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

{"title":"Patient and Visit Characteristics of Families Accessing Pediatric Urgent Care Telemedicine During the COVID-19 Pandemic.","authors":"Patricia Solo-Josephson,&nbsp;Joanne Murren-Boezem,&nbsp;Cynthia M Zettler-Greeley","doi":"10.1089/tmj.2021.0135","DOIUrl":"https://doi.org/10.1089/tmj.2021.0135","url":null,"abstract":"<p><p><b>Introduction:</b> Telemedicine expansion during the coronavirus pandemic improved health care access for some. However, studies show disparate uptake among marginalized communities, where minority patients experience higher infection rates. We examined changes in pediatric telemedicine utilization as related to social determinants of health and characteristics of families accessing care. <b>Materials and Methods:</b> This IRB-approved study is a retrospective, cross-sectional comparison of completed visits for parent-initiated, urgent care telemedicine services received by a pediatric health care system between January to May 2019 and January to May 2020. Patient and visit characteristics were evaluated by region (Florida or Delaware Valley) and year for age, race, gender, ethnicity, zip code, language, median household income, insurance type, and patient draw. <b>Results:</b> Outcomes varied by region. Pediatric patient visits jumped by 172% in 2020 from the year prior. In Florida, the proportion of Hispanic patients utilizing telemedicine increased, as did patients utilizing government-supported health insurance during the pandemic (<i>p</i>s < 0.05). Practically meaningful, although nonsignificant increases in patient language diversity were found across years in both regions (<i>p</i>s > 0.05). Rural patient utilization remained low (2-5%; <i>p</i>s > 0.05). <b>Discussion:</b> Changes in telemedicine use were observed among pediatric patients in vulnerable populations during the coronavirus disease 2019 (COVID-19) pandemic. Despite increased utilization among Hispanic and low-income families, access to virtual care remains a challenge among patients residing in rural locales. <b>Conclusion:</b> Researchers, health care providers, and policymakers should examine the implementation of varying mitigation strategies that support equal access and use of virtual health care among an increasingly diverse, post-COVID-19 pediatric patient population.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"558-565"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186681","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":"Perspectives of Patients and Providers on the Use of Telemedicine for Chronic Disease Specialty Care in the Alaska Tribal Health System.","authors":"Elizabeth D Ferucci,&nbsp;Tammy L Choromanski,&nbsp;Rabecca I Arnold,&nbsp;Jaclynne K Richards,&nbsp;Cornelia M Jessen","doi":"10.1089/tmj.2021.0175","DOIUrl":"https://doi.org/10.1089/tmj.2021.0175","url":null,"abstract":"Background: There are disparities in access to specialty care for chronic diseases in rural populations. Telemedicine has been proposed to improve access. Introduction: The objective of this study was to identify predictors of telemedicine use for chronic disease specialty care in the Alaska Tribal Health System. Materials and Methods: We collected data from patients and providers about benefits, barriers, and deciding factors for or against telemedicine use. Participants were recruited from three regional tribal health organizations in Alaska during 2019. Data were collected using a patient survey, a provider survey, and patient focus groups. Results: Of the 153 patients surveyed, 104 had never used telemedicine, and 71 (68% of never users) were open to it if offered. Of the 29 providers surveyed, 27 (93%) stated a preference for using telemedicine in the follow-up phase of care. In the focus groups conducted with telemedicine ever users (n = 23) and never users (n = 14), the identified barriers and benefits were similar, but never users were more likely to emphasize patient preference as a deciding factor, whereas ever users described clinic-related deciding factors more commonly. Relationship building before telemedicine visits was identified as important by some focus group participants. Discussion: This study adds to the literature on patient and provider views of benefits, barriers, and deciding factors for or against the use of telemedicine before the COVID-19 pandemic. These views may evolve over time. Conclusions: Patients and providers identify benefits of telemedicine that may outweigh the barriers in many settings.","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"535-543"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39299681","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":"Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic.","authors":"Theresa