Telemedicine Commons^™

Show Me The Money: Finance Models In Epilepsy Practice., Deepti Zutshi, Emily Klatte, Maysaa Basha, Leisha Osburn, Eric Segal, Nina Garga, Rohit R Das

Medical Education Articles

Healthcare models and the finances associated with such models are complex. Patients with epilepsy (PWE) receive care in a variety of settings, and each is associated with differing reimbursement, financial levers, as well as unique strengths and weaknesses. As the financial climate of healthcare system changes rapidly in the setting of an aging population, physician shortages, and increasing costs of healthcare delivery, it is important for clinicians to understand the financial aspects of caring for PWE. In this review, we examine basic concepts in healthcare economics and then review the financial aspects of care in an academic context, a private …

Integrating Telehealth Into Advanced Health Assessment: A Bimodal Approach, Heather M. Jones, Tracy Alam, Beth A. Ammerman, John Jardine, Carolyn Rutledge

Ellmer School of Nursing Faculty Publications

The expansion of telehealth emphasizes the need for advanced practice registered nurses (APRNs) to develop competencies in telehealth technology and techniques. Limitations in physical assessments and the lack of comprehensive telehealth curricula in APRN programs have been identified as barriers to students' preparedness and confidence in performing telehealth assessments in clinical practice. This project evaluated integrating telehealth content into an advanced health assessment course with both in-person and online laboratories. Presurveys and postsurveys showed increased student confidence and competency in telehealth skills across both modalities. These findings support incorporating standardized telehealth education into APRN curricula to enhance telehealth clinical readiness.

Intensive Telemedicine Transitions Of Care Clinic: A Prospective Feasibility Study Of A Novel Ambulatory Model Serving Appalachian Patients, Jessica Thayer, Brett Miller, Marcelino Mederos Liriano, Kathryn Hoffman, Gina Baugh, Jenna Sizemore

Journal of Appalachian Health

Introduction: Hospital discharge is a complex process plagued with medical errors and poor coordination. Disjointed discharges are detrimental to Appalachian patients with access barriers and multiple chronic diseases. Telehealth is a tool used to improve access within rural Appalachia. To address this high-risk transition period, an interprofessional team deployed telemedicine to improve post-hospital care for Appalachian patients.

Purpose: Patients with uncontrolled chronic medical conditions were enrolled into the Intensive Telemedicine Transition of Care Clinic (I-TTC) with a primary outcome of 30-day Emergency Department (ED) presentations and hospital readmissions. Secondary outcomes included improved control of chronic conditions and patient cost savings. …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

Educating Healthcare Providers To Prevent And Mitigate The Effects Of Zoom Fatigue, Andrea Lima

Doctor of Nursing Practice Scholarly Projects

Zoom Fatigue (ZF), or physical and neuropsychological responses to excessive videoconferencing (VC), increased during the COVID-19 pandemic. Like burnout, ZF can compromise patient safety by causing decreased job satisfaction, social isolation, disrupted focus, and difficulty empathizing with patients. This Plan-Do-Study-Act quality improvement project aimed to assess feelings about VC, raise awareness of the adverse effects of overuse, and empower primary care providers (PCPs) to improve their work experiences. A group of on-site PCPs at a tertiary care medical center in the Southwest, who continued holding exclusive virtual team meetings after the pandemic, was asked to complete the 15-question Zoom Exhaustion …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

Development Of Recommendations For The Future Of Telehealth Use Among Sexual And Gender Minorities (Sgm), Jeffrey A. Wilhite

Dissertations and Theses

It is now well-documented that sexual and gender minoritized individuals (SGMs) face consistent stigmatization from not just the health care system, but also from overarching community, federal, and societal entities. Subsections of the SGM community, like gay men for example, face higher rates of eating disorders, certain cancers, alcoholism, mental illness and even obesity, when compared to heterosexual counterparts. Many of these challenges could be exacerbated by current political administration efforts to silence the community. Ensuring access to clinical care is one way of preserving the health and livelihood of the community. Telehealth, or synchronous, remote based clinical care, can …

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 …

Improving Telehealth Education And Training: A Needs Assessment Of Healthcare Providers And Trainees, Conor Duffy

Theses and Dissertations

Telehealth utilization has increased dramatically since the start of the COVID-19 pandemic. There are many positive impacts of this shift to telehealth, including increasing access to care and reducing patient burden. However, healthcare providers report several consistent challenges that limit their ability to deliver telehealth, such as effective communication, technological difficulties, and difficulty performing physical examinations. To address these concerns, it is necessary to integrate telehealth education and training into healthcare professional training programs and healthcare systems. While many institutions have implemented telehealth education and training since the start of the pandemic, there is little consistency in the content, duration, …

Use Of Telemedicine In A Sports Medicine Clinic: An Investigation Of Patient Satisfaction, Kelly Harrington, Lindsey E. Eberman, Matthew J. Rivera, J'Nai Pittman, Shelby Broughton, Regina Hash

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Objective: Compare patient satisfaction between telemedicine and in-office visits and between providers post-operatively in an orthopedics setting with athletic trainers and physicians.

