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JBJS Reviews Jul 2020
Review
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Cost-Benefit Analysis; Humans; Orthopedic Procedures; Pandemics; Pneumonia, Viral; SARS-CoV-2; Telemedicine; Treatment Outcome
PubMed: 32759613
DOI: 10.2106/JBJS.RVW.20.00083 -
The Journal of Allergy and Clinical... Feb 2020Telemedicine (TM) has become a popular method of accessing medical services between providers and patients and is viewed as a cost-effective alternative to more... (Review)
Review
Telemedicine (TM) has become a popular method of accessing medical services between providers and patients and is viewed as a cost-effective alternative to more traditional episodic face-to-face encounters. TM overcomes 2 barriers that patients face when seeking health care: distance and time. It is as effective as in-person visits for outpatient treatment of asthma, and it is a convenient way to provide inpatient consultations for patients when the allergist practices outside of the hospital. TM also has been used to manage patients with asthma in schools. Patients tend to be as satisfied with TM or they prefer TM over in-person visits, but infrequently they do prefer in-person visits. In addition to virtual visits using TM, there are several emerging technologies that are relevant to the practice of allergy/immunology including electronic diaries (eg, symptoms and medication use), wearable technology (eg, to monitor activity and vital signs), remote patient monitoring (eg, environmental exposures and medication adherence) as well as electronic medical records augmented with clinical decision support. We believe that the use of TM, particularly when combined with information technologies such as electronic health records, has the potential to cause a transformational change in the way care is delivered by altering the process of interaction between patient and provider. TM addresses the shortage of allergy specialists in rural and underserved urban communities and facilitates patient access to allergy services. As patients take more control of their health care, use of TM is likely to increase because a large part of the move to adopt TM is driven by patient preference.
Topics: Allergy and Immunology; Humans; Telemedicine
PubMed: 32035604
DOI: 10.1016/j.jaci.2019.12.903 -
Surgery Jul 2022The need to continue providing care to patients during the corona virus disease 2019 pandemic facilitated telemedicine's rapid adoption, including in surgical clinic...
BACKGROUND
The need to continue providing care to patients during the corona virus disease 2019 pandemic facilitated telemedicine's rapid adoption, including in surgical clinic settings. Our purpose was to evaluate integration of telemedicine into an academic colorectal surgery practice and assess physician experiences providing telemedicine care.
METHODS
Patients seen in colorectal surgery clinic by telemedicine and in person from March 31, 2020 to August 31, 2020 were evaluated. Demographic and clinical outcomes were assessed for patients. Physician responses to a survey were collected.
RESULTS
Two hundred and thirty-one telemedicine visits were performed by 4 physicians, comprising 20% of visits during the study period. Patients were 47.6% male and 90.9% Caucasian. In addition, 85.7% were established patients and 21.2% were postoperative visits. Diagnoses evaluated by telemedicine included benign and malignant anorectal and colorectal disease as well as inflammatory bowel disease. All providers reported being able to provide adequate care via telemedicine and were planning to continue providing telemedicine. Patients seen via telemedicine were more likely to be Caucasian and less likely to be African American (P < .001) and more likely to be established patients than those seen in person (P < .001).
CONCLUSION
During the COVID-19 pandemic, telemedicine was most successfully used to facilitate care for established patients, particularly the long-term care of colorectal cancer and inflammatory bowel disease. We identified significant differences in ethnicity between patients seen via telemedicine and those seen in person. Telemedicine represents an exciting advancement in patient care, although ongoing study is required regarding providing access to this technology to all colorectal surgery patients, particularly minority populations.
Topics: COVID-19; Colorectal Surgery; Female; Humans; Inflammatory Bowel Diseases; Male; Pandemics; Telemedicine
PubMed: 35248363
DOI: 10.1016/j.surg.2022.01.033 -
Journal of Medical Internet Research Nov 2020Telemedicine refers to the delivery of medical care and provision of general health services from a distance. Telemedicine has been practiced for decades with increasing...
Telemedicine refers to the delivery of medical care and provision of general health services from a distance. Telemedicine has been practiced for decades with increasing evidence proving its potential for enhanced quality of care for patients, reduction in hospital readmissions, and increase in savings for both patients and providers. The COVID-19 pandemic has resulted in a significant increase in the reliance on telemedicine and telehealth for provision of health care services. Developments in telemedicine should be structured as complements to current health care procedures, not with the goal of completely digitizing the entire health care system, but rather to use the power of technology to enhance areas that may not be working at their full potential. At the same time, it is also clear that further research is needed on the effectiveness of telemedicine in terms of both financial and patient benefits. We discuss the current and rapidly increasing knowledge about the use of telemedicine in the United States, and identify the gaps in knowledge and opportunities for further research. Beginning with telemedicine's origins in the United States to its widespread use during the COVID-19 pandemic, we highlight recent developments in legislation, accessibility, and acceptance of telemedicine.
