-
American Society of Clinical Oncology... May 2018Telemedicine uses telecommunications technology as a tool to deliver health care to populations with limited access to care. Telemedicine has been tested in multiple... (Review)
Review
Telemedicine uses telecommunications technology as a tool to deliver health care to populations with limited access to care. Telemedicine has been tested in multiple clinical settings, demonstrating at least equivalency to in-person care and high levels of patient and health professional satisfaction. Teleoncology has been demonstrated to improve access to care and decrease health care costs. Teleconsultations may take place in a synchronous, asynchronous, or blended format. Examples of successful teleoncology applications include cancer telegenetics, bundling of cancer-related teleapplications, remote chemotherapy supervision, symptom management, survivorship care, palliative care, and approaches to increase access to cancer clinical trials. Telepathology is critical to cancer care and may be accomplished synchronously and asynchronously for both cytology and tissue diagnoses. Mobile applications support symptom management, lifestyle modification, and medication adherence as a tool for home-based care. Telemedicine can support the oncologist with access to interactive tele-education. Teleoncology practice should maintain in-person professional standards, including documentation integrated into the patient's electronic health record. Telemedicine training is essential to facilitate rapport, maximize engagement, and conduct an accurate virtual exam. With the appropriate attachments, the only limitation to the virtual exam is palpation. The national telehealth resource centers can provide interested clinicians with the latest information on telemedicine reimbursement, parity, and practice. To experience the gains of teleoncology, appropriate training, education, as well as paying close attention to gaps, such as those inherent in the digital divide, are essential.
Topics: Clinical Trials as Topic; Delivery of Health Care; Education, Medical; Humans; Interdisciplinary Communication; Medical Oncology; Telemedicine; Telemetry; Time Factors
PubMed: 30231354
DOI: 10.1200/EDBK_200141 -
Arthritis Care & Research Oct 2017To identify and summarize the published and gray literature on the use of telemedicine for the diagnosis and management of inflammatory and/or autoimmune rheumatic... (Review)
Review
OBJECTIVE
To identify and summarize the published and gray literature on the use of telemedicine for the diagnosis and management of inflammatory and/or autoimmune rheumatic disease.
METHODS
We performed a registered systematic search (CRD42015025382) for studies using MEDLINE (1946 to July 2015), Embase (1974 to July 2015), Web of Science (1900 to July 2015), and Scopus (1946 to July 2015) databases. We included studies that demonstrated the use of telemedicine for diagnosis and/or management of inflammatory/autoimmune rheumatic disease. Following data extraction, we performed a descriptive analysis.
RESULTS
Our literature search identified 1,468 potentially eligible studies. Of these studies, 20 were ultimately included in this review. Studies varied significantly in publication type, quality of evidence, and the reporting of methods. Most demonstrated a high risk of bias. Rheumatoid arthritis was the most commonly studied rheumatic disease (42% of patients). Studies demonstrated conflicting results regarding the effectiveness of telemedicine (18 found it effective, 1 found it effective but possibly harmful, and 1 found it ineffective). A limited number of studies included some component of a cost analysis (n = 6; 16% of patients); all of these found telemedicine to be cost-effective.
CONCLUSION
Studies identified by this systematic review generally found telemedicine to be effective for the diagnosis and management of autoimmune/inflammatory rheumatic disease; however, there is limited evidence to support this conclusion. Further studies are needed to determine the best uses of telemedicine for the diagnosis and management of these conditions.
Topics: Autoimmune Diseases; Cost-Benefit Analysis; Evidence-Based Medicine; Health Care Costs; Humans; Rheumatic Diseases; Rheumatology; Telemedicine; Treatment Outcome
PubMed: 27863164
DOI: 10.1002/acr.23153 -
Sleep Medicine Clinics Sep 2020Telemedicine is about more than simply using audio-visual technology to care for patients, but rather an opportunity to fundamentally improve patient access, quality,... (Review)
Review
Telemedicine is about more than simply using audio-visual technology to care for patients, but rather an opportunity to fundamentally improve patient access, quality, efficiencies, and experience. Regarding sleep medicine, it has the potential to drive sleep medicine's evolution. By enabling care across geographies and facilitating population-based management, sleep medicine is poised to take advantage of telemedicine capabilities. In this introductory chapter, we highlight issues related to sleep telemedicine, while providing a framework in which to approach this transformational journey thoughtfully. We thereby set the stage for the individual chapters in this edition of Sleep Medicine Clinics.
Topics: Humans; Quality of Health Care; Sleep Wake Disorders; Telemedicine
PubMed: 32762967
DOI: 10.1016/j.jsmc.2020.05.005 -
Missouri Medicine 2020Missouri is a national leader in telemedicine, and the Missouri Telehealth Network has led operational, legal and regulatory, and research and evaluation efforts since...
