Health Information Technology Commons^™

A Multi-Level Assessment Of Healthcare Facilities Readiness, Willingness, And Ability To Adopt And Sustain Telehealth Services, Jamie Larson

Theses & Dissertations

Telehealth technologies are becoming more pervasive throughout the healthcare system as a way to provide services to patients that would otherwise have difficulty with access. Currently, little is known about the current state of telehealth use within clinics and hospital in the US. Most studies evaluating telehealth programs are feasibility or small patient outcome studies from one location. Utilizing a hybrid framework combining the levels of complex socio-technical systems with the theory of ready, willing and able. The theory of ready, willing, and able is founded on the basis that these three preconditions need to be met for a change …

Surgical And Medical Applications Of Drones: A Comprehensive Review, Brent Terwilliger, James C. Rosser Jr., Vudatha Vignesh, Brett C. Parker

Publications

Drones have the ability to gather real time data cost effectively, to deliver payloads and have initiated the rapid evolution of many industrial, commercial, and recreational applications. Unfortunately, there has been a slower expansion in the field of medicine. This article provides a comprehensive review of current and future drone applications in medicine, in hopes of empowering and inspiring more aggressive investigation.

Adult Experts' Perceptions Of Telemental Health For Youth: A Delphi Study., Abigail Howard, Mindy Flanagan, Michelle Drouin, Maria D. Carpenter, Elizabeth Chen, Catherine Duchovic, Tammy Toscos

Health Services and Informatics Research

OBJECTIVES: Our objectives were to measure experts' opinions and develop consensus via the Delphi process on the barriers, applications, and concerns associated with telemental health (TMH) for youth.

MATERIALS AND METHODS: We delivered 3 online surveys over 2 months in Summer, 2016-2025 adult experts, including adults who experienced youth depression or suicidality, parents of youth with lived experience, and professionals (ie youth mental health researchers, clinicians/staff, or educators). We used the Delphi method to construct Likert and open-ended questions, developing expert consensus over 3 iterative surveys on the barriers and benefits of TMH for youth.

RESULTS: Adult experts identified stigma …

Utilization Of Telehealth Technology In Addiction Treatment In Colorado, J. Michael Faragher, Ying Shan Doris Zhang, Virginia Low, Demi Folds, Mita Johnson

Counseling Psychology: Faculty Scholarship

The growing presence of electronic technology in the health service professions is redefining the boundaries of counseling services. Commonly referred to as telehealth, utilization of electronic communication strategies to expand connectedness has opened new frontiers in behavioral health through applications ranging from digital phones, interactive video sessions, to virtual supervision. Substantial research suggests that telehealth is generally equal in effectiveness to traditional forms of treatment, especially for those individuals struggling with substance abuse problems. Unfortunately, research also suggests that telehealth is often underutilized when it comes to providing addiction treatment services. Telehealth trends in Colorado were examined using a Telehealth …

Patient And Health System Experience With Implementation Of An Enterprise-Wide Telehealth Scheduled Video Visit Program: Mixed-Methods Study., Rhea E. Powell, Md, Mph, Danica Stone, Judd Hollander, Md

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Real-time video visits are increasingly used to provide care in a number of settings because they increase access and convenience of care, yet there are few reports of health system experiences.

OBJECTIVE: The objective of this study is to report health system and patient experiences with implementation of a telehealth scheduled video visit program across a health system.

METHODS: This is a mixed methods study including (1) a retrospective descriptive report of implementation of a telehealth scheduled visit program at one large urban academic-affiliated health system and (2) a survey of patients who participated in scheduled telehealth visits. Health …

Healthcare Cost Savings Through Telemedicine Use At Correctional State Facilities, Sydney Davis, Paulius Mui, Tamara Broadnax, David Collins, Vimal Mishra

