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telemedicine and primary care

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https://www.readbyqxmd.com/read/28056832/telemedicine-and-primary-care-obesity-management-in-rural-areas-innovative-approach-for-older-adults
#1
John A Batsis, Sarah N Pletcher, James E Stahl
BACKGROUND: The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity...
January 5, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28025929/hemophilia-management-via-data-collection-and-reporting-initial-findings-from-the-comprehensive-care-sustainability-collaborative
#2
Michael D Tarantino, Vanita K Pindolia
BACKGROUND: Despite being a rare disorder, hemophilia represents a significant driver of health care resource utilization and requires expert hematologic and multidisciplinary services to achieve optimal outcomes. Since their inception nearly 40 years ago, hemophilia treatment centers (HTCs) have served as centers of excellence in providing the intensive care and ancillary services necessary for this unique patient base; however, the full capabilities of these centers may be underused in the current framework of managed care, largely because of a lack of communication and information shared between payers and HTC stakeholders...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28002690/diabsat-telemedicine-itinerant-screening-of-chronic-complications-of-diabetes-using-a-satellite
#3
Marie-Christine Turnin, Solène Schirr-Bonnans, Marie-Christine Chauchard, Patrice Deglise, Catherine Journot, Yann Lapeyre, Antonio Güell, Benoit Lepage, Helene Hanaire, Jacques Martini
BACKGROUND: Health authorities recommend regular screening for the chronic complications of diabetes. The ENTRED (*) survey results show that insufficient screening is undertaken. The DIABSAT (†) program aims to improve care for diabetes patients in rural areas of the Midi-Pyrénées region, telemonitoring complications of diabetes through an itinerant screening service. METHODS: A vehicle was equipped with a satellite dish and medical equipment for screening ophthalmological, renal, vascular, and neuropathic damage and assessing the level of risk of diabetic foot ulceration...
December 21, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28002689/design-and-implementation-of-a-telepediatric-primary-level-and-low-cost-system-to-reduce-unnecessary-patient-transfers
#4
Christian Cifuentes, Eduardo Romero, Javier Godoy
BACKGROUND: Most inhabitants in Latin America are concentrated in large urban foci with different access to facilities. Although the main hospitals offer specialized services, economically vulnerable populations cannot easily afford these services, the pediatric population being most affected. This article presents the design and implementation of a low cost telepediatric system, applied to primary care hospitals through a study in Bogotá, Colombia, mainly aimed to reduce the number of unnecessary transfers commonly sent to specialized medical services...
December 21, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27998682/telemedicine-specialty-support-promotes-hepatitis-c-treatment-by-primary-care-providers-in-the-department-of-veterans-affairs
#5
Lauren A Beste, Thomas J Glorioso, P Michael Ho, David H Au, Susan R Kirsh, Jeffrey Todd-Stenberg, Michael F Chang, Jason A Dominitz, Anna E Barón, David Ross
BACKGROUND & AIMS: The Department of Veterans Affairs (VA) is the largest US provider of hepatitis c treatment. Although antiviral regimens are becoming simpler, hepatitis c antivirals are not typically prescribed by primary care providers (PCPs). The VA-Extension for Community Health Outcomes (VA-ECHO) program was launched to promote primary care-based hepatitis C treatment using videoconferencing-based specialist support. We aimed to assess whether PCP participation in VA-ECHO was associated with hepatitis C treatment and sustained virologic response...
December 17, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27998380/the-past-is-prologue-the-future-of-sleep-medicine
#6
Nathaniel F Watson, Ilene M Rosen, Ronald D Chervin
The field of sleep medicine has gone through tremendous growth and development over a short period of time, culminating in recognition of the field as an independent medical subspecialty by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS). However, the fellowship training requirement that is now mandatory for sleep medicine board certification eligibility has had the unintended consequence of restricting the influx of young physicians to the field...
December 16, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27932050/icu-telemedicine-program-financial-outcomes
#7
Craig M Lilly, Christine Motzkus, Teresa Rincon, Shawn E Cody, Karen Landry, Richard S Irwin
BACKGROUND: Intensive care unit (ICU) telemedicine improves access to high quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following tele-ICU implementation and after the addition of logistic center function has not been published. METHODS: Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across 3 groups that differed with regard to telemedicine support: a group without tele-ICU support (Pre-ICU intervention group), a group with tele-ICU support (ICU Telemedicine group) and a tele-ICU group with added logistical center functions and support for quality care standardization (Logistic Center Group)...
