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https://www.readbyqxmd.com/read/27909208/evaluation-of-a-national-telemedicine-initiative-in-the-veterans-health-administration-factors-associated-with-successful-implementation
#1
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/27726962/cost-effectiveness-of-a-national-telemedicine-diabetic-retinopathy-screening-program-in-singapore
#2
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
https://www.readbyqxmd.com/read/27557039/mixed-methods-study-of-uptake-of-the-extension-for-community-health-outcomes-echo-telemedicine-model-for-rural-veterans-with-hiv
#3
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
https://www.readbyqxmd.com/read/27545591/a-community-engaged-assessment-of-barriers-and-facilitators-to-rapid-stroke-treatment
#4
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...
December 2016: Research in Nursing & Health
https://www.readbyqxmd.com/read/27472158/determinants-of-the-intention-to-use-telemedicine-evidence-from-primary-care-physicians
#5
Francesc Saigi-Rubió, Ana Jiménez-Zarco, Joan Torrent-Sellens
OBJECTIVES: While most studies have focused on analyzing the results of telemedicine use, it is crucial to consider the determinants of its use to fully understand the issue. This article aims to provide evidence on the determinants of telemedicine use in clinical practice. METHODS: The survey targeted a total population of 398 medical professionals from a healthcare institution in Spain. The study sample was formed by the ninety-three primary care physicians who responded...
January 2016: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/27467293/a-man-with-worsening-gastrointestinal-and-neurologic-symptoms
#6
David Irving
A Coast Guardsman deployed to a remote island in the Bahamas contacted his primary care office about worsening gastrointestinal and neurologic complaints. This article describes the telemedicine consultation to determine the cause of his symptoms, whether he needed emergency evacuation, and how treatment was handled.
August 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27430301/telemedicine-versus-standard-follow-up-care-for-diabetes-related-foot-ulcers-protocol-for-a-cluster-randomized-controlled-noninferiority-trial-diafoto
#7
Marjolein M Iversen, Birgitte Espehaug, Marie F Hausken, Marit Graue, Truls Østbye, Svein Skeie, John G Cooper, Grethe S Tell, Bodo Erhardt Günther, Håvard Dale, Hilde Smith-Strøm, Beate-Christin H Kolltveit, Marit Kirkevold, Berit Rokne
BACKGROUND: This paper presents the protocol for an ongoing study to evaluate a telemedicine follow-up intervention for patients with diabetes-related foot ulcers. Diabetes-related foot ulcers represent challenges for patients and the health services. The large increase in the prevalence of diabetes, combined with the aging population, means that the absolute number of patients with diabetes-related foot ulcers is likely to continue to increase. Health care services therefore need to provide close clinical follow-up care for people with diabetes both in primary and specialist care...
July 18, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27387752/telemedicine-supported-transition-of-stable-coronary-artery-disease-patients-from-tertiary-to-primary-health-care-facilities-protocol-for-a-randomized-non-inferiority-trial
#8
Joanna d'Arc Lyra Batista, Mariana Vargas Furtado, Natan Katz, Milena Rodrigues Agostinho, Brasil Silva Neto, Erno Harzheim, Carisi Anne Polanczyk
BACKGROUND: Many Brazilian patients with complex diseases who are treated in tertiary referral clinics have been stable for long periods. The main needs of these patients involve monitoring of risk factors and review of drug prescriptions, which could be satisfactorily done in primary care facilities. The goal of this protocol is to evaluate the safety and effectiveness of telemedicine services to support the transition of patients with stable chronic coronary artery disease from the tertiary to the primary level of care...
July 7, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27232532/patient-perspectives-on-ems-alternate-destination-models
#9
Kevin G Munjal, Siri Shastry, George T Loo, Daniel Reid, Corita Grudzen, Manish N Shah, Hugh H Chapin, Brandon First, Sasilada Sirirungruang, Erin Alpert, Kevin Chason, Lynne D Richardson
INTRODUCTION: Studies have shown that a large number of ambulance transports to emergency departments (ED) could have been safely treated in an alternative environment, prompting interest in the development of more patient-centered models for prehospital care. We examined patient attitudes, perspectives, and agreement/comfort with alternate destinations and other proposed innovations in Emergency Medical Services (EMS) care delivery and determined whether demographic, socioeconomic, acuity, and EMS utilization history factors impact levels of agreement...
