Telemedicine and e-Health最新文献

{"title":"Guideline-Based Telemedicine Assessment of Orthopedic Low-Risk Conditions by General Practitioners is Not Inferior to that of Face-to-Face Consultations with Specialists in the Emergency Department: A Randomized Trial.","authors":"Noel Oizerovici Foni, Tarso Augusto Duenhas Accorsi, Renata Farias Vidigal Correia, Flavio Tocci Moreira, Karine De Amicis Lima, Renata Albaladejo Morbeck, Jose Leão de Souza, Carlos Henrique Sartorato Pedrotti, Nelson Wolosker","doi":"10.1089/tmj.2024.0312","DOIUrl":"10.1089/tmj.2024.0312","url":null,"abstract":"<p><p><b>Background:</b> There is a lack of randomized controlled trials focusing on orthopedic telemedicine (TM). The objective of this research was to compare the diagnostic accuracy and pattern of TM consultations of low-risk orthopedic patients performed by general practitioners (GPs) with those of face-to-face evaluations by orthopedists at an emergency department (ED). <b>Methods:</b> This randomized, single-center study was conducted between October 2021 and November 2022 on patients at an ED. Inclusion criteria were age >18 years, low back pain, extremity contusion, ankle sprain, or neck pain. Eligible patients were randomized 1:1 for TM consultations by generalist physicians with subsequent face-to-face orthopedic evaluations (TM-ED group) or face-to-face evaluations by orthopedic physicians (ED group). Primary outcomes were syndromic diagnosis, physical examination, and tests ordered. Secondary analysis included a satisfaction survey. <b>Results:</b> A total of 99 patients were enrolled; mean age was 41 ± 10.1 years, and 62.6% were female. The most common conditions were foot contusion (28.3%), ankle sprain (27.3%), hand contusion (19.2%), low back pain (19.2%), and neck pain (6.1%). Syndromic diagnosis showed no difference between groups (<i>p</i> = 0.231). In the TM-ED group (<i>n</i> = 51), self-examination demonstrated moderate to good agreement with face-to-face evaluations in several areas. Both groups showed similar tests practices. Patient satisfaction was higher in the TM-ED group across multiple measures. <b>Conclusion:</b> TM consultations for low-risk orthopedic patients by GPs are not inferior to face-to-face specialist evaluations at the ED. Virtual assessments are associated with higher patient satisfaction. Clinical Trial Identifier: NCT04981002.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2859-2869"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009951","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":"Identifying and Validating Data Elements and Main Characteristics of a Teleconsultation and Televisit System for Patients with Multiple Sclerosis in Iran.","authors":"Fatemeh Sarpourian, Maryam Poursadeghfard, Leila Erfannia, Seyed Raouf Khayami, Roxana Sharifian","doi":"10.1089/tmj.2024.0103","DOIUrl":"10.1089/tmj.2024.0103","url":null,"abstract":"<p><p><b>Background:</b> Patients with multiple sclerosis (MS) face barriers and disparities in accessing care for evaluation and treatment. Given the unmet needs and barriers to access to care, teleservices (e.g., teleconsultation and televisit) could support these patients by providing reliable information, offering specialty care and managing symptoms. The objective of this work was to identify and validate the data elements and main characteristics required for the design and implementation of a teleconsultation and televisit system for patients with MS. <b>Methods:</b> This descriptive, cross-sectional, multicenter study was completed through three main stages in 2023-2024. Various methods, including literature review, focus group discussion, and the Delphi technique, were employed to identify the data elements. A review of the literature was carried on electronic databases to detect the elements for the system. A focus group was established to review, add, or delete the data elements obtained from searching the literature. The Delphi technique was employed to achieve consensus and validate the preliminary system design. <b>Results:</b> A total of 97 data elements were classified into seven distinct categories, including patients' demographic information, physicians' demographic information, clinical information, teleconsultation, televisit, statistics/reports generation, and other system capabilities. Overall, 104 data elements were approved by the specialists for inclusion in the system. <b>Conclusions:</b> In this research, the necessary data elements for the design and implementation of a teleconsultation and televisit system for patients with MS were suggested. System developers and decision makers can utilize these data elements to recognize the specific information required in the system while initiating the design process for various systems for patients with MS.