Telemedicine Commons^™

Abnormal Motion Capture In Acute Stroke (Bionics): A Low-Cost Tele-Evaluation Tool For Automated Assessment Of Upper Extremity Function In Stroke Patients, Syed A Zamin, Kaichen Tang, Emily A Stevens, Melissa Howard, Dorothea M Parker, Allyson Seals, Xiaoqian Jiang, Sean Savitz, Shayan Shams

Faculty, Staff and Student Publications

BACKGROUND: The incidence of stroke and stroke-related hemiparesis has been steadily increasing and is projected to become a serious social, financial, and physical burden on the aging population. Limited access to outpatient rehabilitation for these stroke survivors further deepens the healthcare issue and estranges the stroke patient demographic in rural areas. However, new advances in motion detection deep learning enable the use of handheld smartphone cameras for body tracking, offering unparalleled levels of accessibility.

METHODS: In this study we want to develop an automated method for evaluation of a shortened variant of the Fugl-Meyer assessment, the standard stroke rehabilitation scale …

Cancer Patients' Preferences And Perceptions Of Advantages And Disadvantages Of Telehealth Visits During The Covid-19 Pandemic, Deepika Kumar, Nancy Gordon, Constanza Zamani, Tammy Sheehan, Ernesto Martin, Olga Egorova, Jessica Payne, Tatjana Kolevska, Elad Neeman, Raymond Liu

Faculty, Staff and Student Publications

PURPOSE: We aimed to ascertain oncology patients' perceptions of telehealth versus in-person (IP) visits for different types of clinical encounters.

METHODS: We surveyed adults undergoing cancer treatment at Kaiser Permanente Northern California infusion centers between November 2021 and May 2022 using a self-administered questionnaire. Patients were asked about visit modality preferences (video, phone, and IP) for six types of clinical discussions, overall advantages and disadvantages of telehealth (video or phone) versus IP modalities, and barriers to video visit use.

RESULTS: The 839 patients who completed surveys in English were 63% female; median age 63 years; 64% White; and 73% college-educated …

A Novel Virtual-Based Comprehensive Clinical Approach To Headache Care, Thomas Berk, Stephen Silberstein, Peter Mcallister

Department of Jefferson Headache Center Papers and Presentations

One major innovation, a result of the coronavirus pandemic, has been the proliferation of telemedicine. Telehealth can help solve the access problems that plague headache medicine, allowing patients in areas with no headache expertise to consult and work with a headache specialist. This is a retrospective chart review of patients seen by Neura Health, a comprehensive app-based telehealth headache center. Patients are seen by a specialist and, in addition to any medical recommendations, are given care plans individualized to their condition and recommendations at the end of their clinical appointments. The primary outcome of this study is a decrease in …

Leveraging Telehealth Supportive Oncology Services To Combat Covid-19 Isolation In Breast Cancer Patients: A Cancer Center’S Perspective, Jake R. Erickson, Maranda K. Pahlkotter, Paul D. Thielking, Jane M. Porretta, Regina Rosenthal, Cindy B. Matsen, Kirstyn E. Brownson

Patient Experience Journal

During the COVID-19 pandemic, breast cancer patient in-person visits were converted to telehealth visits. Given our concerns about increased isolation amongst breast cancer patients during the pandemic, and the deleterious effects of such isolation on patient outcomes, we investigated utilization rates of psycho-social services amongst newly diagnosed breast cancer patients at our institution. We explored visit platforms (telehealth versus in-person) and time points prior to and encompassing the early pandemic. Despite decreased new breast cancer visits, there was a greater than 2-fold increase in supportive oncology service encounters in breast cancer patients during COVID-19 suggesting increased need for psycho-oncology resources. …

Racial Disparities In Access To Dbs: Results Of A Real-World U.S. Claims Data Analysis, Michael Frassica, Drew S Kern, Mitra Afshari, Allison T Connolly, Chengyuan Wu, Nathan Rowland, Juan Ramirez-Castaneda, Mwiza Ushe, Claudia Salazar, Xenos Mason

