Medicine and Health Sciences Commons^™

Response To: A Telehealth Explosion: Using Lessons From The Pandemic To Shape The Future Of Telehealth Regulation, Joanna Sax

Texas A&M Law Review

In A Telehealth Explosion: Using Lessons from the Pandemic to Shape the Future of Telehealth Regulation, published in the Texas A&M Law Review, Professor Deborah Farringer tackles the critical issue of the efficacy and implementation of telehealth, using our experience(s) of telehealth during the COVID–19 pandemic as the guide. This is important, as Professor Farringer acknowledges, because while telehealth advocates pre-date the pandemic, barriers prevented the implementation of telehealth in a widespread manner. These barriers included a concern about fraud and a question as to whether telehealth visits could provide effective outcomes compared to in-person visits. Professor Farringer …

Evaluating Technology-Mediated Collaborative Workflows For Telehealth, Christopher Bondy Ph.D., Pengcheng Shi, Pamela Grover Md, Vicki Hanson, Linlin Chen, Rui Li

Articles

Goals: This paper discusses the need for a predictable method to evaluate gains and gaps of collaborative technology-mediated workflows and introduces an evaluation framework to address this need. Methods: The Collaborative Space Analysis Framework (CS-AF), introduced in this research, is a cross-disciplinary evaluation method designed to evaluate technology-mediated collaborative workflows. The 5-step CS-AF approach includes: (1) current-state workflow definition, (2) current-state (baseline) workflow assessment, (3) technology-mediated workflow development and deployment, (4) technology-mediated workflow assessment, (5) analysis, and conclusions. For this research, a comprehensive, empirical study of hypertension exam workflow for telehealth was conducted using the CS-AF approach. Results: The CS-AF …

Evolution Or Revolution In Telehealth Regulation, George Horvath

Texas A&M Law Review

A frequently repeated adage, attributed to a wide range of authors and orators, holds that a serious crisis should never be allowed to go to waste. The moment in which we find ourselves renders this adage particularly timely. Responses to one of the defining crises of our age—the COVID–19 pandemic—have mostly been reactive. This includes the responses of multiple actors involved with telehealth. Congress, federal regulators, state legislatures, state regulators, private insurers, and health care providers, confronting the challenges of the pandemic, have responded by making ad hoc adjustments to the regulation and use of telehealth. Moving the conversation beyond …

Patient Perceptions Of Trauma-Focused Telemental Health Services Using The Telehealth Satisfaction Questionnaire (Tsq), Bianca T. Villalobos, Aubrey R. Dueweke, Rosaura Orengo-Aguayo, Regan W. Stewart

Psychological Science Faculty Publications and Presentations

Telehealth services can address many barriers to traditional office-based mental health services. Few studies have assessed youth and caregiver perceptions of and satisfaction with trauma-focused interventions delivered via telemental health. The current study presents data collected using the Telehealth Satisfaction Questionnaire (TSQ), which was developed to measure child and caregiver satisfaction with services, comfort with the telehealth equipment, and barriers to traditional office-based services. Thirteen clinicians delivered home- and school-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) via videoconferencing on tablets and computers to 60 child patients (71.7% Latinx, 18.3% Black, and 10.0% non-Hispanic White). Patients and caregivers completed the TSQ at …

Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington

Doctor of Nursing Practice (DNP) Projects

Aims and Objectives. This literature review's objective was to synthesize evidence from previously published literature on telemedicine interventions' effectiveness on CPAP (Continuous Positive Airway Pressure) therapy compliance.

Background. It is estimated that 22 million Americans suffer from a form of Sleep Apnea (SA), and those up to 80 percent of the cases of moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed (Sleep Apnea, n,d). The first-line therapy for OSA is CPAP. However, CPAP therapy is associated with low compliance rates.

Design. Systematic review.

