Telemedicine Commons^™

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Access Barriers To Telehealth, Quynh Chau, Amita Behuria Pathak, Daniel Turner, Jacquelyn Cheun, Carl Noe

SMU Data Science Review

Abstract. Telehealth has long been touted as an efficient and cost-effective way to deliver health care services to patients. The COVID-19 global pandemic hastened the adoption of this technology in the United States. Despite its promises, telehealth as a technology-based model of health service delivery has also highlighted access to care inequities in the form of uneven utilization across various patient demographics. This research uses machine learning and publicly available data sources to describe telehealth utilization based on social determinants of care. The implications of this application can be used to inform health care providers of how to target efforts …

Enhancing Cancer Care Of Rural Dwellers Through Telehealth And Engagement (Encore): Protocol To Evaluate Effectiveness Of A Multi-Level Telehealth-Based Intervention To Improve Rural Cancer Care Delivery, Tuya Pal, Pamela C. Hull, Tatsuki Koyama, Phillip Lammers, Denise Martinez, Jacob Mcarthy, Emma Schremp, Ann Tezak, Anne Washburn, Jennifer G. Whisenant, Debra L. Friedman

Markey Cancer Center Faculty Publications

BACKGROUND: Despite lower cancer incidence rates, cancer mortality is higher among rural compared to urban dwellers. Patient, provider, and institutional level factors contribute to these disparities. The overarching objective of this study is to leverage the multidisciplinary, multispecialty oncology team from an academic cancer center in order to provide comprehensive cancer care at both the patient and provider levels in rural healthcare centers. Our specific aims are to: 1) evaluate the clinical effectiveness of a multi-level telehealth-based intervention consisting of provider access to molecular tumor board expertise along with patient access to a supportive care intervention to improve cancer care …

A Telehealth Explosion: Using Lessons From The Pandemic To Shape The Future Of Telehealth Regulation, Deborah Farringer

Texas A&M Law Review

From board rooms, to classrooms, to Saturday Night Live skits, the video conferencing app Zoom became a seemingly overnight sensation as a way to connect while businesses were shuttered and individuals were forced to stay at home when the coronavirus pandemic erupted in the United States in March 2020. From 10 million daily users in December 2019 to over 200 million daily users by March 2020, the company founded in 2011 became a market leader as the country tried to figure out how to continue business as usual—to the extent possible—during the global pandemic. While hospitals prepared for the onslaught …

Health Technology In School-Based Health Centers: Supporting Continuous Care During Covid-19, Erin Sullivan, Anna Goddard, Paula Fields, Suzanne Mackey

Nursing Faculty Publications

Background: Children and adolescents in the United States face disparities by race, ethnicity, and socioeconomic status, including unequal access to consistent and high-quality healthcare. School-based health centers (SBHCs) promote health equity by delivering primary, mental, and other health services directly to students in their schools. The COVID-19 outbreak in the United States resulted in schools and SBHCs closing their physical sites and pivoting to virtual service delivery. Methods: In the months immediately following school closures, school-based health center practitioners and sponsors participated in an online listening series to share how they used technology to creatively advertise services, engage with students, …

A Review Of Mobile Apps For Chronic Kidney Disease Patients, Clarisse Zigan, Carl Russell Iii, Kirsten Wozniak, Kshaunish Soni

The Journal of Purdue Undergraduate Research

No abstract provided.

Pandemic Pearl: Innovations In Virtual Improvement Coaching, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Andrew Levine

Operations Transformation

The success of local performance improvement efforts depends on the engagement of clinical care teams in a culture of continuous improvement. At the onset of the COVID-19 pandemic, many teams at Maine Medical Center (and across the globe), transitioned to remote work to stop the spread of the virus. While some are returning to office, a significant amount of work is still being done remotely. For continued success, we need to understand how we can best coach clinical care teams in a hybrid or remote environment.

A Rollout Of A Blood Pressure Remote Patient Monitoring Program To Improve High-Risk Maternal Outcomes At A Pilot Clinic For Systemwide Expansion, Laura Geron

Seton Hall University Dissertations and Theses (ETDs)

An existing virtual care platform provides an innovative means of early recognition, identification, and intervention for women with elevated blood pressures during pregnancy, known as preeclampsia. A pilot program took place at a Northeastern prenatal care clinic where patients were identified as high-risk for preeclampsia, enrolled, educated by their providers, and equipped with Bluetooth-enabled blood pressure cuffs.

