Telemedicine Commons^™

Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

Evaluating Surge Capacity In The Emergency Department: A Comprehensive Literature Review On Preparedness And Response Frameworks, Tanner J. Riscoe

Capstone Experience: Master of Public Health

Medical surge capacity in emergency departments is influenced by four critical factors: staff, stuff, space, and systems. Understanding these factors and the interplay between them is critical. Emergency departments are increasingly encountering issues with overcrowding, patient boarding, and medical surge events causing interruptions in care and depleting critical resources. Coordination of medical surge is challenging during normal operations but is intensified during times of crisis. This comprehensive literature review seeks to better understand the current state of the literature surrounding surge preparedness and response in emergency departments across the United States, identify gaps in the current literature, and ultimately recommend …

Barriers To Telehealth Uptake And Use: A Scoping Review, Mackenzie Kemp, Kristin L. Rising, Gregory Laynor, Jessica Miao, Brooke Worster, Anna Marie Chang, Andrew J. Monick, Amanda Guth, Tracy Esteves Camacho, Kiana Mcintosh, Grace Amadio, Lindsey Shughart, Tingann Hsiao, Amy E. Leader

Jefferson Center for Connected Care Faculty Papers

OBJECTIVES: We conducted a scoping review to identify barriers to telehealth use and uptake from the perspective of patient, provider, and system that were documented in the literature. In addition to identifying and categorizing the barriers, we aimed to assess how barriers differed for studies conducted during the COVID-19 pandemic, as well as how barriers differed between the United States vs internationally based studies.

MATERIALS AND METHODS: Comprehensive searches of the PubMed/MEDLINE, CINAHL, and Scopus databases conducted on December 29, 2021 yielded 17 887 results, with 11 221 potentially eligible documents after duplicates were removed. The team conducted an initial …

The Opportunities And Barriers Surrounding The Use Of Digital Health And Telemedicine In Sub-Saharan Africa, Aveline Langmead, Afua Osei-Wusu, Erica Tutuwan, Sara Mcmahon, Porter Biggs

Annual Research Symposium

No abstract provided.

Addressing Barriers To Equitable Telehealth For Older Adults, Bruce Leff, Christine S. Ritchie, Kristin L. Rising, Kendell Cannon, Liane Wardlow

Jefferson Center for Connected Care Faculty Papers

No abstract provided.

A Proposed Mhealth Intervention To Address Patient Barriers To Colposcopy Attendance: Qualitative Interview Study Of Clinic Staff And Patient Perspectives, Jennifer Hemler, Rachel Wagner, Brittany Sullivan, Myneka Macenat, Erin Tagai, Jazmarie Vega, Enrique Hernandez, Suzanne Miller, Kuang-Yi Wen, Charletta Ayers, Mark Einstein, Shawna Hudson, Racquel Kohler

Department of Medical Oncology Faculty Papers

BACKGROUND: Cervical cancer disparities persist among minoritized women due to infrequent screening and poor follow-up. Structural and psychosocial barriers to following up with colposcopy are problematic for minoritized women. Evidence-based interventions using patient navigation and tailored telephone counseling, including the Tailored Communication for Cervical Cancer Risk (TC3), have modestly improved colposcopy attendance. However, the efficacious TC3 intervention is human resource-intense and could have greater reach if adapted for mobile health, which increases convenience and access to health information.

OBJECTIVE: This study aimed to describe feedback from clinic staff members involved in colposcopy processes and patients referred for colposcopy regarding adaptions …

Implementation Of Psychiatric Collaborative Care Management In Rural Primary Care Practices, Ryan Dean Kruis

MUSC Theses and Dissertations

Behavioral health (BH) disorders are highly prevalent in the United States and especially concerning in rural communities which disproportionately lack access to BH services. While models for integrating BH into primary care, such as psychiatric collaborative care management (CoCM), have shown promise in mitigating the BH crisis, implementation in rural communities has proved challenging.
This dissertation examines implementation of CoCM nationally and in rural settings through three distinct aims. First, a claims-based retrospective cohort study was used to determine whether commercially insured patients receiving CoCM had lower acute BH care utilization and cost as compared to similar patients not receiving …

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.

