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telemedicine and primary care

Hisanao Akiyama, Yasuhiro Hasegawa
RATIONALE: Video-based treatment in telemedicine is a potential alternative to face-to-face treatment. We describe our trial use of telemedicine to treat a patient with primary headache. PATIENT CONCERNS: A 25-year-old woman visited our branch hospital with a chief complaint of recurrent headache. Our branch hospital had no headache specialist, so a headache specialist at our main hospital provided treatment remotely. DIAGNOSES: She was diagnosed with migraine without aura by the headache specialist using telemedicine...
March 2018: Medicine (Baltimore)
Tamara T Perry, Jill S Halterman, Rita H Brown, Chunqiao Luo, Shemeka M Randle, Cassandra R Hunter, Mallikarjuna Rettiganti
BACKGROUND: Asthma morbidity is high among low-income children living in rural U.S. regions, yet few interventions have been designed to reduce asthma burden among rural populations. OBJECTIVE: Examine the impact of a school-based asthma education program delivered via telemedicine among children living in an impoverished, rural region. METHODS: We conducted a cluster randomized trial with rural children, ages 7-14 years, comparing a school-based telemedicine asthma education intervention to usual care...
February 19, 2018: Annals of Allergy, Asthma & Immunology
Christian Schmidt, Alper Öner, Miriam Mann, Katja Krockenberger, Melanie Abbondanzieri, Bernard Brandewiede, Armin Brüge, Gisela Hostenkamp, Axel Kaiser, Henriette Neumeyer, Andreas Ziegler
BACKGROUND: Cardiovascular diseases are the major cause of death globally and represent a major economic burden on health care systems. Positive effects of disease management programs have been shown for patients with heart failure (HF). Remote monitoring and telemonitoring with active intervention are beneficial in atrial fibrillation (AF) and therapy-resistant hypertension (TRH), respectively. For these patients, we have developed a novel integrated care concept (NICC) which combines telemedicine with intensive support by a care center, including a call center, an integrated care network including inpatient and outpatient care providers and guideline therapy for patients...
February 20, 2018: Trials
G Gras
Communication technologies have invaded our daily lives. Several studies have assessed these technologies in the management of infectious diseases (mainly HIV). Weekly short text messages and real-time compliance monitoring assessed in HIV patients are both associated with higher compliance in low-income countries. Virtual consultations to monitor stable chronic HIV patients or tuberculosis treatment in high-income countries appear to be acceptable and efficient. Although assessed in small studies, virtual monitoring seems to reinforce the doctor-patient relationship and the relation between primary care settings and hospitals in various infectious diseases (endocarditis, urinary tract infection, skin and soft tissue infection, HIV, tuberculosis, hepatitis C)...
February 13, 2018: Médecine et Maladies Infectieuses
Bruno R Nascimento, Craig Sable, Maria Carmo P Nunes, Adriana C Diamantino, Kaciane K B Oliveira, Cassio M Oliveira, Zilda Maria A Meira, Sandra Regina T Castilho, Júlia P A Santos, Letícia Maria M Rabelo, Karlla C A Lauriano, Gabriel A L Carmo, Allison Tompsett, Antonio Luiz P Ribeiro, Andrea Z Beaton
BACKGROUND: Considering the limited accuracy of clinical examination for early diagnosis of rheumatic heart disease (RHD), echocardiography has emerged as an important epidemiological tool. The ideal setting for screening is yet to be defined. We aimed to evaluate the prevalence and pattern of latent RHD in schoolchildren (aged 5-18 years) and to compare effectiveness of screening between public schools, private schools, and primary care centers in Minas Gerais, Brazil. METHODS AND RESULTS: The PROVAR (Rheumatic Valve Disease Screening Program) study uses nonexperts and portable and handheld devices for RHD echocardiographic screening, with remote interpretation by telemedicine, according to the 2012 World Heart Federation criteria...
February 14, 2018: Journal of the American Heart Association
Stephen E Bartnik, Stephen P Copeland, Angela J Aicken, Angus W Turner
BACKGROUND: Lions Outback Vision has run a state-wide teleophthalmology service since 2011. In September 2015 the Australian federal government introduced a Medicare reimbursement for optometry-facilitated teleophthalmology consultations under specific circumstances. This audit demonstrates the first 12 months experience with this scheme. We aim to provide practical insights for others looking to embed a telemedicine program as part of delivering outreach clinical services. METHODS: A 12-month retrospective audit was performed between September 2015 and August 2016, inclusive...
