Telemedicine and e-Health最新文献

{"title":"Longer-Term Results of a Clinician-to-Clinician e-Consult Program in Patients with Heart Failure: Implications for Heart Failure Clinical Management.","authors":"Sergio Cinza-Sanjurjo, Pilar Mazón-Ramos, María Álvarez-Barredo, Inés Gómez-Otero, Daniel Rey-Aldana, David García-Vega, Manuel Portela-Romero, José R González-Juanatey","doi":"10.1089/tmj.2024.0383","DOIUrl":"10.1089/tmj.2024.0383","url":null,"abstract":"<p><p><b>Objectives:</b> To compare the health outcomes, specifically hospitalization and mortality rates, of primary care physicians' referrals to the cardiology department for ambulatory assistance in heart failure (HF) over three clearly defined periods: before, during the electronic consultation program implementation (e-consult), and during the COVID-19 pandemic. <b>Methods:</b> Between 2010 and 2021, 6,859 HF patients were referred at least once. Of these, 4,851 received e-consultations, and 2,008 underwent single-act consultations. A time series regression model was used to analyze the impact of e-consult implementation (started in 2013) on all-cause, cardiovascular (CV), and HF-related hospital admissions and mortality rates. <b>Results:</b> e-Consults reduced the waiting time for cardiology care to 9 days. Hospital admissions decreased significantly after the implementation of e-consult (relative risk incidence [RRi] [95% confidence interval {CI95%}]: 0.867 [0.875-0.838] for HF, 0.838 [0.825-0.856] for cardiovascular disease, and 0.639 [0.635-0.651] for all-cause diseases), and mortality decreased (RRi [CI95%]: 0.981 [0.977-0.983] for HF, 0.977 [0.970-0.980] for CV, and 0.985 [0.984-0.985] for all causes). These improvements persisted during the COVID-19 pandemic. <b>Conclusions:</b> The implementation of the e-consult program for managing HF patient referrals resulted in reduced waiting times for cardiology care and decreases in hospitalizations and mortality rates. These benefits were maintained during the COVID-19 pandemic.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"829-837"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Sepsis Recognition on Telemedicine Use in Rural Emergency Department Sepsis Treatment.","authors":"Anna M Kaldjian, Priyanka Vakkalanka, Uche Okoro, Cole Wymore, Karisa K Harland, Kalyn Campbell, Morgan B Swanson, Brian M Fuller, Brett Faine, Anne Zepeski, Edith A Parker, Luke Mack, Amanda Bell, Katie DeJong, Kelli Wallace, Keith Mueller, Elizabeth Chrischilles, Christopher R Carpenter, Michael P Jones, Marcia M Ward, Nicholas M Mohr","doi":"10.1089/tmj.2024.0281","DOIUrl":"10.1089/tmj.2024.0281","url":null,"abstract":"<p><p><b>Background:</b> Provider-to-provider emergency department telehealth (tele-ED) has been proposed to improve rural sepsis care. The objective of this study was to measure the association between sepsis documentation and tele-ED use, treatment guideline adherence, and mortality. <b>Methods:</b> This analysis was a multicenter (<i>n</i> = 23) cohort study of sepsis patients treated in rural emergency departments (EDs) that participated in a tele-ED network between August 2016 and June 2019. The primary outcome was whether sepsis was documented explicitly in the clinical note impression in the local ED, and the primary exposure was rural tele-ED use, with secondary outcomes of time to tele-ED use, 3-h guideline adherence, and in-hospital mortality. <b>Results:</b> Data from 1,146 rural sepsis patients were included, 315 (27%) had tele-ED used and 415 (36%) had sepsis recognized in the rural ED. Tele-ED use was not independently associated with sepsis recognition (adjusted odds ratio [aOR]: 1.23, 95% confidence interval [CI]: 0.90-1.67). Sepsis recognition was associated with earlier tele-ED activation (adjusted hazard ratio 1.66, 95% CI: 1.28-2.15) and greater 3-h guideline adherence (aOR 1.37, 95% CI 1.03-1.83) Sepsis recognition was not independently associated with mortality (aOR 1.32, 95% CI 0.97-1.80). <b>Conclusions:</b> Although tele-ED care is a promising strategy to improve sepsis outcomes, its use was limited by under-recognition of sepsis in rural EDs.