Telemedicine and e-Health最新文献

{"title":"A Qualitative Evidence Synthesis of Patient and Provider Attitudes Toward Audio-Only Telemental Health Care.","authors":"Samantha L Connolly, Yamini Adusumelli, Robert P Azario, Sierra D Ferris, Andrew R Hwang, Christopher J Miller","doi":"10.1089/tmj.2024.0355","DOIUrl":"10.1089/tmj.2024.0355","url":null,"abstract":"<p><p><b>Background:</b> Audio-only (phone) telemental health care can increase access to care, but its lack of nonverbal information may negatively impact care quality as compared to video or in-person visits. The objective of this work was to understand patient and provider attitudes toward phone care via a review of qualitative research. <b>Methods:</b> A qualitative evidence synthesis was conducted of peer-reviewed qualitative research published between 2013 and 2023. Studies were required to include qualitative data regarding patient and/or provider attitudes toward audio-only telemental health care. Results pertinent to phone care were extracted and underwent coding followed by theme identification. <b>Results:</b> We identified 2,065 abstracts and 29 articles were ultimately included in the synthesis; 27 of these studies were conducted during the COVID-19 pandemic. Five themes described benefits of phone care, nine described drawbacks, and three themes were neutral. Phone care was seen as easy to use, particularly for briefer check-ins or as a back-up option if video calls failed, and some patients preferred the privacy of not being seen. However, the loss of visual information during phone visits was considered particularly challenging in the treatment of more complex or severe patients; providers questioned whether they were able to provide high quality care, and patients reported feeling less supported and understood by their providers. <b>Conclusions:</b> The relative benefits and drawbacks of audio-only telemental health care must be carefully weighed against the options of video or in-person treatment based on patient needs and severity. Future work should continue to examine patient and provider attitudes toward phone care as the mental health landscape evolves postpandemic.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"3-17"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134475","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-Reported Outcomes Improve with a Virtual Diabetes Care Model that Includes Continuous Glucose Monitoring.","authors":"Korey K Hood, Richard M Bergenstal, Terra Cushman, Robin L Gal, Dan Raghinaru, Davida Kruger, Mary L Johnson, Teresa McArthur, Amy Bradshaw, Beth A Olson, Sean M Oser, Tamara K Oser, Craig Kollman, Ruth S Weinstock, Roy W Beck, Grazia Aleppo","doi":"10.1089/tmj.2024.0093","DOIUrl":"10.1089/tmj.2024.0093","url":null,"abstract":"<p><p><b>Background:</b> The objective was to examine patient-reported outcomes (PROs) associated with access to a virtual clinic model for diabetes care. <b>Methods:</b> Adults with diabetes (<i>N</i> = 234) received virtual care, including support for continuous glucose monitoring (CGM) over a 6-month study period. Care was led by a Certified Diabetes Care and Education Specialist and focused on optimizing self-management skills and response to glucose values observed on CGM. After 6 months of CGM use and access to diabetes education, participants could opt in to another 6 months of follow-up with access to the virtual care team. Participants completed PRO surveys and had health and glycemic measures collected at baseline, 3, 6, and 12 months. <b>Results:</b> Participants with type 1 diabetes (<i>N</i> = 160) were 44 ± 14 years and had mean baseline HbA1c of 61 mmol/mol (7.7%). Participants with type 2 diabetes (<i>N</i> = 74) were 52 ± 12 years and had mean baseline HbA1c of 66 mmol/mol (8.2%). Compared with baseline levels, at 6 months participants experienced less depression, diabetes distress, and hypoglycemic fears while also experiencing greater satisfaction with glucose monitoring, diabetes technology and specifically with CGM, and confidence for managing hypoglycemic (<i>p</i> < 0.05). For participants with type 1 diabetes, more time in the target range for glucose levels (70-180 mg/dL) was associated with less depression, diabetes distress, and hypoglycemic fears. <b>Conclusions:</b> PROs improved for adults with diabetes utilizing virtual diabetes care, including support for CGM use. Paired with the glycemic improvements observed in this virtual clinic study, there were robust benefits on the quality of life of adults with diabetes. ClinicalTrials.gov Identifier: NCT04765358.