Graduate Research Posters

Telemedicine offers both soft and hard return on investment, including cost savings avoidance and convenience of access to care. Incarcerated individuals represent a patient population that uniquely benefit from receiving care via telemedicine. They lack access to subspecialty care as prison facilities are located outside of urban areas, which is compounded by security risks, risk to individuals around inmates, and transportation cost to tertiary care facilities. To attend a brief in-office medical visit, an inmate requires hours of administrative support and logistical coordination, including appointment scheduling, transport arrangement and related fuel expense, and guard accompaniment - all at a financial …

Reducing Symptom Distress In Patients With Advanced Cancer Using An E-Alert System For Caregivers: Pooled Analysis Of Two Randomized Clinical Trials, David H. Gustafson, Lori L. Dubenske, Amy K. Atwood, Ming-Yuan Chih, Roberta A. Johnson, Fiona Mctavish, Andrew Quanbeck, Roger L. Brown, James F. Cleary, Dhavan Shah

Health and Clinical Sciences Faculty Publications

Background: Symptom distress in patients toward the end of life can change rapidly. Family caregivers have the potential to help patients manage those symptoms, as well as their own stress, if they are equipped with the proper resources. Electronic health (eHealth) systems may be able to provide those resources. Very sick patients may not be able to use such systems themselves to report their symptoms but family caregivers could.

Objective: The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient’s symptoms, as …

Going Online With Telemedicine: What Barriers Exist And How Might They Be Resolved, Pierron Tackes

Oklahoma Journal of Law and Technology

No abstract provided.

Removing Barriers To Care For The Underserved: Provider And Patient Perception Of Direct To Consumer Telemedicine, Robert M. Grell, Rachel Hatcliffe, Sean M. Gillen, Craig Sable, Vanessa Grant, Matthew Ledda, Mary Fuska, Shireen Atabaki

GW Research Days 2016 - 2020

Purpose of Study: Lack of access to pediatric subspecialty care is a major barrier to pediatric health for underserved populations in the Washington DC, Virginia and Maryland area. Lack of access to transportation, long office wait times, and missed school and work are barriers that prevent access to subspecialty care. Direct to consumer (DTC) telemedicine provides this service to our underserved population by bringing care into their own home through use of computers, tablets, and smart phones.

Methods Used: Structured interviews of parents and providers were performed prior to implementation of a subspecialty DTC telemedicine program for underserved children in …

Telemedicine Coverage For Post-Operative Icu Patients., Tara Ann Collins, Matthew P. Robertson, Corinna P. Sicoutris, Michael A. Pisa, Daniel N. Holena, Patrick M. Reilly, Benjamin A. Kohl

Department of Anesthesiology Faculty Papers

Introduction There is an increased demand for intensive care unit (ICU) beds. We sought to determine if we could create a safe surge capacity model to increase ICU capacity by treating ICU patients in the post-anaesthesia care unit (PACU) utilizing a collaborative model between an ICU service and a telemedicine service during peak ICU bed demand. Methods We evaluated patients managed by the surgical critical care service in the surgical intensive care unit (SICU) compared to patients managed in the virtual intensive care unit (VICU) located within the PACU. A retrospective review of all patients seen by the surgical critical …

Telemedicine And Primary Care Obesity Management In Rural Areas– Innovative Approach For Older Adults?, John A. Batsis, Sarah N. Pletcher, James E. Stahl

Dartmouth Scholarship

Background:

The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity.

Discussion:

We describe the challenges in the implementation and delivery into real-world settings. The challenges in rural settings that have the fastest growing elderly population, high obesity rates, …

Toward A Discourse Community For Telemedicine: A Domain Analytic View Of Published Scholarship, Louiza Patsis

Selected Full Text Dissertations, 2011-

In the past 20 years, the use of telemedicine has increased, with telemedicine programs increasingly being conducted through the Internet and ISDN technologies. The purpose of this dissertation is to examine the discourse community of telemedicine. This study examined the published literature on telemedicine as it pertains to quality of care, defined as correct diagnosis and treatment (Bynum and Irwin 2011). Content analysis and bibliometrics were conducted on the scholarly discourse, and the most prominent authors and journals were documented to paint and depict the epistemological map of the discourse community of telemedicine. A taxonomy based on grounded research of …

Telemedicine And Its Utilization In The Management Of Chronic Heart Failure Patients, Adejoke Sotome, Chirra Pooja

Theses, Dissertations and Capstones

Introduction: Telemedicine is well developed and very useful for heart failure patients in emergencies. Many cases of heart failures are due to inability of reaching the physicians on time and failure of assessing the patient disease condition at earlier stage.

