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Sensors (Basel, Switzerland) Aug 2023Shared decision making is crucial in the pain domain. The subjective nature of pain demands solutions that can facilitate pain assessment and management. The aim of the... (Review)
Review
Shared decision making is crucial in the pain domain. The subjective nature of pain demands solutions that can facilitate pain assessment and management. The aim of the current study is to review the current trends in both the commercial and the research domains in order to reveal the key issues and guidelines that could further help in the effective development of pain-focused apps. We searched for scientific publications and commercial apps in 22 databases and the two major app stores. Out of 3612 articles and 336 apps, 69 met the requirements for inclusion following the PRISMA guidelines. An analysis of their features (technological approach, design methodology, evaluation strategy, and others) identified critical points that have to be taken into consideration in future efforts. For example, commercial and research efforts target different types of pain, while no participatory design is followed in the majority of the cases examined. Moreover, the evaluation of the final apps remains a challenge that hinders their success. The examined domain is expected to experience a substantial increase. More research is needed towards the development of non-intrusive wearables and sensors for pain detection and assessment, along with artificial intelligence techniques and open data.
Topics: Humans; Mobile Applications; Pain Management; Artificial Intelligence; Telemedicine; Pain
PubMed: 37571747
DOI: 10.3390/s23156965 -
Journal of Public Health (Oxford,... Feb 2024Telehealth technologies are playing an increasing role in healthcare. This study aimed to review the literature relating to the use of telehealth technologies in care... (Review)
Review
BACKGROUND
Telehealth technologies are playing an increasing role in healthcare. This study aimed to review the literature relating to the use of telehealth technologies in care homes with a focus on teledentistry.
METHODS
Khangura et al.'s (Evidence summaries: the evolution of a rapid review approach. Syst Rev 2012;1:10) rapid review method included an electronic database search on Embase, PubMed, Web of Science and OpenGrey. Out of 1525 papers, 1108 titles and abstracts were screened, and 75 full texts assessed for eligibility. Risk of bias was assessed using the Mixed Methods Assessment Tool 2018.
RESULTS
Forty-seven papers (40 studies) from 10 countries, published 1997-2021, were included in the review, four studies related to teledentistry. Whilst some preferred in-person consultations, perceived benefits by stakeholders included reduced hospitalization rates (n = 14), cost-savings (n = 8) and high diagnostic accuracy (n = 7). Studies investigating teledentistry using intra-oral cameras reported that teleconsultations were feasible with potentially high diagnostic accuracy (n = 2), cost-savings (n = 1) and patient acceptability (n = 1).
CONCLUSION
There is limited published research on teledentistry, but wider telehealth research is applicable to teledentistry, with findings suggesting that telehealth technologies play a role in care homes consultations that are acceptable, cost-saving and with potential diagnostic accuracy. Further research is needed on the mode, utility and acceptability of teledentistry in care homes.
Topics: Humans; Telemedicine; Remote Consultation; Delivery of Health Care; Health Facilities; Dentistry
PubMed: 38102945
DOI: 10.1093/pubmed/fdad258 -
Medicine Nov 2023Stroke is a major health concern worldwide, and its impact is particularly pronounced across Africa. This paper delves into the challenges faced in African stroke care... (Review)
Review
Stroke is a major health concern worldwide, and its impact is particularly pronounced across Africa. This paper delves into the challenges faced in African stroke care and explores the significant potential benefits of mobile stroke units (MSUs) in mitigating these issues. Key challenges include the limited healthcare infrastructure, funding constraints, difficulties reaching remote and rural areas, and shortages of qualified healthcare professionals, especially neurologists and stroke specialists. To address these challenges, recommendations are provided, emphasizing the importance of infrastructure development, sustainable funding mechanisms, solutions for rural accessibility, and healthcare workforce development through training programs and incentives. Additionally, the paper discusses prospects for MSUs in Africa, highlighting the potential for technology advancements to yield more cost-effective and compact MSU models. The integration of telemedicine capabilities within MSUs is examined to enhance communication with specialist physicians at remote hospitals, ultimately improving stroke care outcomes. Furthermore, data collection on MSU outcomes and their impact on stroke care is emphasized to inform evidence-based policies and enhance MSU operations. Collaboration and partnerships between governments, healthcare organizations, and international stakeholders are critical for facilitating MSU expansion. These partnerships can provide essential funding, expertise, and support for the implementation and sustainable operation of MSUs in Africa.
