Telemedicine and e-Health最新文献

{"title":"Experiences of Older Adults with Heart Failure Using Telemedicine During the COVID-19 Pandemic: A Qualitative Study.","authors":"Sarah J Rhoads, Jean McSweeney, Heba Sadaka, Jing Jin, Claude Pirtle, Joseph Sanford","doi":"10.1089/tmj.2024.0005","DOIUrl":"10.1089/tmj.2024.0005","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine (TM) usage increased rapidly during the COVID-19 pandemic. This study is part of a larger mixed-methods study comparing TM and in-person visits of older adults with heart failure (HF) and describes patient's TM experiences during the pandemic. <b>Methods:</b> This study employed qualitative design using survey responses and individual interviews. Study eligibility requirements included >55 years old, HF diagnosis, and TM visit between September 1, 2020 and May 31, 2021, at one of two participating health systems in the southern United States. <b>Results:</b> Twenty-two TM recipients completed qualitative interviews, and 91 of 125 online survey respondents answered open-ended questions. Data were gathered, sorted, and revealed five themes. <b>Discussion:</b> Interview respondents identified benefits, e.g., convenience, inclusion, decreased exposure, and problems, e.g., connectivity issues, inadequate equipment, and medical conditions impacting use. Recommendations included allocating sufficient appointment time, tailoring visits, and increasing written communication. This study was part of a larger clinical trial registered at ClinicalTrials.gov: NCT04304833.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"191-199"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332399","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 Use of Remote Presence Robotic Tele-Presentation in Rural and Remote Canada: A Systematic Review.","authors":"Kelly Russell, Elysa Sandron, Heather Normand, Michael Ellis, Anne Durcan, Ivar Mendez, Rachel Johnson, Kristy Wittmeier","doi":"10.1089/tmj.2024.0293","DOIUrl":"10.1089/tmj.2024.0293","url":null,"abstract":"<p><p><b>Objective:</b> One potential solution to limited health care in rural and remote regions is remote presence robotic tele-presentation to allow health care providers to care for patients in their home community via a robotic interface. We synthesized evidence regarding the use of remote presence robotic tele-presentation in rural and/or remote Canadian health settings. <b>Methods:</b> Medline, PubMed, and Embase were searched up to August 2023. Remote presence robotic tele-presentation refers to any robotic device used for the purpose of presenting and/or collecting patient information. Primary research was included if the patient was located in remote and/or rural Canada, featured remote presence robotic tele-presentation, and assessed patient, family, or clinician satisfaction, patient transport to nearby regional or urban center, health care costs, clinical outcomes, infrastructure outcomes, adverse events, or telementoring. <b>Results</b>: Six studies were included. Patients, nurses, and physicians all reported high levels of satisfaction when using the remote presence robotic tele-presentation. Fifty to sixty-three percent of patients were managed in their home community and did not require transfer to another center. Remote presence robotic sonography resulted in adequate imaging in 81% of first trimester ultrasound limited exams but was less useful for second trimester complete obstetric ultrasounds (20% adequate imaging). Two of eight laparoscopic colorectal surgeries had to be converted to open surgeries. Telerobotic ultrasound clinics resulted in a diagnosis in 70% of cases. <b>Conclusions:</b> Evidence suggests remote presence robotic tele-presentation is a safe and cost-effective approach to providing care in distant communities and can prevent some transfers and evacuations to tertiary hospitals.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"200-211"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382438","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 Necessity and Acceptability of Text Message Therapy to Peripartum Mothers.","authors":"Ilang M Guiroy, John C S Rodman, Eric Kuhn, Randye J Semple","doi":"10.1089/tmj.2024.0354","DOIUrl":"10.1089/tmj.2024.0354","url":null,"abstract":"<p><p><b>Objective:</b> This study delineated the unmet mental health needs of peripartum mothers with symptoms of depression, ascertained their willingness to engage in psychotherapy via text message, and identified potential determinants of that willingness (e.g., demographics, preferred communication methods) to inform improvement to service delivery. <b>Method:</b> This was a cross-sectional national survey of 897 adults who had given birth in the previous 24 months, had at least one lifetime symptom of depression, had internet access, and could read English. Univariate analysis was followed by multivariable Firth's logistic regression. <b>Results:</b> Peripartum participants with at least one symptom of depression wanted mental health care the most within 2 years of giving birth (64.4%) and had less access to mental health care during