Telemedicine and e-Health最新文献

{"title":"Correlates of Transitioning from In-Person to Telemedicine Outpatient Neurology Clinic Visits.","authors":"Sooyeol Park, Kevin Callison, Michele Longo, Brigham Walker","doi":"10.1089/tmj.2024.0326","DOIUrl":"10.1089/tmj.2024.0326","url":null,"abstract":"<p><p><b>Introduction:</b> The COVID-19 pandemic accelerated telemedicine adoption, impacting appointment no-show rates. This study examines neurology appointment preferences among individuals with previous no-shows. <b>Methods:</b> We analyzed transitions between in-person and telemedicine modalities at the Tulane Center for Clinical Neurosciences from August 2020 to February 2021 by race, sex, and insurance type. Logistic regression was used to assess which individual characteristics were associated with switching modalities. <b>Results:</b> A total of 118 patients were included. Transitions to telemedicine visits were significantly higher for female (odds ratio [OR] = 1.868, <i>p</i> = 0.051), Medicaid (OR = 0.433, <i>p</i> = 0.035), and Medicare (OR = 0.228, <i>p</i> = 0.001) beneficiaries compared with males and those with private coverage. Telemedicine to in-person transitions were significantly higher for Medicaid compared with private coverage (OR = 8.133, <i>p</i> = 0.018). <b>Discussion:</b> Females are more likely to switch to telemedicine following an in-person no-show, whereas Medicare beneficiaries are less likely. Medicaid beneficiaries are more likely to revert to in-person appointments. Telemedicine may enhance equitable neurological care, particularly because of its high utilization among females.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762610","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":"Teledermatology Use in the Elderly: An Analysis of Teledermatology Utilization Patterns Across Age Groups.","authors":"Audrey Hao, Kaviyon Sadrolashrafi, Robin Kikuchi, Lily Guo, Rebecca K Yamamoto, Hannah C Tolson, Sara Bilimoria, Danielle Yee, Jenny C Hu, April W Armstrong","doi":"10.1089/tmj.2024.0169","DOIUrl":"10.1089/tmj.2024.0169","url":null,"abstract":"<p><p><b>Introduction:</b> Telehealth is an emerging tool used to improve access to care for patients. However, there is a lack of literature comparing the use of telehealth between patients of different age groups in dermatology. Our study aims to determine whether differences exist in teledermatology usage between elderly and younger dermatology patients. <b>Methods:</b> We conducted a cross-sectional study using the 2020-2021 Medical Expenditure Panel Survey. Our study population included a weighted total of 150,290,604 patients: Of these, 16.35% were young adults (18-44 years old), 26.32% were midlife adults (45-64 years old), and 57.33% were elderly (65+ years old). <b>Results:</b> Our results showed that elderly patients had significantly lower rates of teledermatology use than young adults (odds ratio [OR] = 0.184, (confidence interval [CI]: 0.081-0.421)), <i>p</i> < 0.000) and midlife adults (OR = 0.193, [CI: 0.091-0.406], <i>p</i> < 0.000). Midlife adults had similar rates of telehealth use when compared with young adults (OR = 1.044, [CI: 0.508-2.145], <i>p</i> = 0.907). Our results were adjusted for sex, race, ethnicity, insurance type, education level, income, travel time, and medical comorbidities. <b>Discussion:</b> We found that elderly patients seeking dermatology care are less likely to use telehealth than younger dermatology patients. Our results demonstrate that barriers to telehealth use for the elderly may be more prohibitive than expected. Understanding these differences in teledermatology use is essential for improving teledermatology delivery across all age groups.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908323","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":"Adherence and Retention Rates to Home-Based Video Exercise Programs in Older Adults-Systematic Review and Meta-Analysis.","authors":"Marcela Rihova, Tereza Jandova, Tomas Vetrovsky, Katerina Machacova, Veronika Kramperova, Michal Steffl, Petra Hospodkova, Małgorzata Marchelek-Myśliwiec, Iva Holmerova","doi":"10.1089/tmj.2024.0100","DOIUrl":"10.1089/tmj.2024.0100","url":null,"abstract":"<p><p><b>Introduction:</b> This systematic review and meta-analysis aimed to investigate adherence and retention rates to home-based video exercise programs and identify key factors associated with these rates in older adults to understand the effectiveness of home-based video exercise interventions. <b>Methods:</b> We searched PubMed, Web of Science, and Scopus for articles addressing