May 27, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27180232/choice-transparency-coordination-and-quality-among-direct-to-consumer-telemedicine-websites-and-apps-treating-skin-disease
#10
Jack S Resneck, Michael Abrouk, Meredith Steuer, Andrew Tam, Adam Yen, Ivy Lee, Carrie L Kovarik, Karen E Edison
IMPORTANCE: Evidence supports use of teleconsultation for improving patient access to dermatology. However, little is known about the quality of rapidly expanding direct-to-consumer (DTC) telemedicine websites and smartphone apps diagnosing and treating skin disease. OBJECTIVE: To assess the performance of DTC teledermatology services. DESIGN AND PARTICIPANTS: Simulated patients submitted a series of structured dermatologic cases with photographs, including neoplastic, inflammatory, and infectious conditions, using regional and national DTC telemedicine websites and smartphone apps offering services to California residents...
July 1, 2016: JAMA Dermatology
https://www.readbyqxmd.com/read/27165979/improving-the-effectiveness-and-efficiency-of-outpatient-services-a-scoping-review-of-interventions-at-the-primary-secondary-care-interface
#11
Eleanor M Winpenny, Céline Miani, Emma Pitchforth, Sarah King, Martin Roland
OBJECTIVES: Variation in patterns of referral from primary care can lead to inappropriate overuse or underuse of specialist resources. Our aim was to review the literature on strategies involving primary care that are designed to improve the effectiveness and efficiency of outpatient services. METHODS: A scoping review to update a review published in 2006. We conducted a systematic literature search and qualitative evidence synthesis of studies across five intervention domains: transfer of services from hospital to primary care; relocation of hospital services to primary care; joint working between primary care practitioners and specialists; interventions to change the referral behaviour of primary care practitioners and interventions to change patient behaviour...
May 10, 2016: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/27159772/prehospital-imaging-based-triage-of-head-trauma-with-a-mobile-stroke-unit-first-evidence-and-literature-review
#12
L Schwindling, A Ragoschke-Schumm, M Kettner, S Helwig, M Manitz, S Roumia, M Lesmeister, I Q Grunwald, K Fassbender
BACKGROUND: An ambulance equipped with a computed tomography (CT) scanner, point-of-care laboratory, and telemedicine capabilities (Mobile Stroke Unit [MSU]) has been shown to enable delivery of thrombolysis to stroke patients at the emergency site, thereby significantly decreasing time to treatment. However, the MSU frequently assesses patients with cerebral disorders other than stroke. For some of these disorders, prehospital CT scanning may also be beneficial. METHODS: Our institution manages a program investigating prehospital stroke treatment of patients with neurological emergencies...
September 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27132754/-implementation-of-a-clinical-practice-guidelines-for-the-management-of-adults-with-schizophrenia-in-colombia
#13
Natalia Sánchez Díaz, Andrés Duarte Osorio, Carlos Gómez Restrepo, Adriana Patricia Bohórquez Peñaranda
OBJECTIVES: To present overall strategies and activities for the implementation process of the recommendations contained in the clinical practice guideline for the management of adults with schizophrenia (GPC_E) published by the Colombian Ministry of Health and Welfare (MSPS). Prioritize the proposed recommendations, identify barriers and solving strategies to implement the GPC_E, and develop a monitoring and evaluation system for the key recommendations. METHOD: The Guideline Developer Group (GDG) included professionals with primary dedication to implementation issues that accompanied the entire process...
April 2016: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/27128779/the-empirical-foundations-of-telemedicine-interventions-in-primary-care
#14
Rashid L Bashshur, Joel D Howell, Elizabeth A Krupinski, Kathryn M Harms, Noura Bashshur, Charles R Doarn
INTRODUCTION: This article presents the scientific evidence for the merits of telemedicine interventions in primary care. Although there is no uniform and consistent definition of primary care, most agree that it occupies a central role in the healthcare system as first contact for patients seeking care, as well as gatekeeper and coordinator of care. It enables and supports patient-centered care, the medical home, managed care, accountable care, and population health. Increasing concerns about sustainability and the anticipated shortages of primary care physicians have sparked interest in exploring the potential of telemedicine in addressing many of the challenges facing primary care in the United States and the world...
May 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27099651/extension-for-community-health-outcomes-hepatitis-c-small-steps-carve-big-footprints-in-the-allocation-of-scarce-resources-for-hepatitis-c-virus-treatment-to-remote-developing-areas
#15
REVIEW
Veysel Tahan, Ashraf Almashhrawi, Ali M Kahveci, Rachel Mutrux, Jamal A Ibdah
Hepatitis C virus (HCV) infection is still a major health problem throughout the world. HCV patients living in rural areas are less fortunate than their counterparts residing in populous urbanized regions. The lack of medical resources and properly trained medical personnel in rural regions make it especially burdensome for HCV patients seeking treatment. Dr. Sanjeev Arora at the University of New Mexico Health Sciences Center took initiative to resolve the issue at hand by developing a model named Project Extension for Community Health Outcomes (ECHO)...
April 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27096384/telehealth-in-rio-grande-do-sul-brazil-bridging-the-gaps
#16
Erno Harzheim, Marcelo Rodrigues Gonçalves, Roberto Nunes Umpierre, Ana Célia da Silva Siqueira, Natan Katz, Milena R Agostinho, Elise B Oliveira, Josué Basso, Rudi Roman, Rafael G Dal Moro, Carlos Pilz, Ricardo S Heinzelmann, Carlos André Aita Schmitz, Lisiane Hauser, Sotero Serrate Mengue
INTRODUCTION: In 1988, Brazil adopted a universal healthcare model in which access is mediated by the primary care level. However, difficulties have emerged in the coordination of care between the primary and specialized levels. Telehealth was thus proposed as a means to overcome this challenge. This article describes initiatives developed by a large Brazilian program, TelessaúdeRS/UFRGS, in the fields of teleconsultation, telediagnosis, tele-education, and information technology development to support the public healthcare system...
April 20, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27091459/telemedicine-in-diabetes-foot-care-delivery-health-care-professionals-experience
#17
Beate-Christin Hope Kolltveit, Eva Gjengedal, Marit Graue, Marjolein M Iversen, Sally Thorne, Marit Kirkevold
BACKGROUND: Introducing new technology in health care is inevitably a challenge. More knowledge is needed to better plan future telemedicine interventions. Our aim was therefore to explore health care professionals' experience in the initial phase of introducing telemedicine technology in caring for people with diabetic foot ulcers. METHODS: Our methodological strategy was Interpretive Description. Data were collected between 2014 and 2015 using focus groups (n = 10)...
April 18, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/26972954/a-systematic-review-of-interventions-targeting-primary-care-or-community-based-professionals-on-cardio-metabolic-risk-factor-control-in-people-with-diabetes
#18
S Seidu, N S Walker, D H Bodicoat, M J Davies, K Khunti
OBJECTIVE: To review the interventions targeting primary care or community based professionals on glycaemic and cardiovascular risk factor control in people with diabetes. RESEARCH DESIGN AND METHODS: A systematic review of randomised controlled trials evaluating the effectiveness of interventions targeting primary care or community based professionals on diabetes and cardiovascular risk factor control. We conducted searches in MEDLINE database from inception up to 27th September 2015...
March 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/26959098/primary-care-team-members-report-greater-individual-benefits-from-long-versus-short-term-specialty-telemedicine-mentorship
#19
Lauren A Beste, Elizabeth A Mattox, Raimund Pichler, Bessie A Young, David H Au, Susan F Kirsh, Maureen W Germani, Ashley Hedeen, Bonnie K Harp, Michael F Chang
BACKGROUND: Primary care providers who participate in structured specialty telemedicine mentorship report improvements in clinical content mastery, professional satisfaction, and specialist communication. INTRODUCTION: Although these programs require investments of infrastructure resources and time, the duration of participation required to accrue optimal benefits is not known. We aimed to assess whether duration of participation is related to improved benefits of a longitudinal telemedicine-based mentorship program, specifically regarding perceived specialty care access, acquisition of new knowledge and skills, team integration, and overall job satisfaction...
August 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/26942359/medication-abortion-through-telemedicine-implications-of-a-ruling-by-the-iowa-supreme-court
#20
REVIEW
Y Tony Yang, Katy B Kozhimannil
In summer 2015, the Iowa Supreme Court unanimously struck down a restriction that would have prevented physicians from administering a medication abortion remotely through video teleconferencing. In its ruling, the Iowa Supreme Court stated that the restriction would have placed an undue burden on a woman's right to access abortion services. It is crucially important for clinicians--especially primary care clinicians, obstetrician-gynecologists (ob-gyns), and all health care providers of telemedicine services--to understand the implications of this recent ruling, especially in rural settings...
February 2016: Obstetrics and Gynecology
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