pregnancy and postpartum (35.1% and 38.1%, compared with 23.9%). Fifty-three percent of participants were willing to engage in psychotherapy via text message. Determinants of willingness to engage in text message therapy for all periods (pregnancy, postpartum, and not peripartum) included wanting mental health treatment but not having access and previous experience with psychotherapy via text message. During pregnancy and not peripartum, more depressive symptoms were associated with willingness to engage in psychotherapy via text message. <b>Conclusion:</b> The peripartum period is an especially high-risk time for mothers to experience depressive symptoms. In general, most wanted therapy but were unable to access it. Most participants were willing to engage in text message therapy.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"222-233"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332402","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":"Time from Diagnostic Suspicion to In-Person Evaluation in Skin Cancer Using Teledermatology.","authors":"José Luis Gatica, Diego Aragón-Caqueo, Héctor Fuenzalida, Rodrigo Loubies, María Francisca Carrasco, Vezna Sabando, Carolina Cunill, María José Letelier, Eva Guzmán","doi":"10.1089/tmj.2023.0660","DOIUrl":"10.1089/tmj.2023.0660","url":null,"abstract":"<p><p><b>Introduction:</b> Early diagnosis of skin cancer is crucial for improving prognosis. Teledermatology (TD) usage can optimize referrals and reduce waiting times. This study aims to evaluate waiting times at the critical referral nodes in teleinterconsultations that raised suspicion of skin malignancy in the Chilean TD platform of the public health care system. <b>Materials and Methods:</b> A cross-sectional observational study that analyzed asynchronous teleinterconsultations and raised suspicion for skin malignancy following the teledermatologist evaluation was uploaded on the Chilean Ministry of Health's TD platform from January 1 to June 30, 2022. <b>Results:</b> Out of 20,522 teleinterconsultations, 1,853 raised suspicion of skin cancer. Among them, 1,119 patients were assessed by in-person examination, while 669 were still on the waiting list. Response times averaged 3.98 days for TD diagnostic suggestions. Overall referral times averaged 75.98 days from initial teleinterconsultation to the final specialist in-person evaluation. Waiting times showed significant differences among health care services and geographic regions. <b>Discussion:</b> In resource-limited settings, TD serves as a valuable tool to optimize referrals and manage the demand for oncologic dermatological consultation. The long waiting times emphasize the need for targeted interventions, especially in regions with longer delays. <b>Conclusion:</b> While TD has shown to be an effective tool in optimizing referrals, waiting times still exceed international recommendations, even in urban centers. The considerable heterogeneity in referral times within health care services and geographic regions highlights the necessity of establishing standardized referral protocols and explicit deadlines to fulfill teleinterconsultations that raise suspicion of skin malignancy in the Chilean public system.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"234-241"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367364","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":"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":" ","pages":"151-166"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","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":"Same as It Ever Was.","authors":"Charles R Doarn","doi":"10.1089/tmj.2025.0014","DOIUrl":"10.1089/tmj.2025.0014","url":null,"abstract":"","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"127-128"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016614","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":"Lessons Learned from Offering Video Visits as an Alternative to Phone Visits: A Case Study from a Safety-Net Obstetrics Clinics.","authors":"Jennifer N Juarez Yoc, Elaine C Khoong, Misa Perron-Burdick, Ben Li, George Su, Courtney Lyles, Malini Nijagal","doi":"10.1089/tmj.2024.0017","DOIUrl":"10.1089/tmj.2024.0017","url":null,"abstract":"<p><p>Before the Covid-19 pandemic, human-centered design work in San Francisco found video visits promising for Medicaid-insured pregnant individuals. They were deemed likely better than phone at addressing concerns about remoteness. We describe our experience with introducing video visits within a safety net clinic that had rapidly adopted phone visits as the standard telemedicine option early in the pandemic. By utilizing Kotter's change framework, providing an equity-focused vision, and supporting the implementation with a skilled, on-the-ground project manager, temporary uptake of offering video visits was achieved. However, competing priorities, staffing structure, and institutional culture were barriers to creating sustained change once grant funding ended, even after improvement of digital infrastructure. Efforts to increase video visit uptake in systems where telephone visits are the norm-as is in many safety net systems-may have limited success without leadership-driven prioritization and culture change at all levels.