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Nursing Outlook 2020Electronic sensors measuring biological and behavioral aspects of health and the environment are becoming ubiquitous and, with advances in data science and ehealth... (Review)
Review
BACKGROUND
Electronic sensors measuring biological and behavioral aspects of health and the environment are becoming ubiquitous and, with advances in data science and ehealth technology, provide opportunities for new inquiry and innovative approaches to nursing research.
PURPOSE
To conceptualize the use of sensor technology from the perspective of nursing science.
METHODS
This review reports the keynote presentation from the Expanding Science of Sensor Technology in Nursing Research Conference presented by the Council for Advancement of Nursing Science in 2019 FINDINGS: Electronic sensors enable collection, recording, and transmission of data in real time in real life settings, remote monitoring, self-monitoring, and communication between health care professionals and patients. A deliberative approach to selecting and applying electronic sensors and analyzing and interpreting the data is needed for successful research.
DISCUSSION
Electronic sensors have high potential to advance nursing science.
Topics: Forecasting; Humans; Inventions; Monitoring, Physiologic; Nursing Care; Telemedicine
PubMed: 32580871
DOI: 10.1016/j.outlook.2020.03.009 -
Revista de Neurologia Sep 2020The stress that the coronavirus pandemic has produced on the health services and the disruption it has caused in the care of other pathologies and their follow-up in... (Review)
Review
The stress that the coronavirus pandemic has produced on the health services and the disruption it has caused in the care of other pathologies and their follow-up in outpatient visits have led us to promote and incorporate telemedicine in our routine medical practice. Telemedicine refers to remote or non-face-to-face medical attention, a new method of administering medical care by accredited professionals, which optimises resources and increases their scope. One drawback for child teleneurology is that our diagnoses require direct observation of the child and carrying out an examination as though playing a game. Mainly in the youngest stages, a new patient evaluated by telemedicine can be more difficult to diagnose and manage, and therefore some neuropaediatricians have chosen to carry out only follow-up visits, medication management and outcome reviews. Telemedicine, however, also has many benefits, such as the possibility of giving rapid advice, coordination among professionals and reaching the patient where and when it is difficult for classical medicine to do so. The aim of this article is to review the possible indications of telemedicine in child neurology, starting out from the fact that we should never delay the diagnosis of something that can be treated, both at the present time and in an eventual situation of resurgence of the pandemic. The advance of telemedicine will depend on the implementation of technology, on solving legal and security/privacy issues, on its clinical outcomes and on the extent to which patients demand and accept these virtual visits.
Topics: Adolescent; Aftercare; Child; Child, Preschool; Disease Management; Humans; Infant; Interdisciplinary Communication; Length of Stay; Neurology; Neuropsychiatry; Patient Care Team; Patient Education as Topic; Pediatrics; Telemedicine
PubMed: 32729111
DOI: 10.33588/rn.7105.2020304 -
Actas Dermo-sifiliograficas Dec 2020Teledermatology has facilitated specialist care during the crisis caused by the coronavirus disease 2019 pandemic, eliminating unnecessary office visits and the possible... (Review)
Review
Teledermatology has facilitated specialist care during the crisis caused by the coronavirus disease 2019 pandemic, eliminating unnecessary office visits and the possible exposure of patients or dermatologists. However, teledermatology brings forward certain ethical and medicolegal questions. A medical consultation in which the patient is not physically present is still a medical act, to which all the usual ethical and medicolegal considerations and consequences apply. The patient's right to autonomy and privacy, confidentiality, and data protection must be guaranteed. The patient must agree to remote consultation by giving informed consent, for which a safeguard clause should be included. Well-defined practice guidelines and uniform legislation are required to preserve the highest level of safety for transferred data. Adequate training is also needed to prevent circumstances involving what might be termed «telemalpractice».
Topics: COVID-19; Checklist; Confidentiality; Delivery of Health Care; Dermatology; Evidence-Based Medicine; Humans; Informed Consent; Malpractice; Pandemics; Patient Acceptance of Health Care; Personal Autonomy; SARS-CoV-2; Spain; Telemedicine
PubMed: 32910922
DOI: 10.1016/j.ad.2020.08.008 -
The Canadian Journal of Cardiology Feb 2022
Topics: Delivery of Health Care; Humans; Leadership; Periodicals as Topic; Telemedicine
PubMed: 34627946
DOI: 10.1016/j.cjca.2021.09.033 -
The Milbank Quarterly Jun 2021Policy Points Telehealth has many potential advantages during an infectious disease outbreak such as the COVID-19 pandemic, and the COVID-19 pandemic has accelerated the...