February 14, 2018: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
Marios-Nikolaos Kouskoukis, Charalambos Botsaris
BACKGROUND: Telemedicine units and information technology systems provide special healthcare services to remote populations using telecommunication technology, in order to reduce or even remove the usual and typical face-to-face contact between doctor and patient. This innovative approach to medical care delivery has been expanding for several years and currently covers various medical specialties. OBJECTIVE: To facilitate installation of telemedicine systems/units in Greek remote areas, this article presents results of a cost-benefit analysis for two Greek islands, Patmos and Leros, using specific economic criteria...
June 2017: PharmacoEconomics Open
Tariq Kazim Shah, Tasneem Tariq, Roger Phillips, Steve Davison, Adam Hoare, Syed Shahzad Hasan, Zaheer-Ud-Din Babar
Almost half of the world's total population reside in rural and remote areas and a large number of these people remain deprived of most basic facilities like healthcare and education. It is deemed impossible for government with scarce resources in developing countries to open and run a health facility in every remote community using conventional means. One increasingly popular unconventional mean is the use of existing technology to improve exchange of medical information for the purpose of improving health of underprivileged communities...
2018: Journal of Pharmaceutical Policy and Practice
Elham Hatef, Miriam Alexander, Bruce G Vanderver, Peter Fagan, Michael Albert
CONTEXT: Digital retinal imaging with the application of telemedicine technology shows promising results for screening of diabetic retinopathy in the primary care setting without requiring an ophthalmologist on site. AIMS: We assessed whether the establishment of telemedicine technology was an effective and efficient way to increase completion of annual eye examinations among underserved, low-income (Medicaid) diabetic patients. SETTINGS AND DESIGN: A cross-sectional study in a primary care setting...
October 2017: Middle East African Journal of Ophthalmology
Hal Lewis, Mirna Becevic, Danny Myers, Dyann Helming, Rachel Mutrux, David Fleming, Karen Edison
INTRODUCTION: The present maldistribution of dermatologists in the USA may make it difficult for patients to access timely and quality care. Access to specialty care may be even more challenging for rural and underserved patients due to geographical limitations and other socioeconomic hardships. With over one-third of primary care patients seeking care for at least one skin problem, it is important to follow the American Academy of Dermatology Special Positioning Workgroup\'s core areas of impact regarding treatment of conditions that affect millions of patients by using a team-based approach and telemedicine technologies...
February 2018: Rural and Remote Health
Robert J Graham, Michael L McManus, Angie Mae Rodday, Ruth Ann Weidner, Susan K Parsons
OBJECTIVE: To describe program design, costs, and savings implications of a critical care-based care coordination model for medically complex children with chronic respiratory failure. DESIGN: All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data...
February 3, 2018: Pediatric Critical Care Medicine
L Brazionis, A Jenkins, A Keech, C Ryan, A Brown, J Boffa, S Bursell
AIM: To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. METHODS: A cross-sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted by locally trained non-ophthalmic retinal imagers in a remote Aboriginal community-controlled primary healthcare clinic in Central Australia and certified non-ophthalmic graders in a retinal grading centre in Melbourne, Australia. The main outcome measure was prevalence of any diabetic retinopathy and sight-threatening diabetic retinopathy...
February 6, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Donna Lee Armaignac, Anshul Saxena, Muni Rubens, Carlos A Valle, Lisa-Mae S Williams, Emir Veledar, Louis T Gidel
OBJECTIVES: To determine whether Telemedicine intervention can affect hospital mortality, length of stay, and direct costs for progressive care unit patients. DESIGN: Retrospective observational. SETTING: Large healthcare system in Florida. PATIENTS: Adult patients admitted to progressive care unit (PCU) as their primary admission between December 2011 and August 2016 (n = 16,091). INTERVENTIONS: Progressive care unit patients with telemedicine intervention (telemedicine PCU [TPCU]; n = 8091) and without telemedicine control (nontelemedicine PCU [NTPCU]; n = 8000) were compared concurrently during study period...
