Telemedicine Commons^™

Telehealth Experiences In Canadian Veterans: Associations, Strengths And Barriers To Care During The Covid-19 Pandemic., Deanna L Walker, M S Nouri, R A Plouffe, J J W Liu, T Le, C A Forchuk, D Gargala, K St Cyr, A Nazarov, Don Richardson

MacDonald Franklin OSI Research Centre

INTRODUCTION: Identifying barriers to care in veteran populations is critical, as veterans face increased social isolation, relationship strains and financial insecurities. For Canadian veterans experiencing barriers to accessing healthcare, telehealth may be a promising alternative with comparable effectiveness to in-person services; however, the potential benefits and limitations of telehealth require further examination to determine its long-term utility, and to inform health policy and planning. The goal of the present research was to identify predictors and barriers to telehealth usage in Canadian veterans in the context of the COVID-19 pandemic.

METHODS: Data were drawn from baseline data of a longitudinal survey …

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 …

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 …

Review Of Telemedicine Use As It Expands Since The Covid-19 Pandemic, Michael P. Perra, Frederick J. Goldstein

Research Day

INTRODUCTION: As new technology advances and the world becomes increasingly connected, medical care and physician-patient interactions have changed. Telemedicine, though present in different forms for many decades, has grown, and its use is changing at a faster-than-ever pace. The COVID-19 pandemic highlighted the utility of different telemedicine platforms and has led to an expansion in its capabilities.

OBJECTIVES: To explore the evolution of telemedicine, its multiple functions, and how this technology has continued to develop since the COVID-19 pandemic in various medical specialties.

METHODS: PubMed was used to assess published studies that either incorporated telehealth resources in their research or …

A Systematic Literature Review Of Ransomware Attacks In Healthcare, Jasler Klien Adlaon

Electronic Theses, Projects, and Dissertations

This culminating experience project conducted a Systematic Literature Review of ransomware in the healthcare industry. Due to COVID-19, there has been an increase in ransomware attacks that took healthcare by surprise. Although ransomware is a common attack, the current healthcare infrastructure and security mechanisms could not suppress these attacks. This project identifies peer-viewed literature to answer these research questions: “What current ransomware attacks are used in healthcare systems? “What ransomware attacks are likely to appear in the future?” and “What solutions or methods have been used to prepare, prevent, and recover from these attacks?” The purpose of this research is …

A Systematic Review Identifying Adverse Health Outcomes And Mortality Rates Associated With Telehealth, Fidelia Cascini, Ana Pantovic, Yazan A. Al-Ajlouni, Omar Al Ta'ani, Giovanna Failla, Andriy Melnyk, Paul Barach, Walter Ricciardi

College of Population Health Faculty Papers

Background: The literature supporting telehealth management is growing accelerated by the COVID-pandemic. We hypothesize that there are risks of adverse events associated with telehealth interventions.

Methods: A review of PubMed (including MEDLINE), Embase, ISI (Web of Science), VHL/GHL, Scopus, Science Direct, and PsycINFO was conducted for all adverse events associated with telehealth from January 1, 1960 to March 1, 2021. This systematic review and meta-analyses were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Of 5,144 citations 78 published studies met criteria for quality evaluation and underwent full text abstraction including the qualitative …

Draws And Windfalls: Comparing Patient Experiences In Inpatient Telehealth And Non-Telehealth Acute Care Units, Geoffrey A. Silvera, Erin Blanchard, Varun Natarajan, Eric Wallace, William Steve Stigler, Bart Kelly, Terri Scarborough, Sue S. Feldman

Patient Experience Journal

The global COVID-19 pandemic has challenged health care delivery in many ways. One solution from the pandemic that offers potential upside is the expansion of telehealth as a means to provide high quality, cost-effective, and safe care while also maintaining excellence in patient and family experience. While most examinations of the use of telehealth over the pandemic have focused on the expansion of outpatient telehealth, few have explored the use of telehealth for hospitalized patients. This article will examine the influence of telehealth use on patient experiences among acute care patients. Inpatient telehealth acute care (ITAC) is a …

Social Worker’S Acceptance Of Telehealth In Rhode Island And Massachusetts: Is It Transformative?, Sinead Martin

Social Work Student Scholarship

Sinead Martin ’23
Major: Social Work>Faculty Mentor: Dr. Katherine Kranz, Social Work

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 …

A Content Analysis Of Media Coverage Of Telehealth In Mississippi, Hailey Layne

Honors Theses

Telehealth’s utilization within healthcare has expanded and changed areas of healthcare delivery. In rural states like Mississippi barriers to accessing healthcare services exist due to demographic factors, socioeconomic factors, or geographic distance. This study was meant to look at the literature related to telehealth that was being disseminated to Mississippians through online news sources. It was noted whether these articles viewed telehealth utilization in a positive or negative way. Utilizing a cross-sectional media analysis, the news articles were screened using a coding form that acknowledged different themes in the literature. Frequency analyses were conducted to aid in interpreting the common …