Topics: COVID-19; Humans; SARS-CoV-2; Students; Telemedicine; United States
PubMed: 33215999
DOI: 10.2196/20839 -
The Nurse Practitioner Aug 2020
Topics: COVID-19; Coronavirus Infections; Forecasting; Humans; Nurse Practitioners; Pandemics; Patient Advocacy; Pneumonia, Viral; Telemedicine; United States
PubMed: 32590451
DOI: 10.1097/01.NPR.0000681804.23530.81 -
Zhonghua Shao Shang Za Zhi = Zhonghua... Sep 2019Telemedicine refers to two or more medical institutions using communication, computer, and network technology to provide remote diagnosis, treatment, and care for... (Review)
Review
Telemedicine refers to two or more medical institutions using communication, computer, and network technology to provide remote diagnosis, treatment, and care for patients. The necessity and feasibility of applying telemedicine are determined by the characteristics of burn injury. This paper reviewed the application of telemedicine in burn surgery at home and abroad, then analyzed the significance and problems of using this technology in the field of burns, finally forecasted the future of application of telemedicine in burn surgery.
Topics: Burns; Humans; Telemedicine
PubMed: 31594190
DOI: 10.3760/cma.j.issn.1009-2587.2019.09.010 -
AMIA ... Annual Symposium Proceedings.... 2023In 2021, the Association of American Medical Colleges published Telehealth Competencies Across the Learning Continuum, a roadmap for designing telemedicine curricula and...
In 2021, the Association of American Medical Colleges published Telehealth Competencies Across the Learning Continuum, a roadmap for designing telemedicine curricula and evaluating learners. While this document advances educators' shared understanding of telemedicine's core content and performance expectations, it does not include turn-key-ready evaluation instruments. At the University of Oklahoma School of Community Medicine, we developed a year-long telemedicine curriculum for third-year medical and second-year physician assistant students. We used the AAMC framework to create program objectives and instructional simulations. We designed and piloted an assessment rubric for eight AAMC competencies to accompany the simulations. In this monograph, we describe the rubric development, scores for students participating in simulations, and results comparing inter-rater reliability between faculty and standardized patient evaluators. Our preliminary work suggests that our rubric provides a practical method for evaluating learners by faculty during telemedicine simulations. We also identified opportunities for additional reliability and validity testing.
Topics: Humans; Reproducibility of Results; Education, Medical, Undergraduate; Telemedicine; Students; Curriculum; Students, Medical
PubMed: 38222442
DOI: No ID Found -
Advances in Skin & Wound Care Sep 2020To review the clinical and scientific literature on remote monitoring and management of postsurgical wounds using smartphone applications (apps). (Review)
Review
OBJECTIVE
To review the clinical and scientific literature on remote monitoring and management of postsurgical wounds using smartphone applications (apps).
DATA SOURCES
MEDLINE, PubMed, EMBASE, and Cochrane libraries were searched for relevant articles on patients who received surgery and were monitored postdischarge via an app.
STUDY SELECTION
Articles were selected with the terms "mobile phones," "smartphones," "wounds," "monitor," and "patient preference."
DATA EXTRACTION
The authors found 276 review articles related to telemedicine in wound care. Investigators reviewed the titles and abstracts of the search results and selected 83 articles that were relevant to the remote monitoring of wounds using smartphone apps.
DATA SYNTHESIS
The topics explored in selected literature included smartphone app importance to telemedicine, benefits (medical and financial), app examples, and challenges in the context of wound monitoring and management. The authors identified several challenges and limitations that future studies in the field need to address.
CONCLUSIONS
Remote monitoring and management of wounds using smartphone apps is a valuable technique to enhance the quality of and access to healthcare. However, although some patients may prefer this technology, some lack technological competence, limiting telemedicine's applicability. In addition, issues remain with the reliable interpretation of data collected through apps.
Topics: Humans; Monitoring, Physiologic; Patient Discharge; Remote Sensing Technology; Smartphone; Telemedicine
PubMed: 32810062
DOI: 10.1097/01.ASW.0000694136.29135.02 -
JMIR MHealth and UHealth Oct 2020Telemedicine has been used widely in China and has benefited a large number of patients, but little is known about the overall development of telemedicine.
BACKGROUND
Telemedicine has been used widely in China and has benefited a large number of patients, but little is known about the overall development of telemedicine.
