Telemedicine Commons^™

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 …

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 …

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 …

Telehealth In Medicine: Predictions 2023–2024, Jiang Li, Ingrid Vasiliu-Feltes, Kathleen Mcgrow, Brendan F. Smith, Paul Barach, Sweta Sneha, Francis X. Campion

College of Population Health Faculty Papers

Each year, Telehealth and Medicine Today asks experts in the field to share their insights into the future and predict how telehealth will influence uptake and healthcare in the new year.

Work-Life Balance: Combating Nurse Practitioner Burnout And Primary Care Provider Shortages Utilizing Telehealth, Jennifer O'Dell

Graduate Research Projects

No abstract provided.

A Call Away: Investigating A Solution To Healthcare Access Barriers In Remote Communities, Tamsin Rogers

Honors Theses

This project focuses on the fact that there exist communities in the United States that are underserved in terms of healthcare. Whether this is due to the community’s geographical (remote) location, lack of education, or other factors, the members of these communities experience disproportionate levels of care. My focus with this project will be the idea that everyone deserves adequate healthcare, regardless of where they live. I focus specifically on one community: Jackman, Maine, which has recently implemented a telemedicine program called ‘FirstNet’ to aid its previously struggling clinic. The Jackman Community Health Center is the only health clinic in …

The Impact Of Telemedicine On Patient-Provider Communication At A University Student Health Center, Venkata Naga Sreelalitapriya Duvuuri

Honors Undergraduate Theses

Effective patient-provider communication (PPC) involves conveying sufficient information to a patient such that the treatment is agreed upon and implemented accurately. Furthermore, a patient must feel adequately involved in the treatment process. With the advent of the COVID-19 pandemic, many clinical visits were shifted online. Although telemedicine was successful in meeting pandemic-specific goals, such as lowering personal contact, it changes the communicative context. Both patients and providers get less input from body language (nonverbal communication) and rely more on verbal communication. Furthermore, the number of telemedicine visits conducted remains elevated over pre-pandemic levels. Much of what is known about effective …

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 …

“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 …

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 …

Telehealth Acceptance Among Appalachian Respondents During Covid 19: A Secondary Data Analysis, Victoria Hood-Wells, Florence M. Weierbach, Amy Wahlquist, Janet M. Keener, Manik Ahuja, Hadii M. Mamudu

ETSU Faculty Works

Purpose: The purpose of this study is to examine the relationship between telehealth use, telehealth satisfaction, and chronic medical conditions among residents living in Appalachian and non-Appalachian communities.

Sample: A COVID-19 public health survey was distributed via social media and healthcare clinics in the tri-state region of central Appalachia. Survey responses were limited to adults aged ≥18 years who consented to participate in the survey that self-identified as an individual with one or more chronic medical conditions (n=195).

Method: Simple descriptive statistics including frequencies, percentages, means, and standard deviations (SDs) were calculated for variables of interest both overall and by …

The U.S. Travel Health Pharmacists’ Role In A Post-Covid-19 Pandemic Era, Keri Hurley-Kim, Karina Babish, Eva Chen, Alexis Diaz, Nathan Hahn, Derek Evans, Sheila M. Seed, Karl Hess

Pharmacy Faculty Articles and Research

Background: Many countries have enforced strict regulations on travel since the emergence of the SARS-CoV-2 (COVID-19) pandemic in December 2019. However, with the development of several vaccines and tests to help identify it, international travel has mostly resumed in the United States (US). Community pharmacists have long been highly accessible to the public and are capable of providing travel health services and are in an optimal position to provide COVID-19 patient care services to those who are now starting to travel again. Objectives: (1) To discuss how the COVID-19 pandemic has changed the practice of travel health and …

Patient And Provider Experiences With Virtual Care During The Covid-19 Pandemic: A Mixed Methods Study, Mars Zhao, Hisham Elshoni, Jennifer O'Brien, Erin Barbour-Tuck, Mary Ellen Walker, Heather Dyck, Andrea Vasquez, Eric Sy, Angela Baerwald, Clara Michaels, Rejina Kamrul, Olivia Reis, Brenda Schuster, Barb Beaurivage, Adam Clay, Mark Lees, Jonathan Gamble