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2851-2858"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009952","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":"Differential Impact of Virtual Family-Centered Rounds in the Neonatal Intensive Care Unit by Social Factors: A Post Hoc Subgroup Analysis.","authors":"Jennifer L Rosenthal, Kristin R Hoffman, Hadley S Sauers-Ford, Daniel Stein, Sarah C Haynes, Daniel J Tancredi","doi":"10.1089/tmj.2024.0176","DOIUrl":"10.1089/tmj.2024.0176","url":null,"abstract":"<p><p><b>Background:</b> Barriers to attending family-centered rounds (FCR) exist for socially disadvantaged families. Using telehealth to conduct virtual FCR could potentially promote equitable parent/guardian FCR access. The objective of this work was to assess whether the effects of a virtual FCR intervention on parent FCR attendance varied by subgroups defined by social factors. <b>Methods:</b> We conducted a post hoc analysis of a randomized controlled trial of virtual FCR in the neonatal intensive care unit. Parents of intervention arm infants were invited to participate in virtual FCR plus usual care; control arm infants received usual care. Participants were analyzed according to the assigned group and by race/ethnicity, insurance, mother's education, and neighborhood health conditions. We used Poisson regression to estimate and compare FCR parent attendance rates. Heterogeneity of intervention effects was assessed using interaction terms to evaluate the relative benefit of the intervention in increasing parent FCR attendance. <b>Results:</b> We included all enrolled trial subjects (74 intervention, 36 control). Intervention arm infants had 3.36 (95% confidence interval [CI]: 2.66-4.23) times the FCR parent attendance rate of subjects in the control arm. Compared with the corresponding reference subgroup, intervention benefits were 2.15 times (95% CI: 1.30-3.56) better for racial/ethnic minorities, 3.08 times (95% CI: 1.59-5.95) better for those with private insurance, 2.68 times (95% CI: 1.12-6.40) better for those whose mother reported no college education, and 4.14 times (95% CI: 2.07-8.25) better for those from a neighborhood with worse health conditions. <b>Conclusions:</b> Virtual FCR improved parent FCR attendance overall, with even greater benefits for certain subgroups. Further research is needed to mitigate the differential benefit demonstrated for privately insured subjects.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2834-2841"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":" ","pages":"2791-2794"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","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}

{"title":"Telehealth to Address Preventable Maternal Deaths: A Call to Action.","authors":"Kelly A Hirko, Ann Heler, Tamara Sampson","doi":"10.1089/tmj.2024.0522","DOIUrl":"10.1089/tmj.2024.0522","url":null,"abstract":"<p><p>Over 80% of maternal deaths are preventable. Telehealth approaches can help address disparities by increasing access to quality maternal health care. In this position statement, we advocate for the utility of telehealth to address maternal mortality disparities, focusing specifically on the postpartum period, where most maternal deaths occur. Specifically, we describe how telehealth visits, mobile health applications, and wearable devices for remote patient monitoring can be used to promote the uptake of postpartum care and adherence to evidence-based treatment for the most common causes of maternal death (i.e., cardiovascular conditions and mental health-related conditions). We discuss challenges that must be overcome to ensure the broad and equitable reach of telehealth and identify specific action steps to address this pressing public health issue.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2782-2786"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632469","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":"Perception, Usability, and Satisfaction with Telemedicine in the United Arab Emirates.","authors":"Kholod Hussain Haj Hussain, Marwah Zakariya Al Shmanee, Fatima Husni Taha, Kamel Aladdein Samara, Hiba Jawdat Barqawi, Nihar Ranjan Dash","doi":"10.1089/tmj.2024.0207","DOIUrl":"10.1089/tmj.2024.0207","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine has become a global tool for enhancing health care accessibility. However, its widespread adoption is still limited by technological illiteracy, lack of appropriate devices, slow internet services, and privacy concerns. In the Middle East and North Africa, including the United Arab Emirates (UAE), there is a dearth of telemedicine research. This study aimed to understand the perceptions and satisfaction levels of the UAE population regarding telemedicine. <b>Methods:</b> Between June and September 2023, a cross-sectional study was undertaken, using an online questionnaire distributed among UAE citizens and residents aged 18 years and above. The survey aimed to gauge the perceptions, usability, and satisfaction levels of telemedicine users, alongside identifying barriers