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"848-857"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experience Scores for Telehealth Visits at an Outpatient Child Neurology Clinic: A Retrospective Cohort Study.","authors":"Gogi Kumar, Laura D Fonseca, Sucheta Joshi, Grant Turek, Elizabeth A Ng, Irma Reyes","doi":"10.1089/tmj.2025.0004","DOIUrl":"10.1089/tmj.2025.0004","url":null,"abstract":"<p><p><b>Background:</b> Since the COVID-19 pandemic, telehealth has been widely adopted, and several studies have highlighted the benefits of telehealth. However, there are limited studies in pediatric neurology with a focus on epilepsy. The objective of this single-site retrospective cohort study was to examine patient experience scores of telehealth versus in-person established encounters in an outpatient pediatric neurology clinic. <b>Methods:</b> Data were abstracted from April 1, 2020 through March 31, 2024. Variables included demographics, appointment type (telehealth vs in-person), appointment date, primary diagnosis and net promoter score (NPS) number and category. A subanalysis of epilepsy diagnosed patients, and a matched patient analysis were conducted. <b>Results:</b> There were 2,863 in-person visit encounters and 635 telehealth visit encounters. Telehealth encounters had a statistically greater mean NPS of 9.7, compared with in-person visits (9.5). Both telehealth and in-person encounters had more than 90% of promoter scores, indicating a high score of 9-10. During the COVID-19 time period (defined as April 1, 2020 to May 4, 2023), NPS were higher with a mean of 9.7 for telehealth encounters, compared with in-person encounters (9.5). There were no differences in NPS post-COVID-19. Primary encounter diagnoses of Epilepsy/Seizure had a slightly greater mean NPS for telehealth visits (9.7) compared with in-person encounters (9.5). The matched patient analysis revealed no difference between telehealth and in-person encounter NPSs with means of 9.7 and 9.6, respectively. <b>Conclusion:</b> NPS, which are a measure of patient experience, were superior or equal to in-person visits for pediatric neurology telehealth encounters both during the COVID-19 pandemic and in the postpandemic period.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"875-884"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth-Facilitated Mental Health Care Access and Continuity for Patients Served at the Health Resources and Services Administration-Funded Health Centers.","authors":"Benjamin Picillo, Helen Yu-Lefler, Cuong Bui, Minh Wendt, Alek Sripipatana","doi":"10.1089/tmj.2025.0011","DOIUrl":"10.1089/tmj.2025.0011","url":null,"abstract":"<p><p><b>Objective:</b> The Health Resources and Services Administration (HRSA)-funded health centers provide critical behavioral health services to historically and medically underserved individuals with complex health and social needs. As health centers rapidly expanded telehealth in response to COVID-19, the objective of the study was to assess whether telehealth use was associated with utilization and continuity within mental health care received by patients of HRSA-funded health centers. <b>Methods:</b> Cross-sectional analyses, using a nationally representative sample of adult patients with mental health needs from the 2022 Health Center Patient Survey (<i>n</i> = 1,044), explored associations between telehealth use and utilization of mental health services from primary care providers (PCP) and continuity of counseling services. Multivariate logistic regression models accounted for predisposing, enabling, and need factors to assess the influence of telehealth use on utilization and continuity outcomes. <b>Results:</b> After adjusting for patient-level factors, telehealth users with mental health needs had statistically significant and higher odds of receiving mental health services from a PCP at a health center compared with nontelehealth users (adjusted odds ratios [aOR] = 2.60, <i>p</i> < 0.001; 95% confidence interval [CI] [1.50, 4.52]). Telehealth-using patients receiving counseling services had statistically significant and higher odds of receiving all counseling services at a health center compared with nontelehealth users (aOR = 3.65, <i>p</i> < 0.001, 95% CI [2.04, 6.53]). <b>Conclusions:</b> Telehealth facilitates mental health care utilization and continuity for historically and medically underserved patients at health centers and can be an important tool for care management and coordination for patients with mental health needs, particularly during and following public health emergencies.