Farber Institute for Neuroscience Faculty Papers

INTRODUCTION: Deep brain stimulation (DBS) is an effective and standard-of-care therapy for Parkinson's Disease and other movement disorders when symptoms are inadequately controlled with conventional medications. It requires expert care for patient selection, surgical targeting, and therapy titration. Despite the known benefits, racial/ethnic disparities in access have been reported. Technological advancements with smartphone-enabled devices may influence racial disparities. Real-world evidence investigations can shed further light on barriers to access and demographic disparities for DBS patients.

METHODS: A retrospective cross-sectional study was performed using Medicare claims linked with manufacturer patient data tracking to analyze 3,869 patients who received DBS. Patients were …

Feasibility Of Delivering A Virtual 1-Day Acceptance And Commitment Therapy Workshop To Rural Veterans Through Community Partnerships, Lilian Dindo, Angelic Chaison, Merlyn Rodrigues, Ken Woods, Alicia Mark, Derrecka Boykin

Faculty, Staff and Students Publications

Background: This single-arm, open pilot study examined the feasibility and initial efficacy of a 1-day virtual Acceptance and Commitment Therapy (ACT) group workshop for distressed veterans.

Methods: We collaborated with veteran-serving community-based organizations to enhance outreach to veterans, especially those in rural areas. Veterans completed a baseline assessment and two follow-up assessments (1 month, 3 months) after workshop participation. Feasibility outcomes included reach (workshop recruitment and completion rates; veteran characteristics) and acceptability (open-ended survey question about satisfaction). Clinical outcomes included psychological distress (Outcome Questionnaire-45), stressor-related distress (PTSD Checklist-5), community reintegration (Military to Civilian Questionnaire), and meaning and purpose (PROMIS Short …

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 …

Use Of Telemedicine For Postdischarge Assessment Of The Surgical Wound: International Cohort Study, And Systematic Review With Meta-Analysis, Nihr Global Health Research Unit On Global Surgery, Globalsurg Collaborative

Faculty, Staff and Student Publications

OBJECTIVE: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardized assessment tools are needed.

BACKGROUND: Surgical site infection (SSI) is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery.

METHODS: The primary outcome of this study was SSI reported up to 30 days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analyzed primary data from …

Development Of 5g-Based Remote Ultrasound Education: Current Status And Future Trends, Jiaojiao Ma, Xinying Jia, Guanghan Li, Dandan Guo, Xuehua Xi, Tongtong Zhou, Ji-Bin Liu, Bo Zhang

Department of Radiology Faculty Papers

The rapid advancement of 5G technology has opened new possibilities for remote ultrasound education, offering the potential to enhance training, real-time consultation, and quality control for primary ultrasound doctors. The 5G remote ultrasound education has the potential to revolutionize the way primary ultrasound doctors are trained and supported, ultimately leading to improved patient care and outcomes. By understanding the current status and development trends of this cutting-edge educational approach, the medical community can better prepare for and contribute to its ongoing evolution. Looking towards the future, the development trends in 5G remote ultrasound education are expected to revolve around continuous …

Telehealth Clinical Appropriateness And Quality, Lulu Wang, Anthony Fabiano, Arjun K. Venkatesh, Nick Patel, Judd E. Hollander

Department of Emergency Medicine Faculty Papers

Contrary to common perception, telehealth is not simply a substitute for in-person care. With an array of modalities—live audio–video, asynchronous patient communication, and remote patient monitoring, to name a few—telehealth creates entirely new avenues of care delivery (Table 1). Although our current care model is reactive—relying on episodic visits to an office or hospital—telehealth allows us to be proactive, filling in the gaps to provide a continuum of care. Widespread uptake of telehealth has created fertile ground for long-overdue health system reform. In this study, we describe essential next steps: redefine telehealth clinical appropriateness, evolve payment models, provide necessary training, …

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 …

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

Optometric Clinical Practice

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

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

Virtual Visits In Routine Prenatal Care, Katrina K. Wu

MUSC Theses and Dissertations

Problem

One million pregnant persons in the United States do not receive early prenatal care or the recommended number of prenatal visits each year, and this gap in care access disproportionately affects people of color, those with lower incomes, and those living in rural communities. Telemedicine was widely utilized in prenatal care during the COVID-19 pandemic, and optimizing prenatal telemedicine has the potential to improve prenatal care access beyond the pandemic.

