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Clinical Obstetrics and Gynecology Dec 2023Telemedicine has become a substantial part of abortion care in recent years. In this review, we discuss the history and regulatory landscape of telemedicine for... (Review)
Review
Telemedicine has become a substantial part of abortion care in recent years. In this review, we discuss the history and regulatory landscape of telemedicine for medication abortion in the United States, different models of care for telemedicine, and the safety and effectiveness of medication abortion via telemedicine, including using history-based screening protocols for medication abortion without ultrasound. We also explore the acceptability of telemedicine for patients and their perspectives on its benefits, as well as the use of telemedicine for other parts of abortion care. Telemedicine has expanded access to abortion for many, although there remain limitations to its implementation.
Topics: Pregnancy; Female; Humans; United States; Abortion, Induced; Abortion, Spontaneous; Telemedicine
PubMed: 37910115
DOI: 10.1097/GRF.0000000000000818 -
Orthopadie (Heidelberg, Germany) Jul 2023The care of patients over long distances has a long tradition. Modern technology offers more and more possibilities for communication. While initially only radio... (Review)
Review
The care of patients over long distances has a long tradition. Modern technology offers more and more possibilities for communication. While initially only radio signals could be exchanged, image transmission is now possible without any problems and is part of everyday life in many areas of medicine. Telemedicine includes communication between service providers with each other, with the patient, and also communication in medicine via electronic media. Success factors are the engagement of users, remuneration, legislation, human factors, interoperability, standards, performance indicators and compliance with data protection. The benefits and risks must be carefully weighed against each other. If necessary, telemedicine can bring expertise to the patient, so that not every patient has to be brought to the expert. Thus, optimal care at the optimal place can be made possible.
Topics: Humans; Telemedicine; Communication; Computer Security; Technology
PubMed: 37286623
DOI: 10.1007/s00132-023-04396-0 -
Chirurgie (Heidelberg, Germany) Jun 2024
Topics: Humans; Telemedicine; General Surgery; Surgical Procedures, Operative; Germany
PubMed: 38748288
DOI: 10.1007/s00104-024-02090-1 -
Clinical Therapeutics Oct 2023This study assessed the feasibility of the Telepharmacy Model of Care, a medication review and deprescribing model for use in older adults, with innovations in cognitive...
PURPOSE
This study assessed the feasibility of the Telepharmacy Model of Care, a medication review and deprescribing model for use in older adults, with innovations in cognitive and functional evaluation, in telemedicine delivery, and in the use of a pharmacy technician.
METHODS
This retrospective medical record review/abstraction analyzed (from March 1, 2022, to December 31, 2022) data from US veteran participants in a pilot implementation (April 13, 2021, to May 20, 2022) of the Telepharmacy Model of Care at the Veterans Affairs Ann Arbor Healthcare System (Ann Arbor, Michigan). The project team assessed and made recommendations about multiple factors in medication management: medication list accuracy; safety of medications and their combinations; older adults' cognition, health literacy, and physical abilities and impairments in self-managing medications; and caregivers' ability to compensate for those impairments.
FINDINGS
The pilot included 60 US veterans (mean age, 75 years [range, 59-93 years]; 97% were men). Overall, participants were successful in using telemedicine (98%). Encounters required 30 to 45 minutes for the visit and 20 minutes for follow-up and documentation (P = 0.14 pharmacist vs pharmacy technician). The median number of medications per patient was 18. A total of 57% of patients had four or more medication-related discrepancies; fewer patients experienced medication-adherence problems, drug-drug interactions, problematic medication combinations, and untreated/undertreated conditions. Using the Safe Medication Algorithm for Older Adults tool, 35% were identified as taking a Red Flag medication (contraindicated in older adults), and 74%, a High Risk medication (eg, an anticoagulant). A total of 37% had cognitive and health literacy impairments, and 45%, physical impairments, interfering with the ability to self-manage medications. Recommendations on deprescribing were made in 98% of patients.
IMPLICATION
The telemedicine-based and pharmacist/pharmacy technician-delivered model was a feasible method for addressing comprehensive medication review and deprescribing in these cognitively and functionally impaired US veterans.
Topics: Male; Humans; Aged; Female; Retrospective Studies; Delivery of Health Care; Telemedicine; Pharmacists; Algorithms
PubMed: 37775470
DOI: 10.1016/j.clinthera.2023.08.009 -
Fertility and Sterility Oct 2023
Topics: Humans; Emotions; Telemedicine
PubMed: 37414206
DOI: 10.1016/j.fertnstert.2023.06.036 -
Clinical Nuclear Medicine Jul 2024Telehealth and telemedicine experienced remarkable growth during and after the recent COVID-19 pandemic. Telehealth is generally defined as nonclinical services that... (Review)
Review
Telehealth and telemedicine experienced remarkable growth during and after the recent COVID-19 pandemic. Telehealth is generally defined as nonclinical services that employ telecommunication technology. Telemedicine refers more specifically to remote clinical services including diagnosis, monitoring, and treatment. Nuclear medicine is no exception in employing telemedicine increasingly in clinical practice for image interpretation and treatment consultation and care delivery supervision. There is no doubt that soon, the use of tele-nuclear medicine will increase, comparable to the employment of telecommunication in other fields of medicine. We review the medicolegal and regulatory aspects of the evolution in the clinical practice of medicine through telehealth and telemedicine.
Topics: Telemedicine; Humans; COVID-19; Pandemics; SARS-CoV-2; Nuclear Medicine
PubMed: 38769654
DOI: 10.1097/RLU.0000000000005254 -
Physical Medicine and Rehabilitation... May 2024Stroke remains a major cause of disability. Intensive rehabilitation therapy can improve outcomes, but most patients receive limited doses. Telehealth methods can... (Review)
Review
Stroke remains a major cause of disability. Intensive rehabilitation therapy can improve outcomes, but most patients receive limited doses. Telehealth methods can overcome obstacles to delivering intensive therapy and thereby address this unmet need. A specific example is reviewed in detail, focused on a telerehabilitation system that targets upper extremity motor deficits after stroke. Strengths of this system include provision of daily therapy associated with very high patient compliance, safety and feasibility in the inpatient or home setting, comparable efficacy to dose-matched therapy provided in-clinic, and a holistic approach that includes assessment, education, prevention, and activity-based therapy.
Topics: Humans; Stroke Rehabilitation; Telerehabilitation; Treatment Outcome; Stroke; Telemedicine
PubMed: 38514220
DOI: 10.1016/j.pmr.2023.06.005 -
International Journal of Technology... Dec 2023Telemedicine may improve healthcare access and efficiency if it demands less clinician time than usual care. We sought to describe the degree to which telemedicine... (Review)
Review
OBJECTIVES
Telemedicine may improve healthcare access and efficiency if it demands less clinician time than usual care. We sought to describe the degree to which telemedicine trials assess the effect of telemedicine on clinicians' time and to discuss how including the time needed to treat (TNT) in health technology assessment (HTA) could affect the design of telemedicine services and studies.
METHODS
We conducted a scoping review by searching clinicaltrials.gov using the search term "telemedicine" and limiting results to randomized trials or observational studies registered between January 2012 and October 2023. We then reviewed trial registration data to determine if any of the outcomes assessed in the trials measured effect on clinicians' time.
RESULTS
We found 113 studies and of these 78 studies of telemedicine met the inclusion criteria and were included. Nine (12 percent) of the 78 studies had some measure of clinician time as a primary outcome, and 11 (14 percent) as a secondary outcome. Four studies compared direct measures of TNT with telemedicine versus usual care, but no statistically significant difference was found. Of the sixteen studies including indirect measures of clinician time, thirteen found no significant effects, two found a statistically significant reduction, and one found a statistically significant increase.
CONCLUSIONS
This scoping review found that clinician time is not commonly measured in studies of telemedicine interventions. Attention to telemedicine's TNT in clinical studies and HTAs of telemedicine in practice may bring attention to the organization of clinical workflows and increase the value of telemedicine.
Topics: Telemedicine; Technology Assessment, Biomedical; Time; Appointments and Schedules
PubMed: 38099431
DOI: 10.1017/S0266462323002830 -
Current Opinion in Ophthalmology Mar 2024Telemedicine has an increasingly significant role in the fields of ophthalmology and glaucoma. This review covers recent advancements in the development and optimization... (Review)
Review
PURPOSE OF REVIEW
Telemedicine has an increasingly significant role in the fields of ophthalmology and glaucoma. This review covers recent advancements in the development and optimization of teleglaucoma techniques and applications.
RECENT FINDINGS
Glaucoma monitoring and diagnosis via remote tonometry, perimetry, and fundus imaging have become a possibility based on recent developments. Many applications work in combination with smart devices, virtual reality, and artificial intelligence and have been tested in patient populations against conventional "reference-standard" measurement tools, demonstrating promising results. Of note, there is still much progress to be made in teleglaucoma and telemedicine at large, such as accessibility to internet, broadband, and smart devices, application affordability, and reimbursement for remote services. However, continued development and optimization of these applications suggest that the implementation of remote monitoring will be a mainstay for glaucoma patient care.
SUMMARY
Especially since the beginning of the COVID-19 pandemic, remote patient care has taken on an important role in medicine and ophthalmology. Remote versions of tonometry, perimetry, and fundus imaging may allow for a more patient-centered and accessible future for glaucoma care.
Topics: Humans; Artificial Intelligence; Pandemics; Glaucoma; Telemedicine; Tonometry, Ocular; Ophthalmology
PubMed: 38295153
DOI: 10.1097/ICU.0000000000001019 -
The Nursing Clinics of North America Dec 2023Although telehealth seems to be an emerging technological marvel, it has been used in some way for many years now. Moreover, although the coronavirus disease 2019... (Review)
Review
Although telehealth seems to be an emerging technological marvel, it has been used in some way for many years now. Moreover, although the coronavirus disease 2019 pandemic wreaked horrific and tragic havoc around the world, it brought with it a new era of patient-centered care that forced many reluctant providers to adopt its use. With newer technologies at our fingertips and on the horizon and an increased number of qualified men's health specialists coming to the fore, men's telehealth will increasingly continue to provide a viable option for men seeking care and treatment.
Topics: Male; Humans; Men's Health; Telemedicine
PubMed: 37832999
DOI: 10.1016/j.cnur.2023.07.002