Health and Medical Administration Commons^™

Advocacy Spotlight: Telehealth Regulations For Dentistry Established, Neema Katibai Jd

The Journal of the Michigan Dental Association

The article discusses the rise of telehealth in the last three years and its implications for dentistry, focusing on recent rulemaking by the Michigan Board of Dentistry. The regulations address key aspects such as definitions, informed consent, scope of practice, and prescribing medications. Dentists must comply with HIPAA and state/federal privacy regulations when using telehealth. Notably, the rules restrict teledentistry delegation to allied personnel after an in-person visit within 24 months. The article emphasizes the importance of understanding and following these regulations for legal telehealth use, reimbursement, and malpractice coverage. The Michigan Dental Association advocates for sensible teledentistry laws to …

The Impact Of Telehealth In Urgent Care Settings, Annie Dong

Applied Research Projects

Telehealth is an emerging modality of patient care and has since expanded to urgent care facilities. Urgent care facilities have been around for decades; however, along with telehealth, it has only grown in popularity in recent years due to the COVID-19 pandemic. However, the implementation and usage of telehealth in urgent care facilities is dependent on the provider being able to use it. This study aimed at looking at the perspective of the provider on the implementation and usage of telehealth in the urgent care setting.

Impact Of A Novel Multi-Specialist Telemedicine Consultation Program Model Of Care For Homebound Older Adults, Samir K. Sinha Dr, Kristina Marie Kokorelias, Nicoda Foster, Pauline Kabitsis, Alfiya Mukharyamova, Mary Ann Hamelin, Nga Truong, Anna Grosse Dr, Janny Lee

Journal of Geriatric Emergency Medicine

BACKGROUND: In 2015, a centralised Multi-Specialist Telemedicine (TM) Consultation Program was established to improve access to specialist care and enhance continuity of care for homebound older adults in Toronto, Canada. Community-dwelling patients were referred to the program by their primary care providers (PCP), treating specialists, and inpatient physicians for specialist-led post hospital discharge follow-up care. A clinical nurse specialist (CNS) thereafter collaborated with hospital-based consulting specialists, utilizing videoconferencing technology to facilitate consultations and follow-up visits for homebound patients

METHODS: We conducted a retrospective observational study of the overall intervention including patient characteristics and the number/type of consultations provided by analyzing …

A Systematic Literature Review Of Telehealth For Health Equity In Pediatric And Women's Health Care: Promise Vs Reality, Sharanya Chandu

Honors Scholar Theses

Background: Telehealth interventions can transform the healthcare system to improve accessibility, quality of care, and outcomes for women’s obstetric health.

Objective: This literature review seeks to summarize current research to understand the effect of telehealth on women’s obstetrics and gynecology outcomes.

Methods: A literature review was conducted following the PRISMA methodology to identify a set of papers containing information related to obstetrics and maternal health. The search terms used identified telehealth or telemedicine interventions used for obstetric, maternal, or prenatal care from the period 2013-2023. 19 articles were identified and reviewed.

Results: The literature review considered three primary aspects from …

Draws And Windfalls: Comparing Patient Experiences In Inpatient Telehealth And Non-Telehealth Acute Care Units, Geoffrey A. Silvera, Erin Blanchard, Varun Natarajan, Eric Wallace, William Steve Stigler, Bart Kelly, Terri Scarborough, Sue S. Feldman

Patient Experience Journal

The global COVID-19 pandemic has challenged health care delivery in many ways. One solution from the pandemic that offers potential upside is the expansion of telehealth as a means to provide high quality, cost-effective, and safe care while also maintaining excellence in patient and family experience. While most examinations of the use of telehealth over the pandemic have focused on the expansion of outpatient telehealth, few have explored the use of telehealth for hospitalized patients. This article will examine the influence of telehealth use on patient experiences among acute care patients. Inpatient telehealth acute care (ITAC) is a …

Limitations Of Telemedicine Vs. Face-To-Face Eye Examination In A Patient With New Headaches, Joseph Hallak, Od, Danielle Kalberer, Od

Optometric Clinical Practice

Background: During the emergence and rise of COVID-19, precaution directives and limitations on in-person eye examinations re-routed a significant portion of care to telemedicine and virtual modalities. While these technologies allowed for healthcare communications that otherwise could not occur during such trying times, there are major limitations to these sanctioned applications. This report will present a seemingly benign case that could have easily been re-routed from an in-person examination to a telemedicine version due to the patient’s seemingly “routine” vision complaints.