Methodology: The methodology for this study was a literature review. Electronic databases used included EBSCO Host, Google Scholar, Academic Search Premier, PubMed, ProQuest, and Marshall Digital Scholar. A total of 32 sources were referenced.

Results: This literature review examined several studies and research articles on the significance of Telemedicine in the treatment of chronic heart failure patients with …

Telehealth And Ehealth In Nurse Practitioner Training: Current Perspectives, Carolyn M. Rutledge, Karen Kott, Rebecca Poston, Christianne Fowler, Tina S. Haney

Ellmer School of Nursing Faculty Publications

Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this …

Decreasing Patient Cost And Travel Time Through Pediatric Rheumatology Telemedicine Visits., Elizabeth A. Kessler, Ashley K. Sherman, Mara L. Becker

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: There is a critical shortage of pediatric rheumatologists in the US. Substantial travel to clinics can impose time and monetary burdens on families. The aim of this study was to evaluate the cost of in-person pediatric rheumatology visits for families and determine if telemedicine clinics resulted in time and cost savings. Factors associated with interest in telemedicine were also explored.

METHODS: Surveys were offered to parents and guardians of patients in Pediatric Rheumatology follow-up clinics in Kansas City, Missouri, the primary site of in-person care, and at a telemedicine outreach site 160 miles away, in Joplin, Missouri. Survey questions …

Bedside Nurses' Perceptions Of Intensive Care Unit Telemedicine In A Rural Setting, Susan Parker

Nursing Theses and Capstone Projects

Healthcare is a rapidly changing and continuously advancing field. Currently, virtual care technology (e-ICU) is moving into many rural healthcare facilities in an effort to improve patient care outcomes and bridge physician and nursing shortages. The purpose of this Masters of Science thesis is to determine the impact that electronic telemedicine has on the quality of nursing care at the bedside. The study done by Mullen-Fortino et al. (2012) in an urban academic center was replicated to compare the bedside nurses’ perception of ICU telemedicine in a rural hospital setting. Thirty-eight rural ICU nurses working with ICU telemedicine responded to …

Harnessing Teams And Technology To Improve Outcomes In Infants With Single Ventricle., Girish S. Shirali, Lori A. Erickson, Johnathan Apperson, Kathy Goggin, David D. Williams, Kimberly J. Reid, Andrea Bradley-Ewing, Dawn Tucker, Michael Bingler, John Spertus, Leslie Rabbitt, Richard Stroup

Manuscripts, Articles, Book Chapters and Other Papers

Infants with single ventricle require staged cardiac surgery, with stage I typically performed shortly after birth, stage II at 4 to 6 months of age, and stage III at 3 to 5 years of age. There is a high risk of interstage mortality and morbidity after infants are discharged from the hospital between stages I and II. Traditional home monitoring requires caregivers to record measurements of weight and oxygen saturation into a binder and requires families to assume a surveillance role. We have developed a tablet PC-based solution that provides secure and nearly instantaneous transfer of patient information to a …

User Acceptance Of Neurology Telemedicine Technology In The Emergency Department, Teresa W. Mcneil

Applied Research Projects

There is currently a significant shortage of trained neurologists in the country. In addition to the shortfall of neurologists, there is an increasing need for this specialty due to an aging population, increase in the incident of neurologic diseases and an increasing demand for healthcare (Freeman, 2013). The development of tele neurology technology has been shown to help address these problems. As with any new technology there are multiple barriers to overcome, one of those being user acceptance of the technology. A survey of users of the telemedicine product VGo was conducted at Hunt Regional Medical Center to access the …

Linking Emr To Virtual Care Of Psychiatric Patients In The Acute Care Setting, Howard Louis Beatty Jr.

