Telemedicine reports最新文献

{"title":"Telemedicine Gatekeeping Over 15,000 Patients from Specialist Consultation Waiting Lists: A Cost-Minimization Study.","authors":"Juliana Nunes Pfeil, Rudi Roman, Dimitris Rucks Varvaki Rados, Roberto Nunes Umpierre, Matheus Grassi de Oliveira, Ana Paula Beck da Silva Etges, Rodolfo Souza da Silva, Natan Katz, Rita Mattiello, Erno Harzheim","doi":"10.1177/26924366251388854","DOIUrl":"10.1177/26924366251388854","url":null,"abstract":"<p><strong>Objective: </strong>This study assesses the cost-minimization of the RegulaSUS telemedicine program, reducing the necessity for face-to-face specialist consultations.</p><p><strong>Methods: </strong>A cost analysis study, utilizing a retrospective cohort design, was conducted from January 2017 to December 2019. The gatekeeping process for waiting lists for specialized consultations was performed by two groups: the RegulaSUS program through telemedicine intervention and those regulated by the usual procedures of the Ambulatory Regulation Center of the State of Rio Grande do Sul (the contemporaneous controls group). The primary outcome was to evaluate the financial impact of the RegulaSUS program on the health system costs using the Time-Driven Activity-Based Costing (TDABC) method.</p><p><strong>Results: </strong>The RegulaSUS program substantially reduced health care and societal expenditures, with gatekeeping by telemedicine costing $85.02 versus $214.45 for usual procedures-a 60% reduction. This intervention resulted in societal savings of R$7,833,882.56 over 36 months by successfully managing 15,064 patients within primary care settings, rather than referring them to specialists.</p><p><strong>Conclusions: </strong>The RegulaSUS program demonstrates a remarkable economic impact by integrating evidence-based gatekeeping protocols with telemedicine infrastructure, effectively decreasing specialist demand. This intervention provides compelling evidence for the potential of telemedicine to optimize health care resource allocation, enhance care coordination, and improve system efficiency. The outcomes present a scalable, financially sustainable model for health system strengthening that merits consideration for broader implementation across Brazil's public health network and adaptation to comparable global health care contexts facing similar resource constraints.</p>","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"363-370"},"PeriodicalIF":1.9,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a Virtual, Collaborative Care Weight Management Program in Rural Primary Care: Pilot Results and Insights.","authors":"Sarah Hales, Caitlin Koob, Jillian Harvey, Ryan Kruis, James McElligott, Dee Ford","doi":"10.1177/26924366251385717","DOIUrl":"10.1177/26924366251385717","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Obesity rates have reached epidemic levels globally, and still, rates of overweight and obesity in South Carolina (SC) remain disproportionately high compared with national statistics. Further, those living in rural areas are at an increased risk of experiencing obesity with limited access to weight management programs, such as specialized nutrition counseling and lifestyle behavior change programs. Collaborative care management (CoCM) is an evidence-based approach that leverage a multidisciplinary team to treat specialized conditions within primary care, most often implemented to manage mental and behavioral health conditions. To our knowledge, the Primary Care Integrated Weight Management program (PCIWM) is the first to adapt CoCM model for weight management.The purpose of this study is to (1) describe pilot PCIWM implementation and (2) identify strategies to improve adoption and inform sustainability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multidisciplinary care team-including Registered Dietitians Nutritionists (RDNs), primary care providers (PCPs), practice managers, and a weight management consultant-was established to develop a PCIWM workflow and patient registry within an academic medical center and four affiliated rural primary care clinics. The PCIWM workflow involved RDN documentation, routing encounter notes to PCPs, monthly consultations between RDNs and weight management consultants, and between-session surveys.Adult patients with weight-related concerns, particularly those with a body mass index (BMI) &gt;25 kg/m&lt;sup&gt;2&lt;/sup&gt;, were referred to PCIWM. Participants underwent a nutrition assessment, set goals, received medical nutrition therapy from RDNs, integrated within their care plans, and were offered monthly RDN sessions. Data were sourced from electronic health records, PCIWM encounters, and survey responses. Descriptive statistics were used to examine baseline patient characteristics, initial service utilization from PCIWM, and survey responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants' mean age was 46.8 years, a majority were female (85.3%) identified as White (65.5%), mean baseline weight was 115.0 kg, and mean baseline BMI was 41.82 (SD = 11.4, [22.25, 78.85]) (&lt;i&gt;N&lt;/i&gt; = 61). 