Telemedicine Commons^™

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 …

Exploring Cultural, Health, And Technology Intersections: A Focus On Migrant Experiences, Merna Mina, Sahij Gill

Bridges: An Undergraduate Journal of Contemporary Connections

Despite the plethora of theories and frameworks addressing culture, health, and technology adoption, there remains a notable absence of a unifying theory that comprehensively encompasses all three aspects, particularly concerning newcomers. The Health Belief Model, for example, underscores individual perceptions and attitudes toward health yet fails to consider the intricate interplay between cultural factors and technology adoption among immigrant populations. The Healthy Immigrant Effect, which posits that immigrants often exhibit better health outcomes than native-born individuals, does not mention the role of technology on health outcomes. Acculturation theories, while shedding light on the adaptation process, often fall short of explaining …

Us Filipino Adults Have Elevated Prevalence Of Hypertension Across The Adult Lifespan: Findings From A Cross-Sectional Electronic Health Record Study, Nancy P Gordon, Irvin C Lien, Jamal S Rana, Joan C Lo

Faculty, Staff and Student Publications

INTRODUCTION: The prevalence of hypertension increases with age and differs by race and ethnicity. Among U.S. Asian adults, prevalence is higher for Filipino adults than for other major Asian subgroups, but whether this disparity exists across the adult lifespan is unknown. This study examined hypertension prevalence by age decade, comparing Filipino adults with South Asian, Chinese, Black, Hispanic, and White adults.

METHODS: This cross-sectional study used 2015-2016 electronic health record data from a Northern California integrated healthcare delivery system for 1,839,603 adults aged 30-79 years, including 128,124 Filipino adults. Hypertension was defined by diagnosis codes. Sex-specific prevalence was calculated by …

Accessible Real-Time Eye-Gaze Tracking For Neurocognitive Health Assessments, A Multimodal Web-Based Approach, Daniel C. Tisdale

Master's Theses

We introduce a novel integration of real-time, predictive eye-gaze tracking models into a multimodal dialogue system tailored for remote health assessments. This system is designed to be highly accessible requiring only a conventional webcam for video input along with minimal cursor interaction and utilizes engaging gaze-based tasks that can be performed directly in a web browser. We have crafted dynamic subsystems that capture high-quality data efficiently and maintain quality through instances of user attrition and incomplete calls. Additionally, these subsystems are designed with the foresight to allow for future re-analysis using improved predictive models, as well as enable the creation …

Telehealth Acceptance And Medical Mistrust Among The Elderly Of Rural Appalachia: A Correlational Study Using The Medical Mistrust Index And Technology Acceptance Model, Victoria Hood-Wells

Electronic Theses and Dissertations

Adults aged 65 years and above have grown substantially over with past decade. However, the chance of developing multiple comorbidities only increases with age. Because elderly residents of rural Appalachia often encounter barriers to healthcare, rural nurses, providers, and policy makers must overcome physical and structural barriers, but also gain a more in-depth understanding of the personal and cultural attitudes impacting the use of new and innovative forms of healthcare delivery. With a slow and variable uptake of telehealth adoption in rural Appalachia, and in the presence of well-documented medical mistrust, this study was designed to better understand the degree …

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 …

Implementation Of Psychiatric Collaborative Care Management In Rural Primary Care Practices, Ryan Dean Kruis

MUSC Theses and Dissertations

Behavioral health (BH) disorders are highly prevalent in the United States and especially concerning in rural communities which disproportionately lack access to BH services. While models for integrating BH into primary care, such as psychiatric collaborative care management (CoCM), have shown promise in mitigating the BH crisis, implementation in rural communities has proved challenging.
This dissertation examines implementation of CoCM nationally and in rural settings through three distinct aims. First, a claims-based retrospective cohort study was used to determine whether commercially insured patients receiving CoCM had lower acute BH care utilization and cost as compared to similar patients not receiving …

Perspectives From Patients With Chronic Lung Disease On A Telehealth-Facilitated Integrated Palliative Care Model: A Qualitative Content Analysis Study, Jeannette Kates, Carrie Tompkins Stricker, Kristin L. Rising, Alexzandra Gentsch, Ellen Solomon, Victoria Powers, Venise J. Salcedo, Brooke Worster

Department of Medicine Faculty Papers

BACKGROUND: Chronic lung disease affects nearly 37 million Americans and often results in significant quality of life impairment and healthcare burden. Despite guidelines calling for palliative care (PC) integration into pulmonary care as a vital part of chronic lung disease management, existing PC models have limited access and lack scalability. Use of telehealth to provide PC offers a potential solution to these barriers. This study explored perceptions of patients with chronic lung disease regarding a telehealth integrated palliative care (TIPC) model, with plans to use findings to inform development of an intervention protocol for future testing.

METHODS: For this qualitative …

Using Implementation Science To Understand Barriers To Telemedicine Use For Burn Care During A Crisis, Amanda Bettencourt, Jeffrey E. Carter, Theresa M. Davis, Katherine R. Buhikire, Joseph Rhodes, Subhash Aryal, Gary Vercruysse, Deena Kelly-Costa, Colleen M. Ryan

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL