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Journal of Medical Internet Research Mar 2023Hypertension and diabetes are becoming increasingly prevalent worldwide. Telemedicine is an accessible and cost-effective means of supporting hypertension and diabetes... (Review)
Review
BACKGROUND
Hypertension and diabetes are becoming increasingly prevalent worldwide. Telemedicine is an accessible and cost-effective means of supporting hypertension and diabetes management, especially as the COVID-19 pandemic has accelerated the adoption of technological solutions for care. However, to date, no review has examined the contextual factors that influence the implementation of telemedicine interventions for hypertension or diabetes worldwide.
OBJECTIVE
We adopted a comprehensive implementation research perspective to synthesize the barriers to and facilitators of implementing telemedicine interventions for the management of hypertension, diabetes, or both.
METHODS
We performed a scoping review involving searches in Ovid MEDLINE, Embase, CINAHL, Cochrane Library, Web of Science, and Google Scholar to identify studies published in English from 2017 to 2022 describing barriers and facilitators related to the implementation of telemedicine interventions for hypertension and diabetes management. The coding and synthesis of barriers and facilitators were guided by the Consolidated Framework for Implementation Research.
RESULTS
Of the 17,687 records identified, 35 (0.2%) studies were included in our scoping review. We found that facilitators of and barriers to implementation were dispersed across the constructs of the Consolidated Framework for Implementation Research. Barriers related to cost, patient needs and resources (eg, lack of consideration of language needs, culture, and rural residency), and personal attributes of patients (eg, demographics and priorities) were the most common. Facilitators related to the design and packaging of the intervention (eg, user-friendliness), patient needs and resources (eg, personalized information that leveraged existing strengths), implementation climate (eg, intervention embedded into existing infrastructure), knowledge of and beliefs about the intervention (eg, convenience of telemedicine), and other personal attributes (eg, technical literacy) were the most common.
CONCLUSIONS
Our findings suggest that the successful implementation of telemedicine interventions for hypertension and diabetes requires comprehensive efforts at the planning, execution, engagement, and reflection and evaluation stages of intervention implementation to address challenges at the individual, interpersonal, organizational, and environmental levels.
Topics: Humans; Diabetes Mellitus; Hypertension; Implementation Science; Telemedicine; Health Services Accessibility; Patient Care Management
PubMed: 36917174
DOI: 10.2196/42134 -
International Journal of Environmental... Jul 2023Telemedical technologies provide significant benefits in sports for performance monitoring and early recognition of many medical issues, especially when sports are... (Review)
Review
Telemedical technologies provide significant benefits in sports for performance monitoring and early recognition of many medical issues, especially when sports are practised outside a regulated playing field, where participants are exposed to rapidly changing environmental conditions or specialised medical assistance is unavailable. We provide a review of the medical literature on the use of telemedicine in adventure and extreme sports. Out of 2715 unique sport citations from 4 scientific databases 16 papers met the criteria, which included all research papers exploring the use of telemedicine for monitoring performance and health status in extreme environments. Their quality was assessed by a double-anonymised review with a specifically designed four-item scoring system. Telemedicine was used in high-mountain sports (37.5%; n = 6), winter sports (18.7%; n = 3), water sports (25%; n = 4), and long-distance land sports (18.7%; n = 3). Telemedicine was used for data transfer, teleconsulting, and the execution of remote-controlled procedures, including imaging diagnostics. Telemedical technologies were also used to diagnose and treat sport-related and environmentally impacted injuries, including emergencies in three extreme conditions: high mountains, ultraendurance activities, and in/under the water. By highlighting sport-specific movement patterns or physiological and pathological responses in extreme climatic conditions and environments, telemedicine may result in better preparation and development of strategies for an in-depth understanding of the stress of the metabolic, cardiorespiratory, biomechanical, or neuromuscular system, potentially resulting in performance improvement and injury prevention.
