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Parkinsonism & Related Disorders Aug 2021The use of telemedicine in the management of chronic neurological conditions including movement disorders has expanded over time. In addition to enabling remote access...
The use of telemedicine in the management of chronic neurological conditions including movement disorders has expanded over time. In addition to enabling remote access to specialized care, telemedicine has also been shown to reduce caregiver burden and to improve patient satisfaction. With the COVID-19 pandemic, implementation of telehealth for patients with movement disorders, particularly those with more severe mobility issues, has increased rapidly. Although telemedicine care has been shown to be effective for patients with various movement disorders, its utilization for patients with device aided therapies such as deep brain stimulation (DBS) is limited due to challenges related to adjusting these devices remotely and to the lack of consensus recommendations for using telemedicine in this patient population. Thus, guidelines for telemedicine and DBS will assist clinicians on the appropriate implementation of telemedicine to provide care to DBS patients. Optimizing the use of telemedicine for DBS will expand this type of therapy to remote locations with limited access to programming expertise, and also reduce the need for patient travel. Telemedicine is particularly important during the ongoing pandemic due to infection risk and limited access to clinic visits. In this article we review the currently available and emerging strategies for telemedicine and remote care for DBS. We then outline common principles and recommendations for telemedicine care in patients with DBS, review patient selection and best practices. Finally, we briefly discuss the current state of reimbursement for DBS telemedicine visits.
Topics: COVID-19; Deep Brain Stimulation; Humans; Pandemics; Remote Consultation; Telemedicine
PubMed: 34274215
DOI: 10.1016/j.parkreldis.2021.07.001 -
Current Opinion in Critical Care Jun 2024This article summarizes recent developments in the application of telemedicine, specifically tele-critical care (TCC), toward enhancing patient care during various types... (Review)
Review
PURPOSE OF REVIEW
This article summarizes recent developments in the application of telemedicine, specifically tele-critical care (TCC), toward enhancing patient care during various types of emergencies and patient rescue scenarios when there are limited resources in terms of staff expertise (i.e., knowledge, skills, and abilities), staffing numbers, space, and supplies due to patient location (e.g., a non-ICU bed, the emergency department, a rural hospital) or patient volume as in pandemic surges.
RECENT FINDINGS
The COVID-19 pandemic demonstrated the need for rapidly scalable and agile healthcare delivery systems. During the pandemic, clinicians and hospital systems adopted telemedicine for various applications. Taking advantage of technological improvements in cellular networks and personal mobile devices, and despite the limited outcomes literature to support its use, telemedicine was rapidly adopted to address the fundamental challenge of exposure in outpatient settings, emergency departments, patient follow-up, and home-based monitoring. A critical recognition was that the modality of care (e.g., remote vs. in-person) was less important than access to care, regardless of the patient outcomes. This fundamental shift, facilitated by policies that followed emergency declarations, provided an opportunity to maintain and, in many cases, expand and improve clinical practices and hospital systems by bringing expertise to the patient rather than the patient to the expertise. In addition to using telemedicine to maintain patient access to healthcare, TCC was harnessed to provide local clinicians, forced to manage critically ill patients beyond their normal scope of practice or experience, access to remote expertise (physician, nursing, respiratory therapist, pharmacist). These practices supported decades of literature from the telemedicine community describing the effectiveness of telemedicine in improving patient care and the many challenges defining its value.
SUMMARY
In this review, we summarize numerous examples of innovative care delivery systems that have utilized telemedicine, focusing on 'mobile' TCC technology solutions to effectively deliver the best care to the patient regardless of patient location. We emphasize how a 'paradigm of better' can enhance the entirety of the healthcare system.
Topics: Humans; COVID-19; Telemedicine; SARS-CoV-2; Critical Care; Emergency Service, Hospital; Pandemics; Emergency Medical Services
PubMed: 38690953
DOI: 10.1097/MCC.0000000000001152 -
International Journal of Environmental... Aug 2022Telemedicine is becoming a standard method of consultation, and the COVID-19 pandemic has increased its need. Telemedicine is suitable for non-communicable diseases... (Review)
Review
Telemedicine is becoming a standard method of consultation, and the COVID-19 pandemic has increased its need. Telemedicine is suitable for non-communicable diseases (NCDs) in the pediatric population, as these are chronic conditions that affect many children worldwide. The aim of this study was to analyze the bibliometric parameters of publications on the use of telemedicine for the most common NCDs in children before and after the COVID-19 pandemic. Following the electronic search, 585 records were selected. "Metabolic diseases" was the most frequent topic before and after the pandemic, accounting for 34.76% in 2017-2019 and 33.97% in 2020-2022. The average IF of the journals from which records were retrieved was 5.46 ± 4.62 before and 4.58 ± 2.82 after the pandemic, with no significant variation. The number of citations per reference averaged 14.71 ± 17.16 in 2017-2019 (95% CI: 12.07; 17.36) and 5.54 ± 13.71 in 2020-2022 (95% CI: 4.23; 6.86). Asthma, metabolic diseases, and neurodevelopmental disorders were the most explored topics. A relevant finding concerns the increasing number of observational studies after the pandemic, with a reduction of the interventional studies. The latter type of study should be recommended as it can increase the evaluation of new strategies for the management of NCDs.
