-
The Journal of Nervous and Mental... Jan 2021The novel coronavirus pandemic and the resulting expanded use of telemedicine have temporarily transformed community-based care for individuals with serious mental... (Review)
Review
The novel coronavirus pandemic and the resulting expanded use of telemedicine have temporarily transformed community-based care for individuals with serious mental illness (SMI), challenging traditional treatment paradigms. We review the rapid regulatory and practice shifts that facilitated broad use of telemedicine, the literature on the use of telehealth and telemedicine for individuals with SMI supporting the feasibility/acceptability of mobile interventions, and the more limited evidence-based telemedicine practices for this population. We provide anecdotal reflections on the opportunities and challenges for telemedicine drawn from our daily experiences providing services and overseeing systems for this population during the pandemic. We conclude by proposing that a continued, more prominent role for telemedicine in the care of individuals with SMI be sustained in the post-coronavirus landscape, offering future directions for policy, technical assistance, training, and research to bring about this change.
Topics: Attitude of Health Personnel; COVID-19; Community Health Services; Health Services Accessibility; Humans; Mental Disorders; Mental Health Services; Patient Acceptance of Health Care; Telemedicine
PubMed: 33003053
DOI: 10.1097/NMD.0000000000001254 -
Journal of Medical Internet Research Apr 2022Telemedicine is increasingly being leveraged, as the need for remote access to health care has been driven by the rising chronic disease incidence and the COVID-19... (Review)
Review
BACKGROUND
Telemedicine is increasingly being leveraged, as the need for remote access to health care has been driven by the rising chronic disease incidence and the COVID-19 pandemic. It is also important to understand patients' willingness to pay (WTP) for telemedicine and the factors contributing toward it, as this knowledge may inform health policy planning processes, such as resource allocation or the development of a pricing strategy for telemedicine services. Currently, most of the published literature is focused on cost-effectiveness analysis findings, which guide health care financing from the health system's perspective. However, there is limited exploration of the WTP from a patient's perspective, despite it being pertinent to the sustainability of telemedicine interventions.
OBJECTIVE
To address this gap in research, this study aims to conduct a systematic review to describe the WTP for telemedicine interventions and to identify the factors influencing WTP among patients with chronic diseases in high-income settings.
METHODS
We systematically searched 4 databases (PubMed, PsycINFO, Embase, and EconLit). A total of 2 authors were involved in the appraisal. Studies were included if they reported the WTP amounts or identified the factors associated with patients' WTP, involved patients aged ≥18 years who were diagnosed with chronic diseases, and were from high-income settings.
RESULTS
A total of 11 studies from 7 countries met this study's inclusion criteria. The proportion of people willing to pay for telemedicine ranged from 19% to 70% across the studies, whereas the values for WTP amounts ranged from US $0.89 to US $821.25. We found a statistically significant correlation of age and distance to a preferred health facility with the WTP for telemedicine. Higher age was associated with a lower WTP, whereas longer travel distance was associated with a higher WTP.
CONCLUSIONS
On the basis of our findings, the following are recommendations that may enhance the WTP: exposure to the telemedicine intervention before assessing the WTP, the lowering of telemedicine costs, and the provision of patient education to raise awareness on telemedicine's benefits and address patients' concerns. In addition, we recommend that future research be directed at standardizing the reporting of WTP studies with the adoption of a common metric for WTP amounts, which may facilitate the generalization of findings and effect estimates.
Topics: Adolescent; Adult; COVID-19; Chronic Disease; Cost-Benefit Analysis; Humans; Pandemics; Telemedicine
PubMed: 35416779
DOI: 10.2196/33372 -
Sleep Medicine Clinics Sep 2020Synchronous telemedicine allows clinicians to expand their reach by using technology to take care of patients who otherwise may not be seen. Establishing a telemedicine... (Review)
Review
Synchronous telemedicine allows clinicians to expand their reach by using technology to take care of patients who otherwise may not be seen. Establishing a telemedicine practice can be daunting. This article outlines how to implement a synchronous telemedicine practice into an existing workflow. Telemedicine-specific considerations are discussed, as well as guidance regarding practice assessment, financial feasibility, technical considerations, and clinical guidance to translate in-person visit skills into an effective virtual visit.
Topics: Humans; Professional Practice; Telemedicine
PubMed: 32762968
DOI: 10.1016/j.jsmc.2020.05.002 -
Telemedicine Journal and E-health : the... Jan 2022nnn
nnn
Topics: COVID-19; Demography; Female; Humans; Male; Pandemics; SARS-CoV-2; Telemedicine
PubMed: 33769092
DOI: 10.1089/tmj.2021.0041 -
Journal of Telemedicine and Telecare Oct 2019There are finite resources available to spend on healthcare, with the increasing burden of disease and the increasing cost of providing healthcare it is imperative that... (Review)
Review
INTRODUCTION
There are finite resources available to spend on healthcare, with the increasing burden of disease and the increasing cost of providing healthcare it is imperative that methods for optimising health systems to improve sustainability are investigated. This study is part of a larger body of work investigating the potential for telehealth to improve the economic sustainability of the health system. The aim of this sub-analysis is to investigate the breakeven point for implementing a telehealth service; that is the point after which the initial investment is recouped and the cost savings have become tangible.
METHOD
Literature searches were conducted using broad terms for telehealth and economics to identify economic evaluation literature focusing on telehealth. Articles were included if they reported their findings from a health system perspective, demonstrated cost savings, and provided sufficient information to calculate the breakeven point.