Topics: Humans; Sports; Telemedicine; Recreation; Remote Consultation; Diagnostic Imaging
PubMed: 37510603
DOI: 10.3390/ijerph20146371 -
Journal of Medical Internet Research Nov 2020Telemedicine refers to the delivery of medical care and provision of general health services from a distance. Telemedicine has been practiced for decades with increasing...
Telemedicine refers to the delivery of medical care and provision of general health services from a distance. Telemedicine has been practiced for decades with increasing evidence proving its potential for enhanced quality of care for patients, reduction in hospital readmissions, and increase in savings for both patients and providers. The COVID-19 pandemic has resulted in a significant increase in the reliance on telemedicine and telehealth for provision of health care services. Developments in telemedicine should be structured as complements to current health care procedures, not with the goal of completely digitizing the entire health care system, but rather to use the power of technology to enhance areas that may not be working at their full potential. At the same time, it is also clear that further research is needed on the effectiveness of telemedicine in terms of both financial and patient benefits. We discuss the current and rapidly increasing knowledge about the use of telemedicine in the United States, and identify the gaps in knowledge and opportunities for further research. Beginning with telemedicine's origins in the United States to its widespread use during the COVID-19 pandemic, we highlight recent developments in legislation, accessibility, and acceptance of telemedicine.
Topics: COVID-19; Humans; SARS-CoV-2; Students; Telemedicine; United States
PubMed: 33215999
DOI: 10.2196/20839 -
Archivio Italiano Di Urologia,... Oct 2016Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient's clinical health status.... (Review)
Review
Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient's clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology. Starting out over forty years ago with demonstrations of hospitals extending care to patients in remote areas, the use of telemedicine has spread rapidly and is now becoming integrated into the ongoing operations of hospitals, specialty departments, home health agencies, private physician offices as well as consumer's homes and workplaces. There's also a current trend in the use of telemedicine in urology. In the present paper we aimed to review the recent literature about telemedicine and the use of telerounding and telementoring in urological procedures.
Topics: Humans; Mentors; Telecommunications; Telemedicine; Urologic Surgical Procedures; Urology
PubMed: 27711099
DOI: 10.4081/aiua.2016.3.206 -
AMIA ... Annual Symposium Proceedings.... 2023In 2021, the Association of American Medical Colleges published Telehealth Competencies Across the Learning Continuum, a roadmap for designing telemedicine curricula and...
In 2021, the Association of American Medical Colleges published Telehealth Competencies Across the Learning Continuum, a roadmap for designing telemedicine curricula and evaluating learners. While this document advances educators' shared understanding of telemedicine's core content and performance expectations, it does not include turn-key-ready evaluation instruments. At the University of Oklahoma School of Community Medicine, we developed a year-long telemedicine curriculum for third-year medical and second-year physician assistant students. We used the AAMC framework to create program objectives and instructional simulations. We designed and piloted an assessment rubric for eight AAMC competencies to accompany the simulations. In this monograph, we describe the rubric development, scores for students participating in simulations, and results comparing inter-rater reliability between faculty and standardized patient evaluators. Our preliminary work suggests that our rubric provides a practical method for evaluating learners by faculty during telemedicine simulations. We also identified opportunities for additional reliability and validity testing.
Topics: Humans; Reproducibility of Results; Education, Medical, Undergraduate; Telemedicine; Students; Curriculum; Students, Medical
PubMed: 38222442
DOI: No ID Found -
Journal of Diabetes Science and... Feb 2016Diabetic retinopathy (DR) is the leading cause of legal blindness in the United States, and with the growing epidemic of diabetes, a global increase in the incidence of... (Review)
Review
Diabetic retinopathy (DR) is the leading cause of legal blindness in the United States, and with the growing epidemic of diabetes, a global increase in the incidence of DR is inevitable, so it is of utmost importance to identify the most cost-effective tools for DR screening. Emerging technology may provide advancements to offset the burden of care, simplify the process, and provide financially responsible methods to safely and effectively optimize care for patients with diabetes mellitus (DM). We review here currently available technology, both in production and under development, for DR screening. Preliminary results of smartphone-based devices, "all-in-one" devices, and alternative technologies are encouraging, but are largely pending verification of utility when used by nonophthalmic personnel. Further research comparing these devices to current nonportable telemedicine strategies and clinical fundus examination is necessary to validate these techniques and to potentially overcome the poor compliance around the globe of current strategies for DR screening.