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"838-847"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Utilization for Primary Care Delivery During Hurricanes Michael (2018) and Ian (2022) in the Veterans Health Administration.","authors":"Anu Ramachandran, Heather Northcraft, W Neil Steers, Claudia Der-Martirosian","doi":"10.1089/tmj.2024.0595","DOIUrl":"10.1089/tmj.2024.0595","url":null,"abstract":"<p><p><b>Background:</b> Maintaining primary care during disasters is crucial for mitigating health impacts. Telehealth can facilitate continuity but is often underutilized. The Veteran's Health Administration (VA) rapidly increased telehealth capacity in 2020, but the impact on disaster telehealth utilization remains unknown. We analyzed the impact of two hurricanes (Hurricane Michael in 2018 and Hurricane Ian in 2022) on telehealth utilization by VA primary care facilities. <b>Design:</b> Interrupted time series analysis of primary care visits to VA facilities in hurricane-affected states for 7 days before and 14 days following each event. Primary care visits were identified from the VA Corporate Data Warehouse. The primary outcome was the proportion of visits conducted virtually after each hurricane. Models included patient demographics, facility rurality, storm severity, and baseline facility telehealth capacity. <b>Results:</b> Seventy-eight VA facilities were evaluated for Hurricane Michael and 126 for Hurricane Ian. After covariate adjustment, Michael was associated with an immediate increase in the proportion of telehealth visits by 8.5 percentage points (95% confidence interval [CI]: 4.3%-12.7%, <i>p</i> < 0.001) and Ian by 12.3 percentage points (95% CI: 8.4%-16.1%, <i>p</i> < 0.001). Analyses by facility rurality demonstrated significant increases in telehealth for urban and rural facilities following Michael in 2018 (urban: 7.1%, 95% CI: 2.7%-11.5%, <i>p</i> < 0.001; rural: 15.1%, 95% CI: 4.5%-25.7%, <i>p</i> < 0.001) but only for urban facilities following Ian in 2022 (13.8%, 95% CI: 9.7%-18.0%, <i>p</i> < 0.001). Increases in telehealth utilization were larger for facilities in severely damaged areas. <b>Conclusions:</b> Telehealth was critical to VA primary care delivery during both hurricanes, with higher utilization seen in 2022 likely from the intervening scale-up of telehealth capacity. Rural facilities may be lagging in disaster telehealth utilization, exacerbating disparities in care delivery.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"866-874"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Large-Scale Remote Patient Monitoring Program on Hospitalization Reduction.","authors":"Sara Margosian, Heather Crossley, Maryann Riggs, Toni Henkemeyer, Mary Fisher, Akshar Patel, Chad Ellimoottil, Grace Jenq, Ghazwan Toma","doi":"10.1089/tmj.2024.0600","DOIUrl":"10.1089/tmj.2024.0600","url":null,"abstract":"<p><p><b>Introduction/Methods:</b> Patient Monitoring at Home is a Remote Patient Monitoring (RPM) program through Michigan Medicine, which provides symptoms and vital sign monitoring via a provided cellular tablet and Bluetooth-connected devices. A team of registered nurses monitors patients 7 days per week. <b>Results:</b> The team examined 6-month outcomes for 1,139 encounters from November 2020 to August 2022, which showed a 59% reduction in the average number of hospital admissions 6 months after the start of enrollment (1.38 vs. 0.57, <i>p</i> < 0.0001) across multiple enrollment diagnoses including COVID-19, congestive heart failure, and hypertension. The duration of enrollment varied, ranging from 7 to 386 days, with a median of 38 days. A shorter duration of monitoring was associated with a more favorable outcome (hospitalization reduction). <b>Discussion:</b> Our findings show that RPM is effective in reducing hospital admissions for a wide variety of conditions. More research is needed to optimize patient selection, ideal method, and duration of monitoring.