Sevilis,&nbsp;Mark McDonald,&nbsp;Amanda Avila,&nbsp;Gregory Heath,&nbsp;Lan Gao,&nbsp;Gayle O'Brien,&nbsp;Mohammed Zaman,&nbsp;Adam Heller,&nbsp;Muhammad Masud,&nbsp;Nima Mowzoon,&nbsp;Thomas Devlin","doi":"10.1089/tmj.2021.0149","DOIUrl":"https://doi.org/10.1089/tmj.2021.0149","url":null,"abstract":"<p><p><b>Introduction:</b> The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted acute stroke care globally. Decreased stroke presentations and concern for delays in acute stroke care have been identified. This study evaluated the impact of COVID-19 on the timely treatment of patients with thrombolytics at hospitals utilizing telestroke acute stroke services. <b>Methods:</b> Acute stroke consultations seen in 171 hospitals (19 states) via telestroke from December 1, 2019, to June 27, 2020, were extracted from the TeleCare™ database. The consults were divided into pre-COVID and COVID groups (March 15, 2020, start of COVID group). The consults were reviewed for age, sex, hospital, state, date seen, last known normal, arrival time, consult call time, needle time, thrombolytic candidate, and National Institutes of Health Stroke Scale (NIHSS) score. The total number of consults, median door to needle (DTN) time for emergency department (ED) patients, and call to needle (CTN) time for inpatients were calculated. <b>Results:</b> Pre-COVID, 15,226 stroke consults were evaluated compared with 11,105 in the COVID group, a 27% decrease. Pre-COVID, 1,071 ED patients (7.9%) received thrombolytics and 66 inpatients (4.0%), while COVID, 813 ED patients (8.2%) and 70 inpatients (5.7%). The median DTN time for ED patients pre-COVID was 42 (32, 55) versus 40 (31, 52) in the COVID group, with no statistically significant difference between groups. CTN time pre-COVID was 53 (35, 67) versus 46 (35, 61) in the COVID group, with no statistically significant difference between groups. <b>Conclusions:</b> Telestroke assessments allowed for uninterrupted acute stroke care and treatment stability despite nursing and other resource realignments triggered by the COVID-19 pandemic.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"481-485"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186687","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":"Patient-Level Factors Associated with Utilization of Telemedicine Services from a Free Clinic During COVID-19.","authors":"Oliver T Nguyen,&nbsp;Amelia K Watson,&nbsp;Kartik Motwani,&nbsp;Chloe Warpinski,&nbsp;Katelin McDilda,&nbsp;Carlos Leon,&nbsp;Neel Khanna,&nbsp;Ryan W Nall,&nbsp;Kea Turner","doi":"10.1089/tmj.2021.0102","DOIUrl":"https://doi.org/10.1089/tmj.2021.0102","url":null,"abstract":"<p><p><b>Background:</b> Disparities in telemedicine use by race, age, and income have been consistently documented. To date, research has focused on telemedicine use among patients with adequate insurance coverage. To address this gap, this study identifies patient-level factors associated with telemedicine use during the coronavirus (COVID-19) pandemic among one free clinic network's patients who are underinsured or uninsured. <b>Methods:</b> Electronic health record data were reviewed for patient-level data on patients seen from March 2020 to September 2020. Patients were grouped by telemedicine use history. We controlled for sociodemographic factors (e.g., age, race/ethnicity) and comorbidities. Logistic regression analyses were conducted. <b>Results:</b> Across 198 adult patients, 56.6% received telemedicine care. Of these, 99.1% elected for audio-only telemedicine instead of video telemedicine. Telemedicine use was more likely among those living within 15 miles of their clinic (adjusted odds ratio [aOR] = 4.43, 95% confidence interval [CI] 1.70-11.53). It was less likely to be used by older patients (aOR = 0.97, 95% CI 0.94-1.00), patients of male sex (aOR = 0.85, 95% CI 0.18-0.92), and those establishing care as a new patient (aOR = 0.01, 95% CI 0.00-0.07). <b>Conclusion:</b> The moderate usage of telemedicine suggests that its implementation in free clinics may be feasible. Solutions specific to patients with smartphone-only internet access are needed to improve the use of video telemedicine as smartphone-specific factors (e.g., data use limits) may influence the ability for underserved patients to receive video telemedicine.