Case Report: A 50-year-old male patient contacted the eye clinic with a complaint of a minor, new, unexplained headache …

A Content Analysis Of Media Coverage Of Telehealth In Mississippi, Hailey Layne

Honors Theses

Telehealth’s utilization within healthcare has expanded and changed areas of healthcare delivery. In rural states like Mississippi barriers to accessing healthcare services exist due to demographic factors, socioeconomic factors, or geographic distance. This study was meant to look at the literature related to telehealth that was being disseminated to Mississippians through online news sources. It was noted whether these articles viewed telehealth utilization in a positive or negative way. Utilizing a cross-sectional media analysis, the news articles were screened using a coding form that acknowledged different themes in the literature. Frequency analyses were conducted to aid in interpreting the common …

Work-Life Balance: Combating Nurse Practitioner Burnout And Primary Care Provider Shortages Utilizing Telehealth, Jennifer O'Dell

Graduate Research Projects

No abstract provided.

Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters

DNP Projects

BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.

PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.

METHODS: Electronic health records of telehealth patients were reviewed in an …

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

AbstractThe COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks

Walden Dissertations and Doctoral Studies

Telehealth became a prominent fixture in the way healthcare was delivered during COVID-19. Providers were forced to offer telehealth as an optional mode of care. Although little research was available, studies about the experiences and attitudes of providers regarding their intention and willingness to use telemedicine before the pandemic was exiguous. The purpose of this study was to understand providers perception and use behavior patterns regarding the acceptance and adoption of telemedicine during the pandemic. Data collected from the COVID-19 Healthcare Coalition Telehealth Impact Survey was used to help characterize the experiences and attitudes of providers regarding telehealth utilization during …

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

Technology About Me Without Me: An Examination Of The Relationship Between Patient-Facing Technology And Patient Experience, Geoffrey A. Silvera Phd, Mha, Courtney N. Haun Phd, Mph

Patient Experience Journal

To appreciate the role of electronic health records (EHRs) in achieving the goals of patient-centered care, scholars have focused primarily on the influence of EHR capabilities on clinical providers’ behaviors. The objective of this study is to examine the degree to which patient-facing technology (P-Tech) in U.S. hospital EHRs are associated with patient evaluations of their care experience. A cross-sectional OLS regression is executed to examine the relationship between P-Tech and patient experience on a sample of U.S. hospitals (n=1,168) compiled via data from CMS, the American Hospital Association’s (AHA) Annual Survey (2014), and the AHA Health …

Virtual Behavioral Health Treatment Satisfaction And Outcomes Across Time, Mindy R. Waite, Sara Diab, James Adefisoye

Journal of Patient-Centered Research and Reviews

Purpose: The COVID-19 pandemic continues to have major and long-lasting impacts on health care delivery and mental health. As health care shifted to telehealth, legislation was adjusted to expand telehealth allowances, creating a unique opportunity to elucidate outcomes. The aim of this study was to assess long-term patient and clinician satisfaction and outcomes with virtual behavioral health.

