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Ugeskrift For Laeger Apr 2024Telemedicine is emerging and has both clinical, scientific, and political interest. In this review, we present the present literature on implementation and describe the... (Review)
Review
Telemedicine is emerging and has both clinical, scientific, and political interest. In this review, we present the present literature on implementation and describe the economic considerations when implementing telemedicine in chronic obstructive pulmonary disease (COPD). The use of telemedicine in COPD is well-received by patients, but there is little evidence to suggest its superiority to standard outpatient care or to support better outcomes for patients. Thus, local settings and cost effectiveness should be considered during the implementational process.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Telemedicine; Ambulatory Care
PubMed: 38606706
DOI: 10.61409/V09230612 -
Zeitschrift Fur Rheumatologie Apr 2024As a result of digitalization in medicine wearable computing devices (wearables) are becoming increasingly more important. Wearables are small portable electronic... (Review)
Review
As a result of digitalization in medicine wearable computing devices (wearables) are becoming increasingly more important. Wearables are small portable electronic devices with which the user can record data relevant to health, such as number of steps, activity profile, electrocardiogram (ECG), heart and breathing frequency or oxygen saturation. Initial studies on the use of wearables in patients with rheumatological diseases show the opening up of new possibilities for prevention, disease monitoring and treatment. This study provides the current data situation and the implementation of wearables in the discipline of rheumatology. Additionally, future potential fields of application as well as challenges and limits of the implementation of wearables are illustrated.
Topics: Humans; Rheumatology; Telemedicine; Wearable Electronic Devices; Electrocardiography
PubMed: 37289217
DOI: 10.1007/s00393-023-01377-8 -
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 -
International Journal of Chronic... 2023Poor adherence to COPD mobile health (mHealth) has been reported, but its association with exacerbation-related outcomes is unknown. We explored the effects of mHealth...
PURPOSE
Poor adherence to COPD mobile health (mHealth) has been reported, but its association with exacerbation-related outcomes is unknown. We explored the effects of mHealth adherence on exacerbation-free weeks and self-management behavior. We also explored differences in self-efficacy and stages of grief between adherent and non-adherent COPD patients.
PATIENTS AND METHODS
We conducted secondary analyses using data from a recent randomized controlled trial (RCT) that compared the effects of mHealth (intervention) with a paper action plan (comparator) for COPD exacerbation self-management. We used data from the intervention group only to assess differences in exacerbation-free weeks (primary outcome) between patients who were adherent and non-adherent to the mHealth tool. We also assessed differences in the type and timing of self-management actions and scores on self-efficacy and stages of grief (secondary outcomes). We used generalized negative binomial regression analyses with correction for follow-up length to analyze exacerbation-free weeks and multilevel logistic regression analyses with correction for clustering for secondary outcomes.
RESULTS
We included data of 38 patients of whom 13 (34.2%) (mean (SD) age 69.2 (11.2) years) were adherent and 25 (65.8%) (mean (SD) age 68.7 (7.8) years) were non-adherent. Adherent patients did not differ from non-adherent patients in exacerbation-free weeks (mean (SD) 31.5 (14.5) versus 33.5 (10.2); p=0.63). Although statistically not significant, adherent patients increased their bronchodilator use more often and more timely, contacted a healthcare professional and/or initiated prednisolone and/or antibiotics more often, and showed at baseline higher scores of self-efficacy and disease acceptance and lower scores of denial, resistance, and sorrow, compared with non-adherent patients.
CONCLUSION
Adherence to mHealth may be positively associated with COPD exacerbation self-management behavior, self-efficacy and disease acceptance, but its association with exacerbation-free weeks remains unclear. Our results should be interpreted with caution by this pilot study's explorative nature and small sample size.
