Telemedicine Commons^™

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 …

Virtual Home Visits During Covid-19 Pandemic: Mothers' And Home Visitors' Perspectives, Abdullah Al-Taiar, Michele A. Kekeh, Stephanie Ewers, Amy L. Prusinski, Kimberly J. Alombro, Nancy Welch

Community & Environmental Health Faculty Publications

Background

The experiences of mothers enrolled in Maternal, Infant and Early Childhood Home Visiting (MIECHV) program with virtual home visiting (VHV) during the pandemic remain mostly unknown. This study aimed to describe in detail the experience of home visitors and mothers with VHV during COVID-19 pandemic. This is a prerequisite for guiding future efforts to optimize MIECHV services that are provided through virtual operation.

Methods

Focus groups discussion were conducted with home visitors (n = 13) and mothers (n = 30) who were enrolled in BabyCare program in Virginia from January 2019 to June 2022. This included mothers who received …

Counselors' Perceptions Of Their Preparedness For Telemental Health Services: A Phenomenological Examination, Daniel C. Holland, Jeffry L. Moe, Alan M. "Woody" Schwitzer, Shana Pribesh, Jeanel Franklin

Counseling & Human Services Faculty Publications

Background: To examine counselors' perceptions of their formal preparation for engaging in telemental health (TMH) counseling with the intent of gaining an understanding of their lived experiences.

Materials and Methods: Semistructured interviews were conducted with seven seasoned counselors who regularly engage in technology-mediated distance counseling.

Results: The results highlighted themes within two emerging categories: the counselor and training/education. Themes related to motivation and specific counselor attributes emerged from the first category and themes of availability, inadequacy, and modality emerged from the second category.

Discussion: The implications from this study suggest a lack of availability and standardization of effective training on …

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 …

Improving Patient Access To Gastroenterology Through A Nurse-Practitioner-Led Clinic: A Quality Improvement Project, Kayla Northam

DNP Scholarly Projects

The United States has a critical healthcare access issue for gastroenterology patients. Delays in treatment can lead to expensive complications, including emergency room visits, hospitalization, and surgery. Creating a rapid-access clinic (RAC) for gastroenterology so that patients can obtain a quick and efficient evaluation of their symptoms in a shorter appointment time can help decrease the delay in care and generate more revenue for the hospital. Over 8 weeks in 2023, Dartmouth Hitchcock Medical Center Department of Gastroenterology used a telemedicine-only RAC to see patients for 20 minutes rather than the traditional 60-minute period. As a result, the RAC saw …

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 …

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 …

Developing And Pre-Testing A Digital Decision-Tree Smartphone Application For Smoking Prevention And Cessation Among Hiv Care Providers, Christine Markham

Faculty, Staff and Student Publications

OBJECTIVES: The diagnosis and continuous care of chronic conditions such as HIV infection present potential teachable moments for delivering smoking prevention and cessation interventions for patients. We designed and pre-tested a prototype of a smartphone application(app), Decision-T, specifically designed to assist healthcare providers when providing personalized smoking prevention and cessation services to their patients.

METHODS: We developed the Decision-T app based on transtheoretical algorithm for smoking prevention and cessation following the 5-A's model. We employed a mixed-methods approach among 18 HIV-care providers recruited from Houston Metropolitan Area for pre-testing the app. Each provider participated in three mock sessions, and the …

Advocacy Spotlight: Mda’S Legislative Priorities For 2023, Neema Katibai Jd

The Journal of the Michigan Dental Association

This article outlines the Michigan Dental Association's (MDA) legislative priorities for the year 2023. The MDA focuses on various key issues, including dental loss ratio, network leasing transparency, teledentistry policy, the state budget's impact on dental services, increasing the dental workforce, and addressing student debt relief. These priorities aim to advocate for the dental profession, enhance patient care, and ensure the dental community's well-being.

“So Many Extra Safety Layers:” Virtual Service Provision And Implementing Social Distancing In Interpersonal Violence Service Agencies During Covid-19, 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 …

Assessing The Most Vulnerable Subgroup To Type Ii Diabetes Associated With Statin Usage: Evidence From Electronic Health Record Data, Xinzhou Guo, Waverly Wei, Molei Liu, Tianxi Cai, Chong Wu

Faculty, Staff and Student Publications

There have been increased concerns that the use of statins, one of the most commonly prescribed drugs for treating coronary artery disease, is potentially associated with the increased risk of new-onset Type II diabetes (T2D). Nevertheless, to date, there is no robust evidence supporting as to whether and what kind of populations are indeed vulnerable for developing T2D after taking statins. In this case study, leveraging the biobank and electronic health record data in the Partner Health System, we introduce a new data analysis pipeline and a novel statistical methodology that address existing limitations by (i) designing a rigorous causal …