hindering its acceptance. Data analysis was performed using Python 3, using Matplotlib v3.3.4 and Pandas v1.2. <b>Results:</b> The data analysis encompassed 1,013 participants, among whom 66.9% (678/1,013) were familiar with telemedicine. From this group, 29.8% (202/678) had previously utilized it. Of these users, 92.3% (186/202) found it to be useful or highly useful, whereas 83.1% (168/202) expressed overall satisfaction with their telemedicine experience. Among those who had not used telemedicine (47%, 476/1,013), the predominant concerns were a preference for in-person health care consultations for better care (77%, 367/476) and uncertainty about the quality of care offered through telemedicine (62%, 296/476). <b>Conclusions:</b> Despite high awareness of telemedicine in the UAE, its actual usage remains limited, highlighting the necessity for increased promotional efforts. Nevertheless, positive feedback suggests considerable potential for broad adoption. Future studies should address participants' concerns to enhance telemedicine utilization in the region.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2805-2814"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789815","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":"Associations Between Telemedicine Use Barriers, Organizational Factors, and Physician Perceptions of Care Quality.","authors":"Kevin Wiley, Ashley Pugh, Brittany L Brown-Podgorski, Joanna R Jackson, David McSwain","doi":"10.1089/tmj.2024.0249","DOIUrl":"10.1089/tmj.2024.0249","url":null,"abstract":"<p><p><b>Introduction:</b> Evaluating physician perceptions of telemedicine use and its impact on care quality among physician providers is critical to sustaining telemedicine programs, given the uncertainty of reimbursement policy, preferences, inadequate training, and technical difficulties. Physicians reported technical barriers to effectively practicing integrated medicine using telemedicine as patient volumes increased during the pandemic. The objective of this work was to examine whether perceived practice barriers and facilitators were associated with physician respondents' perceptions of telemedicine care quality compared with in-person care. <b>Methods:</b> This cross-sectional study analyzed the 2021 National Electronic Health Record Survey. The sample comprised 1,857 nonfederally employed physicians (weighted <i>n</i> = 403,013) delivering integrated patient care. Of those physicians, 1,630 (weighted <i>n</i> = 346,646) reported providing care through telemedicine. We reported frequencies and percentages of reported practice characteristics. Generalized ordinal logistic regressions examined relationships between practice factors and care quality for telemedicine care. <b>Results:</b> Most of the sample (<i>n</i> = 1,630) were male (66.1%), >50 years of age (66.1%), and worked in a single location (73.5%). A total of 70% of respondents reported that patients had difficulty using telemedicine platforms, and 64% reported limitations in patients' access to technology. Most respondents indicated having provided quality care to some extent (45%) and to a great extent (26%) during telemedicine visits compared to in-person visits. Associations between barriers, facilitators, and care quality perceptions were positive, underscoring resiliency in telemedicine programs among practices. <b>Conclusion:</b> Care modalities and the organizational, environmental, and personal facilitators drive quality perceptions among physicians. Perceived fit and usability determine perceptions of care quality for providers integrating telemedicine into their practice.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2883-2889"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiotherapists' Perception of and Readiness to Use, Telerehabilitation for Musculoskeletal Disorders in Malaysia: A Cross-Sectional Study.","authors":"Lee Lee Sia, Shobha Sharma, Saravana Kumar, Devinder Kaur Ajit Singh","doi":"10.1089/tmj.2024.0034","DOIUrl":"10.1089/tmj.2024.0034","url":null,"abstract":"<p><p><b>Introduction:</b> Musculoskeletal ailments exert a significant impact on global populations. To address challenges posed by geographical constraints and financial limitations, physiotherapists have explored and found telerehabilitation to be a viable solution. Despite its proven effectiveness in clinical practice, the integration of telerehabilitation has been sluggish. This cross-sectional survey sought to delve into the perspectives and readiness of physiotherapists in Malaysia regarding telerehabilitation for musculoskeletal disorders. <b>Methods:</b> A customized survey instrument was developed and evaluated for face validity and reliability. The 36-item questionnaire was distributed through the Google Form platform, targeting respondents via social media channels such as Facebook and WhatsApp. Data analysis used descriptive statistics (frequency and percentage). <b>Results:</b> The survey garnered responses from 271 physiotherapists. A majority (76.3%, <i>n</i> = 202) expressed agreement regarding the potential benefits of telerehabilitation in physiotherapy practice. About 77% of the respondents also showcased greater readiness for monitoring client progress through telerehabilitation as opposed to assessment and treatment. Notable benefits identified by respondents included preventing cross-infection (98.5%) and reducing travel time for both clients (94.0%) and physiotherapists (90.6%). <b>Conclusion:</b> The study reveals that physiotherapists in Malaysia exhibit positive attitudes and preparedness for implementing telerehabilitation in managing musculoskeletal conditions.