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telemedicine and primary care

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
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
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
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
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...
October 7, 2016: Ophthalmology
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
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...
October 4, 2016: Clinical Cardiology
María Del C López Jordi, Marcia Ç Figueiredo, Dante Barone, Carolina Pereira
: Dentistry increasingly uses Information and Communication Technology (ICT), which has impact on teaching, research, the profession and dental care in general. However, there is a lack of valid information on ICT resources and use in Latin America. This was a descriptive, cross-sectional, multi-center, interdisciplinary study, the aim of which was to conduct a survey on how extensively ICT is used in Dentistry in Latin American countries by enquiring into two primary components: 1) use of ICT in student training and 2) use of ICT by professionals in consulting rooms and services...
April 2016: Acta Odontológica Latinoamericana: AOL
Marco Rogante, Claudia Giacomozzi, Mauro Grigioni, Dahlia Kairy
AIMS: To evaluate the quality of systematic reviews on telemedicine applications in palliative care. METHODS: A structured literature review was conducted to identify systematic reviews dealing with telemedicine in palliative care; the AMSTAR (Assessment of Multiple Systematic Reviews) checklist was used to appraise the evidence related to the systematic reviews. RESULTS: 405 records were initially identified; of these 14 were eligible for full-text analysis...
July 2016: Annali Dell'Istituto Superiore di Sanità
Samir N Patel, Michael A Klufas, Christina E Douglas, Karyn E Jonas, Susan Ostmo, Audina Berrocal, Antonio Capone, Maria A Martinez-Castellanos, Felix Chau, Kimberly Drenser, Philip Ferrone, Anton Orlin, Irena Tsui, Wei-Chi Wu, Mrinali P Gupta, Michael F Chiang, R V Paul Chan
Importance: Telemedicine is becoming an increasingly important component of clinical care for retinopathy of prematurity (ROP), but little information exists regarding the role of mosaic photography for ROP telemedicine diagnosis. Objective: To examine the potential effect of computer-generated mosaic photographs on the diagnosis and management of ROP. Design, Setting, and Participants: In this prospective cohort study performed from July 12, 2011, through September 21, 2015, images were acquired from ROP screening at 8 academic institutions, and ROP experts interpreted 40 sets (20 sets with individual fundus photographs with ≥3 fields and 20 computer-generated mosaic photographs) of wide-angle retinal images from infants with ROP...
September 29, 2016: JAMA Ophthalmology
Catherine Wolff, Amelia K Boehme, Karen C Albright, Tzu-Ching Wu, Michael T Mullen, Charles C Branas, James C Grotta, Sean I Savitz, Brendan G Carr
BACKGROUND: Women have more frequent and severe ischemic strokes than men, and are less likely to receive treatment for acute stroke. Primary stroke centers (PSCs) have been shown to utilize treatment more frequently. Further, as telemedicine (TM) has expanded access to acute stroke care we sought to investigate the association between PSC, TM and access to acute stroke care in the state of Texas. METHODS: Texas hospitals and resources were identified from the 2009 American Hospital Association Annual Survey...
2016: Journal of Health Disparities Research and Practice
Elizabeth A Kessler, Ashley K Sherman, Mara L Becker
BACKGROUND: There is a critical shortage of pediatric rheumatologists in the US. Substantial travel to clinics can impose time and monetary burdens on families. The aim of this study was to evaluate the cost of in-person pediatric rheumatology visits for families and determine if telemedicine clinics resulted in time and cost savings. Factors associated with interest in telemedicine were also explored. METHODS: Surveys were offered to parents and guardians of patients in Pediatric Rheumatology follow-up clinics in Kansas City, Missouri, the primary site of in-person care, and at a telemedicine outreach site 160 miles away, in Joplin, Missouri...
September 20, 2016: Pediatric Rheumatology Online Journal
Mohammed Alotaibi, Lamia Alibrahim, Nouf Alharbi
BACKGROUND: Type 1 Diabetes Mellitus (T1DM) patients among the children have been increasing rapidly in the recent years in Saudi Arabia, as a result there is a need for extensive research in this area. Various suggestions were kept forward including m-health technologies, telemedicine etc. However, very little research has been conducted in understanding the T1DM among the children, measures being taken to control, and the feasible policies and procedures that could be adopted for managing T1DM among child population...