Through remote patient monitoring (RPM) technology, blood pressure readings could transmit from a patient’s residence to a portal accessible by their clinic provider at any time. This doctoral-level quality improvement project focuses on the identification of patients at high-risk for preeclampsia, their enrollment …

Exploring Digital Health Interventions To Support Community Health Workers In Low-And-Middle-Income Countries During The Covid-19 Pandemic: A Scoping Review Protocol, Anam Shahil Feroz, Komal Valliani, Hajra Khwaja, Sehrish Karim

Community Health Sciences

Introduction: COVID-19 has significantly affected community health workers' (CHWs) performance as they are expected to perform pandemic-related tasks along with routine essential healthcare services. A plausible way to optimise CHWs' functioning during this pandemic is to couple the efforts of CHWs with digital tools. So far, no systematic evidence is available on the use of digital health interventions to support CHWs in low-middle-income countries (LMICs) amid the COVID-19 pandemic. The article describes a protocol for a scoping review of primary research studies that aim to map evidence on the use of unique digital health interventions to support CHWs during COVID-19 …

Facilitating Well-Rounded Clinical Experience For Psychiatric Nurse Practitioner Students, Joan Alviar Fraino, Nancy Selix

Nursing and Health Professions Faculty Research and Publications

There is a steady increase in demand for mental health services and a lack of providers. Recent societal changes resulting from the COVID-19 pandemic have increased these needs. Psychiatric mental health nurse practitioners (PMHNP) are well suited to offer these services. High-quality clinical PMHNP student experiences are based on well-rounded curricula in a variety of clinical settings. Meeting the need for clinical education and finding high-quality preceptors is especially challenging during the pandemic due to the lack of preceptors and access to care for in-person services. Creative approaches are needed to meet student clinical experience needs.

Covid‑19, Race/Ethnicity, And Age: The Role Of Telemedicine To Close The Gaps On Health Disparities, Andreas Kakolyris, Juan J. Delacruz, Christos I. Giannikos

Publications and Research

The novel COVID-19 outbreak is a major public health challenge that quickly turned into an economic recession of great proportions. This pandemic poses a trade-off between health and the economy where social distancing, quarantines, and isolation shut down demand and supply chains across the USA. This paper analyzes the impact of COVID-19 on illness and death among older adults and communities of color with low socioeconomic status in New York City. To achieve this goal, fractional logit models are used to capture changes in the novel virus’ morbidity and mortality rates at the neighborhood level. Median income, race/ethnicity, age, household …

A Pilot Study Of Knee And Hip Osteoarthritis Patient Experience With Telemedicine During The Covid-19 Pandemic, Rondy M. Lazaro, Kyle J. Smith, Mohammad H. Bawany, Nathan Barford, Jennifer H. Paul

Advances in Clinical Medical Research and Healthcare Delivery

Objective: The purpose of this pilot study is to examine patients' experience and satisfaction using telemedicine for knee and hip osteoarthritis care during the COVID-19 pandemic.

Methods: Adult patients seen via telemedicine for knee and/or hip osteoarthritis pain completed surveys through the REDCap online platform or pen/paper evaluating their experiences and satisfaction with telemedicine, assessed using yes/no and Likert scale questions. Demographic information was collected from the electronic medical record (EMR).

Results: 32 subjects (9 males, 23 females, mean age 63.2 years [SD = 12.2 years]) completed surveys. 90.6% of subjects stated that they were satisfied with the audio/video quality …

Key Principles, Policies And Strategies In Promoting Telehealth, Stanley Mierzwa

Center for Cybersecurity

Policymakers, health service providers and community members face a myriad of challenges in rolling out or using telehealth services. These challenges relate to a broad range of issues, including policy and regulatory frameworks, governance structures, user adoption, digital literacy and capacity, infrastructure, as well as service quality, data safeguards, and institutional resistance to digital disruption.

This room aims to facilitate a discussion around the key policy and regulatory drivers, and other key building blocks, including those related to structural, capacity, technical and financial factors, for the effective introduction and scale-up of telehealth.