adherence to and retention of home-based video exercise programs. The study was conducted following PRISMA recommendations. <b>Results:</b> A total of 26 articles, including 1,292 participants older than 65, were included in the final qualitative and quantitative syntheses. The weighted mean of the retention rate was 91.1, and of the attendance rate was 85.0, with low <i>I</i>² = 3.5, not significant <i>p</i> = 0.409 heterogeneity. The generalized regression models showed a positive effect of session duration on the attendance rate (%), where the possible change from <20 min to >60 min duration could decrease the attendance rate (%) <i>B</i> = -24.390 (<i>p</i> <0.001). The delivery method had a significant effect, where the absence of live contact with the coach in web-based or DVD-delivered interventions could decrease the attendance rate (%) compared to the online sessions <i>B</i> = -11.482 (<i>p</i> = 0.010). The lockdown during the COVID-19 pandemic had a positive effect on both the attendance rate (%) B = 10.321 (<i>p</i> = 0.019) and retention rate (%) B = 9.577 (<i>p</i> = 0.032). <b>Conclusions:</b> This systematic review and meta-analysis indicate that supervised home-based video exercise programs lasting less than 60 min might be a suitable and sustainable exercise mode to keep older adults active, especially in times resembling feelings of confinement.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789812","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":"Disparities in Telehealth Offer and Use among U.S. Adults: 2022 Health Information National Trends Survey.","authors":"Nicole Senft Everson, Roxanne E Jensen, Robin C Vanderpool","doi":"10.1089/tmj.2024.0014","DOIUrl":"10.1089/tmj.2024.0014","url":null,"abstract":"<p><p><b>Objective:</b> Understanding the sources of telehealth disparities can inform efforts to ensure equity. This study examines disparities in telehealth offer and use to understand the role of health care providers in increasing telehealth access. <b>Methods:</b> This cross-sectional analysis of the 2022 Health Information National Trends Survey (n = 5,295) used survey-weighted proportions to characterize telehealth use and multivariable logistic regressions to test associations of sociodemographic and social determinants with (1) telehealth offer and (2) use among those offered the option. <b>Results:</b> Among U.S. adults, 57% were offered telehealth, 80% of whom used it. Technology difficulties and privacy concerns were barriers for 15%-20% of U.S. adults. Compared to telehealth users, most nonusers preferred in-person care (25% versus 84%). Age, education, geographic location, and broadband internet access were related to telehealth offer, whereas no significant disparities emerged in telehealth use. <b>Conclusions:</b> Telehealth use is widespread, but structural and provider-level engagement are needed to achieve equity.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460711","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":"Understanding the Personal Barriers of Elderly Patients for Carrying out Teleconsultations During COVID-19 Pandemic: An Observational Study.","authors":"Clara Sousa Diniz, Laryssa Reis Coelho, Sarah Rocha de Almeida, Virgílio Barroso de Aguiar, Caroline Lopes de Amorim, Maria Augusta Matos Corrêa, Rafael Pereira de Moraes Ribeiro, Paullinne Ariel Nogueira Barbosa, Emanuelle Vaz Gontijo, Antonio Luiz P Ribeiro, Clara Rodrigues Alves Oliveira","doi":"10.1089/tmj.2023.0544","DOIUrl":"10.1089/tmj.2023.0544","url":null,"abstract":"<p><p><b>Introduction:</b> The expansion of telehealth during the COVID-19 pandemic may widen digital divides. It is essential to better understand the use of telehealth by the elderly population for the development of equitable telehealth tools. <b>Objectives:</b> This study aimed to describe the socioeconomic, clinical, and functional characteristics of elderly patients who were supported by a COVID-19 telehealth program. It also investigated the characteristics associated with the need for support for teleconsultations, hospitalization, and mortality. <b>Methods:</b> >Elderly patients supported by the TeleCOVID-MG program, between June 2020 and December 2021, in two Brazilian municipalities (Divinópolis and Teófilo Otoni) were included. Data were collected from electronic records and through phone call interviews. Descriptive and multivariable analyses were performed. <b>Results:</b> Among the 237 patients,121 were women (51.1%), mean age was 70.8 years (±8.5), 121 (51.1%) had less than 4 years of formal education, 123 patients (51.9%) had two or more comorbidities, and 68 (29%) reported functional decline in activities of daily life. Age greater than 80 years (odds ratio [OR]:4.68, 95% confidence interval [CI] 1.93-11.37, <i>p</i> = 0.001), lower educational level (OR:3.85, 95% CI 1.8-8.21, <i>p</i> < 0.001), hearing (OR:5.46, 95% CI: 1.24-11.27, <i>p</i> = 0.019), and visual (OR:15.10, 95% CI: 3.21-71.04, <i>p</i> = 0.001) impairments were characteristics associated with the need for support for teleconsultations. The need for support was associated with hospitalization and mortality (OR:5.08, 95% CI: 2.35-10.98, <i>p</i> < 0.001). <b>Conclusion:</b> Older age, lower educational level, and sensory impairments may compromise the effectiveness and the safety of the telehealth assistance to the elderly population. Functional evaluation and frailty screening should be considered part of the telehealth assessment of elderly patients.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789884","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":"Accuracy of Patient-Collected Vital Signs.","authors":"Joshua P Metlay, Ralph Gonzales, Timothy J Judson, Yuchiao Chang, Justin Margolin, Samir Oza, Blair A Parry, Michelle D Tagerman, Emily Hayden","doi":"10.1089/tmj.2023.0548","DOIUrl":"10.1089/tmj.2023.0548","url":null,"abstract":"<p><p><b>Introduction:</b> Telehealth has emerged as an important clinical setting for managing acute respiratory tract infections (ARIs), potentially reducing emergency department and urgent care overcrowding, and reducing nosocomial transmission. Many current algorithms for ARI management incorporate information on patient vital signs. However, the accuracy of vital signs collected by patients using readily available home devices and techniques has not been studied. <b>Methods:</b> A cross-sectional sample of patients seen for urgent conditions at a hospital emergency and urgent care center were given instructions and low-cost, readily available devices to collect their vital signs. A trained research coordinator collected a parallel set of vital signs using standard hospital equipment, serving as the gold standard. We analyzed the performance of patient-collected vital signs compared with vital signs collected by a trained research coordinator. <b>Results:</b> A total of 300 patients completed the study. Patient-collected vital signs were highly specific for traditional levels of abnormalities (HR >100 beats per min, RR >24 breaths per min, temperature >100.4 degrees Fahrenheit, oxygen saturation <94 percent); however, sensitivity was poor for elevated heart rate by pulse estimation (25%) and elevated respiratory rate (60%). Heart rate and oxygen saturation by pulse oximeter and oral temperature had higher sensitivity. <b>Conclusions:</b> Vital signs measured and provided by patients are not uniformly accurate, particularly when using manual techniques rather than automated devices. Telehealth algorithms that rely on these values could provide incorrect triage and management advice.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989530","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":"Reevaluating Value-Based Care in Telemedicine: Clinical Opportunities in the Postpandemic Era.","authors":"Denise Soltow Hershey, David Buzanoski, Supratik Rayamajhi, Drew Murray","doi":"10.1089/tmj.2024.0523","DOIUrl":"https://doi.org/10.1089/tmj.2024.0523","url":null,"abstract":"<p><p>Telehealth during the COVID-19 pandemic became one of the main means for patients to access the health care system. Rules, regulations, and reimbursement policies were loosened, allowing for its expansion into the clinical arena. Since the end of the pandemic, virtual care models have expanded. With a larger emphasis on value-based care, there is a need to understand how telehealth can be utilized to increase value, improve access, enhance the patient experience, improve outcomes, and decrease health inequalities. The article explores the use of telehealth as it relates to a value-based care model, which includes the patient experience, quality of care (access and health equity), provider/clinical practice, and health system/financial. Recommendations for strengthening the use of telehealth to ensure value-based care are provided.