29% were actively engaged and had a mean of 3.4 RDN visits (mean duration = 100.7 min). The majority of survey respondents (&lt;i&gt;N&lt;/i&gt; = 11, 63.6%) reported adhering to their goals. Additionally, 51.9% (&lt;i&gt;n&lt;/i&gt; = 14 of 27) of participants who attended their scheduled appointments and had updated weights maintained (within 1 kg) or lost weight at time of follow-up. Patients' demonstrated mean BMI reductions of 2.7%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;PCIWM provides a unique model for virtual weight management, and pilot data suggest PCIWM is a feasible approach. Still, further research and advocacy efforts are needed for supportive policy and program expansion to manage patient's weight, cardiovascular risk, and other relate","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"341-351"},"PeriodicalIF":1.6,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allied Health Students' Experiences of Telehealth Within Coursework and During Placement: A Survey Study.","authors":"Kate Bridgman, Shane Erickson, Krithika Anil, Adam Bird, Jenny Freeman, Carol McKinstry, Christie Robinson, Sally Abey","doi":"10.1177/26924366251388237","DOIUrl":"10.1177/26924366251388237","url":null,"abstract":"<p><strong>Background: </strong>Despite growing professional utilization, there is limited understanding of how allied health students are prepared for telehealth practice through academic coursework and placements. This study investigates students' exposure to telehealth education, their perceptions of preparedness, and the competencies they believe are needed for graduate practice.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted between October 2024 and March 2025 across two Australian universities offering 24 allied health courses. The survey, adapted from existing tools and informed by telehealth competency frameworks, collected quantitative and qualitative data on students' telehealth learning experiences, placement exposure, and perceived competency needs. Descriptive statistics and content analysis were used to analyze and interpret the data.</p><p><strong>Results: </strong>Of the 108 respondents from 21 disciplines, only 30% reported receiving telehealth education in their coursework, with most learning limited to background knowledge and delivered via online lectures or self-directed modules. Practical skills such as telehealth session setup and communication were less frequently taught, and only 9.3% of students were assessed on telehealth competencies. Placement exposure was similarly limited, with 25% of students engaging in telehealth activities, primarily through observation. Students rated placement support more positively than coursework preparation. Content analysis revealed strong alignment between student-identified graduate competencies and published telehealth frameworks, including technical proficiency, communication, clinical adaptation, and ethical considerations.</p><p><strong>Discussion: </strong>Findings highlight significant gaps in telehealth education across allied health programs. Students expressed a preference for hands-on, experiential learning and identified a need for structured, competency-based curricula. The lack of assessment and inconsistent integration of telehealth content suggest poor alignment between learning outcomes and educational delivery. Educators should adopt established telehealth competency frameworks and enhance both academic and placement-based training to better prepare students for using telehealth in contemporary practice.