Method. A multi-database literature search was conducted to identify published literature between 2009 and 2020. …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Design And Development Of A Mobile Health (Mhealth) Platform For Dementia Prevention In The Prevention Of Dementia By Mobile Phone Applications (Prodemos) Project, Melanie Hafdi, Esmé Eggink, Marieke P. Hoevenaar-Blom, M. Patrick Witvliet, Sandrine Andrieu, Linda Barnes, Carol Brayne, Rachael Brooks, Nicola Coley, Jean Georges, Abraham Van Der Groep, Harm Van Marwijk, Mark Van Der Meijden, Libin Song, Manshu Song, Youxin Wang, Wenzhi Wang, Wei Wang, Anders Wimo, Xiaoyan Ye, Eric P. Moll Van Charante, Edo Richard, Prodemos Consortium

Research outputs 2014 to 2021

Background:

Mobile health (mHealth) has the potential to bring preventive healthcare within reach of populations with limited access to preventive services, by delivering personalized support at low cost. Although numerous mHealth interventions are available, very few have been developed following an evidence-based rationale or have been tested for efficacy. This article describes the systematic development of a coach-supported mHealth application to improve healthy lifestyles for the prevention of dementia and cardiovascular disease in the United Kingdom (UK) and China.

Methods:

Development of the Prevention of Dementia by Mobile Phone applications (PRODEMOS) platform built upon the experiences with the Healthy Aging …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Access Barriers To Telehealth, Quynh Chau, Amita Behuria Pathak, Daniel Turner, Jacquelyn Cheun, Carl Noe

SMU Data Science Review

Abstract. Telehealth has long been touted as an efficient and cost-effective way to deliver health care services to patients. The COVID-19 global pandemic hastened the adoption of this technology in the United States. Despite its promises, telehealth as a technology-based model of health service delivery has also highlighted access to care inequities in the form of uneven utilization across various patient demographics. This research uses machine learning and publicly available data sources to describe telehealth utilization based on social determinants of care. The implications of this application can be used to inform health care providers of how to target efforts …

Enhancing Cancer Care Of Rural Dwellers Through Telehealth And Engagement (Encore): Protocol To Evaluate Effectiveness Of A Multi-Level Telehealth-Based Intervention To Improve Rural Cancer Care Delivery, Tuya Pal, Pamela C. Hull, Tatsuki Koyama, Phillip Lammers, Denise Martinez, Jacob Mcarthy, Emma Schremp, Ann Tezak, Anne Washburn, Jennifer G. Whisenant, Debra L. Friedman

Markey Cancer Center Faculty Publications

BACKGROUND: Despite lower cancer incidence rates, cancer mortality is higher among rural compared to urban dwellers. Patient, provider, and institutional level factors contribute to these disparities. The overarching objective of this study is to leverage the multidisciplinary, multispecialty oncology team from an academic cancer center in order to provide comprehensive cancer care at both the patient and provider levels in rural healthcare centers. Our specific aims are to: 1) evaluate the clinical effectiveness of a multi-level telehealth-based intervention consisting of provider access to molecular tumor board expertise along with patient access to a supportive care intervention to improve cancer care …

A Telehealth Explosion: Using Lessons From The Pandemic To Shape The Future Of Telehealth Regulation, Deborah Farringer

Texas A&M Law Review

From board rooms, to classrooms, to Saturday Night Live skits, the video conferencing app Zoom became a seemingly overnight sensation as a way to connect while businesses were shuttered and individuals were forced to stay at home when the coronavirus pandemic erupted in the United States in March 2020. From 10 million daily users in December 2019 to over 200 million daily users by March 2020, the company founded in 2011 became a market leader as the country tried to figure out how to continue business as usual—to the extent possible—during the global pandemic. While hospitals prepared for the onslaught …

Health Technology In School-Based Health Centers: Supporting Continuous Care During Covid-19, Erin Sullivan, Anna Goddard, Paula Fields, Suzanne Mackey

Nursing Faculty Publications

Background: Children and adolescents in the United States face disparities by race, ethnicity, and socioeconomic status, including unequal access to consistent and high-quality healthcare. School-based health centers (SBHCs) promote health equity by delivering primary, mental, and other health services directly to students in their schools. The COVID-19 outbreak in the United States resulted in schools and SBHCs closing their physical sites and pivoting to virtual service delivery. Methods: In the months immediately following school closures, school-based health center practitioners and sponsors participated in an online listening series to share how they used technology to creatively advertise services, engage with students, …

A Review Of Mobile Apps For Chronic Kidney Disease Patients, Clarisse Zigan, Carl Russell Iii, Kirsten Wozniak, Kshaunish Soni

The Journal of Purdue Undergraduate Research

No abstract provided.