Topics: Aged; Humans; Pulmonary Disease, Chronic Obstructive; Quality of Life; Self-Management; Telemedicine; Randomized Controlled Trials as Topic; Middle Aged
PubMed: 37933244
DOI: 10.2147/COPD.S431199 -
Archives of Iranian Medicine Nov 2023Today, technology has an important impact on the development of medical services, especially during the outbreak of COVID-19. Telemedicine, known by terms such as... (Review)
Review
Today, technology has an important impact on the development of medical services, especially during the outbreak of COVID-19. Telemedicine, known by terms such as telehealth and digital health, refers to the utilization of technology to provide health care services at a distance that leads to improved monitoring, detecting and treatment of disease, and provision of individual care. It has been considered in various fields such as radiology, cardiology, pulmonology, psychiatry, emergency care and surgery. The most important advantages of using telemedicine are saving time for the doctor and the patient, reducing the cost of multiple visits to the doctor, reducing the spread of contagious diseases and caring for patients who cannot see a doctor, such as the elderly. In this paper, we review the research in the field of applying telemedicine, as well as its advantages and disadvantages. Next, we discuss the challenges in the field of using telemedicine which are privacy preserving, data security, cost of infrastructures, lack of physical examination and responsibility for patients' compensation. One of the most important challenges is privacy preserving of patients' information during transmission and process. We categorize and compare the various methods that have been proposed to protect peoples' privacy.
Topics: Humans; Aged; Privacy; Telemedicine; COVID-19; Emergency Medical Services
PubMed: 38310426
DOI: 10.34172/aim.2023.96 -
BMC Health Services Research Aug 2023Prior to the Covid-19 pandemic, heart failure (HF) disease management programmes were predominantly delivered in-person, with telemedicine being uncommon. Covid-19...
BACKGROUND
Prior to the Covid-19 pandemic, heart failure (HF) disease management programmes were predominantly delivered in-person, with telemedicine being uncommon. Covid-19 resulted in a rapid shift to "remote-by-default" clinic appointments in many organisations. We evaluated clinician and patient experiences of teleconsultations for HF.
METHODS
From 16th March 2020, all HF appointments at a specialist centre in the UK were telemedicine-by-default through a mixture of telephone and video consultations, with rare in-person appointments. HF clinicians and patients with HF were invited to participate in semi-structured interviews about their experiences. A purposive sampling technique was used. Interviews were conducted using Microsoft Teams®, recorded and transcribed verbatim. Narrative data were explored by thematic analysis. Clinicians and patients were interviewed until themes saturated.
RESULTS
Eight clinicians and eight patients with HF were interviewed before themes saturated. Five overarching themes emerged: 1) Time utilisation - telemedicine consultations saved patients time travelling to and waiting for appointments. Clinicians perceived them to be more efficient, but more administrative time was involved. 2) Clinical assessment - without physical examination, clinicians relied more on history, observations and test results; video calls were perceived as superior to telephone calls for remote assessment. Patients confident in self-monitoring tended to be more comfortable with telemedicine. 3) Communication and rapport - clinicians experienced difficulty establishing rapport with new patients by telephone, though video was better. Patients generally did not perceive that remote consultation affected their rapport with clinicians. 4) Technology - connection issues occasionally disrupted video consultations, but overall patients and clinicians found the technology easy to use. 5) Choice and flexibility - both patients and clinicians believed that the choice of modality should be situation-dependent.
CONCLUSIONS
Telemedicine HF consultations were more convenient for patients, saved them time, and were generally acceptable to clinicians, but changed workflows, consultation dynamics, and how clinical assessment was performed. Telemedicine should be used alongside in-person appointments in a "hybrid" model tailored to individual patients and settings.
Topics: Humans; Pandemics; COVID-19; Telemedicine; Remote Consultation; Heart Failure
PubMed: 37563576
DOI: 10.1186/s12913-023-09872-z -
Frontiers in Public Health 2024The metaverse, as a new digital interactive platform, is garnering significant attention and exploration across industries due to technological advancements and societal... (Review)
Review
BACKGROUND
The metaverse, as a new digital interactive platform, is garnering significant attention and exploration across industries due to technological advancements and societal digital transformation. In occupational health, there is immense potential for leveraging the metaverse to enhance work environments and occupational health management. It offers companies more efficient and intelligent solutions for occupational health management while providing employees with safer and more comfortable work environments.
METHODS
A comprehensive literature search was conducted using PubMed, Web of Science, IEEE Xplore, and Google Scholar databases to identify relevant studies published between January 2015 and March 2024. The search terms included "metaverse," "virtual reality," "occupational health," "workplace safety," "job training," and "telemedicine." The selected articles were analyzed, and key findings were summarized narratively.