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"914-918"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Care and Medical Cannabis Access: A Geospatial Study of Telehealth's Role in Reducing Socioeconomic Disparities.","authors":"Mitchell L Doucette, Mark Kasabuski, Dipak Hemraj, Emily Fisher, Junella Chin","doi":"10.1089/tmj.2024.0550","DOIUrl":"10.1089/tmj.2024.0550","url":null,"abstract":"<p><p><b>Introduction:</b> Telehealth has the potential to improve health care access and reduce disparities. We examined whether the density of medical cannabis (MC) patients, stratified by those who were seen by a telemedicine provider or not, is associated with a concentrated disadvantage within Pennsylvania in 2022. <b>Methods:</b> This zip code-level analysis assessed associations between the concentrated disadvantage index (CDI) and counts of telemedicine-approved and all other MC patients. Total MC patient counts were obtained from Pennsylvania's Department of Health, counts of telemedicine-approved MC patients were obtained from a telehealth provider (Leafwell), and CDI data were obtained from the 2022 American Community Survey. Multivariable negative binomial regression models with population offsets and robust standard errors were used, accounting for spatial autocorrelation through spatial lag adjustments. <b>Results:</b> The CDI was not associated with the number of telemedicine-approved MC patients (incidence rate ratios [IRR] = 0.962; <i>p</i> = 0.355) but was significantly negatively associated with all other MC patients (IRR = 0.904; <i>p</i> = <0.001). The number of in-office MC providers was significantly associated with the count of all other MC patients but not with telemedicine-approved patients. Spatial factors significantly influenced the distribution of both patient groups. <b>Discussion:</b> These findings suggest that telemedicine may play a crucial role in reducing access disparities for MC in socioeconomically disadvantaged areas. The lack of a significant association between CDI and telemedicine-approved MC patients indicates that telehealth services can overcome barriers such as provider scarcity and transportation issues. By facilitating remote consultations and approvals, telemedicine expands access for patients who might otherwise be unable to obtain MC.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"892-901"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence and Qualitative Analysis of Emergency Department Telemental Health Care Implementation Survey.","authors":"Cameron Keating, Steven C Marcus, Cadence F Bowden, Diana Worsley, Stephanie K Doupnik","doi":"10.1089/tmj.2024.0555","DOIUrl":"10.1089/tmj.2024.0555","url":null,"abstract":"<p><p><b>Background</b>: Implementation of telemental health care in emergency departments (EDs) in the United States (U.S.) has been increasing. Artificial intelligence (AI) can augment traditional qualitative research methods; little is known about its efficiency and accuracy. This study sought to understand ED directors' qualitative recommendations for improving telemental health care implementation and to understand how AI could facilitate analysis of qualitative survey responses. <b>Methods</b>: Directors at a nationally representative sample of 279 U.S. EDs that used telemental health care completed an open-ended survey question about improving telemental health care implementation between June 2022 and October 2023. Two groups of researchers completed independent qualitative coding of responses: one group used traditional qualitative methods, and one group used AI (ChatGPT 4.0) to facilitate analysis. Both groups independently developed a codebook, came to consensus on a combined codebook, and each group independently used it to code the survey responses. The two groups identified themes in ED directors' recommendations and compared codebooks and code application across traditional and AI approaches. <b>Results</b>: Themes included (1) recommendations for improving telemental health care directly and (2) recommendations for improving mental health care systems broadly to make telehealth more effective. ED directors' most common recommendation was enabling faster and more streamlined access to telemental health care. AI augmented human coding by identifying two valid codes not initially identified by human analysts. In codebook application, 75% of responses were coded consistently across AI and human coders. <b>Conclusions and Relevance</b>: For US EDs using telemental health care, there is a need to improve timeliness and efficiency of access to telemental health care.