Telemedicine Commons^™

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 …

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 …

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, …

The Impact Of Telemedicine On Human Immunodeficiency Virus (Hiv)-Related Clinical Outcomes During The Covid-19 Pandemic, Avery Lin Cox, Daniel Tsang, Lisa A. Spacek, Constantine Daskalakis, Dagan Coppock

Division of Infectious Diseases and Environmental Medicine Faculty Papers

The coronavirus disease of 2019 (COVID-19) pandemic exacerbated barriers to care for people living with human immunodeficiency virus (HIV) (PLWH). The quick uptake of telemedicine in the outpatient setting provided promise for care continuity. In this study, we compared appointment and laboratory no-show rates in an urban outpatient HIV clinic during three time periods: (1) Pre-COVID-19: 9/15/2019-3/14/2020 (predominately in-person), (2) "Early" COVID-19: 3/15/2020-9/14/2020 (predominately telemedicine), and (3) "Later" COVID-19: 9/15/2020-3/14/2021 (mixed in-person/telemedicine). Multivariable logistic regression models evaluated the two study hypotheses: (i) equivalence of Period 2 with Period 1 and of Period 3 with Period 1 and (ii) improved outcomes …

Evolution Of Telehealth-Its Impact On Palliative Care And Medication Management, Syed N Imam, Ursula K Braun, Mary A Garcia, Leanne K Jackson

Center for Medical Ethics and Health Policy Staff Publications

Palliative care plays a crucial role in enhancing the quality of life for individuals facing serious illnesses, aiming to alleviate suffering and provide holistic support. With the advent of telehealth, there is a growing interest in leveraging technology to extend the reach and effectiveness of palliative care services. This article provides a comprehensive review of the evolution of telehealth, the current state of telemedicine in palliative care, and the role of telepharmacy and medication management. Herein we highlight the potential benefits, challenges, and future directions of palliative telemedicine. As the field continues to advance, the article proposes key considerations for …

Addressing Untimely Healthcare Access Of Veterans Receiving Care Through The Veteran Healthcare Administration (Vha), Frank Lunetta, Jamie Stern, Lila Mcnamee

School of Professional Studies

The Veteran Healthcare Administration (VHA) serves over nine million veterans (Department of Veterans Affairs, 2023). They are responsible for the health and well-being of veterans with service-connected disabilities (Department of Veterans Affairs, 2023). A major focus for the organization is to keep improving access for veterans, as the population continues to grow (Department of Veterans Affairs, 2023). In 2018, congress passed the MISSION Act in hopes of increasing access for veterans. The MISSION Act would expand private healthcare access for veterans through the Veteran Community Care Program (VCCP) (MISSION ACT, 2018). Despite the initial benefits of the program, the MISSION …

Telehealth Evaluation In The United States: Protocol For A Scoping Review, Yunxi Zhang, Yueh-Yun Lin, Lincy S Lal, Jennifer C Reneker, Elizabeth G Hinton, Saurabh Chandra, J Michael Swint

Faculty, Staff and Student Publications

BACKGROUND: The rapid expansion of telehealth services, driven by the COVID-19 pandemic, necessitates systematic evaluation to guarantee the quality, effectiveness, and cost-effectiveness of telehealth services and programs in the United States. While numerous evaluation frameworks have emerged, crafted by various stakeholders, their comprehensiveness is limited, and the overall state of telehealth evaluation remains unclear.

OBJECTIVE: The overarching goal of this scoping review is to create a comprehensive overview of telehealth evaluation, incorporating perspectives from multiple stakeholder categories. Specifically, we aim to (1) map the existing landscape of telehealth evaluation, (2) identify key concepts for evaluation, (3) synthesize existing evaluation frameworks, …

A Building Block Approach To Implement A Telehealth Clinic And Improve Primary Care Access In The Philippines: A Large-Scale Pilot Project, Annalicia Pickering, Wardah Rafaqat, Adi Balk, Milton Chen, Limuel Abrogena, Shuhan He, Mary Showstark, Alexander Davis, Aidan Chen, Jarone Lee

Ateneo School of Medicine and Public Health Publications

A limited number of healthcare workers and cost constraints encumber primary care access in the Philippines. To test telehealth as a low-cost and effective solution, a large-scale digital health clinic was implemented in the selected urban and rural communities. In collaboration with local authorities, our pilot telemedicine clinic was implemented for 3 days in January 2023. Patients were registered, and their vitals were assessed before they were seen by a remote US-based licensed physician who provided treatment rec-ommendations. Medical devices with real-time streaming capabilities, such as electronic stethoscopes, were utilized to enhance remote examinations. A total of 322 patients were …

Relationship Between On-Demand Telehealth Visits And Emergency Department And Hospital Surge During The Covid-19 Pandemic, B. H. Slovis, Xin Ji, Anna Marie Chang, John C. Kairys, Judd Hollander

Department of Emergency Medicine Faculty Papers

OBJECTIVES: The relationship between COVID-19-related telehealth calls could be used to predict emergency department visits and hospital surges 3 days later potentially facilitating staffing adjustments in advance of patient arrivals. The purpose of this research was to study the temporal association between frequencies of on demand telehealth calls and emergency department surges during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.