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513032","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 Postpandemic: A Model for Michigan and Beyond.","authors":"Bree Holtz, Charles R Doarn","doi":"10.1089/tmj.2024.0519","DOIUrl":"https://doi.org/10.1089/tmj.2024.0519","url":null,"abstract":"<p><p>During the COVID-19 pandemic, telemedicine and telehealth saw a groundswell of growth, only to be shackled in the aftermath of the Public Health Emergency. A Think Tank, funded by Agency for Healthcare Research and Quality, was held at Michigan State University in August 2024. This paper serves as an introduction to a series of articles focusing on the evolution and future of telehealth in a postpandemic world. It highlights key themes including patient equity, technology, clinical opportunities, research, and education, using Michigan as a model for national adaptation. The paper aims to ignite further discussion and innovation within the telehealth community.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513035","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":"Short- and Long-Term Outcomes of e-Health and Internet-Based Psychological Interventions for Chronic Tinnitus: A Systematic Review and Meta-Analysis.","authors":"Heribert Sattel, Petra Brueggemann, Kurt Steinmetzger, Benjamin Boecking, Alexandra Martin, Christian Dobel, Birgit Mazurek","doi":"10.1089/tmj.2024.0050","DOIUrl":"https://doi.org/10.1089/tmj.2024.0050","url":null,"abstract":"<p><p><b>Objective</b>: e-Health or web-based systems in the field of tinnitus have gained increasing interest. Cognitive behavioral therapy (CBT) delivered via the internet is currently witnessing a surge in both attention and offerings. This systematic review analyzed the efficacy and sustainability of internet-based therapies aimed at reducing tinnitus distress and comorbidities such as anxiety, depression, and sleep disorders. The review exclusively considered randomized controlled trials (RCTs) in which trained personnel were actively involved during intervention. <b>Methods</b>: Utilizing search terms such as tinnitus, internet-based therapy, and e-Health therapy, we identified 155 studies, from which 37 RCTs were carefully examined for data availability. Primary outcome measures included treatment effects for tinnitus distress (Tinnitus Questionnaire and other questionnaires) and handicap (Tinnitus Handicap Inventory), while secondary outcomes encompassed depression, anxiety, and sleep problems. Meta-analyses were conducted employing random-effect models. A study effect model was applied, yielding a singular effect size for each sample. The effect sizes were examined for influences of various moderators. <b>Results</b>: We found a statistically significant large effect size for improvement in tinnitus distress (<i>d</i> = 0.83; [confidence interval 0.61-1.06] with total <i>n</i> = 450 for the experimental group and total <i>n</i> = 504 or the controls), while the reduction of tinnitus handicap was smaller (moderate effect size <i>d</i> = 0.59; [0.44-0.73]). Less strong but still significant effects resulted for depression, anxiety, and insomnia. Most of the long-term outcomes remained stable. As moderators, the risk of bias (RoB) and the severity of tinnitus manifestations were identified. <b>Conclusions</b>: Internet-based therapy provides a valuable avenue for initial therapeutic contact, as supporting component in tinnitus treatment if accompanied by therapists. The heterogeneous quality with high drop-out rates or partly high RoB and the wide range of interventions (counseling, eCBT, mindfulness) might be considered as a limiting factor for a first-line management in tinnitus. So far, the use of e-Health is dependent on availability or user preferences.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513034","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":"Rethinking Shared Decision-Making: Delivery of Care Options in a Telehealth World.","authors":"Julia Terhune, Stacey Pylman, Jessica Clarey","doi":"10.1089/tmj.2024.0524","DOIUrl":"https://doi.org/10.1089/tmj.2024.0524","url":null,"abstract":"<p><p>Telehealth modalities have given patients options for delivery of care, and in some cases increased access to care. However, great effort needs to be made by providers and clinic staff to ensure patients are given choice in their delivery of care methods and technological support to work toward equity in care. We propose applying the BEACH model for shared decision-making to help providers support patients in choosing the best care delivery method, while also encouraging providers to seek further education on telehealth competencies. Lastly, we stress the importance of the clinical staff in ensuring patient autonomy, education, and support when choosing telehealth modalities of care.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513033","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}