</p>","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"352-362"},"PeriodicalIF":1.6,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12725421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Intensive Multidisciplinary Telerehabilitation Combined with Health Coaching for Underserved Stroke Survivors: A Pilot Study.","authors":"Emily A Stevens, Robert Suchting, Jane A Anderson, Barbara Kimmel, Anette Ovalle, Anette Walder, Chethan P Venkatasubba Rao, Neha Muraly, Carolyn P Da Silva, Aylen Sosa, Allyson Seals Richard, Salvador Cruz-Flores, Mark P Goldberg, DaiWai Olson, Ashley Zapata, Mary E Russell, Sean I Savitz","doi":"10.1177/26924366251383807","DOIUrl":"10.1177/26924366251383807","url":null,"abstract":"<p><strong>Introduction: </strong>Telerehabilitation (TR) can be as effective as in-clinic therapy; however, the implementation of barriers and facilitators to TR is unknown, especially in the underserved and rural population. In addition to TR, self-management support (SMS) interventions have been successful in improving outcomes for stroke survivors using telehealth. We explored the following: <i>(1) Is an intensive multidisciplinary TR intervention combined with SMS feasible to deliver virtual postacute stroke care? (2) Does an intensive TR intervention combined with SMS lead to improvements in level of impairment, functional outcomes, and quality of life? (3) Does an intensive TR intervention combined with SMS impact patient goal attainment? (4) What barriers and facilitators to TR are perceived by stroke survivors?</i></p><p><strong>Methods: </strong>Virtually assisted home rehabilitation after acute stroke-2 offered two sessions of rehabilitation therapy, 3 days a week, for 4 weeks, consisting of two of the following disciplines: occupational therapy, physical therapy, or speech therapy. SMS was offered during the first and last session each week. Quantitative outcomes were completed at baseline assessment (week 1), postintervention assessment (week 6), and final assessment (week 10). Following grounded theory, semi-structured qualitative interviews were completed to identify barriers and facilitators of TR.</p><p><strong>Results: </strong>A total of <i>N</i> = 15 participants were consented into the program. When excluding the 3 participants who withdrew within or before week 1 of intervention, the average weekly number of therapy sessions completed by the remaining 12 participants was 5.6 (standard deviation [SD] 0.79), 5.6 (SD 0.90), 5.2 (SD 2.19), and 4.9 (SD 1.98) for weeks 2-5, respectively. Posterior probability (PP) results indicated very strong (PP >97%) to extreme (PP >99%) support in favor of change over time across most outcomes, including decreased modified Rankin Scale (marginal improvement of -0.731) and Patient Health Questionnaire scores (-3.606) and increased Montreal Cognitive Assessment (+4.178). Nine participants took part in the semi-structured interviews, and two major themes emerged: 1-\"Perceived Access/Delivery\" and 2-\"Perceived Therapy Advantages.\" In regard to the goal attainment, low sample sizes limited precision for analyses, thus these were not included in analyses.</p><p><strong>Conclusion: </strong>TR after acute stroke is feasible, though barriers still exist. This study proved to be a safe and attainable option for underserved populations of stroke survivors, demonstrating high attendance, improved outcomes, and no intervention-related adverse events.</p>","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"329-340"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explaining Racial/Ethnic Disparities in Telehealth Use with Different Levels of English Proficiency: A Decomposition Approach.","authors":"Nari Yoo, Yumin Hong, Yoonyoung Choi","doi":"10.1177/26924366251379188","DOIUrl":"10.1177/26924366251379188","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study examined disparities in telehealth utilization across various health care services among adults in California, with particular focus on racial, ethnic, and linguistic differences. While telehealth has emerged as a potential tool for addressing health care disparities, evidence suggests that utilization patterns may exacerbate existing inequities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using the 2021-2022 California Health Interview Survey (n = 45,893) conducted in diverse languages, we employed descriptive statistics and nonlinear Blinder-Oaxaca decomposition to analyze disparities in telehealth utilization. The Blinder-Oaxaca method systematically partitions outcome differences between groups into explained components and unexplained components. We stratified analyses by visit purpose: mental health, primary care, acute care, chronic care, orthopedics, dermatology, and ophthalmology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with non-Hispanic Whites, African Americans used telehealth 4.1% more (&lt;i&gt;p&lt;/i&gt; &lt; 0.01), whereas Hispanics/Latinos