Design: Cross-sectional study

Methods: Patients from a Sports Medicine Clinic that received an orthopedic surgical intervention from March 2020-September 2021, and engaged in telemedicine, or an in-office visit post-operatively. Provider type included full-time athletic trainers, resident athletic trainers, physician (MD) resident/fellows, and float athletic trainers. Press-Ganey Patient Experience Surveys were collected at the time of follow up visit, with focus on items, “likelihood to recommend” and “how well staff worked together.”

Results: There was a total of 255 …

Opportunities In Grand Rapids For Oral Surgeons And Dentists With Advanced Training, Brandon Francis Md, Mph

West Michigan District Dental Society Bulletin

Trinity Health Grand Rapids is a 385-bed, Level 2 Trauma Center located in the heart of Grand Rapids. We service a diverse patient population with varied acute care needs. As a Leapfrog Safety Grade A facility, we remain focused on providing safe, high-quality care as we are firmly on a path towards Zero Harm.

Washington’S Ride Program: A Model Providing Rural Practitioners, Mary K. Smith Dds, Mba

The Journal of the Michigan Dental Association

The University of Washington School of Dentistry Regional Initiatives in Dental Education (RIDE) program is an award-winning dental education model that trains dentists to practice in rural and underserved areas. Its first cohort of students graduated in 2012. To date, there have been 96 graduates. More than 80% of RIDE graduates in practice are in rural and underserved areas, including those seeking specialty training. RIDE is successful because it collaborates with multiple universities, community health centers, local dental associations, and community leaders in the area where the students are located.

Advocacy Spotlight: 2024 Regulatory Reminders, Neema Katibai Jd

The Journal of the Michigan Dental Association

The Advocacy Spotlight column delves into critical regulatory reminders for dentists in 2024, emphasizing compliance challenges and potential disruptions to practice. Key areas covered include licensing, amalgam separator renewal, electronic prescribing, and Beneficial Ownership Information reporting. The article stresses the importance of staying informed about evolving regulations to ensure seamless practice operations.

Key To Success: A Comprehensive Examination Of Support Personnel In School-Based Speech-Language Telepractice, Hannah Douglass

Theses and Dissertations--Rehabilitation Sciences

In the school setting, the telepractice team primarily consists of the clinician and a support person known as a telefacilitator. Though telepractice is an accepted method for delivering school-based speech-language therapy, many barriers to the integration of telepractice as routine care persist. A major barrier is clinicians' acceptance of telehealth. However, there has been limited investigation of factors that influence clinician acceptance. Another barrier is related to support personnel. Telefacilitators have been shown to be an integral part of the telepractice program. Yet there are significant gaps in knowledge regarding the roles and responsibilities, staffing and management, and barriers/facilitators to …

Telehealth In Emergency Medicine Residency Training: A Model Curriculum, Laura Oh, Rahul Bhat, Michael J. Carr, Aditi U. Joshi, Bruce M. Lo, Ashley C. Rider, Lulu Wang, Michael C. Wadman, Samuel D. Luber

Department of Emergency Medicine Faculty Publications

Emergency physicians are well-positioned to take a leadership role in telehealth, particularly in emerging categories such as triage, direct acute unscheduled care, and virtual observation. However, the growth of telehealth has outpaced curricular development in emergency medicine (EM) residency programs. This manuscript presents a model longitudinal telehealth curriculum, developed by the consensus of education experts, including representatives from the telehealth interest groups from EM's two primary specialty societies: the American College of Emergency Physicians and the Society for Academic Emergency Medicine. The curriculum describes overarching goals and components that may serve as a foundation for individual institutions seeking to train …

Caries Risk Prediction In Pediatric Patients Using Machine Learning Techniques: A Retrospective Study, Nagarathna P J, Vishnu Priya Veeraraghavan, Aysha Jebin A, Shikar Daniel, Kaladhar Reddy Aileni, Santosh R Patil

International Arab Journal of Dentistry

Introduction: Dental caries is a multifactorial disease prevalent in children and is often influenced by behavioral, environmental, and genetic factors. Traditional caries risk assessment methods have a limited accuracy and objectivity. Machine learning (ML) models provide a data-driven approach for predicting caries risk, thereby enabling targeted interventions.

