Telemedicine Commons^™

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 …

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 …

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 …

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

The Future Role Of Cytologists Regarding Telecytology And Rapid On-Site Evaluation (Rose), A Meta-Narrative Review, James Jeffery Fretwell, Liam Patrick Farley, Melissa Perez, Mary Coolbaugh-Murphy Phd, Denise Juroske Short Phd

Research Methods Poster Session 2024

The use of Telecytology in conjunction with rapid on-site evaluation (ROSE) is currently at the forefront of discussion among cytologists and cytopathologists. In this meta-narrative review, the advancements of Telecytology and ROSE within the discipline of Cytology are discussed. Advancements in telecytology and ROSE enable off-site cytology slide evaluation and diagnosis through digital image transfer. ROSE allows for preliminary cytological assessment during image-guided biopsy procedures to determine specimen adequacy. The meta-narrative review concluded that the combination of these two technologies increases the efficacy of patient diagnosis without sacrificing the quality of patient care.

Improved communication between the presiding technician, the …

Evolution Of Telehealth-Its Impact On Palliative Care And Medication Management, Syed N Imam, Ursula K Braun, Mary A Garcia, Leanne K Jackson

Center for Medical Ethics and Health Policy Staff Publications

Palliative care plays a crucial role in enhancing the quality of life for individuals facing serious illnesses, aiming to alleviate suffering and provide holistic support. With the advent of telehealth, there is a growing interest in leveraging technology to extend the reach and effectiveness of palliative care services. This article provides a comprehensive review of the evolution of telehealth, the current state of telemedicine in palliative care, and the role of telepharmacy and medication management. Herein we highlight the potential benefits, challenges, and future directions of palliative telemedicine. As the field continues to advance, the article proposes key considerations for …

Addressing Untimely Healthcare Access Of Veterans Receiving Care Through The Veteran Healthcare Administration (Vha), Frank Lunetta, Jamie Stern, Lila Mcnamee

School of Professional Studies

The Veteran Healthcare Administration (VHA) serves over nine million veterans (Department of Veterans Affairs, 2023). They are responsible for the health and well-being of veterans with service-connected disabilities (Department of Veterans Affairs, 2023). A major focus for the organization is to keep improving access for veterans, as the population continues to grow (Department of Veterans Affairs, 2023). In 2018, congress passed the MISSION Act in hopes of increasing access for veterans. The MISSION Act would expand private healthcare access for veterans through the Veteran Community Care Program (VCCP) (MISSION ACT, 2018). Despite the initial benefits of the program, the MISSION …

Primary Care Organizational Readiness And Implementation Climate For Task Sharing Of Tele-Mental Health Interventions, Frances Chu, Brenna Renn, Erin Abu-Rish Blakeney, Sean Munson, Oleg Zaslavsky

Articles, Abstracts, and Reports

Primary Care Organizational Readiness and Implementation Climate for Task Sharing of Tele-Mental Health Interventions

Chu, F.; Renn, B.; Blakeney, E.; Munson, S.; Zaskavsky, O. Providence Swedish/University of Washington, Seattle, WA

Purpose: To examine perceptions of organizational readiness and implementation climate for task sharing of telemental health (TMH) interventions from primary care healthcare professionals by levels of behavioral health integration (BHI) and roles. Background/Significance: BHI clinics have positive impact on patient outcomes. Task sharing, a strategy used to address shortages of behavioral/mental health (BMH) specialists, with TMH interventions adds complexity. Method: The mixed methods study surveyed 151 healthcare professionals with Organizational …

The Use Of Telemedicine By Us Nephrologists For In-Center Hemodialysis Care During The Pandemic: An Analysis Of National Medicare Claims, Jingbo Niu, Omar Rosales, Abiodun Oluyomi, Susie Q Lew, Wolfgang C Winkelmayer, Glenn M Chertow, Kevin F Erickson

Faculty, Staff and Students Publications

RATIONALE & OBJECTIVE: Because of coronavirus disease 2019 (COVID-19), the US government issued emergency waivers in March 2020 that removed regulatory barriers around the use of telemedicine. For the first time, nephrologists were reimbursed for telemedicine care delivered during in-center hemodialysis. We examined the use of telemedicine for in-center hemodialysis during the first 16 months of the pandemic.