Missouri is a national leader in telemedicine, and the Missouri Telehealth Network has led operational, legal and regulatory, and research and evaluation efforts since 1994. Telehealth and telemedicine have the potential to increase access to and efficiency of healthcare delivery, improve quality, and improve patient outcomes. Coverage and reimbursement rules vary by regulator, and Missouri enjoys a broad statutory definition of telehealth coverage and reimbursement parity (no distinction between in-person and telehealth services).
Topics: Health Services Accessibility; Humans; Missouri; Rural Population; Telemedicine
PubMed: 32636555
DOI: No ID Found -
Nursing Outlook 2020Electronic sensors measuring biological and behavioral aspects of health and the environment are becoming ubiquitous and, with advances in data science and ehealth... (Review)
Review
BACKGROUND
Electronic sensors measuring biological and behavioral aspects of health and the environment are becoming ubiquitous and, with advances in data science and ehealth technology, provide opportunities for new inquiry and innovative approaches to nursing research.
PURPOSE
To conceptualize the use of sensor technology from the perspective of nursing science.
METHODS
This review reports the keynote presentation from the Expanding Science of Sensor Technology in Nursing Research Conference presented by the Council for Advancement of Nursing Science in 2019 FINDINGS: Electronic sensors enable collection, recording, and transmission of data in real time in real life settings, remote monitoring, self-monitoring, and communication between health care professionals and patients. A deliberative approach to selecting and applying electronic sensors and analyzing and interpreting the data is needed for successful research.
DISCUSSION
Electronic sensors have high potential to advance nursing science.
Topics: Forecasting; Humans; Inventions; Monitoring, Physiologic; Nursing Care; Telemedicine
PubMed: 32580871
DOI: 10.1016/j.outlook.2020.03.009 -
The Canadian Veterinary Journal = La... Feb 2019
Topics: Animals; Canada; Computers; Humans; Telemedicine; Veterinary Medicine
PubMed: 30705446
DOI: No ID Found -
Revista de Neurologia Sep 2020The stress that the coronavirus pandemic has produced on the health services and the disruption it has caused in the care of other pathologies and their follow-up in... (Review)
Review
The stress that the coronavirus pandemic has produced on the health services and the disruption it has caused in the care of other pathologies and their follow-up in outpatient visits have led us to promote and incorporate telemedicine in our routine medical practice. Telemedicine refers to remote or non-face-to-face medical attention, a new method of administering medical care by accredited professionals, which optimises resources and increases their scope. One drawback for child teleneurology is that our diagnoses require direct observation of the child and carrying out an examination as though playing a game. Mainly in the youngest stages, a new patient evaluated by telemedicine can be more difficult to diagnose and manage, and therefore some neuropaediatricians have chosen to carry out only follow-up visits, medication management and outcome reviews. Telemedicine, however, also has many benefits, such as the possibility of giving rapid advice, coordination among professionals and reaching the patient where and when it is difficult for classical medicine to do so. The aim of this article is to review the possible indications of telemedicine in child neurology, starting out from the fact that we should never delay the diagnosis of something that can be treated, both at the present time and in an eventual situation of resurgence of the pandemic. The advance of telemedicine will depend on the implementation of technology, on solving legal and security/privacy issues, on its clinical outcomes and on the extent to which patients demand and accept these virtual visits.
Topics: Adolescent; Aftercare; Child; Child, Preschool; Disease Management; Humans; Infant; Interdisciplinary Communication; Length of Stay; Neurology; Neuropsychiatry; Patient Care Team; Patient Education as Topic; Pediatrics; Telemedicine
PubMed: 32729111
DOI: 10.33588/rn.7105.2020304 -
Critical Care (London, England) Apr 2017Technology has advanced rapidly in recent years and is continuing to do so, with associated changes in multiple areas, including hospital structure and function. Here we... (Review)
Review
Technology has advanced rapidly in recent years and is continuing to do so, with associated changes in multiple areas, including hospital structure and function. Here we describe in 10 points our vision of some of the ways in which we see our hospitals, particularly those in developed countries, evolving in the future, including increased specialization, greater use of telemedicine and robots, the changing place of the intensive care unit, improved pre-hospital and post-hospital management, and improved end-of-life care. New technology is going to increasingly impact how we practice medicine. We must learn how best to adapt to and encompass these changes if we are to achieve maximum benefit from them for ourselves and our patients. Importantly, while the future hospital will be more advanced technologically, it will also be more advanced on a personal, humane patient care level.
Topics: Forecasting; Hospitals; Humans; Robotics; Telemedicine
PubMed: 28395658
DOI: 10.1186/s13054-017-1664-7 -
The Milbank Quarterly Jun 2021Policy Points Telehealth has many potential advantages during an infectious disease outbreak such as the COVID-19 pandemic, and the COVID-19 pandemic has accelerated the...