Topics: Humans; Stroke; Telemedicine; Africa
PubMed: 37933014
DOI: 10.1097/MD.0000000000035899 -
Telemedicine Journal and E-health : the... Feb 2024Telemedicine may increase access to clinical care, particularly for mobility-limited communities such as the spinal muscular atrophy (SMA) community. However, much of...
Telemedicine may increase access to clinical care, particularly for mobility-limited communities such as the spinal muscular atrophy (SMA) community. However, much of the information on exposure to and attitudes toward telemedicine in neuromuscular diseases generally and SMA specifically is anecdotal or from focus groups. Gaining greater insight into patient perspectives is important, given telemedicine's potential for expanding access to care and growing use of telemedicine as a result of technology advances and the COVID-19 pandemic. Cure SMA collected information on the SMA community's exposure to, comfort with, and perceived effectiveness of telemedicine through its 2021 Community Update Survey. The final analytic sample represented 463 SMA-affected individuals, resident in the United States. Descriptive analyses, correlations, and ordered logit regression models were used to characterize the sample and identify predictors of exposure, comfort, and perceived effectiveness. Data were analyzed on weighted and unweighted bases to account for differences between the survey sample and the SMA community. Stratified analyses were used to compare self-completed surveys with caregiver-completed surveys. 463 individuals answered questions about telemedicine. Approximately four-fifths of these respondents had used telemedicine previously. Factors predicting greater likelihood of prior telemedicine use included male gender, increasing income, having received drug treatment for SMA, history of mental illness, and having non-neutral views regarding comfort and perceived effectiveness of telemedicine. Several factors were also significant predictors of comfort with and perceived effectiveness of telemedicine. Stratified analyses indicated differences between self-completed and caregiver-completed surveys. These results can provide insight into patient experiences with telemedicine and can inform approaches to its use by health care professionals and clinical trial sponsors.
Topics: Humans; Male; United States; Pandemics; Muscular Atrophy, Spinal; COVID-19; Caregivers; Telemedicine
PubMed: 37566530
DOI: 10.1089/tmj.2023.0293 -
JMIR Aging Jan 2024Telemedicine is a potential option for caring for older adults with multimorbidity. There is a need to explore the perceptions about telemedicine among older adults with...
BACKGROUND
Telemedicine is a potential option for caring for older adults with multimorbidity. There is a need to explore the perceptions about telemedicine among older adults with multimorbidity to tailor it to the needs of older adults with multiple chronic conditions.
OBJECTIVE
This study aims to explore the perceptions about telemedicine among older patients with multimorbidity.
METHODS
A qualitative study was conducted using semistructured interviews. The interview questions examined older adults' perspectives about telemedicine, including their expectations regarding telemedicine services and the factors that affect its use. Thematic analysis was performed using NVivo (version 12; Lumivero). The study was reported using the Standards for Reporting Qualitative Research guidelines.
RESULTS
In total, 29 patients with multimorbidity-21 (72%) female patients and 8 (28%) male patients with a mean age of 69 (SD 10.39) years-were included. Overall, 4 themes and 7 subthemes emerged: theme 1-perceived benefit of telemedicine among older adults with multimorbidities, theme 2-appropriate use of telemedicine for multimorbid care, theme 3-telemedicine system catering to the needs of older patients, and theme 4-respect patients' decision to decline to use telemedicine.
CONCLUSIONS
Telemedicine for older adults with multimorbidity should focus on those with stable conditions. This can help increase access to care for those requiring continuous condition monitoring. A structured telemedicine program and patient-centered services can help increase patient acceptance of telemedicine. However, health care providers must accept the limitations of older patients that may prevent them from receiving telemedicine services.
Topics: Humans; Female; Male; Aged; Multimorbidity; Health Personnel; Multiple Chronic Conditions; Qualitative Research; Telemedicine
PubMed: 38198201
DOI: 10.2196/52031 -
BMC Health Services Research Jan 2024Despite significant progress in health technology and growing interest among countries in incorporating telemedicine into healthcare delivery, its usage remains limited...
BACKGROUND
Despite significant progress in health technology and growing interest among countries in incorporating telemedicine into healthcare delivery, its usage remains limited in Iran. The aim of this study is to investigate the challenges related to telemedicine in Iran and pinpoint potential solutions from the viewpoint of health policymakers, marking the first such endeavor.
METHODS
This qualitative study was conducted in Iran in 2022. Data were gathered from 19 health policymakers who were selected using purposeful and snowball sampling techniques via in-depth and semi-structured interviews. The research findings were analyzed using the content analysis technique, with coding performed using MAXQDA software. The content analysis approach developed by Erlingsson was utilized to analyze the data.