December 5, 2016: Chest
https://www.readbyqxmd.com/read/27909208/evaluation-of-a-national-telemedicine-initiative-in-the-veterans-health-administration-factors-associated-with-successful-implementation
#8
Lauren Stevenson, Sherry Ball, Leah M Haverhals, David C Aron, Julie Lowery
BACKGROUND: The Consolidated Framework for Implementation Research was used to evaluate implementation facilitators and barriers of Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO) within the Veterans Health Administration. SCAN-ECHO is a video teleconferencing-based programme where specialist teams train and mentor remotely-located primary care providers in providing routine speciality care for common chronic illnesses. The goal of SCAN-ECHO was to improve access to speciality care for Veterans...
November 30, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27893947/challenges-in-the-uptake-of-telemedicine-in-dentistry
#9
Mohamed Estai, Estie Kruger, Marc Tennant, Stuart Bunt, Yogesan Kanagasingam
With the availability of oral care services very unevenly distributed in rural or remote areas, underserved people seek oral care from non-dental care providers. Against this backdrop, and coupled with the decreasing cost of and innovations in technology, there is a growing interest in the adoption of telemedicine services. Regardless of the lack of good-quality evidence supporting the cost-effectiveness of telemedicine, evidence already indicates that telemedicine, even with extra costs, helps in reducing the inequalities in the provision of primary health care...
October 2016: Rural and Remote Health
https://www.readbyqxmd.com/read/27842539/a-randomized-wait-list-control-trial-to-evaluate-the-impact-of-a-mobile-application-to-improve-self-management-of-individuals-with-type-2-diabetes-a-study-protocol
#10
Laura Desveaux, Payal Agarwal, Jay Shaw, Jennifer M Hensel, Geetha Mukerji, Nike Onabajo, Husayn Marani, Trevor Jamieson, Onil Bhattacharyya, Danielle Martin, Muhammad Mamdani, Lianne Jeffs, Walter P Wodchis, Noah M Ivers, R Sacha Bhatia
BACKGROUND: Management of diabetes through improved glycemic control and risk factor modification can help prevent long-term complications. Much diabetes management is self-management, in which healthcare providers play a supporting role. Well-designed e-Health solutions targeting behavior change can improve a range of measures, including glycemic control, perceived health, and a reduction in hospitalizations. METHODS: The primary objective of this study is to evaluate if a mobile application designed to improve self-management among patients with type 2 diabetes (T2DM) improves glycemic control compared to usual care...
November 15, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27835713/psychotherapy-for-depression-in-older-veterans-via-telemedicine-effect-on-quality-of-life-satisfaction-treatment-credibility-and-service-delivery-perception
#11
Leonard E Egede, Ron Acierno, Rebecca G Knapp, Rebekah J Walker, Elizabeth H Payne, B Christopher Frueh
OBJECTIVE: To analyze the impact of telepsychology and same-room care on functioning, satisfaction, and perception of care based on a noninferiority trial of psychotherapy delivered via telemedicine or same-room care to elderly patients with depression. METHODS: 241 elderly patients with depression (meeting DSM-IV diagnostic criteria) were randomly assigned to either telemedicine (n = 120) or same-room treatment (n = 121) between April 1, 2007, and July 31, 2011...
December 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27799615/effect-of-telemedicine-on-glycated-hemoglobin-in-diabetes-a-systematic-review-and-meta-analysis-of-randomized-trials
#12
Labib Imran Faruque, Natasha Wiebe, Arash Ehteshami-Afshar, Yuanchen Liu, Neda Dianati-Maleki, Brenda R Hemmelgarn, Braden J Manns, Marcello Tonelli
BACKGROUND: Telemedicine, the use of telecommunications to deliver health services, expertise and information, is a promising but unproven tool for improving the quality of diabetes care. We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care. METHODS: We searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials databases (to November 2015) and reference lists of existing systematic reviews for randomized controlled trials (RCTs) comparing telemedicine with usual care for adults with diabetes...
October 31, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27770797/towards-comprehensive-early-abortion-service-delivery-in-high-income-countries-insights-for-improving-universal-access-to-abortion-in-australia
#13
Angela Dawson, Deborah Bateson, Jane Estoesta, Elizabeth Sullivan
BACKGROUND: Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries...
October 22, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27756376/telemedicine-with-clinical-decision-support-for-critical-care-a-systematic-review
#14
Nicola Mackintosh, Marius Terblanche, Ritesh Maharaj, Andreas Xyrichis, Karen Franklin, Jamie Keddie, Emily Larkins, Anna Maslen, James Skinner, Samuel Newman, Joana Hiew De Sousa Magalhaes, Jane Sandall
BACKGROUND: Telemedicine applications aim to address variance in clinical outcomes and increase access to specialist expertise. Despite widespread implementation, there is little robust evidence about cost-effectiveness, clinical benefits, and impact on quality and safety of critical care telemedicine. The primary objective was to determine the impact of critical care telemedicine (with clinical decision support available 24/7) on intensive care unit (ICU) and hospital mortality and length of stay in adults and children...