and Asians used it 5.9% (&lt;i&gt;p&lt;/i&gt; &lt; 0.01) and 11.3% (&lt;i&gt;p&lt;/i&gt; &lt; 0.01) less, respectively. For Hispanics/Latinos, approximately 14% of the disparity remained unexplained by measured covariates, while for Asians, 92% was unexplained (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). Individuals with limited English proficiency (LEP) were 9.6% (&lt;i&gt;p&lt;/i&gt; &lt; 0.01) less likely to use telehealth overall, with 38% of this gap unexplained by measured factors (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). The disparity was most pronounced in mental health services, where LEP individuals utilized telehealth 4.9% points less than non-LEP individuals (&lt;i&gt;p&lt;/i&gt; &lt; 0.01), with this gap entirely unexplained by sociodemographic factors. Subgroup analysis revealed telehealth utilization disparities between LEP and non-LEP individuals across all language groups, with LEP Spanish speakers using telehealth 4.3% points less than non-LEP Spanish speakers (&lt;i&gt;p&lt;/i&gt; &lt; 0.01), LEP Asian language speakers using it 7.3% points less than non-LEP Asian language speakers (&lt;i&gt;p&lt;/i&gt; &lt; 0.01), and LEP speakers of other languages using it 7.3% points less than their non-LEP counterparts (&lt;i&gt;p&lt;/i&gt; &lt; 0.01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Our findings reveal significant disparities in telehealth utilization associated with race/ethnicity and English proficiency levels, with linguistic barriers most evident in mental health services. The substantial unexplained components in our decomposition analyses suggest that cultural, structural, and linguistic factors beyond socioeconomic factors significantly influence telehealth utilization. These results underscore the need for efforts to develop linguistically appropriate telehealth services, particularly in mental health care. Addressing these barriers is crucial for harnessing telehealth's potential to promote health equity rather than exacerbating existing health disparities in an increasingly digital health care environment.&lt;/","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"268-278"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Virtual Care on Access to Mental Health Counseling or Therapy to Reduce Health Inequities in the United States: Considerations on Age, Race, and Education.","authors":"Coralia Vázquez-Otero, Jusung Lee","doi":"10.1177/26924366251382425","DOIUrl":"10.1177/26924366251382425","url":null,"abstract":"<p><strong>Aim: </strong>To examine an association between virtual care and mental health care use and whether there is any different pattern in the association across key demographic characteristics, specifically age, race/ethnicity, and educational attainment.</p><p><strong>Methods: </strong>A cross-sectional, observation study was conducted among the general population in the United States. This population-based study used data from the 2022 National Health Interview Survey. Main effect and interaction models using binary logistic regression were performed.</p><p><strong>Results: </strong>Of a total of 708 males and 1,238 females with symptoms of major depressive disorder (MDD), virtual care was associated with an increase in mental counseling or therapy use (males: adjusted odds ratio [aOR]: 2.75, 95% CI: 1.82-4.16, <i>p</i> ≤ 0.001; females: aOR: 3.38, 95% CI: 2.42-4.73, <i>p</i> ≤ 0.001). Females from a Hispanic background (aOR: 7.17, 95% CI: 2.97-17.33, <i>p</i> ≤ 0.001), aged 18-29 (aOR: 7.18, 95% CI: 3.51-14.70, <i>p</i> ≤ 0.001), and with less than high school graduation (aOR: 5.55, 95% CI: 1.97-15.62, <i>p</i> = 0.001) or college degrees (aOR: 5.52, 95% CI: 2.91-10.47, <i>p</i> ≤ 0.001) had notable increases in mental counseling or therapy use with virtual care.</p><p><strong>Conclusions: </strong>Virtual care is associated with a significant increase in accessing mental health care. Individuals who historically experience challenges related to in-person settings, including those with low educational attainment and Hispanics, may significantly benefit from virtual options.</p>","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"317-328"},"PeriodicalIF":1.