Telemedicine Commons^™

Remote Functional Assessment: Experiences Of People Living With Spinal Cord Injury, Adrian David, Mot, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Background: As telerehabilitation gains traction in occupational therapy, validating functional measures is crucial. Understanding clients' views on telehealth is essential, yet literature on spinal cord injury (SCI) in this context is sparse.

Objective: This study aims to describe the experiences of people living with SCI regarding remote and in-person functional testing.

Methods: A qualitative design was used, involving participants from a previous study validating the GRASSP, SCIM, and SCI-MovIN for remote use. Semi-structured interviews explored experiences, and transcripts were coded for thematic analysis. Twenty-five individuals with SCI, aged 18-80 and at least nine months post-injury, were included.

Results: Four themes …

Personalized And Culturally Tailored Features Of Mobile Apps For Gestational Diabetes Mellitus And Their Impact On Patient Self-Management: Scoping Review, Catherine Jones, Yi Cui, Ruth Jeminiwa, Elina Bajracharya, Katie Chang, Tony Ma

College of Pharmacy Faculty Papers

BACKGROUND: Gestational diabetes mellitus (GDM) is an increasingly common high-risk pregnancy condition requiring intensive daily self-management, placing the burden of care directly on the patient. Understanding personal and cultural differences among patients is critical for delivering optimal support for GDM self-management, particularly in high-risk populations. Although mobile apps for GDM self-management are being used, limited research has been done on the personalized and culturally tailored features of these apps and their impact on patient self-management.

OBJECTIVE: This scoping review aims to explore the extent to which published studies report the integration and effectiveness of personalized and culturally tailored features in …

An Exploration Of Telemedicine Application Service Quality And Its Relevance With Patient Satisfaction, Victoria Olguin

Honors Program Theses and Research Projects

When the world experienced a pandemic due to the SARS-CoV-virus (COVID-19) in 2019, a lockdown quickly took place and travel restrictions were applied, placing a barrier to in- person healthcare access. This made the healthcare settings practice alternate ways in delivering healthcare that did not necessarily have to be in-person. The evolvement of a remote setting took place, and the development and usage of telemedicine quickly accelerated. This form of healthcare has transformed the way care is delivered to patients, with many key elements shaping their experience and outcomes. Now that the COVID-19 pandemic has ended, the practice of telemedicine …

The Effective Implementation Of Agile Project Management In Healthcare It Projects, Chinedu Chigbu

Harrisburg University Dissertations and Theses

This research paper investigates the effective implementation of Agile project management in the healthcare sector, focusing on its role in facilitating digital transformation initiatives. Through a comprehensive literature review, this study examines current practices, challenges, and future trends in healthcare digitalization, emphasizing the pivotal role of IT project management. Key concepts, models, and success metrics are analyzed, with particular attention to the adoption of Agile methodologies and stakeholder collaboration. Challenges such as interoperability, resistance to change, and data security are scrutinized alongside strategic solutions. The paper also outlines future opportunities, including AI integration and blockchain, and offers recommendations for enhancing …

Safeguarding Virtual Healthcare: A Novel Attacker-Centric Model For Data Security And Privacy, Suvineetha Herath, Haywood Gelman, John Hastings, Yong Wang

Research & Publications

The rapid growth of remote healthcare delivery has introduced significant security and privacy risks to protected health information (PHI). Analysis of a comprehensive healthcare security breach dataset covering 2009-2023 reveals their significant prevalence and impact. This study investigates the root causes of such security incidents and introduces the Attacker-Centric Approach (ACA), a novel threat model tailored to protect PHI. ACA addresses limitations in existing threat models and regulatory frameworks by adopting a holistic attacker-focused perspective, examining threats from the viewpoint of cyber adversaries, their motivations, tactics, and potential attack vectors. Leveraging established risk management frameworks, ACA provides a multi-layered approach …

Exploring The Contribution Of Mobile Money To The Well-Being Of Rural Tanzanian Villagers And Assessing Their Readiness To Adopt A Similar Model To Advance Their Healthcare Access An Exploratory Study, Sr. Magdalena P. Chubwa

Seton Hall University Dissertations and Theses (ETDs)