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"821-828"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Pelvic Floor Muscle Training Applied via Telerehabilitation During the Postpartum Period: A Randomized Controlled Study.","authors":"Arzu Razak Ozdincler, Damla Korkmaz Dayican, Burcin Ozyurek","doi":"10.1089/tmj.2024.0540","DOIUrl":"10.1089/tmj.2024.0540","url":null,"abstract":"<p><p><b>Purpose:</b> To examine the short- and medium-term effects of pelvic floor muscle training (PFMT) applied via telerehabilitation (TR) on pelvic floor muscle function, pelvic floor symptoms, and quality of life. <b>Methods:</b> Fifty-eight women between the ages of 18 and 35 who were between 6 and 8 weeks postpartum were included. The participants were randomized into the PFMT applied via TR (TR-PFMT) group or the supervised PFMT (S-PFMT) group. The PFMT was performed for 8 weeks, 2 days a week, and 45-50 min a day. The participants' pelvic floor muscle function, pelvic floor symptoms, and quality of life were evaluated with the superficial electromyography, the Pelvic Floor Distress Inventory-20 (PFDI-20), and the Pelvic Floor Impact Questionnaire-7, respectively. <b>Results:</b> Phasic, tonic, and endurance activities of the pelvic floor muscles were significantly higher in both groups immediately after and 8 weeks after the exercise program (all <i>p</i> < 0.05). In addition, total PFDI-20 and all subscales' scores decreased significantly in the TR-PFMT group (all <i>p</i> < 0.05). In the S-PFMT group, total PFDI-20 (<i>p</i> = 0.012) and Urinary Distress Inventory-6 (<i>p</i> = 0.012) scores improved significantly. A significant difference was found between the groups in favor of the TR-PFMT group in terms of total PFDI-20 (<i>p</i> = 0.024; <i>p</i> = 0.024) and Urinary Distress Inventory-6 (<i>p</i> = 0.033; <i>p</i> = 0.040) scores immediately after and 8 weeks after the exercise program. <b>Conclusions:</b> TR-PFMT and S-PFMT improved women's pelvic floor muscle function, pelvic floor symptoms, and quality of life in the short and medium term. Improvement in urinary symptoms was greater after TR-PFMT. TR-PFMT should be considered for postpartum women.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"902-913"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Primary Care Provider Telemedicine Adoption on Pediatric Ophthalmology Referrals.","authors":"Yeabsira Mesfin, Kieran S O'Brien, Maanasa Indaram, Jeremy D Keenan, Julius T Oatts","doi":"10.1089/tmj.2024.0489","DOIUrl":"10.1089/tmj.2024.0489","url":null,"abstract":"<p><p><b>Introduction:</b> This study aims to assess how the adoption of telemedicine by primary care providers influenced new patient referrals to pediatric ophthalmology. <b>Methods:</b> Retrospective chart review of new pediatric ophthalmology referrals from primary care providers within the same 3 months (April, August, and December) each year between 2019 and 2021. Patient demographics, reason for referral, and recommended continued ophthalmical care (as a proxy for referral quality) were evaluated. Logistic regression models, chi-square tests, and Mann-Whitney tests were performed to assess the impact of telemedicine referrals. <b>Results:</b> Of the 1,181 referrals reviewed, 551 were included in the final analysis. Telemedicine use increased over time (<i>p</i> < 0.005). Comparing telemedicine and in-person referrals, there was no difference in patient age, sex, race, language, or insurance type (all <i>p</i> > 0.05). A significant difference was observed between the reasons for referrals by referral type (<i>p</i> < 0.005). The most common reason for telemedicine referrals was ophthalmic manifestations of systemic diseases, while the most common reason for in-person referrals was failed vision screening. Patients with public insurance and those referred after 2020 had higher odds of recommended continued care (adjusted odds ratio [OR]: 1.67, <i>p</i> = 0.01 and 1.98, <i>p</i> = 0.002), though referrals based on telemedicine visits were less likely to require continued ophthalmic care (adjusted OR: 0.33, <i>p</i> = 0.001). <b>Conclusion:</b> Pediatric ophthalmology referrals were influenced by the adoption of telemedicine by primary care providers. Referrals based on telemedicine visits were less likely to warrant continued ophthalmic care, suggesting that the impact of telemedicine on facilitating referrals and improving access to pediatric ophthalmology subspecialty care remains uncertain.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"885-891"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}