Purpose

This dissertation focused on examining the integration of virtual visits in routine prenatal care during the COVID-19 pandemic. The purpose of this dissertation was to:

Aim 1. Explore …

Telemental Health In Emergency Care Settings: A Qualitative Analysis Of Considerations For Sustainability And Spread, Mckenzie K Roddy, Patricia Chen, Alvin D Jeffery, Jeydith Gutierrez, Melissa Rubenstein, Corey Campbell, Eric Blake, Michael J Ward

Faculty, Staff and Students Publications

Objectives: Following rapid uptake of telehealth during the COVID-19 pandemic, we examined barriers and facilitators for sustainability and spread of telemental health video (TMH-V) as policies regarding precautions from the pandemic waned.

Methods: We conducted a qualitative study using semistructured interviews and observations guided by RE-AIM. We asked four groups, local clinicians, facility leadership, Veterans, and external partners, about barriers and facilitators impacting patient willingness to engage in TMH-V (reach), quality of care (effectiveness), barriers and facilitators impacting provider uptake (adoption), possible adaptations to TMH-V (implementation), and possibilities for long-term use of TMH-V (maintenance). Interviews were recorded, transcribed, and analyzed …

Taking A Load Off: User Perceptions Of Smart Offloading Walkers For Diabetic Foot Ulcers Using The Technology Acceptance Model, M G Finco, Gozde Cay, Myeounggon Lee, Jason Garcia, Elia Salazar, Tze-Woei Tan, David G Armstrong, Bijan Najafi

Center on Aging Staff Publications

People with diabetic foot ulcers (DFUs) are commonly prescribed offloading walkers, but inadequate adherence to prescribed use can be a barrier to ulcer healing. This study examined user perspectives of offloading walkers to provide insight on ways to help promote adherence. Participants were randomized to wear: (1) irremovable, (2) removable, or (3) smart removable walkers (smart boot) that provided feedback on adherence and daily walking. Participants completed a 15-item questionnaire based on the Technology Acceptance Model (TAM). Spearman correlations assessed associations between TAM ratings with participant characteristics. Chi-squared tests compared TAM ratings between ethnicities, as well as 12-month retrospective fall …

Pediatric Consultation-Liaison Psychology: Insights And Lessons Learned During The Covid-19 Pandemic, Nicole M Schneider, Dara M Steinberg, Andrea M Garcia, Jessy Guler, Emily Mudd, A Monica Agoston, Katherine N Schwartzkopf, Kristin A Kullgren, Laura Judd-Glossy

Faculty, Staff and Students Publications

COVID-19 has presented a variety of challenges to the provision of psychology services. In the first month of the pandemic, pediatric consultation-liaison (CL) psychologists reported significant changes in methodology of service delivery (Steinberg et al. in Clin Pract Pediatr Psychol 9:1, 2020). To better understand how and if these changes persisted, as well as other emerging trends, a follow-up study examined changes and challenges six months into the pandemic. An anonymous questionnaire assessed topics related to pediatric CL psychology including practice changes, perception of changes, and institutional support. The questionnaire was sent to the APA Society of Pediatric Society's special …

Demographic Data Associated With Digital Inequity Reported In Patient-To-Provider Teledermatology Studies In The United States From 2011 To 2021: Scoping Review, John Miller, Patrick Ioffreda, Shannon Nugent, Elizabeth Jones