STUDY DESIGN: We ascertained telemedicine modifiers on nephrologist claims. We used multivariable regression to examine time trends and patient, dialysis facility, and geographic correlates of telemedicine use. We also examined whether the estimated effects of predictors of telemedicine use changed over time. …

“The Role Of Artificial Intelligence In The Pharmaceutical Field: Enhancing Therapeutic Outcomes And Repurposing Through The Acceleration Of Drug Discovery”, Tonivie Valeriano

[Archive] Belmont University Research Symposium (BURS)

The development of new drugs and their repurposing have considerably benefited the field of pharmacy. It will not only affect the pharmaceutical sector but also its diverse facets of health will be significantly influenced. Yet, the development of innovative medical treatments necessitated a lengthy period of expectancy for human survival. Individual survival rates were decreasing over time before the development of the treatment. Humanity has a limited lifespan. Moreover, investments in new drugs often go unnoticed because of the prolonged and complex process of drug research and development (R&D). In the future of pharmacy, artificial intelligence will continue to have …

Telehealth Evaluation In The United States: Protocol For A Scoping Review, Yunxi Zhang, Yueh-Yun Lin, Lincy S Lal, Jennifer C Reneker, Elizabeth G Hinton, Saurabh Chandra, J Michael Swint

Faculty, Staff and Student Publications

BACKGROUND: The rapid expansion of telehealth services, driven by the COVID-19 pandemic, necessitates systematic evaluation to guarantee the quality, effectiveness, and cost-effectiveness of telehealth services and programs in the United States. While numerous evaluation frameworks have emerged, crafted by various stakeholders, their comprehensiveness is limited, and the overall state of telehealth evaluation remains unclear.

OBJECTIVE: The overarching goal of this scoping review is to create a comprehensive overview of telehealth evaluation, incorporating perspectives from multiple stakeholder categories. Specifically, we aim to (1) map the existing landscape of telehealth evaluation, (2) identify key concepts for evaluation, (3) synthesize existing evaluation frameworks, …

A Building Block Approach To Implement A Telehealth Clinic And Improve Primary Care Access In The Philippines: A Large-Scale Pilot Project, Annalicia Pickering, Wardah Rafaqat, Adi Balk, Milton Chen, Limuel Abrogena, Shuhan He, Mary Showstark, Alexander Davis, Aidan Chen, Jarone Lee

Ateneo School of Medicine and Public Health Publications

A limited number of healthcare workers and cost constraints encumber primary care access in the Philippines. To test telehealth as a low-cost and effective solution, a large-scale digital health clinic was implemented in the selected urban and rural communities. In collaboration with local authorities, our pilot telemedicine clinic was implemented for 3 days in January 2023. Patients were registered, and their vitals were assessed before they were seen by a remote US-based licensed physician who provided treatment rec-ommendations. Medical devices with real-time streaming capabilities, such as electronic stethoscopes, were utilized to enhance remote examinations. A total of 322 patients were …

Enhancing Patient Understanding: The Impact Of Educational Videos On Ophthalmology Visits, Anna Zhao

Medical Student Research Symposium

A major component of effective patient-centered care is the patient’s understanding of their health condition and treatments. Increased knowledge of medical conditions can positively modify health behaviors, such as more participation in cancer screening and better adherence to medications. However, the readability of educational materials often does not match the patients’ reading abilities. Instead, educational videos, which have gained prominence with the emergence of tele-visits following COVID-19, have shown promise in being beneficial to patients with lower literacy levels. For ocular pathologies, early identification and care are key in preventing vision loss. Tele-education in ophthalmology could increase patient awareness of …

Washington’S Ride Program: A Model Providing Rural Practitioners, Mary K. Smith Dds, Mba

The Journal of the Michigan Dental Association

The University of Washington School of Dentistry Regional Initiatives in Dental Education (RIDE) program is an award-winning dental education model that trains dentists to practice in rural and underserved areas. Its first cohort of students graduated in 2012. To date, there have been 96 graduates. More than 80% of RIDE graduates in practice are in rural and underserved areas, including those seeking specialty training. RIDE is successful because it collaborates with multiple universities, community health centers, local dental associations, and community leaders in the area where the students are located.