Methods: Data were obtained over 16 months from surveys to patients and clinicians receiving/providing virtual treatment. Outcomes data also were collected from medical records of adults receiving in-person and virtual behavioral health treatment. Data were summarized using descriptive statistics. Groups were compared using …

Using Digital Storytelling To Assess Patient Experience With Management Of Diabetes In Everyday Life (Model) Study Intervention, Arati Joshi

Longitudinal Scholar's Project

African Americans are disproportionately affected by obesity-associated diabetes compared to their White counterparts. While social determinants of health may contribute to their poor health outcomes, studies have shown that pragmatic primary care-based interventions can be effective in improving the management of obesity-associated diabetes. The Management of Diabetes in Everyday Life (MODEL) is a pragmatic randomized comparative effectiveness trial of three approaches (health coaching, text-messaging, and enhanced usual care) to supporting medically underserved African American patients with uncontrolled diabetes in improving their self-care decisions. The purpose of this study is to assess the effect of the MODEL program participation on the …

Relationship Between Rurality, Home Telehealth, And Bed Days Of Care For Military Veterans Readmitted For Heart Failure, Storm Li Morgan

Walden Dissertations and Doctoral Studies

Heart failure (HF), the leading hospital admission diagnosis for military veteran patients discharged from a Department of Veterans Affairs (VA) hospital, is more common in patients residing in rural than urban areas. Primary care managers prioritize reducing readmissions for HF as up to 80% of health care costs for HF, projected to increase to $69.7 billion annually by 2030, incur during hospitalizations. Underpinned in Andersen’s behavioral model of health services use, the purpose of this quantitative ex post facto correlational study was to examine the relationship between residence rurality, home telehealth enrollment, and bed days of care for military veteran …

Development And Validation Of A Clinical Practice Guideline For Telemedicine, Jennifer Johnell Upton

Walden Dissertations and Doctoral Studies

Access to healthcare necessitated the utilization of telemedicine during the international pandemic of COVID 19. Telemedicine use surged in family practice in 2020 with limited resources for appropriate telemedicine patients. The problem identified for this DNP project was the lack of resources for telemedicine guidelines in family practice. The purpose of this project was to create a clinical practice guideline (CPG) to initiate screenings for appropriate patients for telemedicine. The Plan, Do, Study, Act (PDSA) concept and framework were utilized to develop the CPG. The project question identified was whether the development of a CPG on telehealth delivery in a …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

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 …

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 …

Comparing Patient Experience Survey Scores Between Telehealth And In-Person Ambulatory Pediatric Subspecialty Visits, Sean T. Bomher, Matthew Wood, Elizabeth Uhlhorn, Sandro Marques, Lee Kwiatkowski, Natasa Tekic, Cameron D'Alpe, Natalie M. Pageler, Lane F. Donnelly

Patient Experience Journal

To determine the effect of encounter methods on patient experience, we evaluated patient experience survey data comparing scores between telehealth and in-person visits and pre-COVID-19 and COVID-19 time periods. Pediatric subspecialty visits were either in-person or via telehealth and received the same 16-question patient experience survey. Top box (5/5) scores were compared between in-person and telehealth visits for pre-COVID-19 and COVID-19 periods as well as between periods for in-person and telehealth visits. In addition, for both time periods and encounter methods, correlation analysis was performed to evaluate best correlation between likelihood to recommend practice and the 15 other survey questions. …

Impact Of Covid-19 On Screening Rates For Colorectal, Breast, And Cervical Cancer: Practice Feedback From A Quality Improvement Project In Primary Care, Laura A. Schad, Laura A. Brady, Laurene M. Tumiel-Berhalter, Alexandrea Bentham, Karen Vitale, Amanda Norton, Gary Noronha, Carlos Swanger, Christopher P. Morley

Journal of Patient-Centered Research and Reviews

Purpose: Three New York State practice-based research networks provided quality improvement strategies to improve screening rates for breast, cervical, and colorectal (BCC) cancers in safety-net primary care, over 7 years. In the final year (Y7), the United States experienced the COVID-19 pandemic. The impact of the COVID-19 pandemic on BCC cancer screening rates was assessed qualitatively.