MUSC Theses and Dissertations

The purpose of this study is to test if the implementation of the Tele-Psychiatric Consultation Process (built within the FirstNet (Cerner/EMR) application, which pulls the patient’s current EMR encounter from multiple facility locations to a different physical facility location for consultation) provided increased quality by decreasing in total length of stay. The coordination of virtual care consultations allows for inter-practice data exchange for multi-provider clinical decision support. Documentation of medications and treatment regimens, which may be unfamiliar to the acute care provider, are provided through virtual tele-psychiatric consultations. An eTracking queue within FirstNet was built in-house by Carolinas Healthcare System …

The Importance Of A Pictorial Medical History In Assisting Medical Diagnosis Of Individuals With Intellectual Disabilities: A Telemedicine Approach, Grace Bonanno

CCAC Theses and Dissertations

When face-to-face physical medical exams are not possible, virtual physical exams, in the form of a pictorial medical exam/history, can be substituted, and telemedicine can be the means to deliver these virtual exams. The goal of this work was to determine if presence in the form of a visual and/or pictorial medical history can be of benefit to clinicians in the diagnosis of medical conditions of individuals with developmental disabilities (DDs) and/or intellectual disabilities (IDs), in particular those who cannot, because of their cognitive and/or physical disabilities, verbally relate their illness to a clinician. Virtual exams can also be useful …

Telepsychiatric Assessment Of A Mariner Expressing Suicidal Ideation., Alexander Lee, Neal Sikka, Francis O'Connell, Allen Dyer, Keith Boniface, James Betz

Emergency Medicine Faculty Publications

This case report highlights the successful use of telepsychiatric consultation by secure video chat to remotely assess a mariner expressing suicidal ideation. As a result of this intervention, telemedicine providers initiated psychiatric stabilisation while the mariner was still aboard the vessel, determined that he was safe for repatriation under the care of qualified medical escorts, and facilitated admission to a psychiatric facility near his home in the United States. Mental health emergencies are a significant cause of morbidity and mortality among mariners. Telepsychiatry is a validated method of establishing a psychiatric diagnosis and disposition as well as assessing risk of …

The Development And Application Of An Oncology Therapy-Related Symptom Checklist For Adults (Trsc) And Children (Trsc-C) And E-Health Applications., Arthur R Williams, David D Williams, Phoebe D Williams, Farrokh Alemi, Hosai Hesham, Blaine Donley, Raya Kheirbek

Medicine Faculty Publications

BACKGROUND: Studies found that treatment symptoms of concern to oncology/hematology patients were greatly under-identified in medical records. On average, 11.0 symptoms were reported of concern to patients compared to 1.5 symptoms identified in their medical records. A solution to this problem is use of an electronic symptom checklist that can be easily accessed by patients prior to clinical consultations.

PURPOSE: Describe the oncology Therapy-Related Symptom Checklists for Adults (TRSC) and Children (TRSC-C), which are validated bases for e-Health symptom documentation and management. The TRSC has 25 items/symptoms; the TRSC-C has 30 items/symptoms. These items capture up to 80% of the …

Mhealth: A Utilization Review By Feature Classification For Sustained Use, Elaine Dunn

MUSC Theses and Dissertations

mHealth is a fast growing segment for healthcare. However, there has been little research into the specific elements of mHealth that can drive continued use for optimization of the potential benefits. The purpose of this case study was to use the Delone and McLean Information System Model as a framework for classification of mHealth functionality and then to review the utilization of those categories over a six month period of time. A sample of 137 pediatric diabetics was reviewed. The activation rate was high at 94.9% indicating an interest in using mHealth. There was higher utilization of system features in …

Exploring The Use Patterns Of A Mobile Health Application For Alcohol Addiction Before The Initial Lapse After Detoxification, Ming-Yuan Chih