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"526-534"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39179780","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":"Patient Perception and Preferences for Virtual Telemedicine Visits for Hand and Upper Extremity Surgery.","authors":"Kyra A Benavent,&nbsp;Cassandra M Chruscielski,&nbsp;Stein J Janssen,&nbsp;Brandon E Earp","doi":"10.1089/tmj.2021.0146","DOIUrl":"https://doi.org/10.1089/tmj.2021.0146","url":null,"abstract":"<p><p><b>Introduction:</b> Telemedicine in upper extremity surgery is an evolving modality that provides a viable alternative to the traditional in-person visit for achieving convenient, safe, and cost-effective health care. Our study aimed to identify patient preferences for virtual visits for hand and upper extremity surgery. <b>Methods:</b> An institutional review board approved survey was prospectively administered to all patients >18 years of age, presenting for any complaint to an orthopedic hand and upper extremity clinic at a Level I academic trauma center from September to December 2019. This survey included questions about access and literacy of technology as well as patient preferences regarding virtual visits. The medical record was reviewed to collect demographics, insurance type, and reasons for their visit. Bivariate and multivariate analyses were performed according to survey responses. <b>Results:</b> Two hundred consecutive patients (<i>n</i>) completed surveys. Surveys revealed that >88% of patients own a computer or smartphone, have WiFi access at home, and own a device capable of video chat. In total, 75% of patients reported that they would be moderately or highly comfortable in their ability to use a device for a virtual visit. In bivariate and multivariate analyses, technological literacy and access to a private space to conduct a visit were associated with high interest in virtual visits. <b>Discussion:</b> Telemedicine is a viable alternative to in-person patient visits. Our study demonstrates that most patients are willing and able to participate in a virtual visit for a hand or upper extremity issue.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"509-516"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39176753","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 Patient Satisfaction with Live-Interactive Teledermatology Visits During the COVID-19 Pandemic: A Survey Study.","authors":"Genevieve Kaunitz,&nbsp;Lu Yin,&nbsp;Arielle R Nagler,&nbsp;Kristen Lo Sicco,&nbsp;Randie H Kim","doi":"10.1089/tmj.2021.0200","DOIUrl":"https://doi.org/10.1089/tmj.2021.0200","url":null,"abstract":"<p><p><b>Introduction:</b> Coronavirus disease 2019 (COVID-19) has brought teledermatology to the forefront. Understanding patients' experiences will clarify its benefits and limitations. <b>Materials and Methods:</b> Patients evaluated through live-interactive teledermatology at New York University Langone Health March-June 2020 were surveyed. Patient demographics, satisfaction with, and preferences between teledermatology and in-person visits across four domains (visit preparation, provider communication, physical examination, and treatment plan/follow-up) were collected. <b>Results/Discussion:</b> Of 602 respondents, >70% indicated at least equal satisfaction compared with in-person visits across all domains. More than a quarter of patients were dissatisfied with the virtual examination and more than half preferred in-person examinations. Male gender was associated with treatment plan/follow-up satisfaction (<i>p</i> = 0.03). Patients ≥66 years preferred in-person visit preparation, communication, and treatment plan/follow-up (all <i>p</i> < 0.01). New patients were less satisfied with teledermatology communication (<i>p</i> = 0.02) and treatment plan/follow-up (<i>p</i> < 0.01) but preferred teledermatology visit preparation (<i>p</i> = 0.01). <b>Conclusions:</b> Patients were satisfied with live-interactive teledermatology during the COVID-19 pandemic, although preferred in-person physical examinations. Satisfaction and preferences varied between patient populations.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"591-596"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39252098","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":"Effectiveness of Evidence-Based Telecoaching Delivered Through an Employer-Sponsored Mental Health Benefits Platform.","authors":"Sara J Sagui-Henson,&nbsp;Maximo R Prescott,&nbsp;Julia B Corcoran,&nbsp;Sanil Pillai,&nbsp;Lindsey Mattila,&nbsp;Somya Mathur,&nbsp;Terry Adkins,&nbsp;Myra Altman","doi":"10.1089/tmj.2020.0555","DOIUrl":"https://doi.org/10.1089/tmj.2020.0555","url":null,"abstract":"<p><p><b>Introduction:</b> Coaches delivering telemental health services as part of an employer-sponsored benefit may increase access to affordable and effective care. We examined the effectiveness of evidence-based telecoaching delivered via videoconferencing to people requesting mental health services during the coronavirus disease 2019 (COVID-19) pandemic. <b>Materials and Methods:</b> We analyzed data from 1,228 employees (mean age = 35 ± 8 years; 67.2% female) who utilized telecoaching through the Modern Health benefits platform between March 11, 2020 and March 11, 2021. We used paired samples t tests to examine changes