OBJECTIVE
The aim of this study was to perform a national survey to identify the overall implementation and application of telemedicine in Chinese tertiary hospitals and provide a scientific basis for the successful expansion of telemedicine in the future.
METHODS
The method of probability proportionate to size sampling was adopted to collect data from 161 tertiary hospitals in 29 provinces, autonomous regions, and municipalities. Charts and statistical tests were applied to compare the development of telemedicine, including management, network, data storage, software and hardware equipment, and application of telemedicine. Ordinal logistic regression was used to analyze the relationship between these factors and telemedicine service effect.
RESULTS
Approximately 93.8% (151/161) of the tertiary hospitals carried out telemedicine services in business-to-business mode. The most widely used type of telemedicine network was the virtual private network with a usage rate of 55.3% (89/161). Only a few tertiary hospitals did not establish data security and cybersecurity measures. Of the 161 hospitals that took part in the survey, 100 (62.1%) conducted remote videoconferencing supported by hardware instead of software. The top 5 telemedicine services implemented in the hospitals were teleconsultation, remote education, telediagnosis of medical images, tele-electrocardiography, and telepathology, with coverage rates of 86.3% (139/161), 57.1% (92/161), 49.7% (80/161), 37.9% (61/161), and 33.5% (54/161), respectively. The average annual service volume of teleconsultation reached 714 cases per hospital. Teleconsultation and telediagnosis were the core charging services. Multivariate analysis indicated that the adoption of direct-to-consumer mode (P=.003), support from scientific research funds (P=.01), charging for services (P<.001), number of medical professionals (P=.04), network type (P=.02), sharing data with other hospitals (P=.04), and expertise level (P=.03) were related to the effect of teleconsultation. Direct-to-consumer mode (P=.01), research funding (P=.01), charging for services (P=.01), establishment of professional management departments (P=.04), and 15 or more instances of remote education every month (P=.01) were found to significantly influence the effect of remote education.
CONCLUSIONS
A variety of telemedicine services have been implemented in tertiary hospitals in China with a promising prospect, but the sustainability and further standardization of telemedicine in China are still far from accomplished.
Topics: China; Cross-Sectional Studies; Humans; Remote Consultation; Telemedicine; Videoconferencing
PubMed: 33095175
DOI: 10.2196/18426 -
Rheumatology (Oxford, England) May 2022The Covid-19 pandemic necessitated a rapid global transition towards telemedicine; yet much remains unknown about telemedicine's acceptability and safety in... (Clinical Trial)
Clinical Trial
OBJECTIVES
The Covid-19 pandemic necessitated a rapid global transition towards telemedicine; yet much remains unknown about telemedicine's acceptability and safety in rheumatology. To help address this gap and inform practice, this study investigated rheumatology patient and clinician experiences and views of telemedicine.
METHODS
Sequential mixed methodology combined analysis of surveys and in-depth interviews. Between and within-group differences in views of telemedicine were examined for patients and clinicians using t-tests.
RESULTS
Surveys (patients n = 1340, clinicians n = 111) and interviews (patients n = 31, clinicians n = 29) were completed between April 2021 and July 2021. The majority of patients were from the UK (96%) and had inflammatory arthritis (32%) or lupus (32%). Patients and clinicians rated telemedicine as worse than face-to-face consultations in almost all categories, although >60% found it more convenient. Building trusting medical relationships and assessment accuracy were great concerns (93% of clinicians and 86% of patients rated telemedicine as worse than face-to-face for assessment accuracy). Telemedicine was perceived to have increased misdiagnoses, inequalities and barriers to accessing care. Participants reported highly disparate telemedicine delivery and responsiveness from primary and secondary care. Although rheumatology clinicians highlighted the importance of a quick response to flaring patients, only 55% of patients were confident that their rheumatology department would respond within 48 hours.
CONCLUSION
Findings indicate a preference for face-to-face consultations. Some negative experiences may be due to the pandemic rather than telemedicine specifically, although the risk of greater diagnostic inaccuracies using telemedicine is unlikely to be fully resolved. Training, choice, careful patient selection, and further consultation with clinicians and patients is required to increase telemedicine's acceptability and safety.
TRIAL REGISTRATION
This telemedicine study is part of a pre-registered longitudinal multi-stage trial, the LISTEN study (ISRCTN-14966097), with later Covid-related additions registered in March 2021, including a pre-registered statistical analysis plan.
Topics: COVID-19; Humans; Pandemics; Rheumatology; Surveys and Questionnaires; Telemedicine
PubMed: 34698822
DOI: 10.1093/rheumatology/keab796