Pandemic Pearl: Innovations In Virtual Improvement Coaching, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Andrew Levine

Operations Transformation

The success of local performance improvement efforts depends on the engagement of clinical care teams in a culture of continuous improvement. At the onset of the COVID-19 pandemic, many teams at Maine Medical Center (and across the globe), transitioned to remote work to stop the spread of the virus. While some are returning to office, a significant amount of work is still being done remotely. For continued success, we need to understand how we can best coach clinical care teams in a hybrid or remote environment.

A Rollout Of A Blood Pressure Remote Patient Monitoring Program To Improve High-Risk Maternal Outcomes At A Pilot Clinic For Systemwide Expansion, Laura Geron

Seton Hall University Dissertations and Theses (ETDs)

An existing virtual care platform provides an innovative means of early recognition, identification, and intervention for women with elevated blood pressures during pregnancy, known as preeclampsia. A pilot program took place at a Northeastern prenatal care clinic where patients were identified as high-risk for preeclampsia, enrolled, educated by their providers, and equipped with Bluetooth-enabled blood pressure cuffs.

Through remote patient monitoring (RPM) technology, blood pressure readings could transmit from a patient’s residence to a portal accessible by their clinic provider at any time. This doctoral-level quality improvement project focuses on the identification of patients at high-risk for preeclampsia, their enrollment …

Exploring Digital Health Interventions To Support Community Health Workers In Low-And-Middle-Income Countries During The Covid-19 Pandemic: A Scoping Review Protocol, Anam Shahil Feroz, Komal Valliani, Hajra Khwaja, Sehrish Karim

Community Health Sciences

Introduction: COVID-19 has significantly affected community health workers' (CHWs) performance as they are expected to perform pandemic-related tasks along with routine essential healthcare services. A plausible way to optimise CHWs' functioning during this pandemic is to couple the efforts of CHWs with digital tools. So far, no systematic evidence is available on the use of digital health interventions to support CHWs in low-middle-income countries (LMICs) amid the COVID-19 pandemic. The article describes a protocol for a scoping review of primary research studies that aim to map evidence on the use of unique digital health interventions to support CHWs during COVID-19 …

Facilitating Well-Rounded Clinical Experience For Psychiatric Nurse Practitioner Students, Joan Alviar Fraino, Nancy Selix

Nursing and Health Professions Faculty Research and Publications

There is a steady increase in demand for mental health services and a lack of providers. Recent societal changes resulting from the COVID-19 pandemic have increased these needs. Psychiatric mental health nurse practitioners (PMHNP) are well suited to offer these services. High-quality clinical PMHNP student experiences are based on well-rounded curricula in a variety of clinical settings. Meeting the need for clinical education and finding high-quality preceptors is especially challenging during the pandemic due to the lack of preceptors and access to care for in-person services. Creative approaches are needed to meet student clinical experience needs.

Covid‑19, Race/Ethnicity, And Age: The Role Of Telemedicine To Close The Gaps On Health Disparities, Andreas Kakolyris, Juan J. Delacruz, Christos I. Giannikos

Publications and Research

The novel COVID-19 outbreak is a major public health challenge that quickly turned into an economic recession of great proportions. This pandemic poses a trade-off between health and the economy where social distancing, quarantines, and isolation shut down demand and supply chains across the USA. This paper analyzes the impact of COVID-19 on illness and death among older adults and communities of color with low socioeconomic status in New York City. To achieve this goal, fractional logit models are used to capture changes in the novel virus’ morbidity and mortality rates at the neighborhood level. Median income, race/ethnicity, age, household …

A Pilot Study Of Knee And Hip Osteoarthritis Patient Experience With Telemedicine During The Covid-19 Pandemic, Rondy M. Lazaro, Kyle J. Smith, Mohammad H. Bawany, Nathan Barford, Jennifer H. Paul

Advances in Clinical Medical Research and Healthcare Delivery

Objective: The purpose of this pilot study is to examine patients' experience and satisfaction using telemedicine for knee and hip osteoarthritis care during the COVID-19 pandemic.