February 1, 2018: Critical Care Medicine
Anna Beth Barton, Daniel E Okorodudu, Hayden B Bosworth, Matthew J Crowley
BACKGROUND: Treatment nonadherence and clinical inertia perpetuate poor cardiovascular disease (CVD) risk factor control. Telemedicine interventions may counter both treatment nonadherence and clinical inertia. INTRODUCTION: We explored why a telemedicine intervention designed to reduce treatment nonadherence and clinical inertia did not improve CVD risk factor control, despite enhancing treatment adherence versus usual care. METHODS: In this analysis of a randomized trial, we studied recipients of the 12-month telemedicine intervention...
January 17, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Sydney L Littauer, Dave L Dixon, Vimal K Mishra, Evan M Sisson, Teresa M Salgado
Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up telephone calls) and to highlight the main areas of chronic-disease management where these models have been applied...
October 2017: Pharmacy Practice
Stefan Thomas Kotzian, Angela Schwarzinger, Sandra Haider, Bernd Saletu, Josef Spatt, Michael Timothy Saletu
INTRODUCTION: Meta-analyses report that more than 50% of patients who had a stroke suffer from moderate to severe sleep apnoea (SA), with adherence rates to positive airway pressure (PAP) therapy of only 30%. The primary objective of this study is to determine whether PAP adherence in patients who had a stroke with obstructive sleep apnoea (OSA) can be improved by a PAP training strategy during inhospital rehabilitation combined with a telemedicine monitoring system after discharge. Further objectives are (1) to compare the validity of a non-attended level-III polygraphy with that of a level-II polysomnography (PSG) in the diagnosis of SA, (2) to compare the validity of an apnoea-hypopnoea index (AHI) yielded by the PAP device with that obtained during PSG, (3) to determine changes in nocturnal systolic blood pressure (BP) due to PAP therapy with the pulse transit time (PTT) method and (4) to assess the impact of telemonitored PAP therapy on neurorehabilitation outcome parameters...
January 9, 2018: BMJ Open
Danny Epstein, Neta Petersiel, Erez Klein, Erez Marcusohn, Eyal Aviran, Reut Harel, Zaher S Azzam, Ami Neuberger, Lior Fuchs
BACKGROUND: In the developing world, only a small minority of patients have access to radiological services. Over the past decade, technological developments of ultrasound equipment have led to the emergence of point-of-care ultrasonography (POCUS), which is widely used by healthcare professionals of nearly all specialties. We hypothesized that physicians with only basic POCUS training, but with telemedicine support, can use POCUS successfully in rural hospitals in sub-Saharan Africa...
January 6, 2018: Travel Medicine and Infectious Disease
Ulla Tangermann, Kim-Sarah Kleij, Christian Krauth, Volker Eric Amelung
OBJECTIVE OF THE STUDY: One of the central challenges in health policy is to ensure nationwide provision of primary healthcare services. However, it is not clear how the general public rates the current primary healthcare provision in their region. Furthermore, there is very little information on whether people are willing to make use of new models of care that could contribute to ensuring a nationwide provision of healthcare services. Thus, the objective of this study was to analyse the general public's ratings of the local primary healthcare provision as well as their acceptance of selected new models of care...
January 5, 2018: Das Gesundheitswesen
Gretchen A Benson, Abbey Sidebottom, Arthur Sillah, Jackie L Boucher, Michael D Miedema, Thomas Knickelbine, Jeffrey J VanWormer
Introduction Innovative care delivery programs that support primary care providers are needed to reduce the burden of cardiovascular disease (CVD). HeartBeat Connections (HBC) is a primary prevention telemedicine program utilizing registered dietitian nutritionists (RDNs) and registered nurses (RNs) to deliver health coaching and medication therapy protocols for dyslipidaemia and hypertension among patients at high risk for developing CVD. Methods This retrospective cohort study documents the reach and six-month effectiveness of the HBC program for improving CVD risk factors...
January 1, 2017: Journal of Telemedicine and Telecare
Marc Van De Rijn, Sabrina Paganoni, Mark Levine-Weinberg, Katharine Campbell, Amy Swartz Ellrodt, Juan Estrada, Adam B Cohen, Lee H Schwamm, James D Berry
OBJECTIVE: Telemedicine using video televisits is emerging as a means to provide care directly to patients. Here we report our experience using video televisits to provide follow-up care as a part of the Massachusetts General Hospital (MGH) Telemedicine for People with ALS (TelePALS) initiative. METHODS: This was a retrospective chart review of all video televisit encounters conducted by the MGH ALS clinic between September 2014 and January 2016. RESULTS: A total of 97 distinct ALS patients were seen using video televisits...
December 18, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
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