Investigating Interactive Methods In Remote Chestfeeding Support For Lactation Consulting Professionals In Brazil, Jessica De Souza, Cinthia Calsinski, Kristina Chamberlain, Franceli L. Cibrian, Edward Jay Wang

Engineering Faculty Articles and Research

Objective: Lactation consultants (LCs) positively impact chestfeeding rates by providing in-person support to struggling parents. In Brazil, LCs are a scarce resource and in high demand, risking chestfeeding rates across many communities nationwide. The transition to remote consultations during the COVID-19 pandemic made LCs face several challenges to solve chestfeeding problems due to limited technical resources for management, communication, and diagnosis. This study investigates the main technological issues LCs have in remote consultations and what technology features are helpful for chestfeeding problem-solving in remote settings.

Methods: This paper implements qualitative investigation through a contextual study (n = 10) and …

Inequities In Telemedicine Use Among Patients With Stroke And Cerebrovascular Diseases: A Tricenter Cross-Sectional Study, Imama A. Naqvi, Audrey S Cohen, Youngran Kim, Jennifer Harris, Mary Carter Denny, Kevin Strobino, Nathan Bicher, Ryan A Leite, Dylan Sadowsky, Comfort Adegboye, Nnedinma Okpala, Munachi Okpala, Sean I Savitz, Randolph S Marshall, Anjail Sharrief

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: In response to the COVID-19 pandemic, outpatient stroke care delivery was rapidly transformed to outpatient evaluation through video (VTM) and telephone (TPH) telemedicine (TM) visits around the world. We sought to evaluate the sociodemographic differences in outpatient TM use among stroke patients.

METHODS: We conducted a retrospective chart review of outpatients evaluated at 3 tertiary stroke centers in the early period of the pandemic, 3/16/2020 through 7/31/2020. We compared the use of TM by patient characteristics including age, sex, race/ethnicity, insurance status, stroke type, patient type, and site. The association between TM use and patient characteristics was …

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 …

Experiences And Perspectives Of Filipino Patients With Stroke On Physical Therapy Telerehabilitation: A Phenomenological Study Protocol, Christopher G. Cruz, Donald S. Lipardo, Nicole Trizia S. Esplana, Beatrice Ann Q. Loa, Micah L. Dismaya, Janelle Meara Y. Lau, Mirzi Chelsea R. Quizzagan, Arianne B. Cardenas, Adellene Therese S. Celso, Hanz Lauren A. Taguinod, Kristian Joseph C. Martin, Leonardo S. Uy Iii

Philippine Journal of Physical Therapy

Introduction: Stroke is the third leading cause of death in the Philippines, so these patients must continuously undergo rehabilitation for faster recovery. With the rise of COVID-19, physical therapy (PT) telerehabilitation (TR) has emerged, where services are provided outside the usual rehabilitation setting for patients with stroke to continue their treatment while reducing the risk of acquiring COVID-19. However, it is a relatively new service in the country; hence, further research is needed to identify the factors and needs of these patients during TR, which may help improve PT TR services.

Objective: This study aims to explore the experiences …

Exploring The Transtheoretical Model Of Change, Barriers, And Motives To Telemedicine Adoption In Athletic Training, Gabrielle A. Griffin, Kenneth E. Games, David F. Gallegos, Samantha E. Scarneo-Miller, Amanda L. Kottak, Zachary K. Winkelmann

Internet Journal of Allied Health Sciences and Practice

Purpose: The delivery of healthcare services by athletic trainers (ATs) has evolved over the past two years as a result of the COVID-19 pandemic. Previous research has identified an integration of telemedicine as a necessary, urgent replacement for face-to-face patient encounters in athletic training; however, there is a lack of data to support the habitual and intentional change to one’s clinical practice that includes telemedicine. Therefore, the purpose of this study was to identify and analyze ATs respective stages of change related to telemedicine adoption, as well as explore motivating factors and barriers related to the adoption of telemedicine. Methods: …

A Scoping Review Of Digital Health Interventions For Combating Covid-19 Misinformation And Disinformation, Katarzyna Czerniak, Raji Pillai, Abhi Parmar, Kavita Ramnath, Joseph Krocker, Sahiti Myneni

Faculty, Staff and Student Publications

OBJECTIVE: We provide a scoping review of Digital Health Interventions (DHIs) that mitigate COVID-19 misinformation and disinformation seeding and spread.

MATERIALS AND METHODS: We applied our search protocol to PubMed, PsychINFO, and Web of Science to screen 1666 articles. The 17 articles included in this paper are experimental and interventional studies that developed and tested public consumer-facing DHIs. We examined these DHIs to understand digital features, incorporation of theory, the role of healthcare professionals, end-user experience, and implementation issues.

