Telemedicine and e-Health最新文献

{"title":"Current Use, Challenges, Barriers, and Chances of Telemedicine in the Ambulatory Sector in Germany-A Survey Study Among Practicing Cardiologists, Internists, and General Practitioners.","authors":"Jan Gehrmann, Franziska Hahn, Johannes Stephan, Alexander Steger, Manuel Rattka, Isabel Rudolph, David Federle, Josephine Heller, Geraldine Wunderlin, Karl-Ludwig Laugwitz, Petra Barthel, Stefan Veith, Eimo Martens","doi":"10.1089/tmj.2024.0528","DOIUrl":"10.1089/tmj.2024.0528","url":null,"abstract":"<p><p><b>Introduction:</b> Digital technologies, such as telemedicine and wearable devices, are transforming health care by enhancing cross-sectoral care and targeted health responses. Despite these advancements, challenges such as data protection, lack of interoperability, reimbursement, and financial costs hinder telemedicine's broader implementation, especially within the German health care system. This study explores the use, acceptance, and barriers of telemedicine among cardiologists, internists, and general practitioners in Germany. <b>Methods:</b> A web-based survey was conducted from October 2023 to January 2024, targeting cardiologists, internists, and general practitioners. The survey assessed current telemedicine usage, acceptance, and barriers. Data analysis included descriptive statistics and exploratory cluster analysis. <b>Results:</b> Of the 172 physicians analyzed, 76.2% were cardiologists. Telemonitoring (45.9%) and wearable devices (26.2%) were the most used telemedicine applications, whereas video consultations (11.0%) and apps (19.2%) were less common. Despite high costs (57.7%), insufficient technical expertise (20.8%), and lack of system interoperability (45.8%), respondents rated telemedicine positively and saw several chances and potentials. Cluster analysis identified four user groups: The pioneers, the focused practitioners, the using skeptics, and the uninformed distanced, each with unique needs and challenges. <b>Discussion:</b> The acceptance of elemedicine among physicians indicates recognition of its benefits for patient care. Only half of the respondents felt reasonably well informed about telemedicine. Overall, our study shows the current use of telemedicine as well as the acceptance, barriers, and challenges perceived in the German ambulatory sector. It underlines the increasing importance of telemedicine for patient care and highlights existing barriers to enable wider implementation in the outpatient sector. The results show that telemedicine in Germany is on a promising path. The biggest obstacles still appear to be reimbursement and the technical infrastructure.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"779-792"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256686","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":"Building a Telemedicine Program to Create a Sustainable Care Delivery Model for a Rural Hospital at Risk for Closure.","authors":"Yotam Papo, Jillian Harvey, Dunc Williams, Kit N Simpson, Ryan Kruis, Kathryn King, Dee W Ford, Susanne Jaques, Robert W Harrington, Marc Heincelman","doi":"10.1089/tmj.2024.0488","DOIUrl":"10.1089/tmj.2024.0488","url":null,"abstract":"<p><p><b>Introduction:</b> Rural hospitals continue to close nationally. High fixed costs, low patient volume, and outmigration remain problematic for surviving rural hospitals. This article presents an innovative telemedicine partnership between a small, not-for-profit rural hospital and a tertiary care medical center in the southeast. The vision was to create a sustainable care delivery model where patients receive care at a rural hospital in their home community with the added benefit of clinical expertise from a tertiary care center. <b>Methods:</b> A single-center descriptive case study involving a 32-bed not-for-profit rural community hospital and South Carolina's only comprehensive medical center. This article details the development and implementation of this innovative care delivery model. The strategy and logic model utilized to analyze the program is described. <b>Results:</b> From fiscal year 2019 to 2022, Hampton Regional Medical Center saw an increased number of yearly admissions from 442 to 965. Associated, there was a 20% reduction in inpatient transfers to another facility and a 35% reduction in 30-day readmission, while seeing a more complex patient population as demonstrated by an increase in case-mix index. There was no increase in outmigration. <b>Conclusions:</b> While rural hospitals continue to close nationally, we describe an innovative telemedicine partnership between a small, not-for-profit rural hospital and a tertiary care medical center to build a sustainable care delivery model that can support rural hospital survivability.