in well-being, burnout, absenteeism, and presenteeism before and after telecoaching and moderated regressions to test whether these changes depended on visit utilization. We analyzed rates of clinical improvement for well-being and reduction from entry in symptoms for burnout. We conducted analyses in the full sample and participants presenting with elevated symptoms at baseline. <b>Results:</b> Participants utilized an average of 2.6 visits. Well-being (p = 0.02) significantly increased, while both presenteeism (p < 0.001) and absenteeism (p < 0.001) significantly decreased at follow-up in our full sample, but represented negligible effect sizes. Burnout was not found to have significantly changed at follow-up in our full sample (p = 0.69). In participants beginning care with elevated depressive-related symptoms, well-being significantly increased (p < 0.001) and 46.3% experienced a clinically relevant improvement. In participants beginning care with elevated levels of burnout, burnout significantly decreased (p < 0.001) and 20.9% experienced a reduction in symptoms from entry. <b>Conclusions:</b> Leveraging videoconferencing, telecoaching had positive effects on mental health and workplace outcomes, even during the COVID-19 pandemic. Evidence-based telecoaching represents a promising option for achieving optimal outcomes in people who need mental health services.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"486-494"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39123296","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":"Pandemic Telemedicine Technology Response Plan and Technology Assessment Phase 2: Pandemic Action Plan Key Issues and Technology Solutions for Health Care Delivery Organizations in a Pandemic.","authors":"Mark VanderWerf,&nbsp;Jordana Bernard,&nbsp;Doris T Barta,&nbsp;Jordan Berg,&nbsp;Tim Collins,&nbsp;Mike Dowdy,&nbsp;Kenneth Feiler,&nbsp;Douglas L Moore,&nbsp;Costi Sifri,&nbsp;Garret Spargo,&nbsp;Carl W Taylor,&nbsp;Cara B Towle,&nbsp;Kathy Hsu Wibberly","doi":"10.1089/tmj.2021.0215","DOIUrl":"https://doi.org/10.1089/tmj.2021.0215","url":null,"abstract":"<p><p><b>Introduction:</b> The Covid-19 pandemic created critical challenges for hospitals and healthcare providers. Suddenly clinics were forced to close; scheduled visits were cancelled; emergency rooms were overcrowded; hospital beds, equipment and personal protective equipment (PPE) was in short supply; and staff were faced with rapidly changing circumstances, care protocols, trauma and personal risk. In order to better address the ongoing the Covid-19 pandemic and prepare for future pandemics, the National Telemedicine Technology Assessment resource Center (TTAC) was asked to develop an Pandemic Response Action Plan that would allow its user to address critical issues with available telemedicine and related technologies. The project was constructed into three phases: Phase 1. Develop a Pandemic Response Action Plan (this document) and a Policy document which identifies the regulatory challenges in the Pandemic Response as well as policy recommendations (published separately). Phase 2. Publish the plan and policy documents. Phase 3 Look at healthcare providers who used the approaches, tools and technology in the Pandemic Action Plan and document the results (to be published separately). TTAC will also assess selected technology and publish results as part of their normal course of services. <b>Materials and Methods</b>: A multi-disciplinary team was created representing leadership expertise and key stakeholders in healthcare delivery during a pandemic (administration, infection control, physicians, nurses, public health, contingency planning, disaster response, information technology) as well as a facilitator. The group used structured brainstorming, current literature and iterative review to identify the most critical challenges facing healthcare providers during the current Covid 19 pandemic. The team then used structured brainstorming, professional experience and current literature to take a deeper look into these impacts, identify applicable solutions and develop a plan to address the critical challenges using telemedicine and related technologies. <b>Result:</b> A Pandemic Action Response Plan that describes the critical challenges and then identifies approaches, tools and technology to address them as well as identifying samples of the technology. <b>Conclusions:</b> The impact of the Covid 19 Pandemic was severe and identified multiple critical challenges and weaknesses in most healthcare providers. Applying the approaches, tools and technology in this Pandemic Action Plan will help providers address these challenges and increase the capabilities and resilience of their organizations in the provision of care during this and future pandemics.