informed health care decisions, which partly reflect their desire to deprescribe. <b><i>Objectives:</i></b> The current study aimed to explore the relationship between eHealth literacy and willingness to deprescribe among patients with chronic diseases. Additionally, the predictors of willingness to deprescribe were examined. <b><i>Materials and Methods:</i></b> This cross-sectional study was conducted among adult patients with chronic diseases in Jordan. An online questionnaire comprising two validated tools, namely the Electronic Health Literacy Scale (eHEALS) and the Revised Patients' Attitudes Toward Deprescribing (rPATD) Questionnaire, was used for data collection. The questionnaire targeted adult patients with chronic medical conditions in Jordan and was posted to social media portals, following a convenience sampling technique. <b><i>Results:</i></b> A total of 719 responses were recorded and included in the final analysis. Participants with higher levels of eHealth literacy were more willing to get their medications deprescribed, as indicated by the perceived use of unneeded medications (<i>p</i> = 0.042). Meanwhile, participants with low levels of eHealth literacy were more likely to report fear of missing out on the potential benefits of deprescribed medications (<i>p</i> = 0.003). Other items that were commonly agreed upon by both the low and high eHealth literacy groups, respectively, included desire for dose reduction (<i>p</i> < 0.001, <i>p</i> < 0.001), belief in the lack of effectiveness of some prescribed medications (<i>p</i> < 0.001, <i>p</i> < 0.001), and fear of precipitating side effects (<i>p</i> = 0.001, <i>p</i> = 0.007). <b><i>Conclusions:</i></b> The present study highlighted the relationship between eHealth literacy and a number of items reflecting willingness to deprescribe, and these indicators can be used to guide future deprescribing efforts among eligible patients.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1001-1008"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39646788","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":"Updated Review of the Pacific Asynchronous Telehealth System's Impact on Military Pediatric Teleconsultations.","authors":"Mechelle Miller,&nbsp;Kara Delaney,&nbsp;Michael Lustik,&nbsp;Charles Nguyen,&nbsp;Milissa Jones,&nbsp;Jennifer Mbuthia","doi":"10.1089/tmj.2021.0279","DOIUrl":"https://doi.org/10.1089/tmj.2021.0279","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The Pacific Asynchronous TeleHealth (PATH) system is an asynchronous provider-to-provider teleconsultation platform utilized by military medical facilities throughout the Western Pacific Region. This study focused on PATH utilization for pediatric cases and its impact on patient transfers and cost avoidance. <b><i>Methods:</i></b> This retrospective analysis reviewed PATH cases from March 2017 to February 2020 for patients aged 0-17 years. We reviewed the referring users' responses to survey questions related to the impact of PATH consultation on patient travel for in-person subspecialty care and the need for local referral. Data for cost avoidance were estimated using per diem rates and airline flight costs for Fiscal Year 2020. <b><i>Results:</i></b> A total of 2,448 pediatric consultations were submitted from 29 military medical facilities. Pediatric Pulmonology (<i>n</i> = 557, 24.5%), Pediatric Cardiology (<i>n</i> = 446, 19.6%), and Pediatric Neurology (<i>n</i> = 236, 10.37%) had the highest percentage of pediatric teleconsults. Approximately 42% of referring users completed the survey questions. Among survey respondents, 710 (69.4%) indicated that unnecessary patient transfers were prevented, equating to a cost savings of ∼$3.3 million. <b><i>Conclusions:</i></b> We observed robust utilization of the PATH system by pediatric providers in the Military Health System that ultimately resulted in substantial cost avoidance. This asynchronous telemedicine platform is a vital asset in locations with limited access or travel restriction to medical specialists, such as during pandemics.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1009-1015"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39784265","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 Telemedicine Model for Following Keratoconus Patients in the Era of COVID-19 Pandemic.","authors":"Dana Barequet,&nbsp;Shay Gutfreund,&nbsp;Michaella Goldstein,&nbsp;Anat Loewenstein,&nbsp;Ronni Gamzu,&nbsp;David Varssano","doi":"10.1089/tmj.2021.0178","DOIUrl":"https://doi.org/10.1089/tmj.2021.0178","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To evaluate the diagnostic accuracy and reliability of a telemedicine approach for detecting keratoconus patients' progression in the era of coronavirus disease 2019 (COVID-19) pandemic. <b><i>Materials and Methods:</i></b> A retrospective study, comparing the office and telemedicine evaluations in determining whether keratoconus patients were at risk of progression and indicated for further treatment of corneal crosslinking, was conducted. The clinic examination included best spectacle corrected visual acuity measurement and manifest refraction, full ophthalmic examination, and corneal topography, which provided with the gold-standard diagnosis. The remote assessment included two decisions of keratoconus progression or stability: the first evaluation after revealing patient demographics and topography images, and the second with the manifest refraction and clinical findings as documented in the outpatient clinic visit. <b><i>Results:</i></b> Two-hundred and four eyes of 102 keratoconus patients were included. There was an agreement of assessment between the in-person and the remote diagnostic decisions in 192 (94%) of the eyes. Among the remaining 12 eyes, a false-positive diagnosis was made in 8 (3.9%) eyes, whereas a false-negative diagnosis was made in 4 (1.9%) eyes. The remote assessment showed a sensitivity and specificity of 69% and 96%, respectively. In no case was remote diagnostic decision 2 different from remote decision 1. <b><i>Conclusions:</i></b> The telemedicine model yielded high specificity, but low sensitivity values, therefore, not suitable as an alternative for keratoconus patient follow-up (Clinical trial number TLV-0363-20).