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"765-771"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459921","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 Introducing a Temporary Telemedicine Policy on Primary Care Visits: An Analysis of National Claims Data in South Korea.","authors":"Sejin Heo, Weon Jung, Sung Yeon Hwang, Tae Gun Shin, Hee Yoon, Tae Rim Kim, Won Chul Cha, Se Uk Lee","doi":"10.1089/tmj.2024.0511","DOIUrl":"10.1089/tmj.2024.0511","url":null,"abstract":"<p><p><b>Background</b>: This study evaluates the impact of temporary telemedicine implementation on primary care visits, which surged during the COVID-19 pandemic in South Korea. <b>Methods</b>: This study was conducted using national claims data from February 24, 2020 to February 23, 2021. The study included 1,926,300 patients with acute mild respiratory diseases and 1,031,174 patients with acute mild gastrointestinal diseases. The study compared medication prescriptions, follow-up visit patterns, and safety outcomes, including admissions to emergency departments (EDs), general wards (GWs), and intensive care units (ICUs), between telemedicine and in-person visits. <b>Results</b>: Telemedicine was linked to higher medication prescription rates for both respiratory and gastrointestinal conditions, higher levels of antibiotics use, and longer prescription durations. Patients who had an initial telemedicine consultation were more likely to have an in-person follow-up visit within 1 day. Conversely, those with an initial in-person visit were more inclined to use telemedicine for their early second visit within 1 day. There were no significant differences in ED or ICU admissions, except for a slight increase in GW admissions for gastrointestinal conditions. <b>Conclusion</b>: Telemedicine can effectively complement in-person care for acute mild conditions without compromising patient safety, suggesting its potential for broader integration into primary care. Further studies are recommended to optimize telemedicine use and address any long-term impacts on health care delivery.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"726-736"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470048","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":"Needs and Demands of e-Mental Health Interventions for Elite Athletes: User-Centered Design Approach Based on a Cross-Sectional Study.","authors":"Sheila Geiger, Julia Aufderlandwehr, Anna Julia Esser-Seraphin, Eileen Reinemann, Thomas Muehlbauer, Sara Viehweger, Eva-Maria Skoda, Martin Teufel, Alexander Bäuerle","doi":"10.1089/tmj.2024.0496","DOIUrl":"10.1089/tmj.2024.0496","url":null,"abstract":"<p><p><b>Introduction:</b> Elite athletes experience sport-specific stressors and are at risk of developing mental health symptoms during and after their careers. E-Mental health interventions may pioneer a new approach to health care, which could help overcome barriers regarding its accessibility for elite athletes. This study aims to examine the needs and demands regarding the design and content of e-mental health interventions for elite athletes. <b>Methods:</b> A cross-sectional study was conducted via a web-based survey with N = 275 elite athletes, of which 167 were female and who participated in a variety of individual and/or team sports. Previous experience using e-mental health interventions was assessed. Needs and demands regarding format, frequency, content, and topics of an e-mental health intervention were analyzed descriptively and were compared between individual and team athletes using ANOVAs. <b>Results:</b> Elite athletes expressed a preference for an individual program via smartphone app (94.2%) with audio/video material (69.1%) and interactive tasks (60.4%). Regarding the frequency of e-mental health intervention, athletes in individual (62.2%) and team sports (60.0%) both preferred weekly intervention with sessions lasting between 20 and 30 min, whereas athletes engaged in both kinds of sports favored an intervention either on a weekly basis (44.7%) or on request (38.3%). The most relevant topics of e-mental health interventions for elite athletes were \"Coping with pressure\" (92%) and \"Self-worth/self-esteem\" (90%). <b>Conclusions:</b> The results of this study highlight the potential relevance of a user-centered design approach and could contribute valuable insights into developing e-mental health interventions for elite athletes.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"716-725"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400892","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":"Smartphone-Based Applications for Atrial Fibrillation Detection: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy.","authors":"Isabella Oliveira Freitas Barbosa, Beatriz Costa de Oliveira, Charles Karel Martins Santos, Maria Clara Ramos Miranda, Gabriel Alves Barbosa, Antônio da Silva Menezes Júnior","doi":"10.1089/tmj.2024.0579","DOIUrl":"10.1089/tmj.2024.0579","url":null,"abstract":"<p><p><b>Background:</b> Atrial fibrillation (AF) burden is strongly associated with an increased risk of stroke, which, in most cases, can be prevented through earlier detection of AF and the timely initiation of anticoagulation therapy. Smartphone devices can provide a simple, non-invasive, cost-effective early AF detection solution. <b>Methods:</b> PubMed, Embase, and Scopus databases were searched for studies comparing smartphone-based photoplethysmography (PPG) with standard electrocardiogram for AF detection. A bivariate