Patient Experience Journal

The COVID-19 pandemic prompted the rapid uptake of Virtual Care (VC). Positive patient outcomes with VC are previously reported but little is known about the experiences of patients and providers using VC during the pandemic. We aimed to describe patient and primary care provider experiences, satisfaction, perceptions, and attitudes to VC during the COVID-19 pandemic that might explain adoption of VC across the continuum of care and inform sustained uptake. We conducted a sequential explanatory mixed methods study using online surveys and virtual interviews with a convenience sample of primary care providers and patients in a Canadian province (July – …

Virtual Behavioral Health Treatment Satisfaction And Outcomes Across Time, Mindy R. Waite, Sara Diab, James Adefisoye

Journal of Patient-Centered Research and Reviews

Purpose: The COVID-19 pandemic continues to have major and long-lasting impacts on health care delivery and mental health. As health care shifted to telehealth, legislation was adjusted to expand telehealth allowances, creating a unique opportunity to elucidate outcomes. The aim of this study was to assess long-term patient and clinician satisfaction and outcomes with virtual behavioral health.

Methods: Data were obtained over 16 months from surveys to patients and clinicians receiving/providing virtual treatment. Outcomes data also were collected from medical records of adults receiving in-person and virtual behavioral health treatment. Data were summarized using descriptive statistics. Groups were compared using …

Who And How: Telemedicine Eligibility And Participant Guidelines In The Ambulatory Setting, Tracy Jalbuena, Rebecca Hemphill, Megan Selvitelli, Jasmine Bishop, Adam Ouellette, Rachel Alfiero

Journal of Maine Medical Center

Introduction: Telehealth use has dramatically increased due to the COVID-19 pandemic. Yet there are significant gaps in evidence regarding the clinical appropriateness of synchronous visits for ambulatory telemedicine that are under the umbrella of telehealth and defined as video appointments between patients and providers. As a result, there are few sensible guidelines for day-to-day practice, resulting in a lack of standardization and risk of suboptimal care.

Methods: We developed patient inclusion/exclusion guidelines for use in ambulatory telemedicine. Complementary tools included guides on patient preparation, telemedicine physical exam, and provider etiquette. We analyzed telemedicine use by practice type and surveyed a …

Telerounding: A Scoping Review And Implications For Future Healthcare Practice, Natasha N Ludwig, Amanda E Child, Dasal Tenzin Jashar, Allison J Mostow, Ericka L Wodka

Faculty, Staff and Student Publications

A diagnosis of autism spectrum disorder (ASD) provides access to interventions that are important for fostering development and improving quality of life. Thus, the timeliness of a diagnosis should not be limited by social-distancing limitations whenever possible. Despite this, clear guidance for transitioning autism diagnostic services to a telehealth model of care in the era of the COVID-19 pandemic is lacking. At our Institute, we have adapted our approach to ASD evaluation to promote continued access to evaluation services during this unprecedented time. The purpose of this case series is to provide examples of three different approaches to ASD differential …

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

Doctor of Nursing Practice Final Manuscripts

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

Caregiver Satisfaction Of Telehealth Initiatives For Developmental Surveillance And Evaluation In Pediatric Autism Spectrum Disorder, Aashiyana Patel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

PURPOSE: To examine parental satisfaction of a telehealth program aimed to improve the identification and diagnosis of pediatric ASD in Northwest Arkansas.

DESIGN/METHODS: caregivers referred to the Access for Autism clinic received a satisfaction survey regarding the telehealth practices the clinic employs. This 5-point Likert scale survey was designed to measure six different constructs associated with telehealth satisfaction: assurance, empathy, reliability, responsiveness, usability, and patient satisfaction

CONCLUSIONS: Telehealth is a suitable alternative to attending medical appointments. The key finding indicated that 40% of caregivers believed the level of care received to be equal in telehealth and in-person appointments.