Methods: Adult patients seen via telemedicine for knee and/or hip osteoarthritis pain completed surveys through the REDCap online platform or pen/paper evaluating their experiences and satisfaction with telemedicine, assessed using yes/no and Likert scale questions. Demographic information was collected from the electronic medical record (EMR).

Results: 32 subjects (9 males, 23 females, mean age 63.2 years [SD = 12.2 years]) completed surveys. 90.6% of subjects stated that they were satisfied with the audio/video quality …

Use Of A Remote Patient Home Telemonitoring System (Engage Practice Solutions) In A Rural Health System To Decrease Rural Patients’ Utilization Of Acute Healthcare Services: A Quality Improvement Project, Christopher Baker

Doctor of Nursing Practice (DNP) Manuscripts

Individuals in rural areas of the U.S. have less healthcare access in large part due to access barriers, and include travel and wait time, distance to a provider, cost, transportation, and social and cultural components. Rural individuals have been found to be in poorer health and have higher rates of being uninsured and having chronic disease. These disparities lead to rural individuals requiring more expensive acute care once they are at the point of receiving care. A significant burden is placed on the individual and health system. The rates of emergency department (ED) use in rural areas increased 70% from …

Do Virtual Visits Have An Effect On Outpatient Antibiotic Prescribing For Uris?, Sydney Harris, Eric Young, Jarrod W. Kile Rphd, Kathryn Zaffiri Mph

Research Scholars

No abstract provided.

A Preliminary Evaluation Of The Behavioral Gerontology Staff Training Protocols, Minyoung Kim

Masters Theses

Staff training in aging settings is integral to ensuring quality services, and such training has traditionally been conducted in person. With the COVID-19 outbreak, there is a need for innovative approaches to training that reduce exposure for trainers and staff. However, the efficacy of such an approach has not yet been demonstrated. To prevent the waste of staff resources at long-term care facilities, this study evaluates the efficacy of behavioral gerontology staff training protocols as a form of telehealth by utilizing graduate and undergraduate students as pilot participants. We use an additive concurrent multiple-probe design across participants to evaluate the …

Effectiveness Of An Adapted Virtual Medication Reconciliation Osce Compared With In Person Osce, Rick Hess, Kelly L. Covert, Mckenzie Calhoun Highsmith, Jennifer Trotter, Brian Cross

International Journal of Health Sciences Education

Introduction:

The objective of this study was to measure virtually-based objective structured clinical exam (OSCE) pass rates of student pharmacists who received remote, synchronous instruction on medication reconciliation compared with OSCE pass rates from the previous class, who received face to face synchronous instruction and OSCEs. The secondary objective was to measure student perceptions of remote instruction and OSCE preparation.

Materials and Methods:

Second year student pharmacists attended four online preparatory labs to learn and practice the process of performing a medication reconciliation. A virtually-based OSCE was used to assess student competency of identifying the primary or life-threatening medication related …

Assessing Telemedicine Outcomes With Hospitality Principles, Wei Wei, Yunying (Susan) Zhong

Rosen Research Review

Hospitality as a concept has relevance across many industries of service provision, including the health care sector. The COVID-19 pandemic has had a major impact on the way in which patients access health care from their service providers. In this study, Dr. Wei Wei and Dr. Yun Ying (Susan) Zhong build a predictive model outlining the most important factors in enabling patients to experience positive emotional outcomes during telemedicine encounters.