RESULTS: The majority of studies (n = 11) used social media in DHIs, but there was a lack of platform-agnostic generalizability. …

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 …

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 …

The Role Of Telehealth In Enabling Sustainable Innovation And Circular Economies In Health, Dimitrios Kalogeropoulos, Paul Barach

College of Population Health Faculty Papers

Digital health interventions including telehealth support an increasingly broad range of improvement goals for prevention and treatment. Limitations obstructing the many digital benefits of telehealth from reaching their full potential include lack of robust usability and user centered design, regulatory policy paradigms, lack of adequate high-quality evidence and methodologies to evaluate the performance generalization and clinical robustness. Health innovation is explored in the context of different value systems and a solution is proposed to the fundamental limitations arising in the data value system, an approach to a new telehealth paradigm and incorporated intervention designs which combine clinical innovation with innovation …

Did The Pandemic Change Future Treatment Choices Amongst Orthodontists?, Ryanna Robinson, John Atere

Annual Research Symposium

No abstract provided.

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 …

Assessing The Suitability Of A Virtual 'Pink Warrior' For Older Breast Cancer Survivors During Covid-19: A Pilot Study, Maria C Swartz, Michael C Robertson, Ursela Christopherson, Stephanie J Wells, Zakkoyya H Lewis, Jinbing Bai, Michael D Swartz, H Colleen Silva, Eloisa Martinez, Elizabeth J Lyons

Faculty, Staff and Student Publications

The COVID-19 pandemic impacted the conduct of in-person physical activity (PA) interventions among older survivors of BC, who need such interventions to stay active and prevent functional decline. We tested the feasibility of virtually delivering an exergame-based PA intervention to older BC survivors. We enrolled 20 female BC survivors ≥55 years and randomly assigned them to two groups. The intervention group (Pink Warrior 2) received 12 weekly virtual exergame sessions with behavioral coaching, survivorship navigation support, and a Fitbit for self-monitoring. The control group received 12 weekly phone-based survivorship discussion sessions and wore a Mi Band 3. Feasibility was evaluated …

The Clinical Suitability Of An Artificial Intelligence-Enabled Pain Assessment Tool For Use In Infants: Feasibility And Usability Evaluation Study, Jeffery David Hughes, Paola Chivers, Kreshnik Hoti

Research outputs 2022 to 2026

Background: Infants are unable to self-report their pain, which, therefore, often goes underrecognized and undertreated. Adequate assessment of pain, including procedural pain, which has short- and long-term consequences, is critical for its management. The introduction of mobile health–based (mHealth) pain assessment tools could address current challenges and is an area requiring further research. Objective: The purpose of this study is to evaluate the accuracy and feasibility aspects of PainChek Infant and, therefore, assess its applicability in the intended setting. Methods: By observing infants just before, during, and after immunization, we evaluated the accuracy and precision at different cutoff scores of …

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 …

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 …

Patient Perceptions Of Trauma-Focused Telemental Health Services Using The Telehealth Satisfaction Questionnaire (Tsq), Bianca T. Villalobos, Aubrey R. Dueweke, Rosaura Orengo-Aguayo, Regan W. Stewart

Psychological Science Faculty Publications

Telehealth services can address many barriers to traditional office-based mental health services. Few studies have assessed youth and caregiver perceptions of and satisfaction with trauma-focused interventions delivered via telemental health. The current study presents data collected using the Telehealth Satisfaction Questionnaire (TSQ), which was developed to measure child and caregiver satisfaction with services, comfort with the telehealth equipment, and barriers to traditional office-based services. Thirteen clinicians delivered home- and school-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) via videoconferencing on tablets and computers to 60 child patients (71.7% Latinx, 18.3% Black, and 10.0% non-Hispanic White). Patients and caregivers completed the TSQ at …

Conducting Clinical Genomics Research During The Covid-19 Pandemic: Lessons Learned From The Cser Consortium Experience, Stephanie A Kraft, Heidi Russell, Jeannette T Bensen, Katherine E Bonini, Jill O Robinson, Nuriye Sahin-Hodoglugil, Kathleen Renna, Lucia A Hindorff, Dave Kaufman, Carol R Horowitz, Margaret Waltz, Jamilyn M Zepp, Sara J Knight

Faculty, Staff and Student Publications

Clinical research studies have navigated many changes throughout the COVID-19 pandemic. We sought to describe the pandemic's impact on research operations in the context of a clinical genomics research consortium that aimed to enroll a majority of participants from underrepresented populations. We interviewed (July to November 2020) and surveyed (May to August 2021) representatives of six projects in the Clinical Sequencing Evidence-Generating Research (CSER) consortium, which studies the implementation of genome sequencing in the clinical care of patients from populations that are underrepresented in genomics research or are medically underserved. Questions focused on COVID's impact on participant recruitment, enrollment, and …