UNLABELLED
Policy Points Telehealth has many potential advantages during an infectious disease outbreak such as the COVID-19 pandemic, and the COVID-19 pandemic has accelerated the shift to telehealth as a prominent care delivery mode. Not all health care providers and patients are equally ready to take part in the telehealth revolution, which raises concerns for health equity during and after the COVID-19 pandemic. Without proactive efforts to address both patient- and provider-related digital barriers associated with socioeconomic status, the wide-scale implementation of telehealth amid COVID-19 may reinforce disparities in health access in already marginalized and underserved communities. To ensure greater telehealth equity, policy changes should address barriers faced overwhelmingly by marginalized patient populations and those who serve them.
CONTEXT
The COVID-19 pandemic has catalyzed fundamental shifts across the US health care delivery system, including a rapid transition to telehealth. Telehealth has many potential advantages, including maintaining critical access to care while keeping both patients and providers safe from unnecessary exposure to the coronavirus. However, not all health care providers and patients are equally ready to take part in this digital revolution, which raises concerns for health equity during and after the COVID-19 pandemic.
METHODS
The study analyzed data about small primary care practices' telehealth use and barriers to telehealth use collected from rapid-response surveys administered by the New York City Department of Health and Mental Hygiene's Bureau of Equitable Health Systems and New York University from mid-April through mid-June 2020 as part of the city's efforts to understand how primary care practices were responding to the COVID-19 pandemic following New York State's stay-at-home order on March 22. We focused on small primary care practices because they represent 40% of primary care providers and are disproportionately located in low-income, minority or immigrant areas that were more severely impacted by COVID-19. To examine whether telehealth use and barriers differed based on the socioeconomic characteristics of the communities served by these practices, we used the Centers for Disease Control and Prevention Social Vulnerability Index (SVI) to stratify respondents as being in high-SVI or low-SVI areas. We then characterized respondents' telehealth use and barriers to adoption by using means and proportions with 95% confidence intervals. In addition to a primary analysis using pooled data across the five waves of the survey, we performed sensitivity analyses using data from respondents who only took one survey, first wave only, and the last two waves only.
FINDINGS
While all providers rapidly shifted to telehealth, there were differences based on community characteristics in both the primary mode of telehealth used and the types of barriers experienced by providers. Providers in high-SVI areas were almost twice as likely as providers in low-SVI areas to use telephones as their primary telehealth modality (41.7% vs 23.8%; P <.001). The opposite was true for video, which was used as the primary telehealth modality by 18.7% of providers in high-SVI areas and 33.7% of providers in low-SVI areas (P <0.001). Providers in high-SVI areas also faced more patient-related barriers and fewer provider-related barriers than those in low-SVI areas.
CONCLUSIONS
Between April and June 2020, telehealth became a prominent mode of primary care delivery in New York City. However, the transition to telehealth did not unfold in the same manner across communities. To ensure greater telehealth equity, policy changes should address barriers faced overwhelmingly by marginalized patient populations and those who serve them.
Topics: Attitude of Health Personnel; COVID-19; Female; Health Equity; Humans; Male; Pandemics; Patient Acceptance of Health Care; Primary Health Care; SARS-CoV-2; Surveys and Questionnaires; Telemedicine
PubMed: 34075622
DOI: 10.1111/1468-0009.12509 -
Sleep Medicine Clinics Sep 2021Interest in telemedicine has increased exponentially. There is a growing body of published evidence on the use of telemedicine for patients using continuous positive... (Review)
Review
Interest in telemedicine has increased exponentially. There is a growing body of published evidence on the use of telemedicine for patients using continuous positive airway pressure. Telemedicine-ready devices can support the transmission on use time, apnea-hypopnea index, and leakage. This approach enables early activation of troubleshooting. Automated, personalized feedback for patients and patient access to their own data provide unprecedented opportunities for integrating comanagement approaches, multiactor interactions, and patient empowerment. Telemedicine is likely cost effective, but requires better evidence. Notwithstanding barriers for implementation that remain, telemedicine has to be embraced, leaving the physician and patient to accept it or not.