October 2016: Diabetes Research and Clinical Practice
Astrid Buvik, Einar Bugge, Gunnar Knutsen, Arvid Småbrekke, Tom Wilsgaard
BACKGROUND: Decentralised services using outreach clinics or modern technology are methods to reduce both patient transports and costs to the healthcare system. Telemedicine consultations via videoconference are one such modality. Before new technologies are implemented, it is important to investigate both the quality of care given and the economic impact from the use of this new technology. The aim of this clinical trial was to study the quality of planned remote orthopaedic consultations by help of videoconference...
2016: BMC Health Services Research
Elisabeth A Stelson, Brendan G Carr, Kate E Golden, Niels Martin, Therese S Richmond, M Kit Delgado, Daniel N Holena
BACKGROUND: Family-centered rounds involve purposeful interactions between patients' families and care providers to refocus the delivery of care on patients' needs. OBJECTIVES: To examine perspectives of patients' family members and health care providers on family participation in rounds in the surgical intensive care unit (ICU) and the potential use of telemedicine to facilitate this process. METHODS: Patients' family members and surgical ICU care providers were recruited for semistructured interviews exploring stakeholders' perspectives on family participation in ICU rounds and the potential role of telemedicine...
September 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Jeffrey Hsu, Di Liu, Ya Min Yu, Hui Tong Zhao, Zhi Rou Chen, Jiao Li, Wei Chen
BACKGROUND: China's mHealth market is on track to become a global leader by industry size. The Chinese mobile app market and health care system have peculiarities that distinguish them from other app markets. To date, Chinese mHealth apps have not been systematically investigated. OBJECTIVE: The objective of this study was to provide an overview of Chinese mHealth apps as of December 2015. METHODS: We identified and investigated the most downloaded apps from the iOS and Android platforms...
August 29, 2016: Journal of Medical Internet Research
Hilde Smith-Strøm, Marjolein M Iversen, Marit Graue, Svein Skeie, Marit Kirkevold
INTRODUCTION: Diabetic foot ulcers are a feared complication of diabetes. Care delivered via telemedicine is suggested to be a more integrated care pathway to manage diabetic foot ulcers than traditionally delivered healthcare. Our aim was to explore patients' experiences with telemedicine follow-up care as compared to traditional care. METHODS: Interpretive description was used as an analysis strategy. Data were collected using individual semi-structured interviews in the context of a larger ongoing clustered randomized controlled trial...
October 2016: International Journal of Medical Informatics
Jane Moeckli, Kenda R Stewart, Sarah Ono, Bruce Alexander, Tyler Goss, Marissa Maier, Phyllis C Tien, M Bryant Howren, Michael E Ohl
PURPOSE: Extension for Community Health Outcomes (ECHO) is a provider-level telemedicine model successfully applied to hepatitis C care, but little is known about its application to Human Immunodeficiency Virus (HIV) care. We performed a mixed-methods evaluation of 3 HIV ECHO programs in the Veterans Health Administration, focusing on uptake by primary care clinics and veterans. METHODS: Administrative data were used to assess program uptake, including adoption (ie, proportion of primary care clinics participating) and reach (ie, proportion of eligible veterans participating)...
August 24, 2016: Journal of Rural Health
Lynne S Nemeth, Carolyn Jenkins, Edward C Jauch, Sharon Conway, Adam Pearlman, Ida J Spruill, Lynette J Brown, Joyce Linnen, Florene Linnen, Jeannette O Andrews
Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement...
August 22, 2016: Research in Nursing & Health
Antonio Jose Reyes, Kanterpersad Ramcharan
We report a patient driven home care system that successfully assisted 24/7 with the management of a 68-year-old woman after a stroke-a global illness. The patient's caregiver and physician used computer devices, smartphones and internet access for information exchange. Patient, caregiver, family and physician satisfaction, coupled with outcome and cost were indictors of quality of care. The novelty of this basic model of teleneurology is characterised by implementing a patient/caregiver driven system designed to improve access to cost-efficient neurological care, which has potential for use in primary, secondary and tertiary levels of healthcare in rural and underserved regions of the world...
2016: BMJ Case Reports
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