Topics: Bibliometrics; COVID-19; Child; Humans; Pandemics; Remote Consultation; Telemedicine
PubMed: 36011421
DOI: 10.3390/ijerph19169787 -
Journal of Clinical Neuroscience :... Sep 2020In the last forty years, the field of medicine has experienced dramatic shifts in technology-enhanced surgical procedures - from its initial use in 1985 for... (Review)
Review
In the last forty years, the field of medicine has experienced dramatic shifts in technology-enhanced surgical procedures - from its initial use in 1985 for neurosurgical biopsies to current implementation of systems such as magnetic-guided catheters for endovascular procedures. Systems such as the Niobe Magnetic Navigation system and CorPath GRX have allowed for utilization of a fully integrated surgical robotic systems for perioperative manipulation, as well as tele-controlled manipulation systems for telemedicine. These robotic systems hold tremendous potential for future implementation in cerebrovascular procedures, but lack of relevant clinical experience and uncharted ethical and legal territory for real-life tele-robotics have stalled their adoption for neurovascular surgery, and might present significant challenges for future development and widespread implementation. Yet, the promise that these technologies hold for dramatically improving the quality and accessibility of cerebrovascular procedures such as thrombectomy for acute stroke, drives the research and development of surgical robotics. These technologies, coupled with artificial intelligence (AI) capabilities such as machine learning, deep-learning, and outcome-based analyses and modifications, have the capability to uncover new dimensions within the realm of cerebrovascular surgery.
Topics: Artificial Intelligence; Endovascular Procedures; Humans; Robotic Surgical Procedures; Stroke; Telemedicine
PubMed: 33070881
DOI: 10.1016/j.jocn.2020.04.125 -
Perspectives in Psychiatric Care Jul 2019Telemedicine in psychiatry is a validated and effective practice of medicine that increases access to health care. Telepsychiatry is also termed as telemental health or... (Review)
Review
PURPOSE
Telemedicine in psychiatry is a validated and effective practice of medicine that increases access to health care. Telepsychiatry is also termed as telemental health or E-mental health using video conferencing which is broadly defined to provide and support psychiatric mental health services across distances. The consumption of knowledge in the mental health field has been renowned sporadically since the sixth decade of the last century.
PRACTICE IMPLICATIONS
It is imperative for nurses to see the telehealth technology as a medium for care, and not a tool to replace high-quality nursing practices. Patient safety will be maintained with telenurses who are able to focus on patient care and not the technology itself.
Topics: Culturally Competent Care; Documentation; Humans; India; Mental Disorders; Mental Health Services; Psychiatry; Telemedicine; Videoconferencing
PubMed: 30479029
DOI: 10.1111/ppc.12342 -
Critical Care Clinics Jul 2019Conceptualizing, designing, implementing, and sustaining a successful critical care telemedicine program is a complex undertaking. All of these steps must be fully... (Review)
Review
Conceptualizing, designing, implementing, and sustaining a successful critical care telemedicine program is a complex undertaking. All of these steps must be fully accomplished as a joint effort between a host facility and the telemedicine service provider. Important administrative considerations that must be incorporated into planning and execution steps include managing change. We briefly discuss critical aspects of establishing a sustainable business model, and aligning the critical care telemedicine program with institutional vision, goals, and mission. Discussed are important telemedicine provider infrastructure, key personnel considerations, and how a program defines and measures value.
Topics: Critical Care; Humans; Models, Economic; Needs Assessment; Telemedicine
PubMed: 31076041
DOI: 10.1016/j.ccc.2019.02.001 -
Fertility and Sterility Dec 2020Telemedicine had been very slowly making inroads into standard clinical practice. The onset of the COVID-19 pandemic resulted in the rapid implementation of telemedicine... (Review)
Review
Telemedicine had been very slowly making inroads into standard clinical practice. The onset of the COVID-19 pandemic resulted in the rapid implementation of telemedicine across most practices. The efficiency and permanence of telemedicine services depends on a multitude of factors including technologic choices, governmental and insurance regulations, reimbursement policies, and staff and patient education and acceptance. Although challenges remain and the extent of implementation is still evolving, it is clear that telemedicine is here to stay and that all those involved in health care need to be familiar with its opportunities and challenges.
Topics: COVID-19; Health Insurance Portability and Accountability Act; Humans; Insurance, Health, Reimbursement; Office Visits; Patient Education as Topic; Personnel Staffing and Scheduling; Reproductive Medicine; SARS-CoV-2; Telemedicine; United States
PubMed: 33280716
DOI: 10.1016/j.fertnstert.2020.10.049 -
Diabetes & Metabolic Syndrome 2020With restrictions on face to face clinical consultations in the COVID-19 pandemic and the challenges faced by health care systems in delivering patient care, alternative... (Review)
Review
BACKGROUND
With restrictions on face to face clinical consultations in the COVID-19 pandemic and the challenges faced by health care systems in delivering patient care, alternative information technologies like telemedicine and smartphone are playing a key role.
AIMS
We assess the role and applications of smartphone technology as an extension of telemedicine in provide continuity of care to our patients and surveillance during the current COVID-19 pandemic.
METHODS
We have done a comprehensive review of the literature using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the first week of May 2020.
RESULTS
Through the published literature on this topic, we discuss role, common applications and its support in extended role of telemedicine technology in several aspects of current COVID-19 pandemic.
CONCLUSION
Smartphone technology on its own and as extension of telemedicine has significant applications in the current COVID-19 pandemic. As the smartphone technology further evolves with fifth generation cellular network expansion, it is going to play a key role in future of health medicine, patient referral, consultation, ergonomics and many other extended applications of health care.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Delivery of Health Care; Humans; Inventions; Pandemics; Pneumonia, Viral; SARS-CoV-2; Smartphone; Telemedicine
PubMed: 32497963
DOI: 10.1016/j.dsx.2020.05.033 -
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 -
Surgery Feb 2021
Topics: Centers for Medicare and Medicaid Services, U.S.; Humans; Patient Preference; Patient Safety; Reimbursement Mechanisms; Specialties, Surgical; Telemedicine; United States
PubMed: 33261822
DOI: 10.1016/j.surg.2020.10.036