UNLABELLED
Policy Points Telehealth has many potential advantages during an infectious disease outbreak such as the COVID-19 pandemic, and the COVID-19 pandemic has accelerated the shift to telehealth as a prominent care delivery mode. Not all health care providers and patients are equally ready to take part in the telehealth revolution, which raises concerns for health equity during and after the COVID-19 pandemic. Without proactive efforts to address both patient- and provider-related digital barriers associated with socioeconomic status, the wide-scale implementation of telehealth amid COVID-19 may reinforce disparities in health access in already marginalized and underserved communities. To ensure greater telehealth equity, policy changes should address barriers faced overwhelmingly by marginalized patient populations and those who serve them.
CONTEXT
The COVID-19 pandemic has catalyzed fundamental shifts across the US health care delivery system, including a rapid transition to telehealth. Telehealth has many potential advantages, including maintaining critical access to care while keeping both patients and providers safe from unnecessary exposure to the coronavirus. However, not all health care providers and patients are equally ready to take part in this digital revolution, which raises concerns for health equity during and after the COVID-19 pandemic.
METHODS
The study analyzed data about small primary care practices' telehealth use and barriers to telehealth use collected from rapid-response surveys administered by the New York City Department of Health and Mental Hygiene's Bureau of Equitable Health Systems and New York University from mid-April through mid-June 2020 as part of the city's efforts to understand how primary care practices were responding to the COVID-19 pandemic following New York State's stay-at-home order on March 22. We focused on small primary care practices because they represent 40% of primary care providers and are disproportionately located in low-income, minority or immigrant areas that were more severely impacted by COVID-19. To examine whether telehealth use and barriers differed based on the socioeconomic characteristics of the communities served by these practices, we used the Centers for Disease Control and Prevention Social Vulnerability Index (SVI) to stratify respondents as being in high-SVI or low-SVI areas. We then characterized respondents' telehealth use and barriers to adoption by using means and proportions with 95% confidence intervals. In addition to a primary analysis using pooled data across the five waves of the survey, we performed sensitivity analyses using data from respondents who only took one survey, first wave only, and the last two waves only.
FINDINGS
While all providers rapidly shifted to telehealth, there were differences based on community characteristics in both the primary mode of telehealth used and the types of barriers experienced by providers. Providers in high-SVI areas were almost twice as likely as providers in low-SVI areas to use telephones as their primary telehealth modality (41.7% vs 23.8%; P <.001). The opposite was true for video, which was used as the primary telehealth modality by 18.7% of providers in high-SVI areas and 33.7% of providers in low-SVI areas (P <0.001). Providers in high-SVI areas also faced more patient-related barriers and fewer provider-related barriers than those in low-SVI areas.
CONCLUSIONS
Between April and June 2020, telehealth became a prominent mode of primary care delivery in New York City. However, the transition to telehealth did not unfold in the same manner across communities. To ensure greater telehealth equity, policy changes should address barriers faced overwhelmingly by marginalized patient populations and those who serve them.
Topics: Attitude of Health Personnel; COVID-19; Female; Health Equity; Humans; Male; Pandemics; Patient Acceptance of Health Care; Primary Health Care; SARS-CoV-2; Surveys and Questionnaires; Telemedicine
PubMed: 34075622
DOI: 10.1111/1468-0009.12509 -
Medical Science Monitor Basic Research Jul 2018Today's medical service delivery platforms provide everything from small urgent care 'offices' to large medical centers. Since 2007, an intermediate entity for care has...
Today's medical service delivery platforms provide everything from small urgent care 'offices' to large medical centers. Since 2007, an intermediate entity for care has been established, namely, the micro-hospital. Micro-hospitals are 24-hour, small inpatient facilities with an average of 2 to 10 beds, designed to provide a diversity of healthcare services consistent with community demands. In addition, they seek to combine a cost-effective healthcare vehicle with potential time-dependent triage/transfer capabilities to a nearby large medical center. This smaller cost-effective entity represents an ideal vehicle for telemedicine, whereby specialists are always on hand for interpretation and consultation, with minimal patient waiting. In all likelihood, telemedicine, including cloud data storage and retrieval, will develop at a faster pace due to emerging 5G technology. Appropriate modification of the micro-hospital may also lead to creation of specialized centers devoted to endocrine and metabolic disorders, pulmonary diseases, and addiction medicine, which are certainly within the realm of medical necessity.
Topics: Hospitals; Humans; Medical Informatics; Medical Informatics Applications; Telemedicine
PubMed: 30006501
DOI: 10.12659/MSMBR.911436