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"75-84"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009953","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 Retrospective Secondary Data Analysis of Telemedicine Service Utilization (2020-2023) Among Patients Covered By The Universal Coverage Scheme in Thailand.","authors":"Nitichen Kittiratchakool, Thanayut Saeraneesopon, Chotika Suwanpanich, Thanakit Athibodee, Patiphak Namahoot, Tanasak Kaewchompoo, Piyada Gaewkhiew, Suthasinee Kumluang, Tanainan Chuanchaiyakul, Sichen Liu, Wanrudee Isaranuwatchai","doi":"10.1089/tmj.2024.0140","DOIUrl":"10.1089/tmj.2024.0140","url":null,"abstract":"<p><p><b>Objective:</b> The National Health Security Office in Thailand introduced a telemedicine program called \"Telehealth/Telemedicine\" in December 2020, which aimed to reimburse telemedicine services for patients with stable chronic diseases under the Universal Coverage Scheme (UCS). The current study investigated patient characteristics and trends in telemedicine service utilization under the UCS in Thailand and examined the impact of COVID-19 outbreaks on telemedicine services. <b>Methods:</b> A retrospective secondary data analysis using e-claim data from December 1, 2020, to April 18, 2023, was conducted. The analytical methods included descriptive analysis and an interrupted time series analysis. <b>Results:</b> During ∼29 months, 110,153 unique patients used telemedicine services, leading to a total of 259,047 visits. The average age was 54 years, and most of patients were female (57%). Hypertension was the most common diagnosis for patients receiving telemedicine services. Patients with mental health conditions often engaged in telemedicine consultation with drug delivery. During the Delta and Omicron outbreaks, telemedicine service utilization significantly increased compared with that in any nonpandemic periods within the 29-month timeframe (odds ratio [OR]: 3.85, <i>p</i>-value <0.01; OR: 2.55, <i>p</i>-value <0.01). <b>Conclusions:</b> The study findings highlight the initial trend of telemedicine services in Thailand from the start of the COVID-19 pandemic to the beginning of the post-COVID-19 period. As telemedicine will play a critical role in the future of health care, this information can support the scale-up of telemedicine, including monitoring and evaluation plans, to help improve the efficiency of the system.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"18-27"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127363","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":"Use of Telemedicine Services Is Associated with Longer Time to Initiation of Hormone Therapy in Transgender Teens and Young Adults.","authors":"Megan Mia Foo, Zaine Roberts, Rosemary Claire Roden","doi":"10.1089/tmj.2024.0302","DOIUrl":"10.1089/tmj.2024.0302","url":null,"abstract":"<p><p><b>Purpose:</b> This is a retrospective chart review examining factors, which may contribute to timing of receipt of prescription for testosterone or estrogen-based interventions for transgender adolescents and young adults who do not receive such a prescription at their first medical appointment. <b>Methods:</b> A total of 176 patient records were available; of this a minority received a prescription for hormone therapy at first medical appointment. Of the remaining 108 unique individuals, 49 received a prescription at a subsequent medical. <b>Results:</b> Participants seen through virtual health care had a significantly longer time in care prior to receipt of estrogen or testosterone prescription (331 days vs. 220 days, <i>p</i> = 0.046). No other significant relationships were found. <b>Conclusion:</b> Patients who utilize telemedicine services for gender-related health care purposes and who did not receive a prescription for estrogen or testosterone at their initial medical encounter have a longer lead time to receipt of hormone therapy.