Health Information Technology Commons^™

Influence Of Telephone Preoperative Evaluations On Patient Medication Compliance On Day Of Surgery, Emmanuel Magsino, Michael Jung, Olga Suarez Md

Graduate Research Posters

Patient compliance with medication instructions on day of surgery (DOS) is an important part of the preoperative assessment, as failure to comply with these may lead to serious perioperative consequences. Prior studies have shown that compliance increases with multimodal interventions. However due to the recent COVID-19 pandemic, many in-person visits transitioned to telephone visits and providers had to rely on patients to follow solely verbal instructions.

To determine medication compliance, this study compared the medication instructions provided by the VCU Preoperative Assessment Communication and Education Clinic, per chart review, with each patient’s own report of which medications they took on …

Impact Of Telemedicine On Heart Failure Readmissions And Mortality: A Literature Review, Stephanie R. Ledvina

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: Heart failure is a chronic condition that commonly results in frequent hospitalizations and increases risk of mortality (Kotb et al., 2015; Ong et al., 2016; Pekmezaris et al., 2018). In addition, heart failure places a significant burden on healthcare costs and utilization of resources (Hale et al., 2016; Kotb et al., 2015; Ong et al., 2016). Measures to reduce heart failure readmissions, mortality, and overall costs are needed. Telemedicine interventions may be beneficial in the management of heart failure; however, the current research provides unclear and inconclusive findings in regard to the effectiveness of telemedicine interventions on heart failure …

Solving Community Sars-Cov-2 Testing With Telehealth: Development And Implementation For Screening, Evaluation And Testing., Aditi Joshi, Resa E. Lewiss, Maria Aini, Bracken Babula, Patricia C. Henwood

Department of Emergency Medicine Faculty Papers

BACKGROUND: Telehealth has emerged as a crucial component of the SARS-CoV-2 pandemic emergency response. Simply stated, telehealth is a tool to provide health care from a distance. Jefferson Health has leveraged its acute care telehealth platform to screen, order testing, and manage patients with COVID-19-related concerns.

OBJECTIVE: This study aims to describe the expansion and results of using a telehealth program to increase access to care while minimizing additional potential exposures during the early period of the COVID-19 pandemic.

METHODS: Screening algorithms for patients with SARS-CoV-2-related complaints were created, and 150 new clinicians were trained within 72 hours to address …

Tele Critical Care Implementation And Education Project, Jeffrey Dover

Master's Projects and Capstones

Abstract

Problem: The intensive care unit has the highest rate of mortality and patient care costs in the hospital. There are significant challenges in improving care and controlling costs. One solution adopted by many healthcare organizations is intensive care telemedicine. Commonly known as eICUs or Tele Critical Care (TCC). These specialty units provide access to intensivists and nurses 24-hours a day and has shown success in reducing mortality and length of stay while providing cost savings.

Challenges exist in introducing telemedicine to a new setting. Barriers identified are high initial cost of equipment, competing priorities for resources, and nurse acceptance. …

Increasing Cms Sepsis Core Measure Adherence Rates Through Virtual Consultation, Angela Cann

Dissertations

Problem: According to the Centers of Disease Control and Prevention (CDC, 2016), it is estimated that sepsis affects around 1.5 million individuals in the United States annually, causing the death of 250,000 individuals and being responsible for one out of three hospital deaths. One-fourth of patients who develop severe sepsis will die during their hospital stay. Delays in sepsis treatment contribute significantly to increased morbidity, mortality, and length of stay in the hospital. The Centers for Medicare and Medicaid (CMS) sepsis bundle guideline adherence rate in the Emergency Department of a Level III Trauma Center was stagnant at 55% through …

Examining The Possibilities Of Telehealth In Tallahatchie County, Taran Carrasco

Honors Theses

This thesis aims to analyze Tallahatchie County and determine the feasibility of establishing a telehealth program in the county. Telehealth is an evolving aspect in the medical field that incorporates technology with healthcare. This thesis used sociotechnical theory to explain how the feasibility of telehealth could be made more likely as the technology is used over time.Through interviewing UMMC telehealth directors, Tallahatchie Wellness center workers, and citizens of Charleston, this study aims to gauge professional and personal opinions on how feasible it would be to implement telehealth into the Charleston community, as well as how positively telehealth would be accepted …