Objectives: The main objective of this study is to develop and validate ML models for predicting caries risk in pediatric patients aged 6–12 years by incorporating clinical, behavioral, dietary, and socioeconomic factors.

Methods: This retrospective observational study included 148 children aged 6–12 years. Data, including demographic details, Decayed Missing Filling …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Barriers And Facilitators To Achieving Well-Being In Pediatric Providers, Whitney Marvin, Jillian Harvey, Natasha Ruth

Journal of Wellness

Introduction: Physician well-being has become increasingly important for health systems across the country due to the strong ties between quality, safety, and overall patient outcomes. Burnout has increased steadily and has been exacerbated by the COVID-19 pandemic. This study seeks to successfully identify factors that both enhance and detract from well-being in a cohort of pediatric faculty and advanced practice providers (APPs).

Methods: This study utilized a multimethod approach including surveys and a total of 8 semi-structured, virtual focus groups of pediatricians and advanced practice providers (orchestrated through Microsoft Teams) to understand perspectives on burnout and well-being. Each …

Telehealth Integration In Primary Care, Ashley Simons

Doctor of Nursing Practice Projects

Telehealth has been proven to be a useful and integral tool in primary care settings. Carlinville Family Health Care Clinic, a rural health clinic, has the current ability to conduct Telehealth visits but is not currently doing so. They have several programs available that are equipped with Telehealth capabilities. The physicians cite lack of education on these programs and lack of a standard streamlined practice for which program to use or how to use it.

According to the physicians in this practice, along with their patients, the use of Telehealth has multiple advantages. Because visits in this clinical are usually …

Implementation And Standardization Of Telehealth Visits In A Specialty Pharmacy Setting, Ivana Wu, Angie Chau, Amber Franck, Adam Saulles

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers 2023

No abstract provided.

Burnout During The Covid-19 Pandemic: A Report On Pediatric Residents, Linessa M Zuniga, Abigail Schuh, Alan Schwartz, Patricia Seo-Mayer, Rachel Cramton, Kira Sieplinga, Ruchi Kaushik, Lauren Nassetta, Jason H Homme, Jessica Babal, John D Mahan, Maneesh Batra

Faculty, Staff and Students Publications

Background and objective: The Pediatric Resident Burnout and Resilience Consortium (PRB-RSC) has described the epidemiology of burnout in pediatric residents since 2016. We hypothesized burnout rates during the pandemic would increase. We explored resident burnout during the COVID-19 pandemic and its relationship to resident perception of workload, training, personal life, and local COVID burden.

Methods: Since 2016, PRB-RSC has sent an annual, confidential survey to over 30 pediatric and medicine-pediatrics residencies. In 2020 and 2021, seven questions were added to explore the relationship of COVID-19 and perceptions of workload, training, and personal life.

Results: In 2019, 46 programs participated, 22 …

Training In The Use Of Interpretive Services For Patients With Limited English Proficiency, Kristina Wooten

Symposium of Student Scholars

In clinical settings, there is a disconnect between health care professionals (HCPs) and patients with limited English proficiency (LEP). HCPs rely on ad hoc interpreters to communicate with patients with LEP (e.g. nurses using untrained friends and family or nursing students to interpret care information). Refusing to use or misusing professional interpreters and other interpretive services may lead patients with LEP to avoid seeking necessary care, misunderstand their diagnoses and treatment regimens, and fail to return for follow-up care. This increases the already existing health care disparity between patients who speak English and patients with LEP. Studies show that if …

Perspectives On Telemedicine From A National Study Of Youth In The United States, Margaret Wasvary

Medical Student Research Symposium

Introduction: Telemedicine is increasingly popular with the recent surge in use due to the COVID-19 pandemic. Despite youth status as "tech natives," limited data are available on their perspectives on telemedicine. Our study seeks to understand youth telemedicine knowledge, prior experiences, preferences for use, and the impact of COVID-19 on these perspectives. Methods: Participants in MyVoice, a national text message cohort of U.S. youth age 14-24, were sent five open-ended questions in October 2019 and October 2020. A codebook was iteratively developed by using inductive analysis. Responses were independently coded by two investigators, with discrepancies resolved by discussion or a …