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"119-123"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301101","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":"Net Promoter Score as a Reflection of Patients' Opinions About Telemedical Visits: A Mixed Methods Analysis.","authors":"Mike Kohut, Tracy Jalbuena, Rachel Alfiero, John DiPalazzo, Eric Anderson, Jasmine Bishop","doi":"10.1089/tmj.2024.0300","DOIUrl":"https://doi.org/10.1089/tmj.2024.0300","url":null,"abstract":"<p><p><b>Introduction:</b> In order to assess patient experiences of telemedicine, researchers and administrators use the net promoter score (NPS), based on a likelihood to recommend (LTR) question. However, there is reason to doubt validity of this metric for this purpose. We assessed the degree to which the LTR question reflects actual patient preferences about telemedicine. <b>Methods:</b> Using data from a patient experience survey collected in Spring 2020, we compared LTR responses to open comments. Through content analysis, we transformed comments into categorical variables and used those variables in a multiple logistic regression model to predict LTR responses. We also thematically analyzed comments to further elucidate our results. <b>Results:</b> Only about half the comments mentioned telemedicine at all. Around 6% of comments were wholly incongruent with LTR responses. In many comments, ideas about telemedicine were semantically entangled with ideas about providers. Our logistic regression found strong associations between sentiments expressed in comments and LTR responses. However, comments about telemedicine were relatively poor predictors for LTR compared to comments about the provider. <b>Discussion:</b> NPS, which is included on many patient experience surveys used by health systems across the United States, has limitations for use as a measure of the acceptability of telemedicine for patients. Patients have more than telemedicine in mind when responding to the LTR question, and ratings conflate attitudes about providers, office policies, and staff with the telemedicine modality. More direct measures are necessary for meaningful research on the acceptability and usability of telemedicine for patients.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900487","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":"Gatekeeping Through Remote Family Physician Consultations in Tertiary University Hospital During the COVID-19 Pandemic: A Cross-Sectional Study.","authors":"Rodrigo Pedroso Tolio, Fabiana Carvalho, Dimitris Varvaki Rados, Rita Mattiello, George Henrique Aliatti Mantese, Roberto Nunes Umpierre, Rodolfo Souza da Silva, Sotero Serrate Mengue, Natan Katz, Marcelo Rodrigues Gonçalves","doi":"10.1089/tmj.2024.0509","DOIUrl":"https://doi.org/10.1089/tmj.2024.0509","url":null,"abstract":"<p><p><b>Objective</b>: To explore the potential of gatekeeping for specialized consultations and patient care via remote interactions with family physicians. <b>Methods:</b> This cross-sectional study was conducted at a tertiary hospital between November 2020 and December 2021, when specialized consultations were canceled due to the COVID-19 pandemic. Patients who were evaluated for remote consultation with family physicians were included. Remote consultations were done by a family physician team facilitated through the TelessaúdeRS-UFRGS service. The primary outcome was potential patients eligible for discharge from specialty ambulatory to primary care. <b>Data Sources and Analytic Sample</b>: Data were collected from hospital records. Candidates for remote consult included stable health conditions, indicating the absence of acute or decompensated symptoms as reported in the consult request via the online platform, absence of necessity for any medical procedures or scheduled surgeries, and absence of time-sensitive situations. The prevalence of the outcome was estimated at a corresponding 95% confidence interval. The chi-square test compared the outcome according to COVID-19 mortality waves and specialty groups. <b>Results</b>: At the outset, 2,429 consultations were assessed against the study's eligibility criteria. Among these, 2,160 consultations were included, of whom 776 were candidates for family physician team consultation. Subsequently, the remote family physicians team conducted 557 (23% of the original sample) consultations. Overall, 10% (95% CI: 9-11) had the potential to be discharged from specialty care. Patients' age was linked to discharged likelihood. Prevalence rates varied across specialty groups (highest in surgical patients) and COVID-19 waves (highest in the second wave). <b>Conclusions</b>: This study, conducted within a tertiary hospital's specialty outpatient clinic, highlights the potential of remote consultations with a family physician team in identifying cases suitable for management in primary care settings. Our findings demonstrate that 10% of cases assessed through remote consultations exhibited potential for primary care management.