Health and Clinical Sciences Faculty Publications

How patients used Addiction-Comprehensive Health Enhancement Support System (A-CHESS), a mobile health intervention, while quitting drinking is worthy exploring. This study is to explore A-CHESS use patterns prior to the initial lapse reported after discharge from inpatient detoxification programs. 142 patients with alcohol addiction from two treatment agencies in the U.S. were included. A comprehensive set of A-CHESS use measures were developed based on a three-level system use framework and three A-CHESS service categories. In latent profile analyses, three A-CHESS system use patterns-inactive, passive, and active users-were found. Compared to the passive users (with the highest chance of the initial …

Chess Improves Cancer Caregivers' Burden And Mood: Results Of An Ehealth Rct, Lori L. Dubenske, David H. Gustafson, Kang Namkoong, Robert P. Hawkins, Amy K. Atwood, Roger L. Brown, Ming-Yuan Chih, Fiona Mctavish, Cindy L. Carmack, Mary K. Buss, Ramaswamy Govindan, James F. Cleary

Community & Leadership Development Faculty Publications

OBJECTIVE: Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. Comprehensive Health Enhancement Support System (CHESS) is a Web-based lung cancer information, communication, and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness, and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites.

METHODS: A total of 285 informal caregivers of patients with advanced nonsmall cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that …

Integrating Addiction Treatment Into Primary Care Using Mobile Health Technology: Protocol For An Implementation Research Study, Andrew R. Quanbeck, David H. Gustafson, Lisa A. Marsch, Fiona Mctavish

Dartmouth Scholarship

Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians.

Pediatric Asthma Telemonitoring: Literature, Theory, And Application To Practice, Erin Christine Shankel

DNP Projects

Asthma is one of the most prevalent and costly chronic diseases faced by Americans today. It is marked by inflammation and hyperresponsiveness of the airways which fluctuates, often unpredictably, in response to triggers. As such, it causes particular challenges symptom management, especially on the part of the patient who is tasked with dealing with these frequent fluctuations for months at a time between regularly scheduled health care appointments. This is further complicated when the patient is a child, and symptoms must be interpreted and managed second-hand by a caregiver. Uncertainty about how to manage symptoms, as well as minimization of …

A Case Study On Empowering A Non-Profit Organization To Better Help People With Disabilities Through M-Health, James Lawler, Hannah Moller, Robert Salloum

Wilson Center for Social Entrepreneurship

Local non-profit organizations are constrained in developing efficient methods for helping people with disabilities confined at their own homes. The cost of labor of physically serving such people is a continued issue at the organizations. This case study explores an entrepreneurial focus on best-in-class applications of m-Health devices for improving methods of home medication support furnished by a leading metropolitan non-profit organization. This study explores further the potential of hosted infrastructure-as-a-service (IaaS) m-Health remote monitoring systems technology. The findings of this study can benefit non-profit organizations considering economic entrepreneurial innovation in interactive managed care technology.

Mobile Delivery Of Treatment For Alcohol Use Disorders: A Review Of The Literature, Andrew Quanbeck, Ming-Yuan Chih, Andrew Isham, David H. Gustafson

Health and Clinical Sciences Faculty Publications

Several systems for treating alcohol-use disorders (AUDs) exist that operate on mobile phones. These systems are categorized into four groups: text-messaging monitoring and reminder systems, text-messaging intervention systems, comprehensive recovery management systems, and game-based systems. Text-messaging monitoring and reminder systems deliver reminders and prompt reporting of alcohol consumption, enabling continuous monitoring of alcohol use. Text-messaging intervention systems additionally deliver text messages designed to promote abstinence and recovery. Comprehensive recovery management systems use the capabilities of smart-phones to provide a variety of tools and services that can be tailored to individuals, including in-the-moment assessments and access to peer discussion groups. Game-based …

Delivering Patient Decision Aids On The Internet: Definitions, Theories, Current Evidence, And Emerging Research Areas, Aubri S. Hoffman, Robert J. Volk, Anton Saarimaki, Christine Stirling, Linda C. Li, Martin Härter, Geetanjali R. Kamath, Hilary Llewellyn-Thomas

Dartmouth Scholarship

Background: In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension — the delivery of patient decision aids on the Internet — is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods: An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results: The updated definition …