Topics: Continuous Positive Airway Pressure; Humans; Sleep Apnea Syndromes; Telemedicine
PubMed: 34325821
DOI: 10.1016/j.jsmc.2021.05.009 -
International Journal of Environmental... Sep 2022For many years, the importance of using telematic technologies in medicine has been growing, especially in the period of the coronavirus pandemic, when direct contact... (Review)
Review
For many years, the importance of using telematic technologies in medicine has been growing, especially in the period of the coronavirus pandemic, when direct contact and supervision of medical personnel over the patient is difficult. The existing possibilities of modern information and communication technologies (ICTs) are not fully used. The aim of the study is to identify the telemedicine technologies that can be used in future implementation projects of the posthospital patient care process after total hip arthroplasty (THA). The literature search is reported according to PRISMA 2020. The search strategy included databases and gray literature. In total, 28 articles (EMBASE, PubMed, PEDro) and 24 records from gray literature (Google Search and Technology presentations) were included in the research. This multi-source study analyzes the possibilities of using different technologies useful in the patient care process. The conducted research resulted in defining visual and wearable types of telemedicine technologies for the original posthospital patient care process after THA. As the needs of stakeholders in the posthospital patient care process after THA differ, the awareness of appropriate technologies selection, information flow, and its management importance are prerequisites for effective posthospital patient care with the use of telemedicine technologies.
Topics: Arthroplasty, Replacement, Hip; Humans; Pandemics; Patient Care; Technology; Telemedicine
PubMed: 36141791
DOI: 10.3390/ijerph191811521 -
International Journal of Technology... Dec 2023Telemedicine may improve healthcare access and efficiency if it demands less clinician time than usual care. We sought to describe the degree to which telemedicine... (Review)
Review
OBJECTIVES
Telemedicine may improve healthcare access and efficiency if it demands less clinician time than usual care. We sought to describe the degree to which telemedicine trials assess the effect of telemedicine on clinicians' time and to discuss how including the time needed to treat (TNT) in health technology assessment (HTA) could affect the design of telemedicine services and studies.
METHODS
We conducted a scoping review by searching clinicaltrials.gov using the search term "telemedicine" and limiting results to randomized trials or observational studies registered between January 2012 and October 2023. We then reviewed trial registration data to determine if any of the outcomes assessed in the trials measured effect on clinicians' time.
RESULTS
We found 113 studies and of these 78 studies of telemedicine met the inclusion criteria and were included. Nine (12 percent) of the 78 studies had some measure of clinician time as a primary outcome, and 11 (14 percent) as a secondary outcome. Four studies compared direct measures of TNT with telemedicine versus usual care, but no statistically significant difference was found. Of the sixteen studies including indirect measures of clinician time, thirteen found no significant effects, two found a statistically significant reduction, and one found a statistically significant increase.
CONCLUSIONS
This scoping review found that clinician time is not commonly measured in studies of telemedicine interventions. Attention to telemedicine's TNT in clinical studies and HTAs of telemedicine in practice may bring attention to the organization of clinical workflows and increase the value of telemedicine.
Topics: Telemedicine; Technology Assessment, Biomedical; Time; Appointments and Schedules
PubMed: 38099431
DOI: 10.1017/S0266462323002830 -
Sleep Medicine Clinics Sep 2020Innovation in technology is redefining the world, including health care. Patients want convenient and quality interactions with their providers. The addition of... (Review)
Review
Innovation in technology is redefining the world, including health care. Patients want convenient and quality interactions with their providers. The addition of telemedicine technologies and asynchronous provider-to-patient communications is creating a more connected model of health care that will improve access and the value of care while decreasing costs, as well as enabling patients to participate more directly in their own care. As new technologies and new models of care continue to emerge, providers need to continue to monitor the rapidly changing landscape of telemedicine coding and reimbursement. Telehealth coding and reimbursement rules are payor and state dependent.
Topics: Communication; Humans; Insurance, Health, Reimbursement; Sleep Wake Disorders; Telemedicine
PubMed: 32762974
DOI: 10.1016/j.jsmc.2020.06.002 -
Romanian Journal of Ophthalmology 2019Telemedicine provides adequate medical assistance for physically distant patients by using the Information and Communication Technologies (ICT). Telemedicine includes... (Review)
Review
Telemedicine provides adequate medical assistance for physically distant patients by using the Information and Communication Technologies (ICT). Telemedicine includes techniques and tools for health monitoring and care implemented through systems providing rapid access to both specialists and patients. Telemedicine may link human and economic resources. Telemedicine may facilitate the access of patients to specialized healthcare in places lacking qualified personnel or in remote or difficult access areas thus reducing long waiting lists and high costs for the health systems. Telemedicine projects between different countries are developing, but ethical and legal issues are emerging. This article refers to telemedicine as a broad concept of distance medicine. The main purpose will be the medical-legal aspects. We will also describe the telemedicine in ophthalmology and the main issues raised by its implementation.
Topics: Delivery of Health Care; Humans; Ophthalmology; Telemedicine
PubMed: 31687620
DOI: No ID Found