The Use Of Telehealth To Improve Patient Outcomes Among Prediabetes And Diabetic Patients In A Rural Women's Health Clinic: An Evidence-Based Practice Project, Alejandra Villegas

Doctor of Nursing Practice Final Manuscripts

Background: Type 2 diabetes mellitus (T2DM) is a global problem. Lack of healthcare access affects the low-income population and telehealth can aid the problem. For newly-diagnosed T2DM patients, customary practice is a 3-month follow-up after they are diagnosed. Patients only have education on diet and medication given by the healthcare provider at the time of appointment. Patients can be overwhelmed and confused to grasp the information. Telehealth has become mainstream due to the current COVID-19 pandemic and that is why it is the right time to use it to help T2DM patients further. Purpose of Project: The project's goal is …

Protocol For An Ehub As An Systemic Intervention For Homeless Shelter Staff And Resident Psychosocial And Behavioral Needs, Celeste Sangiorgio, Cory Crane, Cassandra Berbery, Caroline Easton

Frameless

This paper includes a proposal and outline for a one- stop, web-based eHub for homeless shelter workers and residents. The shelter eHub is proposed as a one-stop portal for staff and resident skills acquisition, shelter and community resources, and rehearsal of coping skills. The theoretical and empirical support for eHub contents is reviewed, as well as the structure for evidence-based psychological skills building and gamified and virtual skills rehearsal components.

Telehealth Simulation And Education Impact On Student Knowledge, Leah Schmitt

Schultz-Werth Award Papers

Background: One of the most recent improvements to the everchanging healthcare is telehealth. Telehealth is used by about 70% of healthcare providers across the United States. It is used to reach patient populations such as those in rural locations or with limited resources. Telehealth can improve patient outcomes and encourage quality patient care. However, many nursing schools include programs to educate students on the utilization of telehealth. Purpose: In undergraduate and graduate nursing school, do telehealth simulations and education improve student knowledge? Methods: A review of literature was completed using the databases: EBSCOhost, PubMed, and CINAHL. Key words searched included …

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

Nursing and Health Professions Faculty Research and Publications

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

Reduced No-Show Rates And Sustained Patient Satisfactionof Telehealth During The Covid-19 Pandemic, Brenden Drerup, Jennifer Espenschied, Joseph Wiedemer, Lisa Hamilton

Medical Student Research Symposium Abstracts and Posters

TheCOVID-19 pandemic thrusted the relatively novel approach of telemedicine to thecenter stage of healthcare infrastructures within the U.S. and around the globe, leadingto adramatically increasedutilization of telehealth services.Since the first reported case ofCOVID-19 in the U.S. on January 20, 2020, telemedicine has played a large role in reducingviraltransmission by preserving PPE and supporting crippled healthcare revenuestreams. The convenience of these serviceshas also reduced caregiver burden and travelcosts for patients. Prior to the COVID-19 pandemic, studies have consistentlydemonstrated a strong association between telehealth utilization and increased patient satisfaction. The impact of telemedicine on patient satisfaction during the currentpandemic has yet to …

Home Telemonitoring Of Covid Patients By Medical Students At The Christiana Care Virtual Practice, Thomas Marconi, Jr, Chelsea Richards

Health Equity and Quality Improvement (HEQI) Summit

SARS-Cov2 arrived in Delaware on March 11, 2020. By March 22, 2020, stay at home orders were in place1. During this time, CareVio, a subsidiary of ChristianaCare, was tasked with developing a strategy to monitor the Delaware community. CareVio repurposed Twistle – a telemonitoring application utilized to distribute symptom related surveys and conduct text message conversations for follow up. This service had the capability to act as a virtual information desk and triage patients to be seen by virtual practice providers or the emergency department. Patient monitoring via Twistle was initiated on March 18, 2020 and medical students from Sidney …

Increasing Utilization Of Telehealth In Outpatient Primary Care, Allison Samuel, Md, Candace Derenge, Md, Anahita Molayi, Md, Amanda Kahn, Md, Jason Ojeda, Md

Health Equity and Quality Improvement (HEQI) Summit

Based on survey data, residents are interested in gaining exposure to Telehealth and attendings would like to increase their number of Telehealth appointments. Providers expressed uncertainty about insurance coverage as a major barrier to increasing Telehealth utilization.

SMART AIM: Increase the total number of Telehealth visits at JIMA by 25% and initiate Telehealth visits for residents by May 1st.