Survey Of Client Perspective On The Use Of Veterinary Telemedicine For Chronic Disease Management, Nathan Jay Matlock

Applied Research Projects

Veterinary Telehealth is a rapidly growing sector of Veterinary Medicine. Technological advancements have allowed for vast changes in the way chronic disease states can be managed. There are many facets of telemedicine that must be researched to determine the productiveness of such technological advances. The first step in determination of implementation is that of community acceptance and likely utilization. This project’s scope is to determine client perspective on the use of veterinary telemedicine for chronic disease state(s) management.

Rural Caregivers: Identification Of Informational Needs Through Telemedicine Questions, Shoshana H. Bardach, Allison Gibson, Kelly Parsons, April Stauffer, Gregory A. Jicha

Sanders-Brown Center on Aging Faculty Publications

OBJECTIVES: The prevalence of Alzheimer's disease and associated disorders is increasing. Rural residents in the United States have less access to memory care specialists and educational and community resources than in other areas of the country. Over a decade ago, we initiated an interdisciplinary rural caregiving telemedicine program to reach Kentucky residents in areas of the state where resources for supporting individuals with dementia are limited. Telemedicine programs involve a short informational presentation followed by a question and answer session; programs are offered 4 times a year. The purpose of this study was to explore questions asked over 1 year …

Improving Hearing Screenings With Tele-Otology, Ryan J. Miller, Joshua George-Lopez, Robert S. Hong Md, Phd

Medical Student Research Symposium

Introduction: The Lions Hearing Center of Michigan (LHC-MI) is an assistance program in Detroit that provides hearing aids to individuals in need. LHC-MI has provided thousands of hearing aids, but such efforts have been costly, requiring patients to make multiple appointments at multiple locations. To streamline this process, the LHC-MI is piloting a new program, titled “Hear Now! Detroit!”, that uses telemedicine to reach patients at community sites.

Purpose: To evaluate the feasibility of a hearing screening program that uses telemedicine to reduce the number of visits required to acquire hearing aids.

Methods: Teams of community volunteers were deployed to …

Launching Virtual Care In A Benign Breast Surgery Clinic, Louisa Antonelli Bs, Hassan Nasser Md, Jessica Bensenhaver Md, Lindsay Petersen Md

Medical Student Research Symposium

The aim of this study is to assess the success of implementation of a telemedicine clinic in a benign breast surgery practice, and the hypothesis was that some women may feel uncomfortable virtually discussing breast complaints and problems. Twelve women seen as new patients in the benign breast surgery clinic and scheduled for surgery were asked if they were interested in having their post-operative visit performed virtually. Demographic information was also collected. Ages ranged from 24 to 77 years, and distance from the hospital ranged from 4.3 miles to 14.3 miles. Of the 12 women surveyed, 8 women were interested …

Telepsychiatry Preferences Among College Students Diagnosed And Undiagnosed With A Mental Health Condition, Wendy Schuh

Health Sciences Publications

College health and counseling centers report an increasing demand for mental health services while students continue to experience barriers such as shortage of providers, transportation, or stigma. Telepsychiatry has been established in some environments to overcome these barriers, but little research has explored an effective higher education model. The purpose of this study was to identify differences in telepsychiatry preferences among college students who have and have not been diagnosed with or treated for a mental health condition in the last year. Students (n = 537; Mage = 21 years; 71% female) at a medium-sized Midwestern university participated in a …

Telemedicine In Pediatric Speech Therapy: Characteristics Of Child, Mother, And Speech-Language Pathologist Vocal Interaction., Abigail L Betts

College of Arts & Sciences Senior Theses

Telemedicine is a potential solution to provide distant or underserved clients with access to their clinician. The purpose of this thesis is to examine how the use of telemedicine affects the vocal characteristics of children who received cochlear implants (CI), their mother, and a speech-language pathologist (SLP) as they engage in a speech-language therapy intervention. The children (n = 5), her caregiver, and the SLP engaged in one 30 minute in person session and one 30 minute telemedicine session in a counterbalanced order. The frequency of vocalizations, vocal turns, and between-speaker pause (BSP) duration in both sessions were examined. The …