Survey Of Telemedicine By Pediatric Nephrologists During The Covid-19 Pandemic., Rupesh Raina, Nikhil Nair, Hui Kim Yap, Guido Filler, Sidharth K. Sethi, Arvind Bagga, Pankaj Hari, Timothy Bunchman, Sharon Bartosh, Katherine Twombley, Gaurav Kapur, Mignon Mcculloch, Bradley A. Warady, Maria Díaz-González De Ferris, Sarah Rush

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: The slow increase in use of telemedicine began to expand rapidly, along with reimbursement changes, during the coronavirus disease-2019 (COVID-19) pandemic. Standardized protocols for these services are lacking but are needed for effective and equitable health care. In this study, we queried pediatric nephrologists and their patients about their telemedicine experiences during the pandemic.

Methods: Surveys that were in compliance with the Health Insurance Portability and Accountability Act were deployed online to patients and physicians.

Results: We collected survey responses from 400 patients and 197 pediatric nephrologists. Patients reported positive experiences with telemedicine visits as it was logistically easier …

Personalized Digital Phenotype Score, Healthcare Management And Intervention Strategies Using Knowledge Enabled Digital Health Framework For Pediatric Asthma, Utkarshani Jaimini, Amit Sheth

Publications

Asthma is a personalized, and multi-trigger respiratory condition which requires continuous monitoring and management of symptoms and medication adherence. We developed kHealth: Knowledge-enabled Digital Healthcare Framework to monitor and manage the asthma symptoms, medication adherence, lung function, daily activity, sleep quality, indoor, and outdoor environmental triggers of pediatric asthma patients. The kHealth framework collects up to 1852 data points per patient per day. It is practically impossible for the clinicians, parents, and the patient to analyze this vast amount of multimodal data collected from the kHealth framework. In this chapter, we describe the personalized scores, clinically relevant asthma categorization using …

The Age Of Artificial Intelligence: Use Of Digital Technology In Clinical Nutrition, Berkeley K. Limketkai, Kasuen Mauldin, Natalie Manitius, Laleh Jalilian, Bradley R. Salonen

Faculty Research, Scholarly, and Creative Activity

Purpose of review

Computing advances over the decades have catalyzed the pervasive integration of digital technology in the medical industry, now followed by similar applications for clinical nutrition. This review discusses the implementation of such technologies for nutrition, ranging from the use of mobile apps and wearable technologies to the development of decision support tools for parenteral nutrition and use of telehealth for remote assessment of nutrition.

Recent findings

Mobile applications and wearable technologies have provided opportunities for real-time collection of granular nutrition-related data. Machine learning has allowed for more complex analyses of the increasing volume of data collected. The …

Session 2: Access To Health And Health Services Panel - The Covid-19 Experience, Annette Clark, Wendy Chalres, Dan Laster, Anna Santos Rutschman, Madhavi Sunder, Margret Chon

SITIE Symposiums

COVID-19 has had a massive impact on the U.S. and the world regarding health care and health care access. Improving access has been the topic of scholarship for many years. It took the COVID- 19 pandemic to bring these issues to the forefront of public discussion. Inequities in public health access, not only domestically but globally, have become apparent in the light of COVID-19. This expert panel addresses the inequities of vaccines worldwide and the concept of vaccine sharing programs. It also explores the role that intellectual property plays in these equity issues and some of the risks inherent in …

Social Distancing With Your Doctor: The Promise Of Telemedicine In Medicare And Medicaid, And How To Pay For It, Jacob Hauschild

Minnesota Journal of Law, Science & Technology

No abstract provided.

Addressing The Limitations Of Neurosurgical Care Via Telemedicine, Nikolaos Mouchtouris, Md, Robert Sergott, Md, Mark Moster, Md, Michael Karsy, Md, Laura Sweeney, Crnp, Christopher Farrell, Md, James Evans, Md

Health Equity and Quality Improvement (HEQI) Summit

Novel telemedicine software successfully automates cranial nerve assessment of patients from the comfort of their home