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Zhurnal Nevrologii I Psikhiatrii Imeni... 2020This paper is an adapted translation of recommendations on telestroke provided by the European Stroke Organization. Lack of stroke specialists determines that many...
This paper is an adapted translation of recommendations on telestroke provided by the European Stroke Organization. Lack of stroke specialists determines that many European rural areas remain underserved. Use of telemedicine in stroke care has shown to be safe, increase use of evidence-based therapy and enable coverage of large areas of low population density. An aim of the study is to summarise the following recommendations of the Telestroke Committee of the European Stroke Organization on the setup of telestroke networks in Europe: Hospitals participating in telestroke networks should be chosen according to criteria that include population density, transportation distance, geographic specifics and in-hospital infrastructure and professional resources. Three hospital categories are identified to be part of a hub-and-spoke network: (1) the Telemedicine Stroke Centre (an European Stroke Organization stroke centre or equivalent with specific infrastructure and setup for network and telemedicine support), (2) the telemedicine-assisted stroke Unit (equivalent to an European Stroke Organization stroke unit but without 24 h onsite stroke expertise) and (3) the telemedicine-assisted stroke ready hospital (only covering hyperacute treatment in the emergency department and transferring all patients for further treatment).
Topics: Europe; Humans; Practice Guidelines as Topic; Stroke; Telemedicine; Translations
PubMed: 32307428
DOI: 10.17116/jnevro202012003233 -
Diabetes & Metabolic Syndrome 2020With restrictions on face to face clinical consultations in the COVID-19 pandemic, Telemedicine has become an essential tool in providing continuity of care to patients.... (Review)
Review
BACKGROUND AND AIMS
With restrictions on face to face clinical consultations in the COVID-19 pandemic, Telemedicine has become an essential tool in providing continuity of care to patients. We explore the common pitfalls in remote consultations and strategies that can be adopted to avoid them.
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 including 'COVID-19', 'telemedicine' and 'remote consultations'.
RESULTS
Telemedicine has become an integral part to support patient's clinical care in the current COVID-19 pandemic now and will be in the future for both primary and secondary care. Common pitfalls can be identified and steps can be taken to prevent them.
CONCLUSION
Telemedicine it is going to play a key role in future of health medicine, however, telemedicine technology should be applied in appropriate settings and situations. Suitable training, enhanced documentations, communication and observing information governance guidelines will go a long way in avoiding pitfalls associated with remote consultations.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Health Services Needs and Demand; Humans; Pandemics; Patient Acceptance of Health Care; Pneumonia, Viral; Quarantine; Referral and Consultation; SARS-CoV-2; Telemedicine
PubMed: 32534432
DOI: 10.1016/j.dsx.2020.06.007 -
PloS One 2023In March 2020, the Botswana Ministry of Health and Wellness approved a National eHealth Strategy. Although a milestone, the strategy does not mention telemedicine. There...
INTRODUCTION
In March 2020, the Botswana Ministry of Health and Wellness approved a National eHealth Strategy. Although a milestone, the strategy does not mention telemedicine. There is need to address this by developing an evidence-based adjunct strategy for telemedicine to facilitate its introduction and adoption. To do so, several stages of a published eHealth Strategy Development Framework were mimicked. This allowed situational awareness to be created through exploring behavioural factors and perceptions that might influence the adoption of telemedicine in Botswana. The study aim was to explore current issues, concerns, perceptions, attitudes, views, and knowledge of patients and healthcare professionals regarding health-related issues and telemedicine that might influence implementation of telemedicine in Botswana and thereby inform future development of a telemedicine strategy.
METHODS
An exploratory survey study was conducted using different survey questionnaires for patients and healthcare professionals, each using a mix of open- and closed-ended questions. These questionnaires were administered to convenience samples of healthcare professionals and patients at 12 public healthcare facilities in Botswana; seven clinics (three rural; four urban), and five hospitals (two primary, two district, and one tertiary), selected to align with the country's decentralised healthcare structure.
RESULTS
Fifty-three healthcare professionals and 89 patients participated. Few healthcare professionals had actively used telemedicine for clinical consults and self-education using telephone calls, cell phone apps, or video conferencing (doctors 42%, nurses 10%). Only a few health facilities had telemedicine installations. Healthcare professional preference for future telemedicine uses were e-learning (98%), clinical services (92%), and health informatics (electronic records (87%). All healthcare professionals (100%) and most patients (94%) were willing to use and participate in telemedicine programmes. Open-ended responses showed additional perspective. Resource shortages (health human resources and infrastructure) were key to both groups. Convenience, cost effectiveness, and increased remote patient access to specialists were identified as enablers to telemedicine use. However inhibitors were cultural and traditional beliefs, although privacy, security and confidentiality were also identified. Results were consistent with findings from other developing countries.