Barriers, Access And Management Of Paediatric Epilepsy With Telehealth., Kari Gali, Sucheta Joshi, Sarah Hueneke, Alexis Katzenbach, Linda Radecki, Trisha Calabrese, Linda Fletcher, Cristina Trandafir, Carey Wilson, Monisha Goyal, Courtney J. Wusthoff, Jean-Baptist Lepichon, Rhonda Corvalan, April Golson, Jessica Hardy, Michael Smith, Elizabeth Cook, Joshua L. Bonkowsky

Manuscripts, Articles, Book Chapters and Other Papers

Access to paediatric neurology care is complex, resulting in significant wait times and negative patient outcomes. The goal of the American Academy of Pediatrics National Coordinating Center for Epilepsy's project, Access Improvement and Management of Epilepsy with Telehealth (AIM-ET), was to identify access and management challenges in the deployment of telehealth technology. AIM-ET organised four paediatric neurology teams to partner with primary-care providers (PCP) and their multidisciplinary teams. Telehealth visits were conducted for paediatric epilepsy patients. A post-visit survey assessed access and satisfaction with the telehealth visit compared to an in-person visit. Pre/post surveys completed by PCPs and neurologists captured …

Physiotherapists’ Perspectives On The Use Of Telehealth For Service Delivery To Children With Developmental Delays: A Qualitative Focus Group Study, Claire M. Grant, Anne Jones, Helen Land

Internet Journal of Allied Health Sciences and Practice

Purpose: The purposes of the study are to (1) determine what barriers and facilitators physiotherapists perceive to using telehealth, (2) to determine willingness to use and (3) to determine perspectives on training in the use of telehealth. Method: This is a qualitative semi structured interview and focus group design. Participants were recruited from the first stage of the larger research process using purposive sampling. A semi structured guide was used to facilitate discussion of shared experiences and to allow themes to emerge from the discussion. Results: Thematic analysis was used to synthesise frequent and important themes. Ten participants took part …

Tele-Icu In The Unites States: Is A Cost-Effective Model?, Michael Robie, Stephanie Cole, Archana Suwal, Alberto Coustasse

Management Faculty Research

Introduction: The United States Society of Critical Care Medicine has announced a shortage of all critical care intensivists due to the increased need for critical care for the aging population with comorbidities and improved life expectancy. This shortage has led to tele-ICU programs that have allowed intensivists to care for patients simultaneously remotely.

Methods: This study aimed to assess the potential for the hospital implementation of tele-ICU to determine its overall healthcare cost-effectiveness. The methodology was a review that followed a systematic search approach utilizing 42 sources.

Results: The study findings showed that tele-ICU contributed to reduced hospital LOS by …

Coordinated Speech Therapy, Physiotherapy, And Pharmaceutical Care Telehealth For People With Parkinson Disease In Rural Communities: An Exploratory, 8-Week Cohort Study For Feasibility, Safety, And Signal Of Efficacy, Mary Jo Cooley Hidecker, Merrill R. Landers, Annalisa Piccorelli, Erin Bush, Reshmi Singh

Communication Sciences and Disorders Faculty Publications

Introduction: The potential for coordinated, multidisciplinary telehealth to help connect people with Parkinson disease (PD) in rural areas to PD specialists is crucial in optimizing care. Therefore, this study aimed to test the feasibility, safety, and signal of efficacy of a coordinated telehealth program, consisting of speech therapy, physiotherapy, and pharmaceutical care, for people with PD living in some rural US communities.