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Musculoskeletal Care: Effectiveness of a Physician-Led Telemedicine Integrated Practice Unit.","authors":"Ryan A Grant, Mary I O'Connor, Patrick Myers, Jim Fiechtl","doi":"10.1177/26924366251382437","DOIUrl":"10.1177/26924366251382437","url":null,"abstract":"<p><strong>Background: </strong>The growing crisis of musculoskeletal (MSK) disease is overwhelming health care systems and straining payors worldwide. Current telemedicine programs that focus solely on exercise therapy are not structured to deliver comprehensive care. In contrast, physician-led integrated practice units (IPUs)-multidisciplinary medical teams designed around patient-centered, holistic care-offer an innovative path forward.</p><p><strong>Methods: </strong>We analyzed the clinical outcomes of 2,851 patients treated in our digital MSK IPU.</p><p><strong>Results: </strong>Pain (scale, 0-10) improved in 75.2% of all patients from 4.7 to 2.6 and in 84.2% in those with severe pain (≥7) from 7.7 to 4.1. Functional status (Single assessment numeric evaluation [SANE] scale, 0-100) in 2,018 patients, significantly improved in 68.9% from 54.6 to 73.7. Even more compelling, in 274 patients with severe functional compromise (SANE ≤20), scores improved 599.0% from 7.9 to 55.1.</p><p><strong>Conclusion: </strong>Our results underscore the power of a telemedicine-based IPU to deliver significant reductions in pain and dramatic functional gains, even for patients starting with severe limitations. As the demand for MSK care continues to surge, a digital MSK IPU is a promising model to support both access to care and quality clinical outcomes.</p>","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"300-308"},"PeriodicalIF":1.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Factors of User Resistance to Adopting Telehealth Technology Among Women.","authors":"Israt Jahan Shithii","doi":"10.1177/26924366251380141","DOIUrl":"10.1177/26924366251380141","url":null,"abstract":"<p><strong>Background: </strong>Despite the growing global shift toward digital health solutions, the adoption of telehealth technologies in Bangladesh remains a concerning issue. Psychological factors such as lack of digital literacy, trust, and familiarity may significantly hinder the uptake of telehealth, particularly in developing countries where digital integration in health care is still evolving.</p><p><strong>Objective: </strong>This study aims to identify and evaluate the psychological barriers-specifically lack of familiarity (LOR), lack of digital literacy (LDL), and lack of trust (LT)-that influence user resistance (UR) to adopting telehealth technologies in Bangladesh. Furthermore, women among different age groups have been used as an independent construct to explore how age influences the resistance to adopting telemedicine technology.</p><p><strong>Methods: </strong>One hundred and fifty respondents were administered a structured questionnaire based on a Likert scale. Constructs were measured using items validated through factor analysis. Reliability was confirmed via Cronbach's alpha. Multiple regression analysis was conducted to test the hypothesized relationships between psychological factors (LOR, LDL, LT) and UR.</p><p><strong>Results: </strong>The model explained 47.6% of the variance in UR (<i>R</i> ² = 0.476, <i>p</i> < 0.001). Both LDL (β = 0.359, <i>p</i> < 0.001) and LT (β = 0.410, <i>p</i> < 0.001) were found to be significant predictors of resistance. However, LOR (β = 0.078, <i>p</i> = 0.201) did not significantly influence UR. All constructs demonstrated strong internal consistency (Cronbach's α > 0.76). The Kruskal-Wallis test indicated that age significantly affects women's resistance to adopting telemedicine. Subsequent pairwise comparisons among age groups revealed that older women exhibit higher levels of resistance compared with their younger counterparts.</p><p><strong>Conclusion: </strong>The findings suggest that enhancing digital skills and building trust are critical to reducing resistance and promoting the adoption of telehealth in Bangladesh. While unfamiliarity alone does not deter adoption, it becomes a barrier when compounded by low digital literacy and trust concerns. Targeted interventions such as digital literacy training and transparent communication about data security could facilitate greater acceptance and integration of telehealth technologies in the country.</p>","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"279-289"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine and Willingness to Die at Home in Rural and Remote Areas in Japan.","authors":"Masanori Harada, Ryusuke Ae, Takao Kojo, Hiroya Masuda, Minoru Kibata, Hossain Mahbub, Tsuyoshi Tanabe","doi":"10.1177/26924366251382752","DOIUrl":"10.1177/26924366251382752","url":null,"abstract":"<p><strong>Background: </strong>Few studies have assessed the potential of telemedicine to improve end-of-life care quality in rural and remote areas. We investigated health care services needed for end-of-life care at home and examined their associations with willingness to die at home, testing the hypothesis that telemedicine facilitates at-home death in rural and remote settings.