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"443-456"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/39/tmj.2021.0215.PMC9058875.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186682","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":"Trends in Adoption and Maturation of Telehealth Programs at Teaching Hospitals and Health Systems.","authors":"Matthew C Baker,&nbsp;Sarah L King,&nbsp;Neal Sikka,&nbsp;Elizabeth A Krupinski,&nbsp;Scott A Shipman,&nbsp;Merle Haberman","doi":"10.1089/tmj.2020.0571","DOIUrl":"https://doi.org/10.1089/tmj.2020.0571","url":null,"abstract":"<p><p><b>Introduction:</b> Although early adopters of telehealth have built and sustained telehealth programs over long periods, little research has been conducted differentiating the characteristics of health systems at different stages of maturation. <b>Methods:</b> This study surveyed 165 major teaching hospitals and health systems from fiscal year 2015 through 2018 about the stage and characteristics of their telehealth services. Respondents reported (i) the progression level of their telehealth program, (ii) which of six services they provide, and (iii) greatest barriers and motivators to implementing telehealth, as well as their overall operational and financial characteristics. <b>Results:</b> Telehealth programs at teaching hospitals progressed steadily and adoption of a wide range of telehealth delivery modes expanded. Hospital operational and financial characteristics corresponding to both higher maturation and the adoption of more delivery modes were identified. Reported barriers and motivations were similar across maturation levels. <b>Discussion:</b> With telehealth's broader use and the heterogeneity of delivery modes being utilized, a binary metric of whether or not to implement telehealth does not sufficiently capture key differences in telehealth programs or differentiate implementation scope and scale across health systems. <b>Conclusions:</b> The findings suggest that programs at different levels of maturation are characteristically different from one another. Identifying factors related to mature telehealth programs may help guide policymakers, future telehealth program leaders, and other stakeholders in identifying barriers to continued investment in telehealth.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"517-525"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186688","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":"Remote Patient Monitoring Identifies the Need for Triage in Patients with Acute COVID-19 Infection.","authors":"Laura Tabacof,&nbsp;Jamie Wood,&nbsp;Nicki Mohammadi,&nbsp;Katherine E Link,&nbsp;Jenna Tosto-Mancuso,&nbsp;Sophie Dewil,&nbsp;Erica Breyman,&nbsp;Leila Nasr,&nbsp;Christopher Kellner,&nbsp;David Putrino","doi":"10.1089/tmj.2021.0101","DOIUrl":"https://doi.org/10.1089/tmj.2021.0101","url":null,"abstract":"<p><p><b>Introduction:</b> Telehealth was frequently used in the provision of care and remote patient monitoring (RPM) during the COVID-19 pandemic. The Precision Recovery Program (PRP) remotely monitored and supported patients with COVID-19 in their home environment. <b>Materials and Methods:</b> This was a single-center retrospective cohort study reviewing data acquired from the PRP clinical initiative. <b>Results:</b> Of the 679 patients enrolled in the PRP, 156 patients were screened by a clinician following a deterioration in symptoms and vital signs on a total of 240 occasions, and included in the analyses. Of these 240 occasions, 162 (67%) were escalated to the PRP physician. Thirty-six patients were referred to emergency department, with 12 (7%) admitted to the hospital. The most common risk factors coinciding with hospital admissions were cardiac (67%), age >65 (42%), obesity (25%), and pulmonary (17%). The most common symptoms reported that triggered a screening event were dyspnea/tachypnea (27%), chest pain (14%), and gastrointestinal issues (8%). Vital signs that commonly triggered a screening event were pulse oximetry (15%), heart rate (11%), and temperature (9%). <b>Discussion:</b> Common factors (risk factors, vital signs, and symptoms) among patients requiring screening, triage, and hospitalization were identified, providing clinicians with further information to support decision making when utilizing RPM in this cohort. <b>Conclusion:</b> A clinician-led RPM program for patients with acute COVID-19 infection provided supportive care and screening for deterioration. Similar models should be considered for implementation in COVID-19 cohorts and other conditions at risk of rapid clinical deterioration in the home setting.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"495-500"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39208894","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}