Neuromotor Changes In Participants With A Concussion History Can Be Detected With A Custom Smartphone App, Christopher K. Rhea, Masahiro Yamada, Nikita A. Kuznetsov, Jason T. Jakiela, Chanel T. Lojacono, Scott E. Ross, F. J. Haran, Jason M. Bailie, W. Geoffrey Wright

Moss-Magee Rehabilitation Papers

Neuromotor dysfunction after a concussion is common, but balance tests used to assess neuromotor dysfunction are typically subjective. Current objective balance tests are either cost- or space-prohibitive, or utilize a static balance protocol, which may mask neuromotor dysfunction due to the simplicity of the task. To address this gap, our team developed an Android-based smartphone app (portable and cost-effective) that uses the sensors in the device (objective) to record movement profiles during a stepping-in-place task (dynamic movement). The purpose of this study was to examine the extent to which our custom smartphone app and protocol could discriminate neuromotor behavior between …

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 …

Training In The Use Of Interpretive Services For Patients With Limited English Proficiency, Kristina Wooten

Symposium of Student Scholars

In clinical settings, there is a disconnect between health care professionals (HCPs) and patients with limited English proficiency (LEP). HCPs rely on ad hoc interpreters to communicate with patients with LEP (e.g. nurses using untrained friends and family or nursing students to interpret care information). Refusing to use or misusing professional interpreters and other interpretive services may lead patients with LEP to avoid seeking necessary care, misunderstand their diagnoses and treatment regimens, and fail to return for follow-up care. This increases the already existing health care disparity between patients who speak English and patients with LEP. Studies show that if …

Interventions To Prevent Hospital Acquired Pressure Injuries, Astrid Geronimo

Symposium of Student Scholars

Background: Hospital acquired pressure injuries (HAPIs) are the most common preventable complication among critical care patients. This project is conducted to compare the effectiveness between the current implemented preventative measure versus the new measures that have data supporting their effectiveness. Brief Significance: Five articles were chosen that outlined the prevalence of hospital acquired pressure injuries in critical care patients and alternative interventions that have been effective in the prevention of HAPIs. These evidence-based interventions include: The application of multilayered foam dressing with hypo oxygenated fatty oils which would reduce sheer and provide support from the pressure of laying in the …

Barriers And Facilitators In Implementing Multiplatform Remote Patient Monitoring Of Heart Failure Patients In Clinical Settings, Zachary Andrew Reilly

All Theses

Remote patient monitoring (RPM), which provides continuous monitoring of vital signs, has become increasingly utilized in patients with heart failure (HF). As this condition impacts more than 26 million Americans each year, it is important to determine the barriers and facilitators of RPM to both improve patient care and help medical professionals make more informed medical decisions. To determine these barriers and facilitators, our research team partnered with Prisma Health-Upstate to interview healthcare professionals working at Carolina Cardiology Consultants--Greenville, which uses multiple RPM systems to monitor heart failure patients.

The twelve interviews conducted support that healthcare professionals would benefit from …

Outpatient Visit Modality And Parallel Patient Satisfaction: A Multi-Site Cohort Analysis Of Telemedicine And In-Person Visits During The Covid-19 Pandemic, Nicole J. Ploog, Jordan Coffey, Laurie Wilshusen, Bart Demaerschalk

Patient Experience Journal

Telemedicine approaches provide many benefits to patients across both primary and specialty care. Patient acceptance is imperative to successful telemedicine implementation. As telemedicine utilization continues to surge, it is imperative that healthcare organizations have a method for evaluating the patient experience with these types of visits. Previous studies on experience with telemedicine have focused on smaller patient populations with narrow inclusion criteria and limited geographical reach. This research described how patients’ satisfaction with video telemedicine-based visits varied based on patient characteristics and how they compare with in-person visits. We obtained and analyzed results from standardized patient experience surveys to compare …

Feasibility Of Cell Phone Surveys In People With Mental Illness Experiencing Homelessness During Covid-19, Tina Thomas, Namrata Walia, Landon Presnall, Jasper Shei, Jane Elizabeth Hamilton

Journal of Digital Psychiatry

People experiencing homelessness (PEH) may be at increased risk for negative physical and mental health outcomes in the context of community spread of COVID-19. Research into the impacts of COVID-19 on this vulnerable population can be affected by inaccessibility and poor engagement resulting in minimal representation in population-based survey data. The increased use of mobile phone technology (mHealth) to provide medical and psychiatric care during the COVID-19 pandemic could provide an effective platform for gathering data from this hard-to-reach group. This paper examines feasibility, via review of the barriers and facilitators, of using a mobile phone intervention to administer a …

Journal Of Digital Psychiatry: A New Journal, Salih Selek

Journal of Digital Psychiatry

no abstract

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 …