Telemedicine Commons^™

J Mich Dent Assoc June 2020

The Journal of the Michigan Dental Association

Every month,The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story with an interview with the MDA’s 2020-21 president Dr. Stephen Meraw.
• “Implementing Teledentistry: The Why and How” discusses the background and guidance on this important – and growing – aspect of telehealth.
• “Key Tips in Communicating Evidence in the Clinical Setting”, another feature in our series of articles focusing on evidence-based dentistry. …

Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Nienke Sahelijo Bsn, Rn, Dnp-Fnp Student, Kori Fitzgerald Dnp, Fnp-C, Joseph F. Burkard Dncs, Crna

Doctor of Nursing Practice Final Manuscripts

Objectives: Palliative care services constitute a vital part of the oncology treatment plan. Much of the suffering associated directly with cancer itself or as a result of treatments can be mitigated with the early incorporation of palliative services. Unfortunately, access to palliative care remains elusive due to a lack of qualified providers. This evidence-based project was implemented in an effort to address gaps in care for advanced cancer patients. The goal was to provide telehealth visits for follow-up of stable patients to manage symptoms and psychosocial challenges with equivalent or improved satisfaction as compared to their last in-office visit …

Covid-19 Student Telehealth Support Initiative, Yash Varma, Mary White, Alexandra Leto

Health Equity and Quality Improvement (HEQI) Summit

SKMC students partnered with numerous TJUH departments and developed a telehealth support initiative to:

• Help TJUH patients navigate the telehealth system
• Reduce system-wide appointment delays experienced by patients
• Provide direction to COVID-19 resources

A Volunteer Script was prepared to help patients troubleshoot common issues with accessing the telehealth system and provide up to date recommendations from the CDC to remain safe.

Telemedicine Certified Recovery Specialists For Patients With Opioid Use Disorders In The Emergency Department In Covid-19, Kory S. London, Md

Health Equity and Quality Improvement (HEQI) Summit

COVID-19 is a staggering tragedy in a number of manners, but the lack of available access points to healthcare services due to federal, state, local and institutional regulations and decisions creates higher levels of patient vulnerability.

Patients with opioid use disorders (OUD) are especially vulnerable given high levels of coexistent housing insecurity, food insecurity and lack of primary care at baseline. These patients frequently utilize the emergency department for both medical and non-medical concerns.

Existing pathways to assist these patients utilize in person certified (peer) recovery specialists (CRS) who are not employed by the enterprise. Given the need to limit …

A Telehealth Clinical Workflow For Academic Radiation Oncology Programs During The Covid19 Pandemic, Gregor Manukian, Md, Phd, Christian Fernandez, Md, Paul Forrest, Adam Dicker, Md, Phd, Mark D. Hurwitz, Md

Health Equity and Quality Improvement (HEQI) Summit

• COVID19 has resulted in drastic measures to decrease exposure risks within healthcare systems, with cancer patients at increased risk of infection and death (Liang. Lancet Oncol. 2020).
• Telehealth is the delivery of medical care via interactive audio and/or video telecommunication services.
• Telehealth was previously used sparingly within the department of radiation oncology but has suddenly become the preferred method of contact.
• In order to maintain quality of care, patient satisfaction, resident learning, and reimbursement, a robust telehealth clinical workflow is critical.
• Our department engaged various stakeholder to quickly develop a clinical workflow.

Home Telemonitoring Of Covid Patients By Medical Students At The Christiana Care Virtual Practice, Thomas Marconi, Jr, Chelsea Richards

Health Equity and Quality Improvement (HEQI) Summit

SARS-Cov2 arrived in Delaware on March 11, 2020. By March 22, 2020, stay at home orders were in place1. During this time, CareVio, a subsidiary of ChristianaCare, was tasked with developing a strategy to monitor the Delaware community. CareVio repurposed Twistle – a telemonitoring application utilized to distribute symptom related surveys and conduct text message conversations for follow up. This service had the capability to act as a virtual information desk and triage patients to be seen by virtual practice providers or the emergency department. Patient monitoring via Twistle was initiated on March 18, 2020 and medical students from Sidney …

Increasing Utilization Of Telehealth In Outpatient Primary Care, Allison Samuel, Md, Candace Derenge, Md, Anahita Molayi, Md, Amanda Kahn, Md, Jason Ojeda, Md

Health Equity and Quality Improvement (HEQI) Summit

Based on survey data, residents are interested in gaining exposure to Telehealth and attendings would like to increase their number of Telehealth appointments. Providers expressed uncertainty about insurance coverage as a major barrier to increasing Telehealth utilization.

SMART AIM: Increase the total number of Telehealth visits at JIMA by 25% and initiate Telehealth visits for residents by May 1st.

Utilizing Telehealth Technology To Reduce Social Isolation And Depression In Seniors, Bohan Farrell

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Social isolation in the elderly has been identified as a risk factor for poor mental and physical health, as well as higher rates of mortality, depression, and cognitive decline. Loneliness is the unpleasant experience that occurs when a person’s network of social relationships is deficient in some important way, either quantitatively or qualitatively. Depression is a mental condition characterized by feelings of severe despondency and dejection, typically with feelings of inadequacy and guilt, and accompanied by lack of energy and disturbance of appetite and sleep. Physically, lonely people have more disorders, such as sleeping problems, stomach pain, and …

Examining The Possibilities Of Telehealth In Tallahatchie County, Taran Carrasco

Honors Theses

This thesis aims to analyze Tallahatchie County and determine the feasibility of establishing a telehealth program in the county. Telehealth is an evolving aspect in the medical field that incorporates technology with healthcare. This thesis used sociotechnical theory to explain how the feasibility of telehealth could be made more likely as the technology is used over time.Through interviewing UMMC telehealth directors, Tallahatchie Wellness center workers, and citizens of Charleston, this study aims to gauge professional and personal opinions on how feasible it would be to implement telehealth into the Charleston community, as well as how positively telehealth would be accepted …

Healthcare Workers' Perceptions Of Different Types Of Interpreters In The Gulf South, Meg Hayslip

Honors Theses

Medical interpreters are important in the healthcare community. Many studies have focused on the consequences of not having an interpreter. A variety of problems can be caused by "language brokering" when no interpreter is available. These studies will be discussed in the literature review. Many states have requirements to become certified as an interpreter, and the selection criteria is what makes a person a “good” interpreter. Previous research, such as that by Chan et al., has shown how different styles of interpreting can affect the quality of health care. This study focuses on how healthcare personnel and their patients view …

A Look Into The Impacts Of Tele-Optometry Expansion, Anna Hulsey

Honors Theses

Objective This study aims to assess the health and economic costs and benefits to society and patients resulting from the expansion of telemedicine into online refractive exams and to determine the likelihood of potential consumers to utilize such services. Methods A paper survey was distributed at the Inaugural Cempa Health Fair in October of 2019 to both vendors and participants. 105 responses were used to evaluate personal perceptions, practices, and likelihood across a diverse range of demographics. Responses were then entered and analyzed using descriptive statistics and percentages/frequencies. Results Results showed respondents were most attracted to online refractive exams due …

Rural Caregivers: Identification Of Informational Needs Through Telemedicine Questions, Shoshana H. Bardach, Allison Gibson, Kelly Parsons, April Stauffer, Gregory A. Jicha

Sanders-Brown Center on Aging Faculty Publications

OBJECTIVES: The prevalence of Alzheimer's disease and associated disorders is increasing. Rural residents in the United States have less access to memory care specialists and educational and community resources than in other areas of the country. Over a decade ago, we initiated an interdisciplinary rural caregiving telemedicine program to reach Kentucky residents in areas of the state where resources for supporting individuals with dementia are limited. Telemedicine programs involve a short informational presentation followed by a question and answer session; programs are offered 4 times a year. The purpose of this study was to explore questions asked over 1 year …

Teaming Together To Care For Our Deaf Patients: Insights From The Deaf Health Clinic, Kate Panzer, Junghyun Park, Leslie Pertz, Michael M. Mckee

JADARA

Deaf patients often struggle with accessing culturally competent care. Poor communication and inaccessible health information negatively impact Deaf individuals, resulting in poorer health outcomes and inappropriate health care use. To address this problem, the Family Medicine Department established the Deaf Health Clinic in 2015 through the efforts of healthcare providers fluent in American Sign Language. After that, the clinic faced several management issues, and implemented strategies to address them. The paper discusses lessons learned and suggests potential and tested solutions to reduce gaps in health care for Deaf individuals.