Background: Healthcare for rural villages in Tanzania has always been rudimentary. Lack of the infrastructure and poverty are among the many obstacles facing this population’s access to healthcare. While, the rise of telehealth has improved access to healthcare in many parts of the world, its use in rural Tanzania has been extremely limited to poor internet access. However, given the availability of non-internet connected mobile phones in rural Tanzania, the potential to use this devise to improve healthcare access exists. Individuals using mobile phones for financial transactions may be motivated to access healthcare via telehealth by using their non-internet connected …

Safety And Clinical Outcomes Of Endovascular Therapy Versus Medical Management In Late Presentation Of Large Ischemic Stroke, Adnan Mujanovic, Daniel Strbian, Jelle Demeestere, João Pedro Marto, Volker Puetz, Raul G Nogueira, Mohamad Abdalkader, Simon Nagel, Jean Raymond, Marc Ribo, Patrik Michel, Shinichi Yoshimura, Osama O Zaidat, Simon Winzer, Santiago Ortega-Gutierrez, Sunil A Sheth, James E Siegler, Anne Dusart, Diogo C Haussen, Hilde Henon, Bettina L Serrallach, Mahmoud H Mohammaden, Markus A Möhlenbruch, Marta Olive-Gadea, Ajit S Puri, Nobuyuki Sakai, Piers Klein, Liisa Tomppo, Francois Caparros, João Nuno Ramos, Mouhammad Jumaa, Syed Zaidi, Tomas Dobrocky, Nicolas Martinez-Majander, Stefania Nannoni, Flavio Bellante, Aaron Rodriguez-Calienes, Sergio Salazar-Marioni, Pekka Virtanen, Daniel Po Kaiser, Rita Ventura, Jessica Jesser, Alicia C Castonguay, Muhammad M Qureshi, Hesham E Masoud, Milagros Galecio-Castillo, Manuel Requena, Riikka Lauha, Wei Hu, Eugene Lin, Zhongrong Miao, Daniel Roy, Hiroshi Yamagami, David J Seiffge, Davide Strambo, Peter A Ringleb, Robin Lemmens, Urs Fischer, Thanh N Nguyen, Johannes Kaesmacher

Faculty, Staff and Student Publications

Introduction: The benefit of endovascular therapy (EVT) among stroke patients with large ischemic core (ASPECTS 0-5) in the extended time window outside of trial settings remains unclear. We analyzed the effect of EVT among these stroke patients in real-world settings.

Patients and methods: The CT for Late Endovascular Reperfusion (CLEAR) study recruited patients from 66 centers in 10 countries between 01/2014 and 05/2022. The extended time-window was defined as 6-24 h from last-seen-well to treatment. The primary outcome was shift of the 3-month modified Rankin scale (mRS) score. Safety outcomes included symptomatic intracranial hemorrhage (sICH) and mortality. Outcomes were analyzed …

Telerehabilitation For Aphasia (Terra) Phase Ii Trial Design, Christy Cassarly, Alexandra Basilakos, Lisa Johnson, Janina Wilmskoetter, Jordan Elm, Argye E. Hillis, Leonardo Bonilha, Chris Rorden, Gregory Hickok, Dirk B. Den Ouden, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Background and purpose

Methods

Effect Of Telehealth Interventions On Hypertension Management In A Veterans Affairs Community-Based Outpatient Clinic (Cboc), Cherilyn Schumacher

Student Scholarly Projects

Practice Problem: Per U.S. Department of Veterans Affairs (2020), hypertension (HTN) is prevalent in active and retired military personnel with 13% of those in active duty and in “more than one in three Veterans…making it the most common chronic condition for Veterans” (p. 1). Per the Electronic Quality Measure (eQM) portal, a PACT clinic in a CBOC is scoring well below the national and facility benchmarks, showing a need for an intervention that will improve HTN management.

PICOT: For current veteran patients ages 18-85 assigned to a PACT (P), what is the effect of nurse-led telehealth blood pressure …

Interactive Virtual Presence: A New Tool For Remote Healthcare, David C. Schwebel

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic transformed use of telemedicine for healthcare. Many healthcare objectives can be successfully delivered through traditional telemedicine platforms, and others must be delivered in person. Lying between those extremes is a subset of healthcare objectives that might benefit from use of interactive virtual presence, a form of augmented reality that can be delivered on standard smartphones to offer immersive presence as well as simultaneous voice and visual stimuli. Using interactive virtual presence, a healthcare provider can communicate both verbally and visually with a remotely-located patient, but also can interact with that patient through merged reality by pointing with …

Patient-Reported Convenience And Effectiveness Of Telehealth For Breast Cancer Management, Akshara Singareeka Raghavendra, Kristofer Jennings, Gil Guerra, Debu Tripathy, Meghan S Karuturi

Faculty, Staff and Student Publications

Background: Before the coronavirus disease 2019 (COVID-19) pandemic, telehealth was rarely used for breast cancer management at tertiary care centers. We sought to examine patient satisfaction, experiences, preferences, and perceived effectiveness and technical quality of telehealth visits in follow-up patients receiving routine outpatient care in the breast medical oncology practice at The University of Texas MD Anderson Cancer Center.