CONCLUSION
Although use, knowledge, and awareness of telemedicine are low, general acceptance, willingness to use, and understanding of benefits are high. These findings bode well for development of a telemedicine-specific strategy for Botswana, complementary to the National eHealth Strategy, to guide more systematic adoption and application of telemedicine in the future.
Topics: Humans; Botswana; Telemedicine; Delivery of Health Care; Health Personnel; Health Facilities
PubMed: 36795740
DOI: 10.1371/journal.pone.0281754 -
Journal of General Internal Medicine Dec 2019
Topics: Humans; Patient Acceptance of Health Care; Primary Health Care; Telemedicine
PubMed: 31342331
DOI: 10.1007/s11606-019-05201-5 -
PloS One 2021The use of telemedicine in ICUs has grown and is becoming increasingly recognized. However, its impact on PICUs remains unclear. This systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis
The use of telemedicine in ICUs has grown and is becoming increasingly recognized. However, its impact on PICUs remains unclear. This systematic review and meta-analysis aimed to evaluate whether telemedicine in the PICU has the potential to improve clinical and non-clinical outcomes. PubMed, Scopus, LILACS, and CINAHL electronic databases were searched to identify studies that assessed the impact of telemedicine on clinical outcomes, with no publication date restrictions. The reference lists of the selected articles were hand-searched for additional studies that had not been identified by the initial electronic search. Studies were included if they had a cohort design, used telemedicine, were conducted in PICUs or specialized PICUs, and were published in Portuguese, English, or Spanish. Two groups of reviewers independently screened titles and abstracts for inclusion. The same group of reviewers independently assessed the full-text articles for eligibility and extracted the following information: telecommunication method, intervention characteristics, patient characteristics, sample size, and main results. Studies were meta-analyzed using a random-effects model to estimate the pooled prevalence of PICU mortality and length of PICU stay. Risk of bias was assessed using the Newcastle-Ottawa Scale. Of 2703 studies initially identified, 2226 had their titles and abstracts screened. Of these, 53 were selected for full-text reading, of which 10 were included and analyzed. The main results of interest were length of PICU stay, number of deaths or mortality rate, and satisfaction of health professionals and family members. The results of meta-analysis show that the mortality rate reduced by 34% with an increase of the length of PICU stay in the PICUs with the use of telemedicine. Family members and health professionals were satisfied with the use of telemedicine. Telemedicine has the potential to improve PICU outcomes, such as mortality rate and family and staff satisfaction. However, it extended length of PICU stay in the studies included in this systematic review.
Topics: Data Management; Humans; Telemedicine
PubMed: 34048494
DOI: 10.1371/journal.pone.0252409 -
Expansion of Telemedicine Services: Telepharmacy, Telestroke, Teledialysis, Tele-Emergency Medicine.Critical Care Clinics Jul 2019As more specialized care gets centralized in centers of excellence, patients admitted to rural hospitals may be at a disadvantage at the time of accessing expertise or... (Review)
Review
As more specialized care gets centralized in centers of excellence, patients admitted to rural hospitals may be at a disadvantage at the time of accessing expertise or receiving advanced care. In this setting, telemedicine models provide a justification to equalize care across different levels. The diversity in telemedicine services is vast and is expanding. Even with all the subsets of telemedicine, including telepharmacy, telestroke, teledialysis, and tele-emergency medicine, the reasons for providing services and associated limitations are similar. However, there is a lack of empirical research including best practices and resultant outcomes for these subsets of telemedicine models.
Topics: Dialysis; Emergency Service, Hospital; Humans; Pharmacy Service, Hospital; Stroke; Telemedicine
PubMed: 31076051
DOI: 10.1016/j.ccc.2019.02.007 -
International Journal of Medical... Apr 2020Ophthalmology is one of the most requested medical speciality services in the elderly population. Although numerous studies have shown the potentials of telemedicine for... (Review)
Review
BACKGROUND
Ophthalmology is one of the most requested medical speciality services in the elderly population. Although numerous studies have shown the potentials of telemedicine for the provision of ophthalmology services, the extent of its usability in older adults and the aged population is not clear. The aim of this study was to investigate the characteristics and usability features of teleophthalmology for the elderly population.
METHOD
We searched PubMed, Embase, Scopus and CINAHL for relevant studies since 2008. Forty-five papers met the eligibility criteria and included in this review. We used a multifaceted model to extract the data and analyze findings by cross-tabulation.