Telemedicine And Malpractice: Creating Uniformity At The National Level, Tyler D. Wolf

William & Mary Law Review

Picture this: an elderly gentleman living alone, isolated in a rural, midwestern locale. One day, this elderly gentleman awakes to find a distinct rash forming on his chest. The nearest doctor capable of performing an examination is located over a hundred miles away, and this man has not driven more than ten miles in twenty years. Shambling into his living room, the elderly man logs onto his computer and begins typing. Within twenty minutes he is videoconferencing with a doctor who examines the rash remotely and makes a diagnosis.

Through advances in telemedicine, the scenario described above is becoming an …

Improving Hearing Screenings With Tele-Otology, Ryan J. Miller, Joshua George-Lopez, Robert S. Hong Md, Phd

Medical Student Research Symposium

Introduction: The Lions Hearing Center of Michigan (LHC-MI) is an assistance program in Detroit that provides hearing aids to individuals in need. LHC-MI has provided thousands of hearing aids, but such efforts have been costly, requiring patients to make multiple appointments at multiple locations. To streamline this process, the LHC-MI is piloting a new program, titled “Hear Now! Detroit!”, that uses telemedicine to reach patients at community sites.

Purpose: To evaluate the feasibility of a hearing screening program that uses telemedicine to reduce the number of visits required to acquire hearing aids.

Methods: Teams of community volunteers were deployed to …

Launching Virtual Care In A Benign Breast Surgery Clinic, Louisa Antonelli Bs, Hassan Nasser Md, Jessica Bensenhaver Md, Lindsay Petersen Md

Medical Student Research Symposium

The aim of this study is to assess the success of implementation of a telemedicine clinic in a benign breast surgery practice, and the hypothesis was that some women may feel uncomfortable virtually discussing breast complaints and problems. Twelve women seen as new patients in the benign breast surgery clinic and scheduled for surgery were asked if they were interested in having their post-operative visit performed virtually. Demographic information was also collected. Ages ranged from 24 to 77 years, and distance from the hospital ranged from 4.3 miles to 14.3 miles. Of the 12 women surveyed, 8 women were interested …

Telepsychiatry Preferences Among College Students Diagnosed And Undiagnosed With A Mental Health Condition, Wendy Schuh

Health Sciences Publications

College health and counseling centers report an increasing demand for mental health services while students continue to experience barriers such as shortage of providers, transportation, or stigma. Telepsychiatry has been established in some environments to overcome these barriers, but little research has explored an effective higher education model. The purpose of this study was to identify differences in telepsychiatry preferences among college students who have and have not been diagnosed with or treated for a mental health condition in the last year. Students (n = 537; Mage = 21 years; 71% female) at a medium-sized Midwestern university participated in a …

Telemedicine In Pediatric Speech Therapy: Characteristics Of Child, Mother, And Speech-Language Pathologist Vocal Interaction., Abigail L Betts

College of Arts & Sciences Senior Theses

Telemedicine is a potential solution to provide distant or underserved clients with access to their clinician. The purpose of this thesis is to examine how the use of telemedicine affects the vocal characteristics of children who received cochlear implants (CI), their mother, and a speech-language pathologist (SLP) as they engage in a speech-language therapy intervention. The children (n = 5), her caregiver, and the SLP engaged in one 30 minute in person session and one 30 minute telemedicine session in a counterbalanced order. The frequency of vocalizations, vocal turns, and between-speaker pause (BSP) duration in both sessions were examined. The …

Amending The Ryan Haight Act: Elevating Telemedicine Law To New Heights, Dillon Vaughn