Methods: We administered a survey to 60 follow-up patients for a duration of 9 months (January 5, 2021 to October 27, 2021) who had at least one telehealth consultation during the COVID-19 pandemic, from April 10, 2020 to October 21, 2021. …

Telemedicine For Patients With Systemic Lupus Erythematosus In A Publicly Funded Hospital System: Retrospective Study, Sebastian Bruera, Kristen Andrews Staggers, Maria Eugenia Suarez-Almazor, Sandeep Krishna Agarwal

Faculty, Staff and Students Publications

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that requires frequent clinic and laboratory visits. However, patients with SLE, particularly those who are underresourced, have unacceptably high rates of no-shows.

OBJECTIVE: This study aims to determine no-show rates associated with telemedicine visits during the COVID-19 pandemic in comparison to no-show rates associated with contemporaneous and historic in-person visits.

METHODS: We performed a retrospective cohort study in a publicly funded county hospital system in Houston, Texas. We identified a cohort of established patients with SLE by the International Classification of Diseases codes that were independently confirmed as SLE by …

Nursing Informatics: The Vital Nursing Link Between Technology And Patient Care, Sherri L. Hess, Caryn Alper

HCA Healthcare Journal of Medicine

Advances in technology offer additional health care tools to improve the health of patients and efficiencies for our clinicians in innovative ways. These technologies cover a huge variety of therapeutics, ranging from wearable devices, such as insulin pumps, to robotic-assisted surgeries. Nursing informatics is firmly embedded in the use of technology to improve nursing care and science. One of the most recent developments in nursing is the exploration of virtual nursing. This paper will present the past, current, and future projections for this unique blend of nursing art and science with cutting-edge technology.

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 …

Digital Assessments For Children And Adolescents With Adhd: A Scoping Review, Franceli L. Cibrian, Elissa M. Monteiro, Kimberley D. Lakes

Engineering Faculty Articles and Research

Introduction: In spite of rapid advances in evidence-based treatments for attention deficit hyperactivity disorder (ADHD), community access to rigorous gold-standard diagnostic assessments has lagged far behind due to barriers such as the costs and limited availability of comprehensive diagnostic evaluations. Digital assessment of attention and behavior has the potential to lead to scalable approaches that could be used to screen large numbers of children and/or increase access to high-quality, scalable diagnostic evaluations, especially if designed using user-centered participatory and ability-based frameworks. Current research on assessment has begun to take a user-centered approach by actively involving participants to ensure the development …

How Have Occupational Therapy Services Been Delivered During The Covid-19 Pandemic?, Hulya Yucel, Selen Aydoner

Internet Journal of Allied Health Sciences and Practice

The provision of traditional healthcare services has encountered obstacles due to the Coronavirus Disease-2019 (COVID-19) pandemic. The inability of healthcare professionals and clients to survive the pandemic and the inadequacy of personal protective equipment have created uncertainties regarding the appropriate practices for addressing individuals' health conditions. Furthermore, the field of rehabilitation, including occupational therapy, has experienced changes in the delivery of traditional practices. Therefore, this review aimed to examine occupational therapy services delivered during the COVID-19 pandemic. As a result of the literature review, the most commonly provided services by occupational therapists during COVID-19 were discussed and a total of …

Impact Of Covid-19 Lockdown On Patient-Provider Electronic Communications, Michael A Hansen, Rebecca Chen, Jacqueline Hirth, James Langabeer, Roger Zoorob

Faculty, Staff and Students Publications

BACKGROUND: SARS CoV-2 virus (COVID-19) impacted the practice of healthcare in the United States, with technology being used to facilitate access to care and reduce iatrogenic spread. Since then, patient message volume to primary care providers has increased. However, the volume and trend of electronic communications after lockdown remain poorly described in the literature.