RESULTS
The review summarizes the broad application prospects of metaverse technology in immersive training, occupational risk identification and assessment, and occupational disease monitoring and diagnosis. However, applying the metaverse in occupational health also faces challenges such as inadequate technical standards, data privacy issues, human health hazards, high costs, personnel training, and lagging regulations.
CONCLUSION
Metaverse offers new possibilities for addressing the numerous challenges faced in occupational health and has broad application prospects. In the future, collaborative efforts from multiple stakeholders will be necessary to promote the sustainable development of metaverse technology in occupational health and better protect workers' occupational health.
Topics: Humans; Occupational Health; Workplace; Virtual Reality; Telemedicine
PubMed: 38665240
DOI: 10.3389/fpubh.2024.1396878 -
Medicina (Kaunas, Lithuania) Aug 2023: In the era of the COVID-19 pandemic, telemedicine, so far underestimated, has gained in value. Currently, telemedicine is not only a telephone or chat consultation,... (Review)
Review
: In the era of the COVID-19 pandemic, telemedicine, so far underestimated, has gained in value. Currently, telemedicine is not only a telephone or chat consultation, but also the possibility of the remote recording of signals (such as ECG, saturation, and heart rate) or even remote auscultation of the lungs. The objective of this review article is to present a potential role for, and disseminate knowledge of, telemedicine during the COVID-19 pandemic. : In order to analyze the research material in accordance with PRISMA guidelines, a systematic search of the ScienceDirect, Web of Science, and PubMed databases was conducted. Out of the total number of 363 papers identified, 22 original articles were subjected to analysis. : This article presents the possibilities of remote patient registration, which contributes to an improvement in remote diagnostics and diagnoses. : Telemedicine is, although not always and not by everyone, an accepted form of providing medical services. It cannot replace direct patient-doctor contact, but it can undoubtedly contribute to accelerating diagnoses and improving their quality at a distance.
Topics: Humans; COVID-19; Pandemics; Telemedicine; Databases, Factual; Heart Rate
PubMed: 37763659
DOI: 10.3390/medicina59091541 -
BMC Complementary Medicine and Therapies Aug 2023Telemedicine includes the delivery of health-care services and sharing of health information across distances. Past research has found that telemedicine can play a role... (Review)
Review
BACKGROUND
Telemedicine includes the delivery of health-care services and sharing of health information across distances. Past research has found that telemedicine can play a role in enhancing complementary, alternative, and integrative medicine (CAIM) while allowing the maintenance of cultural values and ancestral knowledge. This scoping review synthesized evidence regarding the use of telemedicine in the context of CAIM.
METHODS
Following Arksey and O'Malley's scoping review framework, CINAHL, PsycINFO, MEDLINE, EMBASE and AMED databases were searched systematically. The CADTH website was also searched for grey literature. Eligible articles included a CAIM practice or therapy offered through telemedicine, with no restrictions placed on the type of telemedicine technology used. Inductive thematic analysis was conducted to synthesise common themes among the included studies.
RESULTS
Sixty-two articles were included in this synthesis. The following themes emerged: 1) the practitioner view of CAIM delivered through telemedicine, 2) the patient view of CAIM delivered through telemedicine, and 3) the technological impacts of telemedicine delivery of CAIM.
CONCLUSIONS
Studies have shown that telemedicine delivery of CAIM is feasible, acceptable, and results in positive health outcomes. Some barriers remain such as the presence of chronic illness and morbidity, inability to form strong patient-provider relationships relative to face-to-face approaches, and technological difficulties. Future intervention research should focus on reducing such barriers, as well as explore which patient population would realize the greatest benefit from CAIM delivered via telemedicine, and the impact of interventions on providers and caregivers.
Topics: Humans; Integrative Medicine; Telemedicine
PubMed: 37533042
DOI: 10.1186/s12906-023-04100-x -
Arquivos Brasileiros de Cardiologia Jun 2023
Topics: Humans; Telemedicine; Cardiology
PubMed: 37377188
DOI: 10.36660/abc.20230281