Department of Dermatology and Cutaneous Biology Faculty Papers

Background: Patient-to-provider teledermatology relies on a patient’s access to technology to ensure a successful visit. However, access to broadband internet and technology varies across populations in the United States—leading to the digital divide. While teledermatology has been recognized as a model to improve access, little is known about how often demographic data associated with digital inequity are captured in studies. Objective: Given the expansion of teledermatology over the past decade, we sought to determine how often demographic data associated with digital inequity are reported in patient-to-provider teledermatology studies. Methods: A scoping literature review search was conducted using the search term …

Teledermatology In Medical Student, Postgraduate Trainee, And Global Dermatology Education: A Systematic Review, Heli Patel, Rishab Revankar, Aly Valliani, Nikita Revankar, Shivani Yerigeri, Nadine Kaskas, Benjamin Stoff

Student Papers, Posters & Projects

BACKGROUND: In the aftermath of the COVID-19 pandemic, medical students and residents in the U.S. and globally have gained more exposure to teledermatology, both for the purposes of clinical practice and education.

OBJECTIVE: We conducted a systematic review to assess outcomes from teledermatology interventions for dermatology trainees in the U.S. and globally in accordance with Preferred Reporting Items for Systematic Reviews (PRISMA).

METHODS: We searched MEDLINE, EMBASE, Web of Science, and Cochrane CENTRAL for articles written in English and published database inception to November 20, 2022.

RESULTS: In total, 15 studies met the inclusion criteria. Outcomes reported ranged broadly from …

Adapting International Clinical Trials During Covid-19 And Beyond, Kamala Thriemer, Kamala Thriemer, Mohammad Shafiul Alam, Bipin Adhikari, Rupam Tripura, Mohammad Sharif Hossain, Michael Christian, Najia Bano Ghanchi, Hellen Mnjala, Muhammad Asim

Department of Pathology and Laboratory Medicine

Background: The COVID-19 pandemic and resulting restrictions, particularly travel restrictions, have had significant impact on the conduct of global clinical trials. Our clinical trials programme, which relied on in-person visits for training, monitoring and capacity building across nine low- and middle-income countries, had to adapt to those unprecedented operational challenges. We report the adaptation of our working model with a focus on the operational areas of training, monitoring and cross-site collaboration.
The new working model: Adaptations include changing training strategies from in-person site visits with three or four team members to a multi-pronged virtual approach, with generic online training for …

Telemedicine Use Among Physiatrists During The Early Phase Of The Covid-19 Pandemic And Potential For Future Use, Sameer Siddiqui, Ellen Farr, Nathaniel Dusto, Liqi Chen, Masha Kocherginsky, Felicia Skelton, Monica Verduzco-Gutierrez, Sujin Lee

Faculty, Staff and Students Publications

No abstract provided.

A Standardized Protocol For Remote Outpatient Blood Pressure Management, Nicholas Dorsey, Justin Taylor, Elvira Mercado

North Florida Division GME Research Day 2023

No abstract provided.

“So Many Extra Safety Layers:” Virtual Service Provision And Implementing Social Distancing In Interpersonal Violence Service Agencies During Covid-19, Rachel J Voth Schrag, Sarah Leat, Bethany Backes, Saltanat Childress, Leila Wood

Faculty, Staff and Student Publications

The coronavirus pandemic necessitated rapid shifts in approach for service providers working with survivors of interpersonal violence. To reduce the spread of the virus, providers and agencies implemented a rapid and unplanned expansion of virtual services while also developing new protocols to support safe and socially distant in-person services. To understand how these shifts have impacted victim service professionals and the survivors they serve, to provide guidance for on-going efforts, and to inform planning for future public health emergencies, this study asks the question: What approaches did the interpersonal violence workforce use to address social distancing needs during COVID-19? Semi-structured …

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 …

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

DNP Projects

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

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

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

Dual-Task Upper Extremity Motor Performance Measured By Video Processing As Cognitive-Motor Markers For Older Adults, Changhong Wang, Mohsen Zahiri, Ashkan Vaziri, Bijan Najafi

Center on Aging Staff Publications

Introduction: The use of dual-task model such as dual-task gait has been extensively studied to assess cognitive-motor performance among older adults. However, space restriction and safety factor limit its applications in remote assessment. To address the gap, we propose a video processing-based approach to remotely quantify cognitive-motor performance using a 20-s repetitive elbow flexion-extension test with dual-task condition, called video-based motoric-cognitive meter (MCM).