RESULTS
The study revealed eight main challenges that inhibit the widespread use of telemedicine in Iran. These challenges include policy weaknesses, uncertainty around operating mechanisms, inadequate communication and telecommunication infrastructure, insufficient cultural infrastructure, lack of electronic requirements, redundant bureaucracies, legal gaps, and economic factors. Furthermore, four key solutions to these challenges were identified. These include a national commitment to the development of telemedicine, the establishment of a telemedicine roadmap, the enhancement of e-health requirements and infrastructure, and the preparation of the community to accept telemedicine as a viable option for healthcare delivery.
CONCLUSION
The implementation of telemedicine in Iran faces significant challenges, some of which are related to the national healthcare system, while others stem from various policy-related institutions and organizations. Addressing these challenges will require extensive inter-organizational cooperation and strong leadership at the governance level. However, it should be noted that fully resolving these issues is a time-consuming process.
Topics: Humans; Iran; Telemedicine; Biomedical Technology; Communication; Electronics
PubMed: 38200535
DOI: 10.1186/s12913-023-10488-6 -
Journal of Medical Internet Research Feb 2024The increasing prevalence of DH applications has outpaced research and practice in digital health (DH) evaluations. Patient experience (PEx) was reported as one of the... (Review)
Review
BACKGROUND
The increasing prevalence of DH applications has outpaced research and practice in digital health (DH) evaluations. Patient experience (PEx) was reported as one of the challenges facing the health system by the World Health Organization. To generate evidence on DH and promote the appropriate integration and use of technologies, a standard evaluation of PEx in DH is required.
OBJECTIVE
This study aims to systematically identify evaluation timing considerations (ie, when to measure), evaluation indicators (ie, what to measure), and evaluation approaches (ie, how to measure) with regard to digital PEx. The overall aim of this study is to generate an evaluation guide for further improving digital PEx evaluation.
METHODS
This is a 2-phase study parallel to our previous study. In phase 1, literature reviews related to PEx in DH were systematically searched from Scopus, PubMed, and Web of Science databases. Two independent raters conducted 2 rounds of paper screening, including title and abstract screening and full-text screening, and assessed the interrater reliability for 20% (round 1: 23/115 and round 2: 12/58) random samples using the Fleiss-Cohen coefficient (round 1: k1=0.88 and round 2: k2=0.80). When reaching interrater reliability (k>0.60), TW conducted the rest of the screening process, leaving any uncertainties for group discussions. Overall, 38% (45/119) of the articles were considered eligible for further thematic analysis. In phase 2, to check if there were any meaningful novel insights that would change our conclusions, we performed an updated literature search in which we collected 294 newly published reviews, of which 102 (34.7%) were identified as eligible articles. We considered them to have no important changes to our original results on the research objectives. Therefore, they were not integrated into the synthesis of this review and were used as supplementary materials.
RESULTS
Our review highlights 5 typical evaluation objectives that serve 5 stakeholder groups separately. We identified a set of key evaluation timing considerations and classified them into 3 categories: intervention maturity stages, timing of the evaluation, and timing of data collection. Information on evaluation indicators of digital PEx was identified and summarized into 3 categories (intervention outputs, patient outcomes, and health care system impact), 9 themes, and 22 subthemes. A set of evaluation theories, common study designs, data collection methods and instruments, and data analysis approaches was captured, which can be used or adapted to evaluate digital PEx.
CONCLUSIONS
Our findings enabled us to generate an evaluation guide to help DH intervention researchers, designers, developers, and program evaluators evaluate digital PEx. Finally, we propose 6 directions for encouraging further digital PEx evaluation research and practice to address the challenge of poor PEx.
Topics: Humans; Reproducibility of Results; Delivery of Health Care; Text Messaging; Digital Health; Patient Outcome Assessment; Telemedicine
PubMed: 38315545
DOI: 10.2196/46308 -
Women's Health (London, England) 2024Confidential medical care for adolescent patients is essential as they are likely to forgo needed care if privacy cannot be maintained. The use of telemedicine for... (Review)
Review
Confidential medical care for adolescent patients is essential as they are likely to forgo needed care if privacy cannot be maintained. The use of telemedicine for adolescent health has rapidly expanded due to the COVID-19 pandemic and can increase access to important services like reproductive care; however, it has raised challenges for providers, patients, and their parents/guardians related to confidentiality and privacy. Health care providers are often uncertain about the laws and regulations that govern confidential services including the 21st Century Cures Act. Through a narrative review of studies on confidentiality and telemedicine, this article seeks to summarize the available evidence and provide recommendations on maintaining privacy during virtual encounters and identify current best practices for prescribing contraception via telemedicine.