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"249-253"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513030","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":"Efficacy of Remote Psychological Interventions for Patients with Anxiety and Depression Symptoms: Systematic Review and Meta-Analysis.","authors":"Priscila Oliveira Machado Cecagno, Natália Donati Polesello, Tatiana Duque-Cartagena, Pedro Machado Luz, Eduardo Mundstock, Marcello Dala Bernardina Dalla, Douglas Kazutoshi Sato, Rita Mattiello","doi":"10.1089/tmj.2024.0297","DOIUrl":"10.1089/tmj.2024.0297","url":null,"abstract":"<p><p><b>Background:</b> Anxiety and depression are common mental disorders that are highly prevalent worldwide. Clinical trials have found that telehealth interventions result in increased accessibility and improved mental treatment effectiveness. However, a few comprehensive syntheses of evidence from randomized clinical trials that have been conducted to evaluate remote psychological vs face-to-face interventions for anxiety and depression are not conclusive. The objective of this work was to evaluate the efficacy of remote psychological interventions for patients with anxiety and depression symptoms. <b>Methods:</b> Randomized clinical trials with the following criteria were included: participants aged ≥5 years, of both sexes, and who underwent psychological therapy to treat anxiety and or depression symptoms. They were randomized to receive the same psychological treatment remotely or face-to-face. Review studies, animal studies, pilot studies, and studies with patients diagnosed with chronic diseases were excluded. Searches were performed on March 2024 in the following databases: MEDLINE, EMBASE, LILACS, CENTRAL, CINAHL, Web of Science, SciELO, APA PsycINFO, and Scopus. The meta-analysis was conducted using the random-effects model, and the standardized mean difference with the 95% confidence interval (CI) was used to estimate the effect. <b>Results:</b> Six studies were included in this systematic review. The meta-analysis showed no statistically significant difference when comparing remote or face-to-face treatment for depression (SMD of -0.10 [95% CI: -0.57 to 0.37; <i>I</i>²: 77%]) and anxiety (SMD of -0.06 [95% CI: -0.34 to 0.21; <i>I</i>²: 0%]) symptoms. <b>Conclusion:</b> Our meta-analysis indicates that remote psychotherapy demonstrates comparable efficacy to face-to-face care in mitigating symptoms of depression and anxiety. It allows patients to select the best modality for their daily routines, promoting greater engagement and adherence to treatment.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"141-150"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301099","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":"https://doi.org/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":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","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":"A Statewide Telemedicine Referral System for Regional Monoclonal Antibody Infusion Centers.","authors":"Romeo R Fairley, Andrew Ta, Tatiana Emanuel, Traceee Rose, Justine Skyler, Ralph Riviello","doi":"10.1089/tmj.2023.0666","DOIUrl":"https://doi.org/10.1089/tmj.2023.0666","url":null,"abstract":"<p><p><b>Background:</b> Regional infusion centers (RICs) played an integral role in treating high-risk patients with COVID-19, with mild to moderate symptoms, who did not need acute hospitalization, with monoclonal antibodies. While any medical provider could place a RIC referral, it was recognized that many people face challenges with accessing care. A dedicated medical team was created to provide telemedical evaluation of patients and place appropriate referrals to RICs. The objective of this work was to assess patient populations who utilized a telemedicine referral system for COVID-19 antibody infusions. <b>Methods:</b> Providers used Pulsara, a Health Insurance Portability and Accountability Act-compliant video chat platform, to remotely screen patients and refer them to regional monoclonal antibody infusion centers if they met criteria. Basic demographic data were collected anonymously on all patients referred to the RICs, and medically underserved populations were determined using the uniform data system mapper. <b>Results:</b> A total of 6,031 patients were referred to RICs through Pulsara. Of these, 1,723 (29%) lived in medically underserved areas and 1,042 (17%) lived in mixed zones. In the second half of the program, 36 providers virtually screened 3,531 patients with 1,890 patients (53.5%) receiving an infusion. <b>Conclusions:</b> The successful implementation of a telehealth referral system facilitated the decentralization of monoclonal antibody infusion therapy from emergency departments to RICs. This system reached a significant number of people living within medically underserved areas.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069769","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}