Relationship Between On-Demand Telehealth Visits And Emergency Department And Hospital Surge During The Covid-19 Pandemic, B. H. Slovis, Xin Ji, Anna Marie Chang, John C. Kairys, Judd Hollander

Department of Emergency Medicine Faculty Papers

OBJECTIVES: The relationship between COVID-19-related telehealth calls could be used to predict emergency department visits and hospital surges 3 days later potentially facilitating staffing adjustments in advance of patient arrivals. The purpose of this research was to study the temporal association between frequencies of on demand telehealth calls and emergency department surges during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.

METHODS: This cohort study examined patients who self-initiated synchronous audio-video on-demand telehealth calls between January 1, 2020 and June 30, 2022, and compared these to emergency department arrivals. The exposure in question was a synchronous audio-video on-demand telehealth …

Ctl+Heal: A Scoping Review On Therapeutic Alliance And Technology, Vineet Sadarangani

Annual Research Symposium

A strong therapeutic alliance between a healthcare provider and patient is built upon a strong bond, trust, and open communication, all essential for successful healthcare outcomes. Establishing a robust therapeutic alliance relies significantly on non-verbal behaviors, including tone, facial expression, and eye contact. Traditionally, expert feedback was essential for addressing undesirable non-verbal behaviors and cultivating desirable ones; however, technological advancements have introduced the concept of technology-assisted feedback. This would eliminate the immediate need for experts, thus allowing the clinician more time to focus on their clinical skills; however, these methods are scattered across various fields of medical education, technology and …

Evaluation Of The Effectiveness Of Telemedicine In Postoperative Follow-Up Care After Dental Implant Surgery A Pilot Study, Praveen Kumar Patel, Anuj Kishor Shukla, Varun Sachan, Paawan Sharma, Sonal Singh, Swapnil Saxena, Ramanpal S Makkad

Faculty, Staff and Student Publications

AIM: Telemedicine has emerged as a potential solution to enhance postoperative follow-up care after dental implant surgery, offering the convenience of remote monitoring and reduced need for in-person visits.

MATERIALS AND METHODS: Participants were randomly assigned to either the telemedicine group (n = 15) or the in-person group (n = 15). In the telemedicine group, patients received remote follow-up care through virtual consultations, during which they could communicate their concerns and share images of the surgical site. The in-person group received standard in-person follow-up visits. Patient satisfaction was measured using a standardized survey, with responses collected on a Likert scale. …

Advocacy Spotlight: 2024 Regulatory Reminders, Neema Katibai Jd

The Journal of the Michigan Dental Association

The Advocacy Spotlight column delves into critical regulatory reminders for dentists in 2024, emphasizing compliance challenges and potential disruptions to practice. Key areas covered include licensing, amalgam separator renewal, electronic prescribing, and Beneficial Ownership Information reporting. The article stresses the importance of staying informed about evolving regulations to ensure seamless practice operations.

Patient Perceptions Of Audio-Only Versus Video Telehealth Visits: A Qualitative Study Among Patients In An Academic Medical Center Setting, Ryan Kruis, Elizabeth A. Brown, Jada Johnson, Kit N. Simpson, James Mcelligott, Jillian Harvey

Community & Environmental Health Faculty Publications

Introduction: Telehealth utilization surged during the COVID-19 pandemic, offering expanded health care access. Audio-only visits emerged as a crucial tool for patients facing technology or connectivity barriers to still use telehealth. This qualitative study aims to better understand patient perceptions of audio-only versus video telehealth visits during the COVID-19 pandemic, and how patients perceive the role of each in their overall health care. Methods: Semi-structured interviews were conducted with 14 adult patients seeking care at an academic medical center located in the Southeast region of the United States. Patients had experienced both an audio-only and video telehealth visit within the …

The Impact Of Telestroke Services On Diagnosis, Patient Outcomes, And Treatment, Dustin Baum

Theses, Dissertations and Capstones

Introduction: In 2011, an estimated 20% of U.S. residents lacked timely access to stroke care. As of 2019, that number plummeted to 4% of patients. A reason for this improved access was the implementation of telestroke services. Telestroke services have utilized remote stroke specialists to help guide local emergency department physicians in reviewing imaging, diagnosing, treating, or transferring patients appropriately.

Purpose: The purpose of this research was to analyze the impact of telestroke implementation in the hospital setting. The study hypothesized the implementation of telestroke services in the hospital setting maintained an accurate stroke diagnosis, decreased inappropriate hospital transfers, reduced …