Telemedicine and e-Health最新文献

{"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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","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":"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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-09","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":"Delivering Telegenetics Services: Review and Synthesis of Best Practices.","authors":"David Flannery, Dale Alverson, Carol Greene, Elizabeth Krupsinksi, Sylvia Mann, Alissa Terry, Janet Thomas, Megan Lyon, Rani Singh, Lori Williamson Dean","doi":"10.1089/tmj.2024.0110","DOIUrl":"10.1089/tmj.2024.0110","url":null,"abstract":"<p><p><b>Introduction:</b> Before the COVID-19 public health emergency, few genetics providers used telehealth. As a response to this, many genetics providers began conducting telehealth care, referred to as telegenetics, usually with guidance from their institutions but without specific guidance related to the uniqueness of genetic services. <b>Objectives:</b> The Telegenetics Workgroup of the National Coordinating Center for Regional Genetics Networks convened a panel of experts in the fields of telemedicine, genetics, and genomics to review the existing literature on telegenetics and synthesize best operating practices for medical geneticists, genetic counselors, and metabolic dietitians providing telegenetics services. <b>Methods:</b> The group searched PubMed using the terms \"telegenetics,\" \"telemedicine + genetics,\" and \"telehealth + genetics.\" The group also reviewed the Northeast Telehealth Resource Center's telegenetics webliography. Websites were searched, including the American Telemedicine Association's website, Center for Connected Health Policy, and National Telehealth Resource Center for position statements, standards documents, and guidelines. The group met frequently by videoconference and discussed the literature, and using expert consensus, the group determined best practices in providing telegenetics services. <b>Results:</b> These telegenetics best practices cover important aspects of telegenetics services, including, but not limited to, ongoing delivery of telegenetics services, use of special technology, legal and regulatory requirements, and considerations regarding special settings and circumstances in which telegenetics may be conducted. <b>Conclusions:</b> Recognizing the growing use of telegenetics and a future in which telegenetics continues to be part of the regular practice of genetics, this guide informs genetics providers of best practices for delivering telegenetics services to patients.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447630","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 Role of Telemedicine in Strabismus Assessment: A Narrative Review and Meta-Analysis.","authors":"Dominic S H Wong, Abdulmalik Alsaif, Lloyd Bender","doi":"10.1089/tmj.2024.0115","DOIUrl":"10.1089/tmj.2024.0115","url":null,"abstract":"<p><p><b>Purpose:</b> Strabismus is a common ocular condition requiring precise quantification of gaze deviation and qualification of strabismus category. Telemedicine refers to the use of technology to remotely diagnose and treat medical conditions. This narrative review aimed to assess the efficacy of a variety of telemedicine modalities for the assessment of strabismus. A secondary objective was to quantify overall accuracy, sensitivity, and specificity of automated methods using meta-analysis of available data. <b>Methods:</b> A literature search was conducted using the Ovid MEDLINE, Embase, and Cochrane Library data libraries. Keywords, including \"strabismus,\" \"phoria,\" \"telemed*,\" and \"telehealth,\" were used to locate relevant studies, with Medical Subject Headings terms, free text, and synonyms. No year restrictions were applied. Studies not in English were excluded. Risk of bias was assessed using the QUADAS-2 tool. <b>Results:</b> Thirty-four studies were included. All outcomes relating to accuracy and reliability of telemedicine versus a reference standard were extracted, as well as qualitative observations. High sensitivity, specificity, accuracy, and agreement were consistently shown across studies. Meta-analysis of two subsets featuring automated methods, for which relevant data were available, revealed a pooled accuracy of 0.877 (0.806-0.949), sensitivity of 0.856 (0.805-0.907), and specificity of 0.900 (0.845-0.954). Subcategories \"remote standard assessment,\" \"digital image analysis,\" \"wearable devices,\" \"mobile health (mHealth),\" and \"artificial intelligence\" were independently examined. <b>Conclusions:</b> The majority of systems achieved parity with standard physician assessment, with the added benefit of eliminating subjectivity. Meta-analysis results suggest potential introduction of remote automated assessment where conventional assessment is unavailable, although accuracy of current technologies remains limited compared to in-person examination. Telemedicine modalities described offer convenience for patients, shorter examination times, and the potential to go beyond in-person assessments. The evidence gathered in this review supports the beginning of telemedicine integration into the world of strabismus diagnosis.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447634","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":"Pediatric Tele-Critical Care: Initial Experience with a Continuous Surveillance Model Aiming to Prevent Cardiac Arrest in Children with Critical Heart Disease.","authors":"Alejandro Lopez Magallon, Lucas Saenz, Rittal Mehta, Maria Angelica Chacón, Santiago Martinez Ransanz, Kellie Swink, Menchee Berris, Sofia Hanabergh, Can Yerebakan, David Wessel, Ricardo Munoz","doi":"10.1089/tmj.2024.0035","DOIUrl":"10.1089/tmj.2024.0035","url":null,"abstract":"<p><p><b>Introduction:</b> Despite advances in treatment of children with critical heart disease, cardiac arrest (CA) remains a common occurrence. We provided virtual support to bedside teams (BTs) from a tele-critical care (TCC) unit in a pediatric cardiac intensive care unit (CICU) and focused on early detection of concerning trends (CT) and avoidance of CA. Virtual surveillance workflows included a review of remote monitoring, video feed from patient room cameras, medical records, and artificial intelligence tools. We present our initial experience with a focus on critical communications (CCs) to BTs. <b>Methods:</b> A retrospective, descriptive review of TCC activities was conducted from January 2019 to December 2022, involving electronic databases and electronic medical records of patients in the CICU, including related CCs to BTs, responses from BTs, and related CA. <b>Results:</b> We conducted 18,171 TCC activities, including 2,678 non-CCs and 248 CCs. Over time, there was a significant increase in the proportion of CCs related with CT (<i>p</i> = 0.002), respiratory concerns (<0.001), and abnormalities in cardiac rhythm (<i>p</i> = 0.04). Among a sample of 244 CCs, subsequent interventions by BTs resulted in adjustment of medical treatment (127), respiratory support (68), surgery or intervention (19), cardiac rhythm control (17), imaging study (14), early resuscitation (9), and others (10). <b>Conclusions:</b> CCs from a TCC unit in a pediatric CICU changed over time with an increased focus on CT and resulted in early interventions, potentially contributing to avoiding CA. This model of care in pediatric cardiac critical care has the potential to improve patient safety.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472683","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 Provision and Perceptions of Telemedicine Services Among Traditional Chinese Medicine Practitioners During COVID-19: A Cross-Sectional Study in Hong Kong, China.","authors":"David C N Wong, Yushan Wu, Hong Fung, Eng-Kiong Yeoh, Ho-Man Shum, William Y H Cheung, Yi Chung Cheung, Chun Pong Lam, Vincent C H Chung","doi":"10.1089/tmj.2023.0635","DOIUrl":"10.1089/tmj.2023.0635","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Telemedicine has been widely used during the COVID-19 pandemic. Among other health care professionals, Chinese medicine practitioners (CMPs) face practical challenges in providing telemedicine consultations. This study aims to explore CMPs' experience and perceptions of telemedicine service provision before and during the pandemic. <b><i>Methods:</i></b> A territory-wide cross-sectional online survey was conducted in Hong Kong between April and May 2022. A structured questionnaire with open-ended questions was used to investigate the provision of and perception on telemedicine service, as well as usability of telemedicine among CMPs. <b><i>Results:</i></b> A total of 195 CMPs participated the survey. Before COVID-19, 42% (81/195) had been providing telemedicine services, and the proportion doubled during COVID-19. CMPs in the private sector are the main providers. Mobile apps including WhatsApp, WeChat, and Zoom were commonly used for consultations (75%, 120/161). Barriers in providing telemedicine included inability of conducting physical examination on patients (69%, 134/195), legal and ethical concerns over medical negligence (61%, 118/195), and patients' incompetence on e-literacy (50%, 98/195). Respondents urged professional and regulatory bodies to provide an explicit clinical guideline that demonstrate best practice in traditional Chinese medicine telemedicine, and to clarify legal and ethical implications of such practice. <b><i>Conclusions:</i></b> CMPs demonstrated their competency in telemedicine, and most of them provided telemedicine during COVID-19. Development of appropriate guidelines on the provision of telemedicine would support CMPs to continue provision after the pandemic, whereas a user-friendly and comprehensive telemedicine e-platform would enhance quality of such service. Facilitating patients with lower e-literacy to access telemedicine is key to reduce disparities.