METHODS: All incoming inbox items (telephone calls, refill requests, and electronic messages) sent to providers from patients amongst four primary care clinics were collected. Inbox item rates were calculated as a ratio of items per patient encountered each week. Trends in inbox rates were assessed during …

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.

Development And Preliminary Validation Of A Screener For Digital Health Readiness, Kristin Rising, Amanda Guth, Alexzandra Gentsch, Karla Martin Gonzalez, Richard Hass, Lindsey Shughart, Serena Gelfer, Megan Mcvane, Brooke Worster, Amy Leader

Department of Medicine Faculty Papers

IMPORTANCE: While telehealth use has grown, patient uptake is variable, which has the potential to increase health disparities. Identifying and understanding individuals' barriers to digital health readiness can help health systems efficiently deploy resources to provide personalized patient-centered support.

OBJECTIVE: To develop and validate an instrument to evaluate digital health readiness to identify and quantify barriers to digital readiness.

DESIGN, SETTING, AND PARTICIPANTS: In this qualitative mixed-methods study conducted from April 26, 2022, to June 8, 2023, the instrument was created in 4 phases. Patients and health care professionals were interviewed to explore barriers to telehealth use, scale items were …

"Addressing Barriers To Digital Health Readiness Among A Latino Population", Karla Martin Gonzalez, Alexzandra T. Gentsch, Chelsea Torres, Elias Borne, Josefina Hendry, Lianette Pappaterra, Maryann Salib, Brooke Worster, Steven Gravier-Leon, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

No abstract provided.

Addressing Dermatologic Concerns And Teledermatology In Undomiciled And Sheltered Populations, Kennedy Gallagher, Sahithi Talasila, Anna Bistline, Rebecca Krain, Leena Ramani, Elizabeth Jones

Student Papers, Posters & Projects

Homelessness in the United States is a significant public health issue, with dermatologic disease being the most prevalent health concern among the undomiciled and sheltered populations. Despite a growing need for dermatologic care, the supply of dermatologists remains insufficient, contributing to disparities in healthcare access for this vulnerable group. This review aims to detail the spectrum of dermatologic conditions experienced by homeless individuals, identify barriers to adequate care, and explore teledermatology as a potential solution to bridge these gaps. A comprehensive literature review was conducted, analyzing studies and reports on dermatologic issues prevalent among the homeless population and the efficacy …

Central Tracking And Billing System For Insurance Bills, Kehinde Alabi

Harrisburg University Dissertations and Theses

In this article, we introduce a new centralized billing platform designed for insurance bills including auto insurance, health insurance, home insurance, life insurance, etc. This system consolidates all bills for individual users eliminating the need for them to manage and pay bills separately. Users stand to benefit from significant time and effort savings each month, reducing the likelihood of missed payments and associated late fees. Insurance billing organizations and banks can also capitalize on timely payments and reduced physical mailings, leading to cost savings and environmental benefits. The proposed system offers users the ability to track and review their historical …

Examining The Impact Of Telehealth Visits On Patient And Family Experience In A Pediatric Emergency And Urgent Care Center, Abigail Gauthier Md, Callie Krentz Md, Shiran Chan Ms, Michelle Widecan Dnp, Aprn, Cpnp, Ac/Pc, Adam A. Vukovic Md, Med

Patient Experience Journal

Providers and healthcare organizations have created novel ways of evaluating patients using telehealth. Patient volumes in urgent cares (UCs) and emergency departments (EDs) continue to climb, contributing to longer wait times and suboptimal patient and family experiences (PFEs). Optimizing use of telehealth may not only impact PFE of those evaluated virtually, but also reduce crowding in EDs and UCs, indirectly impacting PFE in those spaces as well. The purpose of this study is to identify any association between telehealth encounters and PFE scores. This is a retrospective review of patients seen via telehealth in virtual urgent care, UC, or the …

Perspectives On Telemedicine Across Urban, Rural And Remote Areas In The Philippines During The Covid-19 Pandemic, Noleen Fabian, Regine Ynez De Mesa, Carol Tan-Lim, Gillian Sandigan, Johanna Lopez, Arianna Maever Loreche, Leonila Dans, Zharie Benzon, Herbert Zabala, Josephine Sanchez, Nanette Sundiang, Mia Rey, Antonio Dans

Ateneo School of Medicine and Public Health Publications

Objectives

This study explored attitudes, subjective norms, and perceived behavioural control of participants across urban, rural and remote settings and examined intention-to-use telemedicine (defined in this study as remote patient-clinician consultations) during the COVID-19 pandemic.

Methods

This is a cross-sectional study. 12 focus group discussions were conducted with 60 diverse telemedicine user and non-user participants across 3 study settings. Analysis of responses was done to understand the attitudes, norms and perceived behavioural control of participants. This explored the relationship between the aforementioned factors and intention to use.

Results

Both users and non-users of telemedicine relayed that the benefits of telemedicine …

Advancing Telehealth Through Artificial Intelligence: Incorporating Emotional Intelligence And Addressing Cybersecurity Challenges, Mahima Rajendra Pulgaonkar

Electronic Theses, Projects, and Dissertations

This culminating experience project explores the integration of Emotional Artificial Intelligence (Emotional AI) into telehealth systems, addressing the dual challenges of enhancing patient care and mitigating cybersecurity risks. The research questions are: (Q1) How can Emotionally Intelligent AI improve telehealth systems' ability to recognize and respond to mental health symptoms? and (Q2) What are the specific cybersecurity challenges associated with AI in telehealth and how can they be mitigated? The findings for each question are: Q1: Emotionally Intelligent AI can significantly enhance telehealth by providing personalized, empathetic interactions that improve patient engagement, adherence to treatment plans, and early detection of …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Vysion Software, Isaias Hernandez-Dominguez Jr, Chander Luderman Miller

2024 Symposium

Vision loss presents significant challenges in daily life. Existing solutions for blind and visually impaired individuals are often limited in functionality, expensive, or complex to use. Vysion Software addresses this gap by developing a user-friendly, all-in-one AI companion app that provides features including text summarization, real-time audio descriptions, and AI-enhanced navigation. This project details the development plan, initial functionalities, and future vision for Vysion Software.

Evaluation Of An Educational Training On Telehelath Utilization Rates And Hospital Readmissions In A Home Health Setting., Gabrielle A. Coomer

Doctor of Nursing Practice Papers

Background: Hospital readmissions are on the rise and continue to be a concern within healthcare due to their effects on the quality of care and healthcare costs. Telehealth strategies have been utilized across healthcare settings to improve hospital readmission rates.

Purpose: The purpose of this project was to evaluate the effectiveness of a telehealth training program in increasing telehealth utilization rates and reducing the acute care hospitalization rate within a single home health agency.

Intervention: A 30-minute PowerPoint presentation on the definition of telehealth, goals, and benefits of telehealth, patient eligibility, special considerations for clinicians, billing and coding guidelines, …

Mhealth-Based Just-In-Time Adaptive Intervention To Improve The Physical Activity Levels Of Individuals With Spinal Cord Injury: Protocol For A Randomized Controlled Trial, Rachel Carey, Ha Le, Donna Coffman, Inbal Nahum-Shani, Mohanraj Thirumalai, Cole Hagen, Laura Baehr, M. Schmidt-Read, Marlyn Lamboy, Stephanie A Kolakowsky-Hayner, Ralph Marino, Stephen Intille, Shivayogi Hiremath

Moss-Magee Rehabilitation Papers

BACKGROUND: The lack of regular physical activity (PA) in individuals with spinal cord injury (SCI) in the United States is an ongoing health crisis. Regular PA and exercise-based interventions have been linked with improved outcomes and healthier lifestyles among those with SCI. Providing people with an accurate estimate of their everyday PA level can promote PA. Furthermore, PA tracking can be combined with mobile health technology such as smartphones and smartwatches to provide a just-in-time adaptive intervention (JITAI) for individuals with SCI as they go about everyday life. A JITAI can prompt an individual to set a PA goal or …

Implementation Of A Health Information Technology Safety Classification System In The Veterans Health Administration’S Informatics Patient Safety Office, Danielle Kato, Joe Lucas, Dean F Sittig

Faculty, Staff and Student Publications

Objective: Implement the 5-type health information technology (HIT) patient safety concern classification system for HIT patient safety issues reported to the Veterans Health Administration's Informatics Patient Safety Office.

Materials and methods: A team of informatics safety analysts retrospectively classified 1 year of HIT patient safety issues by type of HIT patient safety concern using consensus discussions. The processes established during retrospective classification were then applied to incoming HIT safety issues moving forward.

Results: Of 140 issues retrospectively reviewed, 124 met the classification criteria. The majority were HIT failures (eg, software defects) (33.1%) or configuration and implementation problems (29.8%). Unmet user …