Topics: Diabetic Retinopathy; Diagnostic Techniques, Ophthalmological; Female; Humans; Male; Mass Screening; Telemedicine
PubMed: 26888973
DOI: 10.1177/1932296816629158 -
Rheumatology (Oxford, England) May 2022The Covid-19 pandemic necessitated a rapid global transition towards telemedicine; yet much remains unknown about telemedicine's acceptability and safety in... (Clinical Trial)
Clinical Trial
OBJECTIVES
The Covid-19 pandemic necessitated a rapid global transition towards telemedicine; yet much remains unknown about telemedicine's acceptability and safety in rheumatology. To help address this gap and inform practice, this study investigated rheumatology patient and clinician experiences and views of telemedicine.
METHODS
Sequential mixed methodology combined analysis of surveys and in-depth interviews. Between and within-group differences in views of telemedicine were examined for patients and clinicians using t-tests.
RESULTS
Surveys (patients n = 1340, clinicians n = 111) and interviews (patients n = 31, clinicians n = 29) were completed between April 2021 and July 2021. The majority of patients were from the UK (96%) and had inflammatory arthritis (32%) or lupus (32%). Patients and clinicians rated telemedicine as worse than face-to-face consultations in almost all categories, although >60% found it more convenient. Building trusting medical relationships and assessment accuracy were great concerns (93% of clinicians and 86% of patients rated telemedicine as worse than face-to-face for assessment accuracy). Telemedicine was perceived to have increased misdiagnoses, inequalities and barriers to accessing care. Participants reported highly disparate telemedicine delivery and responsiveness from primary and secondary care. Although rheumatology clinicians highlighted the importance of a quick response to flaring patients, only 55% of patients were confident that their rheumatology department would respond within 48 hours.
CONCLUSION
Findings indicate a preference for face-to-face consultations. Some negative experiences may be due to the pandemic rather than telemedicine specifically, although the risk of greater diagnostic inaccuracies using telemedicine is unlikely to be fully resolved. Training, choice, careful patient selection, and further consultation with clinicians and patients is required to increase telemedicine's acceptability and safety.
TRIAL REGISTRATION
This telemedicine study is part of a pre-registered longitudinal multi-stage trial, the LISTEN study (ISRCTN-14966097), with later Covid-related additions registered in March 2021, including a pre-registered statistical analysis plan.
Topics: COVID-19; Humans; Pandemics; Rheumatology; Surveys and Questionnaires; Telemedicine
PubMed: 34698822
DOI: 10.1093/rheumatology/keab796 -
International Journal of Environmental... Mar 2023Telemedicine is a process of delivering health care using information and communication technologies. Audit and feedback (A&F) constitute a systematic intervention that... (Review)
Review
Telemedicine is a process of delivering health care using information and communication technologies. Audit and feedback (A&F) constitute a systematic intervention that is aimed at collecting data, which are subsequently compared with reference standards and then returned to health care operators through feedback meetings. The aim of this review is to analyse different audit procedures on and by mean of telemedicine services and to identify a practice that is more effective than the others. Systematic searches were performed in three databases evaluating studies focusing on clinical audits performed on and by means of telemedicine systems. Twenty-five studies were included in the review. Most of them focused on telecounselling services with an audit and a maximum duration of one year. Recipients of the audit were telemedicine systems and service users (general practitioners, referring doctors, and patients). Data resulting from the audit were inherent to the telemedicine service. The overall data collected concerned the number of teleconsultations, service activity, reasons for referral, response times, follow-up, reasons why treatment was not completed, technical issues, and other information specific to each telemedicine service. Only two of the considered studies dealt with organizational aspects, and of these, only one analysed communicative aspects. The complexity and heterogeneity of the treatments and services provided meant that no index of uniformity could be identified. Certainly, some audits were performed in an overlapping manner in the different studies, and these show that although attention is often paid to workers' opinions, needs, and issues, little interest was shown in communicative/organizational and team dynamics. Given the importance and influence that communication has in teamwork and care settings, an audit protocol that takes into account intra- and extra-team communication processes could be essential to improving the well-being of operators and the quality of the service provided.