Methods: Eighteen older participants (age: 78.6 ± 6.5 years) who were clinically diagnosed as having either mild cognitive impairment or dementia were included in this study. Participants were asked to perform 20-s repetitive elbow flexion-extension exercise with …

Assessing The Most Vulnerable Subgroup To Type Ii Diabetes Associated With Statin Usage: Evidence From Electronic Health Record Data, Xinzhou Guo, Waverly Wei, Molei Liu, Tianxi Cai, Chong Wu, Jingshen Wang

Faculty, Staff and Student Publications

There have been increased concerns that the use of statins, one of the most commonly prescribed drugs for treating coronary artery disease, is potentially associated with the increased risk of new-onset Type II diabetes (T2D). Nevertheless, to date, there is no robust evidence supporting as to whether and what kind of populations are indeed vulnerable for developing T2D after taking statins. In this case study, leveraging the biobank and electronic health record data in the Partner Health System, we introduce a new data analysis pipeline and a novel statistical methodology that address existing limitations by (i) designing a rigorous causal …

Barriers And Facilitators In Implementing Multiplatform Remote Patient Monitoring Of Heart Failure Patients In Clinical Settings, Zachary Andrew Reilly

All Theses

Remote patient monitoring (RPM), which provides continuous monitoring of vital signs, has become increasingly utilized in patients with heart failure (HF). As this condition impacts more than 26 million Americans each year, it is important to determine the barriers and facilitators of RPM to both improve patient care and help medical professionals make more informed medical decisions. To determine these barriers and facilitators, our research team partnered with Prisma Health-Upstate to interview healthcare professionals working at Carolina Cardiology Consultants--Greenville, which uses multiple RPM systems to monitor heart failure patients.

The twelve interviews conducted support that healthcare professionals would benefit from …

Journal Of Digital Psychiatry: A New Journal, Salih Selek

Journal of Digital Psychiatry

no abstract

Evidence Of Phone Vs Video-Conferencing For Mental Health Treatments: A Review Of The Literature, Patricia V Chen, Ashley Helm, Steve G Caloudas, Anthony Ecker, Giselle Day, Julianna Hogan, Jan Lindsay

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: The goal of this paper is to provide a comparative review of using phone (audio-only) or video for mental health treatments. Our review includes evidence of phone and video's effectiveness in terms of reduced symptomology, retention, satisfaction, therapeutic alliance, and other outcomes of interest. This review also discusses how patients and providers' experiences and attitudes differ between these two modalities. Finally, we present information on different usage rates of phone and video across patient populations and mental health provider types, and different implementation strategies.

RECENT FINDINGS: Treatments through phone and video are both able to reduce symptoms …

Use Of Telemedicine In An Obgyn Residency Clinic During Covid, Sarah Dreibelbis, Anna Grassi, Daniel Jiang, John Dougherty

Transformative Medicine

INTRODUCTION: Telemedicine can address healthcare disparities by improving access to care and eliminating barriers to in-office appointments. The primary goal of this study is to compare the number of completed telemedicine appointments to the number of completed in-office appointments for an OBGYN residency clinic during the early months of the COVID pandemic. The study also aims to evaluate patient demographics and types of visits performed using telemedicine. METHODS: All OBGYN residency clinic visits at a single institution from March 2020 – May 2020 were included and reviewed. Proportions of the visit type were evaluated for completion as well …