</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1023-1027"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39721070","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":"Opportunities and Barriers to Rural Telerobotic Surgical Health Care in 2021: Report and Research Agenda from a Stakeholder Workshop.","authors":"Ryan N Hansen,&nbsp;Basil Matthew Saour,&nbsp;Brian Serafini,&nbsp;Blake Hannaford,&nbsp;Lanu Kim,&nbsp;Takayoshi Kohno,&nbsp;Ryan James,&nbsp;Wayne Monsky,&nbsp;Stephen P Seslar","doi":"10.1089/tmj.2021.0378","DOIUrl":"https://doi.org/10.1089/tmj.2021.0378","url":null,"abstract":"<p><p><b><i>Background:</i></b> There are well-recognized challenges to delivering specialty health care in rural settings. These challenges are particularly evident for specialized surgical health care due to the lack of trained operators in rural communities. Telerobotic surgery could have a significant impact on the rural-urban health care gap, but thus far, the promise of this method of health care delivery has gone unrealized. With the increasing adoption of telehealth over the past year, along with the maturation of telecommunication and robotic technologies over the past 2 decades, a reappraisal of the opportunities and barriers to widespread implementation of telerobotic surgery is warranted. Here we report the outcome of a rural telerobotic stakeholder workshop to explore modern-day issues critical to the advancement of telerobotic surgical health care. <b><i>Materials and Methods:</i></b> We assembled a multidisciplinary stakeholder panel to participate in a 2-day Rural Telerobotic Surgery Stakeholder Workshop. Participants had diverse expertise, including specialty surgeons, technology experts, and representatives of the broader telerobotic health care ecosystem, including economists, lawyers, regulatory consultants, public health advocates, rural hospital administrators, nurses, and payers. The research team reviewed transcripts from the workshop with themes identified and research questions generated based on stakeholder comments and feedback. <b><i>Results:</i></b> Stakeholder discussions fell into four general themes, including (1) operating room team interactions, (2) education and training, (3) network and security, and (4) economic issues. The research team then identified several research questions within each of these themes and provided specific research strategies to address these questions. <b><i>Conclusions:</i></b> There are still important unanswered questions regarding the implementation and adoption of rural telerobotic surgery. Based on stakeholder feedback, we have developed a research agenda along with suggested strategies to address outstanding research questions. The successful execution of these research opportunities will fill critical gaps in our understanding of how to advance the widespread adoption of rural telerobotic health care.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1050-1057"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39639139","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":"The Utilization of an Electronic Consultation Service During the Coronavirus Disease 2019 Pandemic.","authors":"Jatinderpreet Singh,&nbsp;Erin Keely,&nbsp;Sheena Guglani,&nbsp;Gary Garber,&nbsp;Clare Liddy","doi":"10.1089/tmj.2021.0497","DOIUrl":"https://doi.org/10.1089/tmj.2021.0497","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The coronavirus disease 2019 (COVID-19) pandemic forced many clinicians to rapidly adopt changes in their practice. In this study, we compared patterns of utilization of Ontario eConsult before and after the onset of the COVID-19 pandemic, to assess COVID 19's impact on how eConsult is used. <b><i>Materials and Methods:</i></b> We conducted a longitudinal analysis of registration and utilization data for Ontario eConsult. All primary care providers (PCPs) and specialists who joined the service between March 2019 and November 2020, and all eConsult cases closed during the same period were included. The data were divided into two timeframes for comparison: prepandemic (March 2019-February 2020) and pandemic (March 2020-November 2020). <b><i>Results:</i></b> In total, 5,925 PCPs joined during the study period, more than doubling total enrollment to 11,397. The average monthly number of eConsults increased from 2,405 (standard deviation [SD] = 260) prepandemic to 3,906 (SD = 420) pandemic. Case volume jumped to 24.3% in the first month of the pandemic, and increased by 71% during the COVID-19 pandemic timeframe. The median response time was similar in both timeframes (prepandemic: 1.0 days; pandemic: 0.9 days). The proportion of cases resulting in new/additional information (prepandemic: 55%, pandemic: 57%) or avoidance of a contemplated referral (prepandemic: 52%, pandemic: 51%) remained consistent between timeframes. <b><i>Conclusions:</i></b> Registration to and usage of eConsult increased during the pandemic. Metrics of the service's impact, including response time, percentage of cases resulting in new or additional information, and avoidance of originally contemplated referrals were all consistent between the prepandemic and COVID-19 pandemic timeframes, suggesting scalability.