Topics: Humans; Adolescent; Contraceptive Agents; Privacy; Pandemics; Confidentiality; Telemedicine; Health Services
PubMed: 38424665
DOI: 10.1177/17455057241233126 -
Hawai'i Journal of Health & Social... Nov 2023Prior to the COVID-19 pandemic, telemedicine was not well adopted in US nursing facilities. Many nursing facilities have since acknowledged its value due to the need for...
Prior to the COVID-19 pandemic, telemedicine was not well adopted in US nursing facilities. Many nursing facilities have since acknowledged its value due to the need for stricter infection control and reduction of exposure risk from face-to-face visits. A quality improvement project was conducted to improve telemedicine protocols in a high-volume post-acute care nursing facility, enhance provider and facility capability for visits, improve attitudes and skills toward telemedicine, and expand patient access to medical care during the pandemic. Process improvement was facilitated through identifying core areas of need and implementing interventions to address them. Project impact was measured by a retrospective pre-post survey of 7 questions to evaluate process improvement, attitudes, skills, and perceptions using a 5-point Likert scale (5=strongly agree, 1=strongly disagree) completed by 22 respondents (8 medical providers and 14 staff). Scores from before and after implementation were compared using paired t-tests. Respondents expressed improvement in perceived value (3.2 vs 4.8), personal skill/efficiency (2.3 vs 4.2), comfort level (2.3 vs 4.5), and scheduling process (2.3 vs 3.9) for telemedicine visits (all P≤.001). Respondents expressed increased awareness of barriers/benefits of telemedicine (2.8 vs 4.7, P<.001) and improved leadership commitment (2.6 vs 4.4, P<.001). The weekly average number of telemedicine visits per respondent increased significantly after protocol implementation (6.5 vs 25.6, P=.002). With support of facility leadership, interdisciplinary team members and engagement of key stakeholders, a telemedicine protocol was implemented in a single, high-volume, post-acute care skilled nursing facility during the COVID-19 pandemic, allowing patients to receive needed care.
Topics: Humans; COVID-19; Pandemics; Quality Improvement; Skilled Nursing Facilities; Retrospective Studies; Telemedicine
PubMed: 37969237
DOI: No ID Found -
Frontiers in Public Health 2024The quality assessment of the home-based isolation and care program (HBIC) relies heavily on patient satisfaction and length of stay. COVID-19 patients who were isolated...
BACKGROUND
The quality assessment of the home-based isolation and care program (HBIC) relies heavily on patient satisfaction and length of stay. COVID-19 patients who were isolated and received HBIC were monitored through telephone consultations (TC), in-person TC visits, and a self-reporting application. By evaluating patient satisfaction and length of stay in HBIC, healthcare providers could gauge the effectiveness and efficiency of the HBIC program.
METHODS
A cross-sectional study design enrolled 444 HBIC patients who answered a structured questionnaire. A binary logistic regression model assessed the association between independent variables and patient satisfaction. The length of stay in HBIC was analyzed using Cox regression analysis. The data collection started on April (1-30), 2022, in Addis Ababa, Ethiopia.
RESULTS
The median age was 34, and 247 (55.6%) were females. A greater proportion (313, 70.5%) of the participants had high satisfaction. Higher frequency of calls (>3 calls) (AOR = 2.827, 95% CI = 1.798, 4.443, = 0.000) and those who were symptomatic (AOR = 2.001, 95% CI = 1.289, 3.106, = 0.002) were found to be significant factors for high user satisfaction. Higher frequency of calls (>3 calls) (AHR = 0.537, 95% CI = 0.415, 0.696, = 0.000) and more in-person visits (>1 visit) (AHR = 0.495, 95% CI = 0.322, 0.762, = 0.001) had greater chances to reduce the length of stay in the COVID-19 HBIC.
CONCLUSION
70.5% of the participants had high satisfaction with the system, and frequent phone call follow-ups on patients' clinical status can significantly improve their satisfaction and length of recovery. An in-person visit is also an invaluable factor in a patient's recovery.
Topics: Humans; COVID-19; Female; Male; Patient Satisfaction; Adult; Cross-Sectional Studies; Telemedicine; Middle Aged; Ethiopia; Surveys and Questionnaires; Length of Stay; SARS-CoV-2; Adolescent; Home Care Services; Young Adult; Quarantine; Aged
PubMed: 38645451
DOI: 10.3389/fpubh.2024.1384078