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted with a target population of 6,382 residents aged ≥20 years living in designated rural and remote areas of Shunan City, Yamaguchi, Japan. Stratified random sampling was employed to select survey participants, resulting in 3,767 individuals who were mailed self-administered questionnaires. First, we assessed health care services needed for end-of-life care at home (telemedicine, home doctor visits, home nursing care, home personal care services, home support services, and senior day care). Multivariable logistic regression analysis was then performed to determine which services were independently associated with willingness to die at home.</p><p><strong>Results: </strong>Of 3,767 eligible participants, 1,884 (50.0%) responded, and 1,451 were included in the analysis. Among them, 608 (41.9%) were male, 1,166 (80.3%) were aged ≥60 years, and 733 (50.5%) expressed a wish to die at home. Home doctor visits were the most frequently selected service (776 participants [53.5%]), while telemedicine was selected by 193 (13.3%). After adjustment for all measured variables, telemedicine (adjusted odds ratio, 1.41 [95% confidence interval, 1.01-1.98], <i>p</i> = 0.045) and home doctor visits (adjusted odds ratio [OR], 1.50 [95% confidence interval, 1.19-1.90], <i>p</i> < 0.001) were independently associated with willingness to die at home.</p><p><strong>Discussion: </strong>These findings suggest that physician-provided services are central to enabling at-home death. Integrating telemedicine with traditional home doctor visits may improve end-of-life care and facilitate at-home death in rural and remote settings.</p>","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"309-316"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience in Health Care: The Role of Telemedicine and e-Health Enabling Adaptive Strategies in Sleep Medicine Practice During the COVID-19 Pandemic.","authors":"Mithri R Junna, Amy Glasgow, Timothy I Morgenthaler","doi":"10.1177/26924366251378098","DOIUrl":"10.1177/26924366251378098","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic brought profound changes to health care systems worldwide. This study examines the adaptive responses of a sleep medicine practice that successfully pivoted to telemedicine, remote diagnostics, and agile operations, resulting in sustained growth and improved patient accessibility.</p><p><strong>Methods: </strong>We analyzed organizational and cultural elements enabling responsiveness, including telemedicine infrastructure, adaptive leadership, quality-focused processes, and effective communication. Objective outcomes were assessed by analyzing patient demographics, telemedicine visits, and sleep testing patterns during three phases: pre-pandemic (June 1, 2018 to March 8, 2020), acute COVID-19 (March 9, 2020 to April 19, 2020), and post-acute COVID-19 (April 20, 2020 to December 31, 2021).</p><p><strong>Results: </strong>Across 105,199 encounters, monthly sleep medicine visits and testing declined ∼50% during acute COVID-19, but rebounded to surpass baseline in the post-acute phase. Virtual visits increased significantly, replacing many face-to-face encounters. Home sleep apnea test use rose sharply, driven by disposable WatchPAT tests, while polysomnography use decreased. Testing volumes increased overall post-acute compared with pre-pandemic. Patients served during acute and post-acute phases were younger, more often female, non-White, and postgraduate-educated (all <i>p</i> < 0.001). Nonlocal patients increased during the post-acute phase, reflecting telemedicine expansion.</p><p><strong>Conclusions: </strong>Proactive telemedicine investments, adaptive leadership, quality-focused processes, and effective communication enabled this practice to adapt successfully during the pandemic. These resilience strategies provide a model for navigating future health care challenges, underscoring telemedicine and e-health's critical roles in maintaining care delivery during crises.</p>","PeriodicalId":94218,"journal":{"name":"Telemedicine reports","volume":"6 1","pages":"290-299"},"PeriodicalIF":1.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}