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"994-1000"},"PeriodicalIF":4.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39802201","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":"Ophthalmic Virtual Visit Utilization and Patient Satisfaction During the COVID-19 Pandemic.","authors":"Darren A Chen,&nbsp;Ann Q Tran,&nbsp;Marc J Dinkin,&nbsp;Gary J Lelli","doi":"10.1089/tmj.2021.0392","DOIUrl":"https://doi.org/10.1089/tmj.2021.0392","url":null,"abstract":"<p><p><b><i>Background:</i></b><i>Due to the COVID-19 pandemic, there was a surge in synchronous ophthalmic telehealth visits. The purpose of this study is to analyze the utilization and patient satisfaction of synchronous ophthalmic video visits over the course of the COVID-19 pandemic.</i><b><i>Methods:</i></b><i>In this retrospective, single-center cross-sectional study, 1,756 patients seen through synchronous video visits between March 1, 2020, and March 31, 2021, were identified using billing codes. E-mails containing a validated, 11-item, telehealth satisfaction scale were sent to patients who had at least one video visit within the study period. Questions were scored on a 1-4 scale, corresponding to poor, fair, good, and excellent. Main outcome measures included patient satisfaction scores, frequency of repeat video visits, and primary visit diagnoses.</i><b><i>Results:</i></b><i>The top 3 subspecialties by virtual visit volume were oculoplastic surgery (999 visits, 42.9%), neuro-ophthalmology (331 visits, 17.0%), and cornea (254 visits, 14.2%). The top 3 diagnoses seen were chalazion/hordeolum, dry eye, and meibomian gland dysfunction. The overall survey response rate was 14.3% (252 participants). The mean patient satisfaction score was 3.67 ± 0.63, with no significant difference in scores between specialties. A total of 380 (21%) patients had repeat virtual visits. Mean survey response scores were significantly higher for patients with repeat visits than those without (3.82 ± 0.42 vs. 3.62 ± 0.68,</i> p<i> = 0.03). Patients undergoing oculoplastic services were more likely to have repeat visits (odds ratio 2.58, 95% confidence interval 2.18-3.06,</i> p <i>< 0.001). Multivariate regression analysis found that provider thoroughness/skillfulness was the most predictive feature of the patient returning to a telehealth encounter (</i>p<i> = 0.01).</i><b><i>Conclusions:</i></b><i>Our study suggests that synchronous videoconferencing for ophthalmology is a highly satisfactory delivery method and will likely find continued success in select subspecialties as the pandemic fades.</i></p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"798-805"},"PeriodicalIF":4.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39486668","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":"Use of Teleophthalmology for Evaluation of Ophthalmic Emergencies by Ophthalmology Residents in the Emergency Department.","authors":"Yesha S Shah,&nbsp;Michael J Fliotsos,&nbsp;Abdulaziz Alaqeel,&nbsp;Michael V Boland,&nbsp;Sidra Zafar,&nbsp;Divya Srikumaran,&nbsp;Fasika A Woreta","doi":"10.1089/tmj.2021.0334","DOIUrl":"https://doi.org/10.1089/tmj.2021.0334","url":null,"abstract":"<p><p><b><i>Background:</i></b><i>Utilizing telemedicine is one approach to reduce the ever-increasing burden of patients on emergency departments (EDs) and consulting physicians. Utilization of telemedicine services in the ED may also benefit resident education.</i><b><i>Materials and Methods:</i></b><i>Ten first-year ophthalmology residents were trained to use a Topcon 3D Optical Coherence Tomography (OCT)-1 Maestro to capture OCT images and fundus photos in patients presenting to the ED with urgent ophthalmic concerns. Findings were communicated to the supervising ophthalmologist. Retrospective chart review was conducted to obtain patient characteristics and final ophthalmologist diagnosis. Residents rated ease of use, technical reliability, and educational value through a survey.</i><b><i>Results:</i></b><i>From December 1, 2019, to December 1, 2020, the device was used in 109 patient encounters, capturing 887 images (average 8.1 images per encounter). Patients on whom the device was used were on average 48.5 years old (±17.2, range 17-90) and 59.6% were female. The imaging device was utilized most commonly for evaluating papilledema (</i>n<i> = 21, 18.6%), new-onset visual acuity/visual field defects (</i>n<i> = 12, 10.6%), retinal detachment/tear (</i>n<i> = 8, 7.1%), and ophthalmic trauma workup (</i>n<i> = 8, 7.1%). Eight residents completed the survey and most (</i>n<i> = 7) agreed or strongly agreed that the device helped them diagnose patients more accurately. Technical issues such as machine malfunction, image artifacts, and problems syncing with the electronic health record and computer were noted by survey respondents.</i><b><i>Conclusions:</i></b><i>The most common use of teleophthalmology in the ED setting was evaluation of papilledema; the majority of residents perceived an educational benefit from this tool. Efforts should be made to address the technical challenges to increase the utility of this device.</i></p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"858-864"},"PeriodicalIF":4.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39493921","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}