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2842-2850"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908322","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 Promise of Remote Patient Monitoring.","authors":"Bree E Holtz, Frank A Urban, Jill Oesterle, Roger Blake, Androni Henry","doi":"10.1089/tmj.2024.0521","DOIUrl":"10.1089/tmj.2024.0521","url":null,"abstract":"<p><p>The promise of remote patient monitoring (RPM) lies in its ability to revolutionize health care delivery by enabling continuous, real-time tracking of patient health outside traditional clinical settings. The COVID-19 pandemic accelerated the adoption of RPM, particularly in underserved and rural populations, highlighting both its potential and the persistent barriers that limit its widespread use. This paper explores the critical role of technological advancements-such as wearables, artificial intelligence (AI), and broadband expansion-in sustaining and optimizing RPM in the postpandemic era. We examine Michigan as a microcosm of national health care challenges, focusing on its diverse population and geographic barriers, and propose condition-specific RPM protocols to address these inequities. Key facilitators and barriers to RPM implementation are discussed, with a focus on AI integration, community engagement, and digital infrastructure. We also explore the role of policy reform and public-private partnerships in supporting RPM's scalability and long-term sustainability. Our findings suggest that while RPM offers a powerful tool for improving health care access and outcomes, especially for chronic conditions and rural maternal health, sustained investment in technology and infrastructure is critical. By addressing these challenges, RPM can become a cornerstone of modern health care, reducing disparities and improving care delivery for underserved populations.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2776-2781"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632474","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":"Usability and Feasibility of an in-Home Remote Exam Device in Children with Medical Complexity During the COVID-19 Pandemic.","authors":"Marie A Pfarr, James D Odum, Joanna Thomson, Scott Callahan, Ken Tegtmeyer, Kathleen Pulda, Michelle Rummel, Jennifer Ruschman, Lisa E Herrmann","doi":"10.1089/tmj.2024.0058","DOIUrl":"10.1089/tmj.2024.0058","url":null,"abstract":"<p><p><b>Background:</b> Children with medical complexity (CMC) account for high health care utilization. Telemedicine holds significant potential in CMC, as it allows a provider to engage with CMC in their home environment and can alleviate both financial and transportation burdens. Remote exam devices that enable the performance of a physical exam could expand the ability of providers to clinically assess CMC during a telemedicine visit. In this pilot study, our goal was to develop a process for integrating an in-home remote exam device into a complex care clinic during the COVID-19 pandemic and evaluate the usability and feasibility of this device. <b>Methods:</b> The remote exam device was distributed to caregivers of CMC cared for at a complex care outpatient center. Using deliberate practice framework, our onboarding process provided opportunities for caregivers and providers to learn how to utilize the device. Surveys examining usability and feasibility were administered to both caregivers and providers after each telemedicine encounter. <b>Results:</b> A total of 43 caregivers participated in the onboarding process, which included a total of 83 practice visits. The remote exam device was rated as having excellent usability by caregivers; however, providers rated the device as having lower usability. Feasibility was notable for technology issues contributing to 15% of encounters being cancelled or ending early. <b>Conclusions:</b> The remote exam device was successfully integrated into a complex care clinic. Data from this pilot study supports the usability and feasibility of deploying a remote exam device across a telemedicine platform in a busy and complex outpatient academic practice.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"2870-2875"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}