Amending The Ryan Haight Act: Elevating Telemedicine Law To New Heights, Dillon Vaughn

Texas A&M Law Review

The Ryan Haight Act has established excessive restrictions on controlled substance prescribing through telemedicine by first requiring an in-person exam. If the Act is not amended, many individuals in need of medication will go without proper medical care. While other agencies and states have made moves to expand telehealth, the DEA has dragged its feet on making any significant changes. This Comment argues that the federal government should amend the Ryan Haight Act, allowing telemedicine providers to prescribe controlled substances without an in-person exam. This amendment would focus on the standard of care while requiring stringent documentation by physicians who …

Bridging The Digital Divide: A Risk-Based “Telehealth Needs” Scoring Model For Patient Outcome Prediction, Cindy Ann Crump

Theses and Dissertations

The purpose of the research was to develop a predictive model of the effect of patient characteristics on outcomes and resource utilization in telehealth interventions for chronic disease management. Clinical studies have shown high variability in telehealth across settings and populations. The central hypothesis of this study was that patient characteristics, including disease type, illness severity, demographic information, and socio-technical preferences play a role in determining telehealth intervention outcomes. A non-experimental, retrospective study evaluated the feasibility of creating a Telehealth Needs score using Medicare and Medicaid claims data from 2016 to 2017. Claims were summarized into de-identified cases to train …

Perspectives Of Occupational Therapy Practitioners On Benefits And Barriers On Providing Occupational Therapy Services Via Telehealth, Taylor Corey

Student Capstone Papers

The purpose of this project is to gain a better understanding of the provider’s perspectives about the strengths and barriers of occupational therapy (OT) services provided via telehealth. Based on the evidence that will be collected through surveys and interviews, this research can help determine specific factors on whether or not therapist choose to provide services through telehealth. Centered around those perspectives of telehealth, the results can help explore more in depth on the issues and concerns therapists have regarding telehealth as a service delivery model.

Perspectives Of Occupational Therapists On Telehealth, Taylor Corey, Becki Cohill, Susan Macdermott

San Marcos, Fall 2019

The purpose of this project is to gain a better understanding of the provider’s perspectives about the strengths and barriers of OT services provided via telehealth. Based on the evidence that will be collected through surveys and interviews, it can help determine specific factors on whether or not therapist choose to provide services through telehealth. Centered around those perspectives of telehealth, the results can help explore more in depth on the issues and concerns therapists have when it comes to telehealth as a service delivery model.

Telehealth In Critical Care: Quality And Cost Outcomes, Stephanie Cole, Michael Robie, Bukola Abodunde, Alberto Coustasse

Management Faculty Research

As the population of the United States has continued to age, there has been an increase in usage and Hospital Length of Stay (LOS) costs of Intensive Care Unit (ICU) beds. In the early 2000s, it was determined there would be a shortage of all ICU providers within the next decade due to the increased need for critical care for the aging generation. Around this time, the Leapfrog Group was formed to demand that hospitals improve quality and decrease cost. Utilization of telehealth in the ICU was a possible alternative, which had a positive impact on both clinical and financial …

Quality Assurance In Telehealth: Adherence To Evidence-Based Indicators., Daniel Halpren-Ruder, Anna Marie Chang, Judd E. Hollander, Anuh Shah

Department of Emergency Medicine Faculty Papers

Background: Value enhancing telehealth (TH) lacks a robust body of formal clinically focused quality assessment studies. Innovations such as telehealth must always demonstrate that it preserves or hopefully advances quality. Introduction: We sought to determine whether adherence to the evidence-based Choosing Wisely (CW) recommendations (antibiotic stewardship) for acute sinusitis differs for encounters through direct-to-consumer (DTC) telemedicine verses "in-person" care in an emergency department (ED) or an urgent care (UC) center.