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946503","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":"Feasibility Telerehabilitation at Home on Body Composition, Anthropometric Measures and Muscular Strength After Interruption 4-5 Years of Spinal Cord Injury: Serial Cases Study on Islamic State of Iraq and Syria War Survivors in Iraq.","authors":"Munib Abdullah Fathe, Faical Farhat, Saad K Karim, Wassim Moalla","doi":"10.1089/tmj.2024.0078","DOIUrl":"10.1089/tmj.2024.0078","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The war caused huge devastation to rehabilitation centers in Mosul City, leading to a significant gap in rehabilitation services, which was further compounded by the COVID-19 pandemic. <b><i>Objectives:</i></b> We sought to incorporate simple and safe clinical exercises by utilizing common household items, thereby maximizing effectiveness through a combination of psychological simulation and physical impact while ensuring safety, and evaluate its efficacy as a home telerehabilitation program (HTRP) for participants with spinal cord injury (SCI) following a 4- to 5-year rehabilitation interruption. <b><i>Methods:</i></b> Eighteen volunteers, including 13 with SCI (injuries sustained 53.4-55 months prior), were split into an experimental group (Exp., <i>n</i> = 8), a first control group (first Con., <i>n</i> = 5), and a second control group of healthy individuals (second Con., <i>n</i> = 5), averaging 21.2 years old. The HTRP focused on muscles and whole-body joints, conducted with five weekly sessions gradually increasing from 45 to 120 min, with sufficient rest. Assessments occurred every 3 months. <b><i>Results:</i></b> The Friedman test indicated no significant effect of HTRP on weight, body mass index, 3 of 4 anthropometric measures, and 4 of 19 muscle strength tests, <i>p</i> > 0.05, and small effect sizes (ES). However, significant effects were observed in pelvic strength (<i>p</i> < 0.001, ES = 0.73), exceeding control groups (first Con. 1.6%, second Con. 1.0%). Muscle strength in the lower extremities, head, and trunk showed significant improvements (p < 0.05, ES = 18.3-81.8%), it is indicating functional enhancement despite morphological weaknesses, particularly in individuals with SCI. <b><i>Conclusion:</i></b> The HTRP demonstrated weak effects on muscle morphology but strong effects on functionality, highlighting its potential for long-term management and improvement of muscle functional outcomes in individuals with SCI, even after prolonged rehabilitation interruptions.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860581","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":"Telemedicine Beyond Borders: A Mixed-Methods Approach to Understanding Cross-National Usage Intention.","authors":"Anne Schmitz, Ana M Díaz-Martín, María Jesús Yagüe Guillén","doi":"10.1089/tmj.2023.0678","DOIUrl":"10.1089/tmj.2023.0678","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Drawing on the Unified Theory of Acceptance and Use of Technology 2 and the Diffusion of Innovation Theory, this article investigates the adoption of telemedicine services from a patient perspective in Germany, Spain, and the United States using a mixed-methods approach. Digital health technologies have the potential to improve access to care and to alleviate the burden on traditional health care systems and are becoming more integrated into everyday medicine. Therefore, understanding the factors that impact patients' intentions to use telemedicine is crucial to ensure successful development. <b><i>Methods:</i></b> Based on 1,200 surveys collected in Germany, Spain, and the United States, structural equation modeling (IBM SPSS Amos 24) is employed to test the hypotheses. The article also explores how age and gender moderate the proposed relationships. <b><i>Results:</i></b> Seven out of the 10 hypotheses (performance expectancy, hedonic motivation, habit, relative advantage, and perceived security) are found to be positive, direct, and statistically significant. Furthermore, findings suggest stronger effects for telemedicine usage intention for younger female users than their male counterparts. <b><i>Discussion:</i></b> With digital health technologies becoming more prevalent, the outcomes of this study can endorse the development of effective strategies to promote the adoption of telemedicine, ultimately improving access to care and contributing to the advancement of and modern health care.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946553","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}