October 18, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27755124/telemedicine-based-physician-consultation-results-in-more-patients-treated-and-released-by-ambulance-personnel
#15
Nikolaj Raaber, Morten T Bøtker, Ingunn S Riddervold, Erika F Christensen, Niels-Christian Emmertsen, Thorbjørn Grøfte, Hans Kirkegaard
OBJECTIVE: We examined whether teleconsultation from ambulances to a physician at an emergency medical communication center (EMCC) would increase the proportion of patients with nonurgent conditions being treated and released on site. METHODS: This research was a before-after pilot study. In the intervention period, the EMCC was manned 24/7 with physicians experienced in emergency care. Eligible participants included all patients with nonurgent conditions receiving an ambulance after a medical emergency call...
October 17, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27754958/point-of-care-testing-inr-an-overview
#16
Doris Barcellona, Lara Fenu, Francesco Marongiu
Oral anticoagulant therapies with the anti-vitamin K drugs (AVK), warfarin, acenocoumarol and phenprocoumon, are employed in primary and secondary anti-thrombotic prophylaxis in patients with venous thromboembolism, atrial fibrillation and cardiac mechanical valves. However, a monitoring test such as the International Normalized Ratio (INR) is required. The periodic monitoring of this therapy entails discomfort for the patients. Telemedicine and telecare can provide significant aid in the management of this therapy allowing patients to perform the test at home or anywhere else with a portable device, i...
October 18, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27733904/opioid-use-disorder-patients-perceptions-of-healthcare-delivery-platforms
#17
Uros Rakita, Peter Giacobbe, Chris Cavacuiti
OBJECTIVES: To assess the acceptability and quality of web-based videoconferencing telemedicine consultation platform in the treatment of opioid use disorder at TrueNorth Medical Centre. METHODS: We conducted an interview based quality improvement initiative using an investigator-designed questionnaire. The questionnaire consisted of 17 Agree/Disagree questions, measured on a 7-point Likert scale and 2 questions where patients had the ability to elaborate qualitatively on their perceptions and experiences with their telemedicine service...
2016: SAGE Open Medicine
https://www.readbyqxmd.com/read/27726962/cost-effectiveness-of-a-national-telemedicine-diabetic-retinopathy-screening-program-in-singapore
#18
Hai V Nguyen, Gavin Siew Wei Tan, Robyn Jennifer Tapp, Shweta Mital, Daniel Shu Wei Ting, Hon Tym Wong, Colin S Tan, Augustinus Laude, E Shyong Tai, Ngiap Chuan Tan, Eric A Finkelstein, Tien Yin Wong, Ecosse L Lamoureux
PURPOSE: To determine the incremental cost-effectiveness of a new telemedicine technician-based assessment relative to an existing model of family physician (FP)-based assessment of diabetic retinopathy (DR) in Singapore from the health system and societal perspectives. DESIGN: Model-based, cost-effectiveness analysis of the Singapore Integrated Diabetic Retinopathy Program (SiDRP). PARTICIPANTS: A hypothetical cohort of patients aged 55 years with type 2 diabetes previously not screened for DR...
December 2016: Ophthalmology
https://www.readbyqxmd.com/read/27721190/trajectory-of-cost-overtime-after-psychotherapy-for-depression-in-older-veterans-via-telemedicine
#19
Leonard E Egede, Mulugeta Gebregziabher, Rebekah J Walker, Elizabeth H Payne, Ron Acierno, B Christopher Frueh
BACKGROUND: Little evidence exists regarding the costs of telemedicine, especially considering changes over time. This analysis aimed to analyze trajectory of healthcare cost before, during, and after a behavioral activation intervention delivered via telepsychology and same-room delivery to elderly Veterans with depression. METHODS: 241 participants were randomly assigned into one of two study groups: behavioral activation for depression via telemedicine or via same-room treatment...
September 28, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27701750/assessment-of-respiratory-distress-by-the-roth-score
#20
Ehud Chorin, Allison Padegimas, Ofer Havakuk, Edo Y Birati, Yacov Shacham, Anat Milman, Guy Topaz, Nir Flint, Gad Keren, Ori Rogowski
INTRODUCTION: Health care demand is increasing due to greater longevity of patients with chronic comorbidities. This increasing demand is occurring in a setting of resource scarcity. To address these changes, high-value care initiatives, such as telemedicine, are valuable resource-preservation strategies. This study introduces the Roth score as a telemedicine tool that uses patient counting times to accurately risk-stratify dyspnea severity in terms of hypoxia. HYPOTHESIS: The Roth score has correlation with dyspnea severity...
November 2016: Clinical Cardiology
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