Materials and Methods: Study design was a retrospective review. Patients with a symptom complex consistent with acute sinusitis treated through DTC were matched with ED and UC patients, based upon …

Teens Using Screens For Help: Impact Of Suicidal Ideation, Anxiety, And Depression Levels On Youth Preferences For Telemental Health Resources., Tammy Toscos Phd, Amanda Coupe, Mindy Flanagan, Michelle Drouin, Maria D. Carpenter, Lauren Reining, Amelia Roebuck, Michael Mirro Md, Facc, Fhrs, Faha

Health Services and Informatics Research

BACKGROUND: High rates of mental illness, stress, and suicidality among teens constitute a major public health concern in the United States. However, treatment rates remain low, partially because of barriers that could be mitigated with tech-based telemental health (TMH) resources, separate from or in addition to traditional care.

OBJECTIVE: This study aimed to analyze TMH resource usage by high school students to establish current user characteristics and provide a framework for future development.

METHODS: A total of 2789 students were surveyed regarding demographics, recent anxiety and depression symptoms, suicidality, and stress; people with whom they could openly and honestly discuss …

A Two-Way Interactive Text Messaging Application For Low-Income Patients With Chronic Medical Conditions: Design-Thinking Development Approach, Monika Marko-Holguin, Stephanie Luz Cordel, Benjamin William Van Voorhees, Joshua Fogel, Emily Sykes, Marian Fitzgibbon, Anne Elizabeth Glassgow

Publications and Research

Background: Two-way interactive text messaging between patient and community health workers (CHWs) through mobile phone SMS (short message service) text messaging is a form of digital health that can potentially enhance patient engagement in young adults and families that have a child with chronic medical conditions such as diabetes mellitus, sickle cell disease, and asthma. These patients have complex needs, and a user-centered way can be useful for designing a tool to address their needs.

Objective: The aim of this study was to utilize the user-centered approach of design thinking to develop a two-way interactive communication SMS text messaging tool …

Telemedicine Training In Undergraduate Medical Education: Mixed-Methods Review., Shayan Waseh, Mph, Adam P. Dicker, Md, Phd, Fastro

Student Papers, Posters & Projects

BACKGROUND: Telemedicine has grown exponentially in the United States over the past few decades, and contemporary trends in the health care environment are serving to fuel this growth into the future. Therefore, medical schools are learning to incorporate telemedicine competencies into the undergraduate medical education of future physicians so that they can more effectively leverage telemedicine technologies for improving the quality of care, increasing patient access, and reducing health care expense. This review articulates the efforts of allopathic-degree-granting medical schools in the United States to characterize and systematize the learnings that have been generated thus far in the domain of …

Opioid Use Treatment Via Telemedicine: Treatment Options For Rural Maine, Benjamin Knapp

Thinking Matters Symposium Archive

The ongoing opioid crisis has overwhelmed the traditional opioid use disorder (OUD) treatment resources across America. The treatment resources in rural communities have been especially hard hit as geographic and financial barriers limit service capacity. Telemedicine, or medicine delivered via remote means, has been proposed as a potential solution to the lack of conventional opioid treatment resources in rural Maine. Current legalities in the US prohibit telemedicine being used to prescribe opioid agonist drugs, and insurance reimbursement for telemedicine remains a major barrier. This qualitative content analysis looks at the existing research on telemedicine's treatment efficacy for use with OUD …

Evidence-Based Toolkit To Evaluate Telemedicine Delivery Of Palliative Care, Aubrey E. Dwyer

Doctoral Projects

Advances in healthcare have led to many individuals with cancer to live longer, however the quality of life of these individuals has decreased. Palliative care is a medical sub-specialty that can assist to care for individuals with a life-limiting illness such as cancer. However, the access to palliative care services in rural communities is limited. According to the Institute of Medicine (IOM) report Dying in America, increasing access to palliative care will not only enhance the quality of life for patients with a life-limiting illness, but also contribute to a more sustainable healthcare system. The key stakeholders within a Midwest …

Commentary: Telehealth Holds Promise, But Human Touch Still Needed, Todd Czartoski

Articles, Abstracts, and Reports

No abstract provided.