Outcomes In Type Ii Diabetes Patients Through The Covid 19 Pandemic A Retrospective Chart Review, Zurwa Nishat, Tara Pellegrino, Robert Steer

Rowan-Virtua Research Day

Context: The COVID-19 pandemic provided a unique opportunity for urgent expansion of telemedicine services as providers continued to supply longitudinal care to patients. Patients with type II diabetes were vulnerable to serious infection with COVID-19 as well as disruption in management of their chronic disease.

Objective: To delineate the outcomes in type II diabetes patients through the COVID-19 pandemic by a retrospective chart review in which disease management was evaluated through HbA1c levels and BMI.

Methods: This retrospective chart review included adult T2DM patients receiving care from five university family medicine offices in NJ. HbA1c levels and BMI values were …

Telemedicine, Not The Panacea We Thought It Would Be. A Tale Of Caution, Ahmed Elkhapery, Syed Faiz Abbas, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

In the last few decades, the growing use of telemedicine has allowed access to healthcare at reduced costs and increased monitoring of chronic conditions, especially in underserved and rural areas. It is a tool of great value in low-income countries where there is a paucity of specialists. In the height of the COVID-19 pandemic, telemedicine was used to screen patients with COVID-19 like symptoms and send them to test sites directly. This helped minimize unnecessary healthcare staff and patient exposure to the infection and helped decompress ERs. Due to a lack of testing resources, many mildly symptomatic patients were presumed …

From In-Person To Virtual: A Case Study Of An Animal-Assisted Visiting Program In A Pediatric Setting, Whitney Romine

People and Animals: The International Journal of Research and Practice

This article focuses on the practical aspects of converting a successful in-person AAA program to a virtual program in a health care setting including human, canine, and physical resources; animal welfare considerations; training, infection control, and safety guidelines; and visit delivery procedures. In 1992, an interdisciplinary team at Akron Children’s Hospital founded the Doggie Brigade, an animal-assisted activities (AAA) program where volunteer therapy dogs and their handlers visit pediatric patients. The program has become a cornerstone of the hospital’s culture over its now 30-year tenure. In March 2020, the announcement of the COVID-19 pandemic forced health care organizations to suspend …

Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown

DSW Capstone Projects

Mental health technology is a healthcare delivery model of the future. The engagement in virtual healthcare was intensified when traditional healthcare methods were inaccessible during the federal restrictions implemented due to the COVID-19 pandemic. Utilizing digital apparatuses for healthcare improved the convenience, efficiency, and accessibility of various mental health services that were inoperable in past healthcare models. However, the historical constructs of stigma, discrimination, inequity, exclusion, and structural racism in mental healthcare were prevalent problems that remained present in virtual mental health platforms concerning the experiences of African-American patients and professionals who utilized the spaces.

This research explored mental health …

Improving Egypt’S Access To Vaccines And Medicines: Communication During Covid-19 / تحسين إتاحة الوصول إلى اللقاحات والأدوية في مصر: سياسة توعية الجمهور خلال أزمة فيروس كورونا, Alaa Abdel-Rahman, Sarah Attef, Helen Gabrah, Reem El-Sayed, Sarah El-Lithy

Papers, Posters, and Presentations

Since the start of the COVID-19 pandemic, the Egyptian government has been following protocol as best as possible when it comes to responding to the needs of the health and economic sectors amid difficult times. From lockdown measures to the WHO’s recommended practices in terms of isolation of cases and treatments, Egypt has been lauded as one of the fastest and most effective countries in terms of COVID-19 emergency response. Authorities have implemented several awareness campaigns directed at citizens to inform them about the pandemic, how to prevent infection, what to do if infected and how to act accordingly. Authorities …

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 …

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, …

Physician Perceptions Of Stress And Telemedicine, Jenna Guma, Katelyn Klimowich, Juming Pan, Danielle Cooley, Philip Collins

Rowan-Virtua Research Day

Telemedicine is an emerging field in which physicians are able to interact electronically with patients to improve health. Telemedicine can be performed through virtual platforms such as email, telephone and video, and can provide or augment care to a multitude of patients.

During the Novel Coronavirus (COVID-19) pandemic, the use of telemedicine has grown exponentially in an effort to continue to see patients and manage their care. The unprecedented era of social distancing and overloaded hospital systems has led many primary care providers and specialists alike to rapidly develop these capabilities in their practices.