random-effects model with a 95% confidence interval (CI) was applied to generate the summary receiver operating characteristic (SROC) curve. <b>Results:</b> Fourteen studies were included, comprising 5,090 patients with an AF prevalence of 31.6%. The pooled sensitivity and specificity were 0.96 (95% CI, 0.93-0.97) and 0.97 (95% CI, 0.95-0.98). The area under the SROC curve was 0.98 (95% CI, 0.94-0.99). The diagnostic odds ratio was 960 (95% CI, 439-2,104), with significant heterogeneity (<i>I</i>² = 51%). The projected positive and negative predictive values were 66.5% and 99.7%, respectively, in the elderly population aged >65 years and 39.2% and 99.9% in the general population. <b>Conclusion:</b> Smartphone-based PPG demonstrated relatively high sensitivity and specificity and appears capable of ruling out AF. Patients aged >65 are more likely to benefit from AF screening.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"687-700"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069771","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":"Unlocking The Potential: Telehealth Services and Social Determinants of Health Outcomes in Health Care Delivery.","authors":"Hanadi Y Hamadi, Mei Zhao, Franscisca Sam, Bryan Murphy, Shehzad Niazi, Aaron C Spaulding","doi":"10.1089/tmj.2024.0358","DOIUrl":"10.1089/tmj.2024.0358","url":null,"abstract":"<p><p><b>Background:</b> Unmet social needs may hinder health care providers' ability to deliver suitable care. Telehealth has emerged as a mechanism to broaden care reach; however, limited studies have examined the relationships between telehealth services and social need outcomes. This study explores the impact of telehealth services, encompassing (1) telestroke, (2) telepsychiatry and addiction treatment, (3) teleconsultation and office visits,(4) tele-intensive care units, (5) telemonitoring postdischarge, (6) ongoing chronic care management, and (7) other remote monitoring, on social need performance outcomes. <b>Methods:</b> The 2022 American Hospital Association annual survey and the Area Health Resource Files, which include comprehensive hospital and community indicators, were utilized. A mixed-effects logistic regression was applied, analyzing 1,005 acute care general hospitals. <b>Results:</b> The results revealed that patients who received telemonitoring services after discharge were 1.72 (95% confidence interval [CI]: 1.03-2.88) times more likely to achieve better health outcomes compared with those who did not receive such services. These patients also experienced a significant decrease in the likelihood of requiring additional hospital or system services, with an odds ratio of 2.39 (95% CI: 1.32-4.00). Additionally, patients utilizing telepsychiatry and addiction treatment services had 1.66 times higher odds of reporting improved community health status (95% CI: 1.22-2.27). Lastly, patients who used teleconsultation and office visit services had 38% lower odds of experiencing poor community health status (95% CI: 0.40-0.95). <b>Discussion:</b> The findings highlight the potential of targeted telehealth services to positively impact health outcomes, reduce health care costs, and improve community health status.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"758-764"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442744","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":"Rapid Innovation and Adaptation in Contraceptive Care Using Telemedicine: Evaluating Impact and Sustainability at Planned Parenthood of Illinois.","authors":"Danielle Young, L Philip Schumm, Ashley McHugh, Amy K Whitaker, Debra Stulberg","doi":"10.1089/tmj.2024.0513","DOIUrl":"10.1089/tmj.2024.0513","url":null,"abstract":"<p><p><b>Introduction:</b> The COVID-19 pandemic necessitated swift, dramatic changes to the delivery of essential health care services. Numerous professional societies recommend telehealth care for contraceptive counseling and provision. We conducted a retrospective analysis of service delivery data from Planned Parenthood of Illinois (PPIL), a large reproductive health care provider with 17 health centers in Illinois, to understand if this model preserved access to contraceptive services during the COVID-19 emergency. <b>Methodology:</b> This retrospective analysis compared contraceptive service delivery data 12 months pre-pandemic (March 2019-February 2020) with eight months post-pandemic onset (March 2020-October 2020). PPIL consolidated services to six health centers in late March 2020 and rapidly launched telehealth services in April 2020. Our primary outcome was time to appointment compared with pre- and post-pandemic onset. We also compared access by race/ethnicity, age, and geography. <b>Results:</b> Although visit volume decreased (76% decline) and time to appointment increased post-pandemic onset (2.5-4 days higher), telehealth mitigated these changes and was used by patients across the entire catchment area. We observed no disparities among Black and Hispanic patients relative to White patients in the likelihood of using telehealth relative to in-person visits (odds ratio 0.7, 95% confidence interval 0.6-0.9 for both comparisons). <b>Discussion:</b> Telehealth can play an important role in preserving access to contraceptive services when the health care system is under strain and in increasing accessibility in underserved communities.