Texas A&M Law Review

The Ryan Haight Act has established excessive restrictions on controlled substance prescribing through telemedicine by first requiring an in-person exam. If the Act is not amended, many individuals in need of medication will go without proper medical care. While other agencies and states have made moves to expand telehealth, the DEA has dragged its feet on making any significant changes. This Comment argues that the federal government should amend the Ryan Haight Act, allowing telemedicine providers to prescribe controlled substances without an in-person exam. This amendment would focus on the standard of care while requiring stringent documentation by physicians who …

Barn-Raising On The Digital Frontier: The L.A.U.N.C.H. Collaborative, Bradford W. Hesse, David Ahern, Michele Ellison, Eliah Aronoff-Spencer, Robin C. Vanderpool, Karen Onyeije, Michael C. Gibbons, Timothy W. Mullett, Ming-Yuan Chih, Victoria Attencio, Grant Patterson, Jessica Boten, Christopher Hartshorn, Ben Bartolome, Katie Gorscak, Melanie Mccomsey, Alexandra Hubenko, Bin Huang, Corey Baker, Don Norman

Journal of Appalachian Health

A meta-analysis of oncology papers from around the world revealed that cancer patients who lived more than 50 miles away from hospital centers routinely presented with more advanced stages of disease at diagnosis, exhibited lower adherence to prescribed treatments, presented with poorer diagnoses, and reported a lower quality of life than patients who lived nearer to care facilities. Connected health approaches—or the use of broadband and telecommunications technologies to evaluate, diagnose, and monitor patients beyond the clinic—are becoming an indispensable tool in medicine to overcome the obstacle of distance.

Analysis Of Massive Online Medical Consultation Service Data To Understand Physicians’ Economic Return: Observational Data Mining Study, Jinglu Jiang, Ann-Frances Cameron, Ming Yang

Management and Accounting Faculty Scholarship

Background: Online health care consultation has become increasingly popular and is considered a potential solution to health care resource shortages and inefficient resource distribution. However, many online medical consultation platforms are struggling to attract and retain patients who are willing to pay, and health care providers on the platform have the additional challenge of standing out in a crowd of physicians who can provide comparable services. Objective: This study used machine learning (ML) approaches to mine massive service data to (1) identify the important features that are associated with patient payment, as opposed to free trial–only appointments; (2) explore the …

Examining The Design And Usability Of Telemedicine Communications: A Mixed-Methods Study, Jessica Campbell

Electronic Theses and Dissertations, 2020-2023

This dissertation describes a mixed-methods study that examines the usability of telemedicine provider interfaces. This study consisted of content analysis, survey, and think aloud methodologies, which afford a multifaceted corpus of data for which to draw inferences and identify design features and functions that negatively impact usability. Usability is a critical component of the user experience with a telemedicine provider interface and can suede or impede the acceptance and adoption of telemedicine. Telemedicine has the potential to increase quality healthcare access and positive health outcomes for individuals who use it, and usability is a key component of technology acceptance and …

Mobile Health Technology To Enhance Healthcare Service Delivery In Developing Nations (Saudi Arabia), Nawaf Khan

Electronic Theses and Dissertations, 2020-2023

Saudi Arabia is among the countries that have very high prevalence rates of diabetes and hypertension, with prevalence rates of almost 18% and 25%, respectively. The majority of patients with diabetes and hypertension fail to manage their diseases and to show up for their follow up appointments. Mhealth technology is among the interventions that have been recently adopted to overcome these issues and improve the quality of healthcare services. This study aims to evaluate the effectiveness of a mobile phone application named diabetes and hypertension application (DHA Tracking) to promote adherence for patients with diabetes and hypertension in Mecca, Saudi …

Telehealth: An Important Player During The Covid-19 Pandemic, Naureen Akber Ali, Adeel Khoja

School of Nursing & Midwifery

No abstract provided.