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878474","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":"Remote Consultations in General Practice in Ireland: Who Is Missing Out?","authors":"Ellen McHugh, Sheelah Connolly","doi":"10.1089/tmj.2024.0503","DOIUrl":"https://doi.org/10.1089/tmj.2024.0503","url":null,"abstract":"<p><p><b>Introduction</b>: This research examines the characteristics associated with the use of remote consultations in general practice in Ireland during and after the COVID-19 pandemic. <b>Methods</b>: The analysis uses three waves of a nationally representative cross-sectional survey of health in Ireland (\"Healthy Ireland\" survey), relating to the years 2020/2021, 2021/2022, and 2022/2023. The sample includes people aged 15 and over who reported seeing a general practitioner (GP) in the 4 weeks prior to the survey. The outcome variable (\"remote consultation\") captures whether a respondent reported that their most recent GP consultation took place via telephone or video (\"remote consultation\"). Logistic regression analysis was used to assess the relationship between the likelihood of having a remote consultation and a range of potential explanatory variables including age, gender, insurance status, and socioeconomic status. <b>Results</b>: There was a significant decrease in the percentage of respondents reporting remote consultations over the period of analysis, from 39% in 2020/2021 to 10% in 2022/2023. In later periods, being female (odds ratio [OR] = 1.47 [1.04, 2.09]), having private health insurance (OR = 1.76 [1.13, 2.73]), and having a long-term health condition (OR = 1.53 [0.98, 2.39]) were positively associated with the probability of reporting a remote consultation, while being in an older age group (OR = 0.29 [0.13, 0.62]) was negatively associated with the likelihood of a remote consultation. <b>Discussion</b>: The high prevalence of remote consultations during the COVID-19 pandemic was not maintained in the postpandemic period. Policymakers should consider the reasons for this and consider the gendered, age-based, and insurance-based disparities in remote consultation utilization in the development and promotion of digital health care.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840147","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 Patient Portal-Based Telehealth Outreach Program on Recall of Patients with Diabetic Retinopathy.","authors":"Justin Y Yip, Keara C Geckeler, Kailynn M Barton, Shiyoung Roh, David J Ramsey","doi":"10.1089/tmj.2024.0454","DOIUrl":"https://doi.org/10.1089/tmj.2024.0454","url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the effectiveness of a patient portal telehealth outreach program to return patients with diabetic retinopathy (DR) lost to follow-up (LTFU) for eye care. <b>Methods:</b> Patients with DR receiving intravitreal injection (IVI) therapy who were >90 days beyond recommended return were deemed LTFU. Outreach messages were sent via a patient portal, when available, or through the U.S. mail. Patients received information on how to schedule a retinal examination and a symptom-screening questionnaire. The adherence rate to scheduled appointments was assessed 90 days postintervention. Labor costs were estimated based on communication time. <b>Results:</b> Among 359 patients with DR receiving IVIs, 22% were LTFU, overdue by a median of 362 days. Receiving fewer IVIs was the factor most strongly associated with becoming LTFU (8.9  ±  9.1 injections vs. 22 ± 20 injections, <i>p</i> < 0.001). The outreach program engaged 39 patients <i>via</i> the patient portal and 28 patients <i>via</i> the U.S. mail. A similar number of patients in each cohort was scheduled (13% vs. 14%, <i>p</i> = 0.862) and completed appointments (10% vs. 14%, <i>p</i> = 0.616). Whereas patient-portal messages took an average of 64 s to send at a labor cost of $0.35/message, each letter sent by mail took approximately 5 min to prepare at a total cost of $2.19. <b>Conclusions:</b> A patient portal-based telehealth outreach program is effective at returning patients with DR to eye care and can be implemented at a lower cost, compared with conventional mailed recall letters. Efforts are needed to increase digital health literacy and access to improve the efficiency of health care delivery.