Methods: Fifteen individuals with PD living in rural Wyoming and Nevada, USA, participated in this single-cohort, 8-week pilot study. Participants were assessed before and after 8 weeks of coordinated, one-on-one telehealth using the following outcomes: (1) …

Telehealth Delivery Of Acceptance And Commitment Therapy And Recreational Therapy: Supporting People With Chronic Pain During The Covid-19 Pandemic, Grace L. Roy

Honors Theses and Capstones

Chronic pain is a significant public health problem that requires person-centered and comprehensive care to address the many socioecological factors that contribute to pain. Within the context of the COVID-19 pandemic, telehealth options for chronic pain management can help more people access the care that they need. The purpose of the current pilot study was to investigate the efficacy and feasibility of delivering a 6-week Acceptance and Commitment Therapy (ACT) and recreational therapy intervention via telehealth for a group of seven participants with chronic pain. It was found that TeleACT-RT was associated with positive behavioral outcomes including increased psychological flexibility, …

Telehealth Readiness In Older Adults In Kentucky, Kristen Weidner

Theses and Dissertations--Rehabilitation Sciences

During the COVID-19 pandemic, telehealth became an increasingly widespread service delivery model. Not all populations, however, accessed telehealth services equally. Older adults were less likely to use telehealth during the pandemic, continuing a historical trend. These usage patterns persist despite evidence that telehealth could be a helpful service delivery option for this population. Researchers have explored how theoretical frameworks explain older adults’ decisions to use technology, but there is yet to be a measure of older adults’ readiness for telehealth technology. A validated, theory-backed tool of older adults’ perceptions about telehealth, prior to the health care encounter, could help clinicians …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

Elastic Tubes: The Ideal Equipment For Telehealth Exercise Medicine In The Management Of Prostate Cancer?, Georgios Mavropalias

Research outputs 2022 to 2026

Prostate cancer (PCa) affects 1 in 8 men, but exercise therapy has been shown to be a very effective intervention not only to induce physiological benefits but to also reduce the side effects of cancer treatments typically administered during PCa. The COVID19 pandemic has restricted access to exercise clinics, a problem which always existed for people living in rural and remote areas. This caused many exercise physiologists and researchers to transition their clinic-based exercise to online, home-based exercise. We would like to propose that researchers and exercise physiologists should consider the use of elastic tubes in both research and the …

Response To: A Telehealth Explosion: Using Lessons From The Pandemic To Shape The Future Of Telehealth Regulation, Joanna Sax

Texas A&M Law Review

In A Telehealth Explosion: Using Lessons from the Pandemic to Shape the Future of Telehealth Regulation, published in the Texas A&M Law Review, Professor Deborah Farringer tackles the critical issue of the efficacy and implementation of telehealth, using our experience(s) of telehealth during the COVID–19 pandemic as the guide. This is important, as Professor Farringer acknowledges, because while telehealth advocates pre-date the pandemic, barriers prevented the implementation of telehealth in a widespread manner. These barriers included a concern about fraud and a question as to whether telehealth visits could provide effective outcomes compared to in-person visits. Professor Farringer …

Evaluating Technology-Mediated Collaborative Workflows For Telehealth, Christopher Bondy Ph.D., Pengcheng Shi, Pamela Grover Md, Vicki Hanson, Linlin Chen, Rui Li

Articles

Goals: This paper discusses the need for a predictable method to evaluate gains and gaps of collaborative technology-mediated workflows and introduces an evaluation framework to address this need. Methods: The Collaborative Space Analysis Framework (CS-AF), introduced in this research, is a cross-disciplinary evaluation method designed to evaluate technology-mediated collaborative workflows. The 5-step CS-AF approach includes: (1) current-state workflow definition, (2) current-state (baseline) workflow assessment, (3) technology-mediated workflow development and deployment, (4) technology-mediated workflow assessment, (5) analysis, and conclusions. For this research, a comprehensive, empirical study of hypertension exam workflow for telehealth was conducted using the CS-AF approach. Results: The CS-AF …

Evolution Or Revolution In Telehealth Regulation, George Horvath

Texas A&M Law Review

A frequently repeated adage, attributed to a wide range of authors and orators, holds that a serious crisis should never be allowed to go to waste. The moment in which we find ourselves renders this adage particularly timely. Responses to one of the defining crises of our age—the COVID–19 pandemic—have mostly been reactive. This includes the responses of multiple actors involved with telehealth. Congress, federal regulators, state legislatures, state regulators, private insurers, and health care providers, confronting the challenges of the pandemic, have responded by making ad hoc adjustments to the regulation and use of telehealth. Moving the conversation beyond …