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"737-746"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470028","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":"Evidence-Based Experiences of Using Time-Driven Activity-Based Costing in Telemedicine-Based Health Care Delivery Protocols.","authors":"Ágnes Réka Mátó, Márton Vilmányi","doi":"10.1089/tmj.2024.0449","DOIUrl":"10.1089/tmj.2024.0449","url":null,"abstract":"<p><p><b>Background:</b> In the era of value-based health care, maximizing health outcomes and minimizing costs require different value optimization strategies. To maximize value and ensure control of expenditure, time-driven activity-based costing (TDABC) is widely used in health care organizations. In our study, we examined the impact of telehealth technologies on value creation by using the TDABC approach. <b>Methods</b>: We mapped four pairs of (traditional and telemedicine supported) health care delivery processes in terms of time, resource use, and information flow. Data were collected from four sources: approved protocol descriptions, in-depth interviews with senior clinicians, a financial controlling database of unit costs, and additional comments from controlling experts. <b>Results</b>: We found that technological improvements do not necessarily increase the value of protocols. Of the protocols studied, two telemedicine protocols proved to be more cost-effective (80.37% and 45.29% compared with the originals). However, significant cost overruns were detected in two other telemedicine protocols (902.90% and 161.01%, respectively). An increased value could be detected only when the use of telemedicine technology resulted in greater savings in net human capacity compared with the additional expenditure related to telemedicine technology. <b>Conclusions</b>: We concluded that the use of telemedicine technology leads to modifications in protocols at numerous points, which have a significant impact on cost levels. It is not sufficient to examine only the costs of modified steps, as proposed in the TDABC methodology. Our study also suggests that a refined TDABC method is a potential tool for assessing the complex effects of technological change.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"793-798"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517316","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":"\"Four I\" Framework for Telehealth Optimization in Congregate Care Communities.","authors":"Tabor Flickinger, Mary Mathew, David Gordon, Anthony Nappi, Amy Ryall, Michael Patterson, Katharine Wibberly, Samuel Collins, Aaron Pannone, Laurie Archbald-Pannone","doi":"10.1089/tmj.2024.0218","DOIUrl":"10.1089/tmj.2024.0218","url":null,"abstract":"<p><p><b>Background:</b> Telehealth can provide innovative models of care for people living in congregate care communities (CCC), but lack of consistent workflow is a barrier for administrators and staff. We propose a framework for CCC to implement workflows for age-inclusive telehealth. <b>Methods:</b> As part of an infection control initiative with a focus on telehealth optimization, Virginia Infection Mitigation, Prevention and Control Through Technology developed relationships with administrators and staff of CCC across the Commonwealth of Virginia. Partners in this community of practice completed a statewide survey that we conducted on anticipated and experienced barriers to telehealth implementation. Through survey responses, virtual meetings with organizational leadership, and on-site facility visits, our team assessed the strengths, needs, and goals for telehealth capability. Working with administrative and clinical teams, we developed a consultation report to define short- and long-term implementation steps. <b>Results:</b> We collaborated with a nonprofit organization supporting a community of people with neurodevelopmental disabilities and a rural Program of All-Inclusive Care for the Elderly. We developed a framework for telehealth optimization with four tiers: Initiate, Integrate, Incentivize, and Inspire. Each stage included an overall goal with corresponding interventions to guide program implementation. <b>Discussion:</b> The \"Four I\" Framework can be used to outline telehealth readiness and implement workflows for CCC. We aim to further develop an iterative process and to collaborate with additional organizations to optimize telehealth programs.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"799-805"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371430","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":"A Wolf in Sheep's Clothing-What Do We Really Need in Telemedicine!","authors":"Charles R Doarn","doi":"10.1089/tmj.2025.0124","DOIUrl":"10.1089/tmj.2025.0124","url":null,"abstract":"","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"685-686"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081999","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}