Benefits of telemedicine include: increasing access …

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 …

Right To Health In Gats: Can The Public Health Exception Pave The Way For Complementarity?, Swati Gola

Pace International Law Review

This paper demonstrates how a right to health approach in the interpretation of the public health exception outlined in GATS Article XIV(b) can bring about a harmonious application of international human rights and international trade law regimes. Focusing on the interpretive value of the right to health for the public health exception in GATS, it examines whether a WTO Member, who has committed itself under GATS to fully liberalize all service sectors that have implications for health (e.g., hospital and other healthcare services), still retains the regulatory space to undertake measures to fulfill their right to health obligations and can …

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 …

Telehealth: Into The Mainstream?, Lisa Sprague

National Health Policy Forum

Teleheath, and its subset telemedicine, extend across a range of technologies allowing patients to seek diagnosis, treatment, and other services from clinicians by electronic means. Telephone, videoconferencing, iPads, and apps are all employed. In its most established form, hospitals and medical centers use telehealth to reach patients in underserved rural areas. Proponents of telehealth suggest it can relieve medical workforce shortages; save patients time, money, and travel; reduce unnecessary hospital visits; improve the management of chronic conditions; and improve continuing medical education. But telehealth also faces ongoing challenges. States require physicians to be licensed in each state where they treat …

Correctional Telemedicine And Its Benefits For Female Inmates, Chelsea Oliver

Applied Research Projects

The purpose of this study is to identify health issues that are specific to the female population of correctional institutions and how telemedicine would be beneficial in providing healthcare to same. A questionnaire was developed using information from literature on the topics obtained from a variety of places. Once the questionnaire was completed, a randomly selected group of telemedicine providers received the questionnaire, along with an introduction and information on the study that was being conducted.

The barriers of this study came from telemedicine providers either not responding to the questionnaire entirely or the providers only being able to answer …

Consumer Consent Options For Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein

Health Policy and Management Faculty Publications

The issue of whether, to what extent, and how individuals should have the ability to exercise control over their health information represents one of the foremost policy challenges related to the electronic exchange of health information. The current landscape of possible consent models is varied, and the factors involved in choosing among them are complex. States and other entities engaged in facilitating the exchange of electronic health information are struggling with a host of challenges, chief among them the establishment of policies and procedures for patient participation in their exchange efforts. While some have adopted policies enabling patients to exercise …

Personal Health Records: The People's Choice?, Lisa Sprague

National Health Policy Forum

Information technology (IT), especially in the form of an electronic health record (EHR), is touted by many as a key component of meaningful improvement in health care delivery and outcomes. A personal health record (PHR) may be an element of an EHR or a stand-alone record. Proponents of PHRs see them as tools that will improve consumers’ ability to manage their care and will also enlist consumers as advocates for widespread health IT adoption. This issue brief explores what a PHR is, the extent of demand for it, issues that need to be resolved before such records can be expected …

The Electronic Health Record In Practice: Why, How, And What Next?, Lisa Sprague, Sally Coberly

National Health Policy Forum

This local site visit was intended to allow participants to observe the electronic health record (EHR) as used in practice by two U.S. leaders in technology and quality, the Veterans Health Administration (VHA) and Kaiser Permanente (KP). The VHA has employed an EHR system since 1997; KP is in the process of implementing a standard system for all clinicians nationwide. The site visit was designed to provide an opportunity for participants to explore both the expected benefits from EHR adoption and the specific lessons these two large, integrated delivery systems have learned in their transition from paper to electronic records. …

Electronic Health Records: How Close? How Far To Go?, Lisa Sprague

National Health Policy Forum

This paper looks at the central role of the electronic health record (EHR) in health information technology. It considers the extent to which EHRs are in use and initiatives designed to increase their prevalence, as well as barriers to the widespread adoption of EHRs and efforts to surmount them. Particular attention is given to such obstacles as cost, the professional culture of physicians, standardization, and legal questions.

Physician Connectivity: Electronic Prescribing, Robin J. Strongin

National Health Policy Forum

This issue brief focuses on physician connectivity — the electronic linking of physicians with online resources such as clinical databases and sophisticated formulary systems. As physician connectivity increasingly allows physicians to prescribe online via a handheld computer complete with formulary information as well as patient data and drug information, this issue brief examines the issues raised by this technological advance within the broader context of online prescribing.