Methods: A total of 12 primary care practices participated in Y7 of the quality improvement project. BCC cancer screening rates at year beginning and end were assessed. Practice staff were asked about how COVID-19 impacted screening. Average pre/postintervention screening rates and qualitative thematic analysis …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

Evaluating Va Nurse Acceptance Of Virtual Healthcare Technology During The Coronavirus Outbreak, Francesca Bryan-Couch

Doctor of Nursing Practice Scholarly Projects

At a regional Veterans Administration (VA) hospital, nurses performing case management were unable to perform face-to-face visits with patients due to coronavirus. Care coordination and discharge planning efforts occurred through telephonic case management to preserve personal protective equipment and reduce transmission rates through social distancing. Trust and rapport between patients and nurses were reduced without personal contact. Peplau’s theory of interpersonal relations described six nurse roles and three phases of relationship development required to create therapeutic nurse-patient relationships. Connectedness was a key concept considered to be the path to a successful meaningful therapeutic nurse-patient relationship (Hrabe, 2005).

To evaluate current …

The Impact Of Telehealth Services Offered By Home Care Agencies On Patient Safety, Moyna Temple

Walden Dissertations and Doctoral Studies

There is little available research about how home care agencies attempt to address patient safety during the nurse virtual healthcare visit. The purpose of this quantitative correlational study was to determine, during the delivery of telehealth care by a home care agency, to what extent the level of education of the registered nurse, the level of education of the director of the home care agency, and the clinical decision support system (CDSS) impact patient safety. The framework for the study was the complex sociotechnological systems model. Data from the 2007 National Home and Hospice Care Survey were analyzed using logistic …

Multicultural Competencies Of Healthcare Professionals And Disability-Inclusive In Telehealth During The Covid-19 Pandemic, Si-Yi Chao, Keith B. Wilson, Carrie L. Acklin

Early Childhood, Special Education, and Counselor Education Faculty Publications

There is evidence that people with disabilities are more likely to be discriminated against and to have disproportionate health care disparities compared to people who are able-bodied during the devastating COVID-19 pandemic. In light of COVID-19, telehealth has been transformed to the primary health care delivery due to social restrictions of most, globally. Disability-inclusive telehealth design can promote culturally diverse groups access and more accurate COVID-19 information, knowledge, public health measures, and guidelines of preventive strategies for acquiring COVID-19. Applying multicultural competencies is required for healthcare providers to maximize health engagement and outcomes of PWD. In many areas of health …

Utilization Of Telepsychiatry To Combat The Opioid Crisis In The United States, Haley Tallarico

Theses, Dissertations and Capstones

Introduction: In the past five years, the United States (U.S.) has experienced an unprecedented epidemic of opioid misuse, abuse and overdose related death, leading to a national public health crisis. Telepsychiatry along with medication-assisted treatment has been proposed as a viable solution. The purpose of this research was to examine the field of telepsychiatry as a practical means to combat the rapidly increasing opioid epidemic facing America and to determine the effect of telepsychiatry utilization on access to treatment received in an outpatient medical setting.

Methodology: The methodology for this study was a literature review including the use of …

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether …

Telehealth: Advances In Alternative Payment Models, Mei Zhao, Hanadi Hamadi, D Rob Haley, Jing Xu, Cynthia White-Williams, Sinyoung Park

Department of Health Administration Faculty Publications

Introduction

Previous studies indicated that telehealth services may improve hospital performance. However, the extent to which these telehealth provisions would improve hospital total performance score under the hospital value-based purchasing (HVBP) programme is not clear. The aim of this study is to examine the association between telehealth provision and hospital performance.

Methods

We performed a retrospective analysis of the association between the provision of telehealth services and 2699 hospital’s total performance score (TPS) on the 2018 HVBP programme and its four domains. Multivariate regression models were used to analyse TPS and hospital performance on each domain. Telehealth services offered by …

Health Status And Adults Willingness To Encounter A Provider By Telehealth, Jacqueline Perry

Applied Research Projects

Telehealth has proven to be a growing sector providing on-demand health services for consumers. A long history of development and refinement precede what we now know as telehealth technology. Access to telehealth technology has become widely available changing the landscape of healthcare. However, does that mean that consumers desire to use the technology? How does a factor such as health status play a role in the consumers’ willingness to encounter a provider using telehealth as the method for delivery of care? This research project aims to compare self-selected health status to consumers’ willingness to engage with telehealth services.