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016613","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 Telehealth Implementation and Visit Modality on No-Show Rate in a High-Risk Obstetrics Clinic in a Safety Net Healthcare System.","authors":"Elaine C Khoong, Magdalene Kuznia, Kelcie Marie T Rodriguez, Melissa M Gosdin, Jennifer N Juarez Yoc, Lina Tieu, Ben Li, Misa Perron-Burdick, George Su, Malini Nijagal, Courtney R Lyles","doi":"10.1089/tmj.2024.0431","DOIUrl":"https://doi.org/10.1089/tmj.2024.0431","url":null,"abstract":"<p><p><b>Introduction:</b> Few studies have explored patient choice of visit modality between in-person, video, and telephone for prenatal care where exams are viewed as core to care and how this choice impacts no-show rate. This study evaluated the association between choice of visit modality and prenatal care visit attendance. <b>Methods:</b> In this observational (July 2020-June 2022) mixed methods study of an urban safety-net obstetrics clinic, we collected sociodemographic traits, telemedicine eligibility (as determined by a clinician), choice of visit modality (in-person, telephone, and video), and visit completion status. Using logistic regression analysis, we evaluated associations between sociodemographic traits, telemedicine eligibility, and visit modality with visit completion among all visits and only telemedicine-eligible visits. We interviewed patients and used thematic analysis to explore reasons for choosing a telemedicine visit and their visit experience. <b>Results:</b> Of 504 participants, there were 1,311 visits and 554 telemedicine-eligible visits. The no-show rate was 11.3% (148/1,311) among all visits and 14.1% (78/554) in telemedicine-eligible visits. Only phone visits were associated with higher odds of no-shows (vs. in-person visits) (adjusted odds ratio [aOR] = 2.34; 95% confidence interval [CI]: 1.10, 4.98) among all visits and telemedicine-eligible visits (aOR = 2.40; 95% CI: 1.09, 5.27). In 20 patient interviews, patients reported choosing telephone visits when the reason for the visit was perceived as less serious or if they had competing obligations. <b>Discussion:</b> Inconsistent with prior literature, we found higher no-show rates for phone visits, potentially because phone visits are chosen by patients who view their visit as lower priority. More research is needed to understand how telemedicine impacts disparities in prenatal care.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815031","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":"Bridging the Gap: Subspecialty Telemedicine Consultations at a Level III Neonatal Intensive Care Unit.","authors":"Beatrix T Shikani, Helen K Hughes, Emmanuel Opati, Kartikeya Makker, Michelle Gontasz, Anna Sick-Samuels","doi":"10.1089/tmj.2024.0397","DOIUrl":"https://doi.org/10.1089/tmj.2024.0397","url":null,"abstract":"<p><p><b>Background:</b> Many neonatal intensive care units (NICUs) lack access to subspecialist consultants and may transfer patients requiring subspecialty care to referral facilities or seek informal consultation. The objective of this work was to evaluate the feasibility, acceptability, and impact of extending pediatric subspecialty services from a children's hospital to a level III NICU via teleconsultation and describe processes, facilitators, and challenges. <b>Methods:</b> Monitored consultations for 1 year and surveyed clinicians regarding feasibility, perceived benefits, and challenges. <b>Results:</b> Fifty-nine teleconsultations were conducted. NICU providers indicated improved care quality with subspecialty input. Subspecialists reported advantages of documenting, billing, and providing more complete care, but noted logistical strains. Both parties perceived better interdisciplinary communication. <b>Conclusions:</b> This teleconsultation service was feasible, generally acceptable, improved access to subspecialty services, and improved NICU clinicians' perceived care quality. Challenges included infrastructure development costs, workflow training time, logistics, and subspecialist patient volumes. This is among the first descriptions of a pediatric subspecialty teleconsultation service supporting a NICU.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808688","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}