Topics: Humans; Telemedicine; Delivery of Health Care; Clinical Audit; Remote Consultation; Health Facilities
PubMed: 36901491
DOI: 10.3390/ijerph20054484 -
Frontiers in Public Health 2022Telemedicine as a tool that can reduce potential disease spread and fill a gap in healthcare has been increasingly applied during the COVID-19 pandemic. Many studies...
BACKGROUND
Telemedicine as a tool that can reduce potential disease spread and fill a gap in healthcare has been increasingly applied during the COVID-19 pandemic. Many studies have summarized telemedicine's technologies or the diseases' applications. However, these studies were reviewed separately. There is a lack of a comprehensive overview of the telemedicine technologies, application areas, and medical service types.
OBJECTIVE
We aimed to investigate the research direction of telemedicine at COVID-19 and to clarify what kind of telemedicine technology is used in what diseases, and what medical services are provided by telemedicine.
METHODS
Publications addressing telemedicine in COVID-19 were retrieved from the PubMed database. To extract bibliographic information and do a bi-clustering analysis, we used Bicomb and gCLUTO. The co-occurrence networks of diseases, technology, and healthcare services were then constructed and shown using R-studio and the Gephi tool.
RESULTS
We retrieved 5,224 research papers on telemedicine at COVID-19 distributed among 1460 journals. Most articles were published in (166/5,224, 3.18%). The United States published the most articles on telemedicine. The research clusters comprised 6 clusters, which refer to mental health, mhealth, cross-infection control, and self-management of diseases. The network analysis revealed a triple relation with diseases, technologies, and health care services with 303 nodes and 5,664 edges. The entity "delivery of health care" was the node with the highest betweenness centrality at 6,787.79, followed by "remote consultation" (4,395.76) and "infection control" (3,700.50).
CONCLUSIONS
The results of this study highlight widely use of telemedicine during COVID-19. Most studies relate to the delivery of health care and mental health services. Technologies were primarily mobile devices to deliver health care, remote consultation, control infection, and contact tracing. The study assists researchers in comprehending the knowledge structure in this sector, enabling them to discover critical topics and choose the best match for their survey work.
Topics: Bibliometrics; COVID-19; Delivery of Health Care; Humans; Pandemics; Telemedicine; United States
PubMed: 35719666
DOI: 10.3389/fpubh.2022.908756 -
Biomedical Engineering Online Aug 2016Teleoperated medical robotic systems allow procedures such as surgeries, treatments, and diagnoses to be conducted across short or long distances while utilizing wired... (Review)
Review
Teleoperated medical robotic systems allow procedures such as surgeries, treatments, and diagnoses to be conducted across short or long distances while utilizing wired and/or wireless communication networks. This study presents a systematic review of the relevant literature between the years 2004 and 2015, focusing on medical teleoperated robotic systems which have witnessed tremendous growth over the examined period. A thorough insight of telerobotics systems discussing design concepts, enabling technologies (namely robotic manipulation, telecommunications, and vision systems), and potential applications in clinical practice is provided, while existing limitations and future trends are also highlighted. A representative paradigm of the short-distance case is the da Vinci Surgical System which is described in order to highlight relevant issues. The long-distance telerobotics concept is exemplified through a case study on diagnostic ultrasound scanning. Moreover, the present review provides a classification into short- and long-distance telerobotic systems, depending on the distance from which they are operated. Telerobotic systems are further categorized with respect to their application field. For the reviewed systems are also examined their engineering characteristics and the employed robotics technology. The current status of the field, its significance, the potential, as well as the challenges that lie ahead are thoroughly discussed.
Topics: Robotics; Telemedicine
PubMed: 27520552
DOI: 10.1186/s12938-016-0217-7