Room 2: Key Principles, Policies and Strategies in …

Use Of A Remote Patient Home Telemonitoring System (Engage Practice Solutions) In A Rural Health System To Decrease Rural Patients’ Utilization Of Acute Healthcare Services: A Quality Improvement Project, Christopher Baker

Doctor of Nursing Practice (DNP) Manuscripts

Individuals in rural areas of the U.S. have less healthcare access in large part due to access barriers, and include travel and wait time, distance to a provider, cost, transportation, and social and cultural components. Rural individuals have been found to be in poorer health and have higher rates of being uninsured and having chronic disease. These disparities lead to rural individuals requiring more expensive acute care once they are at the point of receiving care. A significant burden is placed on the individual and health system. The rates of emergency department (ED) use in rural areas increased 70% from …

Do Virtual Visits Have An Effect On Outpatient Antibiotic Prescribing For Uris?, Sydney Harris, Eric Young, Jarrod W. Kile Rphd, Kathryn Zaffiri Mph

Research Scholars

No abstract provided.

A Preliminary Evaluation Of The Behavioral Gerontology Staff Training Protocols, Minyoung Kim

Masters Theses

Staff training in aging settings is integral to ensuring quality services, and such training has traditionally been conducted in person. With the COVID-19 outbreak, there is a need for innovative approaches to training that reduce exposure for trainers and staff. However, the efficacy of such an approach has not yet been demonstrated. To prevent the waste of staff resources at long-term care facilities, this study evaluates the efficacy of behavioral gerontology staff training protocols as a form of telehealth by utilizing graduate and undergraduate students as pilot participants. We use an additive concurrent multiple-probe design across participants to evaluate the …

Effectiveness Of An Adapted Virtual Medication Reconciliation Osce Compared With In Person Osce, Rick Hess, Kelly L. Covert, Mckenzie Calhoun Highsmith, Jennifer Trotter, Brian Cross

International Journal of Health Sciences Education

Introduction:

The objective of this study was to measure virtually-based objective structured clinical exam (OSCE) pass rates of student pharmacists who received remote, synchronous instruction on medication reconciliation compared with OSCE pass rates from the previous class, who received face to face synchronous instruction and OSCEs. The secondary objective was to measure student perceptions of remote instruction and OSCE preparation.

Materials and Methods:

Second year student pharmacists attended four online preparatory labs to learn and practice the process of performing a medication reconciliation. A virtually-based OSCE was used to assess student competency of identifying the primary or life-threatening medication related …

Assessing Telemedicine Outcomes With Hospitality Principles, Wei Wei, Yunying (Susan) Zhong

Rosen Research Review

Hospitality as a concept has relevance across many industries of service provision, including the health care sector. The COVID-19 pandemic has had a major impact on the way in which patients access health care from their service providers. In this study, Dr. Wei Wei and Dr. Yun Ying (Susan) Zhong build a predictive model outlining the most important factors in enabling patients to experience positive emotional outcomes during telemedicine encounters.

Telehealth Policy Analysis: Recommendations To Improve Medicaid Reimbursement In Michigan, Adelheid Fisher

Doctoral Dissertations & Projects

Purpose: At the onset of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) granted flexibility for audio-only visits. However, CMS indicated possible cessation of reimbursement for audio-only telehealth when the pandemic ends. This project explored current audio-only telehealth reimbursement and proposed post-pandemic policies for Medicaid beneficiaries at the state level and the perceived benefits and challenges from the perspective of rural providers.

Methods: Data was collected from a rural ambulatory clinic that included patients ≥ 18 who received telehealth during the study period (April 2020 - May 2021). The providers at this clinic were surveyed on the …

Survey Of Telemedicine By Pediatric Nephrologists During The Covid-19 Pandemic., Rupesh Raina, Nikhil Nair, Hui Kim Yap, Guido Filler, Sidharth K. Sethi, Arvind Bagga, Pankaj Hari, Timothy Bunchman, Sharon Bartosh, Katherine Twombley, Gaurav Kapur, Mignon Mcculloch, Bradley A. Warady, Maria Díaz-González De Ferris, Sarah Rush

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: The slow increase in use of telemedicine began to expand rapidly, along with reimbursement changes, during the coronavirus disease-2019 (COVID-19) pandemic. Standardized protocols for these services are lacking but are needed for effective and equitable health care. In this study, we queried pediatric nephrologists and their patients about their telemedicine experiences during the pandemic.

Methods: Surveys that were in compliance with the Health Insurance Portability and Accountability Act were deployed online to patients and physicians.

Results: We collected survey responses from 400 patients and 197 pediatric nephrologists. Patients reported positive experiences with telemedicine visits as it was logistically easier …