METHODS: This cohort study examined patients who self-initiated synchronous audio-video on-demand telehealth calls between January 1, 2020 and June 30, 2022, and compared these to emergency department arrivals. The exposure in question was a synchronous audio-video on-demand telehealth …

Patient Perceptions Of Audio-Only Versus Video Telehealth Visits: A Qualitative Study Among Patients In An Academic Medical Center Setting, Ryan Kruis, Elizabeth A. Brown, Jada Johnson, Kit N. Simpson, James Mcelligott, Jillian Harvey

Community & Environmental Health Faculty Publications

Introduction: Telehealth utilization surged during the COVID-19 pandemic, offering expanded health care access. Audio-only visits emerged as a crucial tool for patients facing technology or connectivity barriers to still use telehealth. This qualitative study aims to better understand patient perceptions of audio-only versus video telehealth visits during the COVID-19 pandemic, and how patients perceive the role of each in their overall health care. Methods: Semi-structured interviews were conducted with 14 adult patients seeking care at an academic medical center located in the Southeast region of the United States. Patients had experienced both an audio-only and video telehealth visit within the …

Advocacy Spotlight: Telehealth Regulations For Dentistry Established, Neema Katibai Jd

The Journal of the Michigan Dental Association

The article discusses the rise of telehealth in the last three years and its implications for dentistry, focusing on recent rulemaking by the Michigan Board of Dentistry. The regulations address key aspects such as definitions, informed consent, scope of practice, and prescribing medications. Dentists must comply with HIPAA and state/federal privacy regulations when using telehealth. Notably, the rules restrict teledentistry delegation to allied personnel after an in-person visit within 24 months. The article emphasizes the importance of understanding and following these regulations for legal telehealth use, reimbursement, and malpractice coverage. The Michigan Dental Association advocates for sensible teledentistry laws to …

Designing A Blockchain-Empowered Telehealth Artifact For Decentralized Identity Management And Trustworthy Communication: Interdisciplinary Approach, Xueping Liang, Nabid Alam, Tahmina Sultana, Eranga Bandara, Sachin Shetty

VMASC Publications

Background: Telehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks.

Objective: The main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance.

Methods: We improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype …

Patient Satisfaction With Telemedicine In The Philippines During The Covid-19 Pandemic: A Mixed Methods Study, Alicia Victoria G. Noceda, Lianne Margot M. Acierto, Morvenn Chaimek C. Bertiz, David Emmanuel H. Dionisio, Chelsea Beatrice L. Laurito, Girrard Alphonse T. Sanchez, Arianna Maever Loreche

Ateneo School of Medicine and Public Health Publications

Background: The capacity to deliver essential health services has been negatively impacted by the COVID-19 pandemic, particularly due to lockdown restrictions. Telemedicine provides a safe, efficient, and effective alternative that addresses the needs of patients and the health system. However, there remain implementation challenges and barriers to patient adoption in resource-limited settings as in the Philippines. This mixed methods study aimed to describe patient perspectives and experiences with telemedicine services, and explore the factors that influence telemedicine use and satisfaction. Methods: An online survey consisting of items adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & …

Will You Go The Distance? A Satisfaction Survey Of Telemedicine In Sexual Medicine, Gal Saffati, Taher Naeem, Jordan Kassab, Daniela Orozco Rendon, Charles Green, Larry I Liphsultz, Mohit Khera

Faculty, Staff and Student Publications

BACKGROUND: The success of telemedicine depends on patient satisfaction with the care that they receive, which is impacted by the ease of use of the technology, quality of the connection, and perceived effectiveness of care.

AIM: The study sought to evaluate patient satisfaction with telemedicine services in a high-volume andrology clinic.

METHODS: We included all patients who had a telemedicine appointment between January 1, 2020, and August 22, 2022. Demographic information was gathered, and a satisfaction survey was conducted using REDCap software. Data were grouped into 2 age categories, with ≥50 years as the cutoff (19-50 years; >50 years). The …

The Impact Of Telehealth In Urgent Care Settings, Annie Dong

Applied Research Projects

Telehealth is an emerging modality of patient care and has since expanded to urgent care facilities. Urgent care facilities have been around for decades; however, along with telehealth, it has only grown in popularity in recent years due to the COVID-19 pandemic. However, the implementation and usage of telehealth in urgent care facilities is dependent on the provider being able to use it. This study aimed at looking at the perspective of the provider on the implementation and usage of telehealth in the urgent care setting.

Comparing Two Telehealth Approaches For Treating Psychiatric Disorders In Primary Care, Reach Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Federally Qualified Health Centers (FQHCs) are community clinics that provide primary care in rural and other underserved areas. FQHCs often don’t have enough mental health specialists to treat patients with complex mental health conditions.

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. …

How Are The Vibes? Patient And Family Experiences Of Rapport During Telehealth Calls In Palliative Care, Wendy English, Jackie Robinson, Merryn Gott

Patient Experience Journal

Interactions with rapport are considered essential to palliative care and beneficial to patient outcomes. With the current interest in telehealth, more knowledge is needed about rapport during telehealth encounters in palliative care from the patient and family viewpoint. The objective of this study was to explore patient and family experiences of rapport with health professionals during telehealth interactions in the community palliative care setting. This was a qualitative Interpretive Description study, with 18 patients and 11 family member participants recruited from four hospice locations in Aotearoa, New Zealand. Semi-structured interviews were conducted, and audio recorded between November 2020 and May …

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 …

Predictive Ability Of A 3d Body Scanning Mobile Application For Metabolic Health Risk, Caleb Brandner

Master's Theses

There is an increasing prevalence of obesity within the US and rising rates of metabolic syndrome among those aged 20-39 concurrent with a decrease in the reception of primary care. Limitations to healthcare including access, cost, and availability, highlighting the need for simple, efficient, and accessible cardiometabolic health risk screening. Given the surge in smartphone ownership over the last decade, this study sought to determine the predictive ability of a mobile 3D-optical (3DO) body composition assessment application in determining metabolic health risk. A total of 62 participants (female: 36) underwent traditional anthropometric measurements, 3DO body scanning using a smartphone application, …

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, …

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 …

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 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 …

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 …

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 …

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: …

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 …