Comparison Of Patient Satisfaction With Telehealth And In-Clinic Post-Operative Visits, Lillian Matthews, Bryan Renslo, Deborah T. Glassman, Md

Phase 1

Introduction: Telehealth has grown rapidly in the healthcare industry as a time efficient, affordable, and accessible means to provide care. Jefferson’s Department of Urology currently employs telehealth for post-operative visits but its efficacy in post-nephrectomy patients has not been well studied. We aim to demonstrate that patient satisfaction is the same for telehealth versus in-clinic post-operative visits in nephrectomy patients. Secondarily we will examine distance saved for telehealth patients.

Methods: We will administer an IRB approved questionnaire to all nephrectomy patients via the EPIC^® EMR platform after their post-operative visit. Each questionnaire will be specific to telehealth or …

Comparison Of Patient Satisfaction Between Telehealth And In-Clinic Post-Operative Visits, Bryan Renslo, Lillian Matthews, Deborah T. Glassman, Md

Phase 1

Introduction: Telehealth has the potential to be an efficient, affordable, and accessible means to give care. In the field of Urology, its use has large potential but has not been well studied. We hypothesize that the use of telehealth for post-op nephrectomy patients will maintain the same level of patient satisfaction. We also hypothesize that telehealth visits will take less time and save patients money by eliminating the need to travel.

Methods: From May through July 2019, post-nephrectomy patients who consented to the study were given either a telehealth or in-clinic post-operative visit. Outcome metrics and demographics information were obtained …

Using Social Media As A Platform For Increasing Knowledge Of Lung Cancer Screening In High-Risk Patients, Aimee Strong, Michelle Renaud

Ellmer School of Nursing Faculty Publications

Background: Uptake in lung cancer screening for high-risk patients remains low. Eligible patients may not know that this preventive service is available and covered by insurance.

Objectives: The objective of this study was to explore using social media to educate patients about lung cancer screening and assess motivation to discuss lung cancer screening with health-care providers after viewing the educational program. Methods: Subjects ages 55 to 77 who were current smokers or former smokers who quit in the past 15 years with a more than 30-pack-year smoking history were recruited via a Facebook advertisement. Subjects completed a demographic survey and …

Application Of The Unified Theory Of Acceptance And Use Of Technology Model To Predict Dental Students' Behavioral Intention To Use Teledentistry, Jafar H. Alabdullah, Bonnie L. Van Lunen, Denise M. Claiborne, Susan J. Daniel, Cherng-Jyh Yen, Tina S. Gustin

Dental Hygiene Faculty Publications

Abstract

Teledentistry is an innovative technology that can be used to improve access to care and oral health outcomes. Dental students’ intention to use teledentistry after completing dental school has not been investigated.

Purpose

The unified theory of acceptance and use of technology (UTAUT) was used to predict intentions to use teledentistry among 4th-year U.S. dental students. Methods A cross-sectional approach was performed for a 7-week period in Spring 2019. All U.S. dental schools (N = 66) were invited to participate and 16 schools agreed to participate. An anonymous survey link was emailed to academic deans for dissemination to students. …

Patient Satisfaction With Telehealth Services Compared To In-Office Visits: A Systematic Literature Review, Crystal L. Fleischhacker

All Graduate Theses, Dissertations, and Other Capstone Projects

Telehealth is changing the current paradigm of healthcare. As an emerging mode of healthcare delivery, telehealth stands to help alleviate the shortage of primary care and specialty care providers especially patients in rural areas. In addition to increasing access of healthcare, this service allows for flexibility, convenience and has the potential to decrease healthcare costs while improving patient outcomes. The objective of this literature review was to examine patient satisfaction with telehealth compared to in-office visits. A systematic search was conducted and a total of 17 articles that met inclusion criteria were examined. Data and factors evolving around patient satisfaction …

Internet Of Things For Sustainable Human Health, Abdul Salam

Faculty Publications

The sustainable health IoT has the strong potential to bring tremendous improvements in human health and well-being through sensing, and monitoring of health impacts across the whole spectrum of climate change. The sustainable health IoT enables development of a systems approach in the area of human health and ecosystem. It allows integration of broader health sub-areas in a bigger archetype for improving sustainability in health in the realm of social, economic, and environmental sectors. This integration provides a powerful health IoT framework for sustainable health and community goals in the wake of changing climate. In this chapter, a detailed description …