RESULTS
Less than half of the economic analysis studies examined reported cost savings for the health system as a result of telehealth. The breakeven point could be calculated for 12 articles, all of which were included in the analysis. These articles described evaluations for store-and-forward, remote monitoring and videoconference services. The breakeven points for these services ranged from near immediate (less than 1 year) to 9 years. Remote monitoring and store-and-forward services reached their breakeven points sooner than the videoconference services.
CONCLUSION
The results demonstrated that telehealth is cost saving for the health system in a proportion of services. When costs are saved, the breakeven point can be immediate (less than 1 year) or may take more time to eventuate.
Topics: Cost Savings; Costs and Cost Analysis; Humans; Telemedicine
PubMed: 31631758
DOI: 10.1177/1357633X19871403 -
The New England Journal of Medicine Sep 2019
Review
Topics: Accelerometry; Biomarkers; Digital Divide; Electronic Health Records; Healthcare Disparities; Humans; Internet; Mobile Applications; Monitoring, Ambulatory; Smartphone; Telemedicine
PubMed: 31483966
DOI: 10.1056/NEJMra1806949 -
Telemedicine Journal and E-health : the... Jul 2023(Review)
Review
Topics: Humans; Cost-Benefit Analysis; Telemedicine; Cost-Effectiveness Analysis
PubMed: 36493368
DOI: 10.1089/tmj.2022.0161 -
Telemedicine Journal and E-health : the... Dec 2021This article reviews the studies examining patients' perspective toward telemedicine and their preference for virtual health care services. An electronic literature... (Review)
Review
This article reviews the studies examining patients' perspective toward telemedicine and their preference for virtual health care services. An electronic literature search using PubMed was conducted to identify relevant research studies published between December 2019 and August 2020. Twenty-five studies were selected out of 1,041 studies based on inclusion and exclusion criteria, which highlight patients' satisfaction and experience with the use of telemedicine during the pandemic. The findings based upon 48,144 surveyed patients and 146 providers in 12 different countries revealed high satisfaction with virtual encounters across a spectrum of diseases. Telemedicine was found satisfactory on various outcome measures, such as addressing patients' concerns, communication with health care providers, usefulness, and reliability. Most common advantages were time saved due to lesser traveling and waiting time, better accessibility, convenience, and cost efficiency. Age and sex did not significantly impact the satisfaction levels. Physicians and patients both showed a strong preference for continued usage and agreed upon telemedicine's potential to complement the regular health care services even after the pandemic. Technical challenges (reported in 10 studies) and lack of physical examination (reported in 13 studies) were the main limitations encountered in virtual visits. Long-term sustainability of telemedicine for all socioeconomic classes requires closer scrutiny of issues such as technology, training, reimbursement, data privacy, legal guidelines, and framework. Telemedicine must be adopted as a proactive strategy and scaled-up even beyond emergency usage due to its immense potential in complementing conventional health care services, such as diagnosis, treatment, follow-up, surveillance, and infection control.
Topics: COVID-19; Humans; Pandemics; Patient Satisfaction; Reproducibility of Results; SARS-CoV-2; Telemedicine
PubMed: 33719577
DOI: 10.1089/tmj.2020.0570 -
Pediatric Clinics of North America Aug 2020Telehealth and telemedicine services can be a solution for improving accessibility and reducing the cost of health care. Challenges remain in designing, implementing,... (Review)
Review
Telehealth and telemedicine services can be a solution for improving accessibility and reducing the cost of health care. Challenges remain in designing, implementing, and sustainably scaling telehealth solutions. Research is lacking on the health impacts and cost-effectiveness of telehealth; more data are needed in the evaluation of telehealth programs, adjusting for potential participant bias and extending the time frame of evaluating impact. In addition, rethinking and addressing the economic incentives and payment for telehealth services, as well as the medical-legal framework for provider competition across geographic regions (and jurisdictions), are needed for greater adoption of telehealth services.
Topics: Computer Security; Cost-Benefit Analysis; Health Services Accessibility; Humans; Medical Record Linkage; Program Development; Telemedicine
PubMed: 32650866
DOI: 10.1016/j.pcl.2020.04.011 -
Journal of the American Board of Family... 2022Telemedicine has been implemented in many health systems by necessity, yet evidence is sparse about its appropriate use for the delivery of primary care. We sought to...
INTRODUCTION
Telemedicine has been implemented in many health systems by necessity, yet evidence is sparse about its appropriate use for the delivery of primary care. We sought to understand what clinicians and patients consider to be appropriate use of telemedicine in primary care to inform future development of a framework that should be valuable to diverse stakeholders.
METHODS
We conducted in-depth, structured interviews of patients, clinicians who deliver primary care, and other select informants. They were asked to discuss optimal, acceptable, and suboptimal uses of telemedicine for delivering care relative to in-person care delivery. Audio was transcribed and paired reviewers analyzed the content to identify the key concepts that motivated the informants. The reviewers did thematic analysis to organize the concepts into unifying themes.
RESULTS
Our 18 key informants generated 103 unique concepts. The unique concepts aggregated into themes suggesting the clinical situations in which telemedicine is appropriately used in primary care and clinical situations in which it should be avoided. We also learned of motivators toward expanded, or at least continued, use of telemedicine and motivators away from telemedicine's continued use. The informants expressed their expectations regarding decision making about telemedicine use and who should make these decisions.
DISCUSSION
These key concepts and themes are expected to be a valuable starting point for the development of a framework to inform appropriate use of telemedicine in primary care.
Topics: Delivery of Health Care; Humans; Primary Health Care; Telemedicine
PubMed: 35641038
DOI: 10.3122/jabfm.2022.03.210229