RESULTS
The majority of the reviewed papers included participants of 65 years of age or older. Most of the studies were conducted in the USA (38 %). Diabetic retinopathy, glaucoma, age-related macular degeneration and cataract were the most researched eye diseases, and among the imaging technologies, retinal photography had been used the most (72 %). The studies showed teleophthalmology can improve access to specialty care, reduce the number of unnecessary visits, alleviate overloads on treatment centers, and provide more comprehensive exams. It also made services cost-saving for stakeholders and cost-effective in rural areas. However, teleophthalmology was not cost-effective for patients above 80 and low-density population areas.
CONCLUSION
Evidence is lacking for the usability and effectiveness of teleophthalmology for the elderly population. The findings suggest that primary care providers in collaboration with ophthalmologists could provide more effective eye care to elderly population. Appropriate training is also necessary for primary care doctors to manage and refer older patients in a timely manner. Diagnostic value and cost-effective imaging modalities which are the core of the teleophthalmology, can be enhanced by image processing techniques and artificial intelligence.
Topics: Aged; Cost-Benefit Analysis; Disease Management; Eye Diseases; Humans; Ophthalmology; Remote Consultation; Telemedicine
PubMed: 32044698
DOI: 10.1016/j.ijmedinf.2020.104089 -
World Journal of Gastroenterology Aug 2019Decompensated cirrhosis is a condition associated with significant morbidity and mortality. While there have been significant efforts to develop quality metrics that... (Review)
Review
Decompensated cirrhosis is a condition associated with significant morbidity and mortality. While there have been significant efforts to develop quality metrics that ensure high-value care of these patients, wide variations in clinical practice exist. In this opinion review, we discuss the quality gap in the care of patients with cirrhosis, including low levels of compliance with recommended cancer screening and other clinical outcome and patient-reported outcome measures. We posit that innovations in telemedicine and mobile health (mHealth) should play a key role in closing the quality gaps in liver disease management. We highlight interventions that have been performed to date in liver disease and heart failure-from successful teleconsultation interventions in the care of veterans with cirrhosis to the use of telemonitoring to reduce hospital readmissions and decrease mortality rates in heart failure. Telemedicine and mHealth can effectively address unmet needs in the care of patients with cirrhosis by increasing preventative care, expanding outreach to rural communities, and increasing high-value care. We aim to highlight the benefits of investing in innovative solutions in telemedicine and mHealth to improve care for patients with cirrhosis and create downstream cost savings.
Topics: Cell Phone; Computers, Handheld; Gastroenterology; Health Plan Implementation; Humans; Liver Cirrhosis; Mobile Applications; Patient Reported Outcome Measures; Professional Practice Gaps; Quality Improvement; Telemedicine
PubMed: 31413523
DOI: 10.3748/wjg.v25.i29.3849 -
Canadian Journal of Rural Medicine :... 2020
Topics: Canada; Humans; Rural Health Services; Telemedicine
PubMed: 32611870
DOI: 10.4103/CJRM.CJRM_33_20 -
Rehabilitation Nursing : the Official... 2019Telemedicine-delivered cardiac rehabilitation (telemedicine-CR) provides an alternative pathway for patients who are unable to participate in conventional CR. Little is...
BACKGROUND
Telemedicine-delivered cardiac rehabilitation (telemedicine-CR) provides an alternative pathway for patients who are unable to participate in conventional CR. Little is known regarding the relationships among potential participants' perceptions of barriers to CR participation, interest in telemedicine-CR, and self-efficacy beliefs toward the use of telemedicine. The purpose of this study was to identify if associations exist between these variables.
METHODS
A quantitative, correlational survey study was conducted using the Cardiac Rehabilitation Barriers Scale and a survey examining interest in and self-efficacy for telemedicine technologies. Eighty-three patients were invited to participate.
RESULTS
Twenty surveys (24%) were returned. Significant correlations were identified between interest in telemedicine-CR and self-efficacy beliefs for the use of live video links, rs(14) = .510, p = .044, and the Cardiac Rehabilitation Barriers Scale Comorbidity subscale, rs(18) = -.469, p = .037.
CONCLUSIONS
Higher self-efficacy for the use of video chat and fewer perceived comorbidity barriers were associated with greater interest in telemedicine-CR.
Topics: Adult; Aged; Aged, 80 and over; Cardiac Rehabilitation; Female; Humans; Male; Middle Aged; Patients; Surveys and Questionnaires; Telemedicine
PubMed: 30681548
DOI: 10.1097/rnj.0000000000000189