The Utilization Of Telehealth/ Telemedicine In Cardiology In Rural Areas, Sophia Noplis, Jocelyn Stout

Theses, Dissertations and Capstones

Introduction: Telecardiology has been defined as a way of practicing cardiology through the utilization of telecommunications and a more cost-effective way to deliver cardiac care. As a subset of telemedicine, telecardiology has functioned to bring providers to underserved communities through technological mechanisms. Rural regions have turned to telemedicine and tapped into a network of clinical institutions exchanging practitioners and patients to emphasize value-based instead of volume-based care.

Methodology: The methodology of this qualitative study was a literature review having used mixed methodologies. Five electronic databases and government websites were utilized, and one semi-structured interview with an expert in …

The Impact Of A Revised Discharge Process From Acute Care To Home Care On Hospital Utilization In Children With Single Ventricle Heart Disease, Brian M. Stahulak

Doctor of Nursing Practice Projects

Problem Description: It is estimated that approximately ~0.5%, or ~400,000, of all U.S. children, are identified as having complex chronic conditions (CCC) and account for as much as one-third, or ~$100 billion, of health care spending for all children. The goal of this quality improvement (QI) project was to identify the impact of a revised discharge process for children with Single Ventricle Heart Disease (SVHD) on hospital utilization rates and the parent’s perception of discharge readiness during the interstage period. The QI project was conducted in a 44-bed cardiac care unit within a 336-bed freestanding pediatric, academic medical center in …

Addressing Cost And Time Barriers In Chronic Disease Management Through Telemedicine: An Exploratory Research In Select Low-And Middle-Income Countries, Saleem Sayani, Momina Muzammil, Karima Saleh, Abdul Muqeet, Fabiha Zaidi, Tehniat Shaikh

Office of the Provost

Despite evidence supporting telehealth provision in developed countries, there is limited evidence regarding its economic benefits for patients living in areas where access and cost present major barriers to health care, particularly in low- and middle-income countries (LMICs). This study explores the economic benefits of telemedicine for patients, in terms of cost and times savings, and its potential role in improving chronic disease outcomes. This retrospective cross-sectional study compared telemedicine services with hypothetical in-person consultations, with a focus on patient travel time and travel cost savings. A database containing teleconsultation visits (N = 25,182) conducted at health facilities in remote …

Dr. Tele-Corporation: Bridging The Access-To-Care Gap, Nader Amer

Dickinson Law Review (2017-Present)

The United States is currently confronting an access-to-healthcare crisis, which rural regions are experiencing at a disproportionate rate. Many commentators have touted telemedicine as a solution for the access-to-care issue. Telemedicine uses video and telecommunication technology to allow physicians to treat patients from distant locations and thus facilitates a more equal distribution of physicians throughout the United States.

Although the telemedicine industry is quickly growing, the corporate practice of medicine doctrine impedes the industry’s expansion and consequently obstructs a viable solution to the access-to-care crisis. Generally, the corporate practice of medicine doctrine prohibits corporations and limited liability companies from employing …

Mobile Technology Use And Mhealth Text Message Preferences: An Examination Of Gender, Racial, And Ethnic Differences Among Emerging Adult College Students, Kristin E. Heron, Kelly A. Romano, Abby L. Braitman

Psychology Faculty Publications

Background: Mobile health (mHealth) interventions are a potentially feasible way of targeting emerging adult college students' physical and mental health concerns, decreasing health-risk, and augmenting health promoting behaviors. However, there is limited evidence attesting to advantageous ways of designing mHealth treatments in a manner that is apt to be well-received by emerging adult college students at large, and gender, racial, and ethnic subgroups in particular. To address these research gaps, this exploratory study examined general trends, and gender (male, female), racial (White, Black), and ethnic (Latino, non-Latino) differences, in emerging adult college students' mobile technology ownership and phone plan characteristics, …

Telehealth In Rural Tennessee- Closing The Gap In Care?, Kara L. Bianchini

Applied Research Projects

Telehealth is quickly becoming a tool used in everyday healthcare. Certain areas, such as rural communities in Tennessee, experience health disparities because of their location and distance from health care providers. This gap in care can be diminished through the use of telehealth services. This research project is taking place to gather data from hospitals in Tennessee currently providing telehealth services. I want to determine if telehealth is closing the gap-in-care seen in rural communities. Through research, I have found there are multiple barriers to telehealth, but also significant benefits. I think with additional education and training, telehealth can become …