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https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#1
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28423156/creation-of-an-internal-teledermatology-store-and-forward-system-in-an-existing-electronic-health-record-a-pilot-study-in-a-safety-net-public-health-and-hospital-system
#2
Zachary A Carter, Shauna Goldman, Kristen Anderson, Xiaxiao Li, Linda S Hynan, Benjamin F Chong, Arturo R Dominguez
Importance: External store-and-forward (SAF) teledermatology systems operate separately from the primary health record and have many limitations, including care fragmentation, inadequate communication among clinicians, and privacy and security concerns, among others. Development of internal SAF workflows within existing electronic health records (EHRs) should be the standard for large health care organizations for delivering high-quality dermatologic care, improving access, and capturing other telemedicine benchmark data...
April 19, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28406066/telemedicine-consultation-for-patients-with-diabetes-mellitus-a-cluster-randomised-controlled-trial
#3
Ajay Sood, Sharon A Watts, Julie K Johnson, Stacey Hirth, David C Aron
Introduction There is a widening discrepancy between the increasing number of patients with diabetes mellitus and the health care resources available to manage these patients. Telemedicine has been used in a number of instances to improve and deliver health care where traditional care delivery methods may encounter difficulty. We conducted a cluster randomised controlled trial of telemedicine consultation to manage patients with diabetes mellitus. Methods Eleven primary care centres attached to one Veteran Administration tertiary care centre were randomised to provide patients with diabetes consultation referral either by usual consultation in diabetes clinic or telemedicine consultations via videoconference...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28375821/new-delivery-model-for-rising-risk-patients-the-forgotten-lot
#4
Lauren Cheung, Justin Norden, Robert A Harrington, Sumbul A Desai
BACKGROUND: Shared-risk models encourage providers to engage young patients early. Telemedicine may be well suited for younger, healthier patients although it is unclear how best to incorporate telemedicine into routine clinical care. INTRODUCTION: We test the assumptions surrounding the use of telemedicine, younger and rising-risk patients, and primary care in ClickWell Care (CWC), a care model developed at our institution for our own accountable care organization...
April 4, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28324938/application-of-semi-supervised-deep-learning-to-lung-sound-analysis
#5
Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher
The analysis of lung sounds, collected through auscultation, is a fundamental component of pulmonary disease diagnostics for primary care and general patient monitoring for telemedicine. Despite advances in computation and algorithms, the goal of automated lung sound identification and classification has remained elusive. Over the past 40 years, published work in this field has demonstrated only limited success in identifying lung sounds, with most published studies using only a small numbers of patients (typically N<;20) and usually limited to a single type of lung sound...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28300993/the-use-of-the-primary-care-assessment-tool-pcat-an-integrative-review-and-proposed-update
#6
Otávio Pereira D'Avila, Luiz Felipe da Silva Pinto, Lisiane Hauser, Marcelo Rodrigues Gonçalves, Erno Harzheim
This study proposes an integrative review of the literature based on articles and publications on the use of the Primary Care Assessment Tool (PCAT) as a tool for evaluating these services, discussing the results found in Brazil and in other countries of the world, from the initial matrix conceived by Professor Barbara Starfield's team and proposing updates for the Brazilian version. We identified 124 studies, of which 42 were selected after full reading and according to the established inclusion criteria. Of this subtotal, 17 (40...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28226619/application-of-semi-supervised-deep-learning-to-lung-sound-analysis
#7
Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher, Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher, Vivek Miglani, Daniel Chamberlain, Richard Ribon Fletcher, Rahul Kodgule, Daniela Ganelin
The analysis of lung sounds, collected through auscultation, is a fundamental component of pulmonary disease diagnostics for primary care and general patient monitoring for telemedicine. Despite advances in computation and algorithms, the goal of automated lung sound identification and classification has remained elusive. Over the past 40 years, published work in this field has demonstrated only limited success in identifying lung sounds, with most published studies using only a small numbers of patients (typically N<;20) and usually limited to a single type of lung sound...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28183341/assessing-the-feasibility-of-ehealth-and-mhealth-a-systematic-review-and-analysis-of-initiatives-implemented-in-kenya
#8
REVIEW
Martin Njoroge, Dejan Zurovac, Esther A A Ogara, Jane Chuma, Doris Kirigia
BACKGROUND: The growth of Information and Communication Technology in Kenya has facilitated implementation of a large number of eHealth projects in a bid to cost-effectively address health and health system challenges. This systematic review aims to provide a situational analysis of eHealth initiatives being implemented in Kenya, including an assessment of the areas of focus and geographic distribution of the health projects. The search strategy involved peer and non-peer reviewed sources of relevant information relating to projects under implementation in Kenya...
February 10, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28169119/reperfusion-therapy-of-myocardial-infarction-in-mexico-a-challenge-for-modern-cardiology
#9
Carlos Martínez-Sánchez, Alexandra Arias-Mendoza, Héctor González-Pacheco, Diego Araiza-Garaygordobil, Luis Alfonso Marroquín-Donday, Jorge Padilla-Ibarra, Carlos Sierra-Fernández, Alfredo Altamirano-Castillo, Amada Álvarez-Sangabriel, Francisco Javier Azar-Manzur, José Luis Briseño-de la Cruz, Salvador Mendoza-García, Yigal Piña-Reyna, Marco Antonio Martínez-Ríos
Mexico has been positioned as the country with the highest mortality attributed to myocardial infarction among the members of the Organization for Economic Cooperation and Development. This rate responds to multiple factors, including a low rate of reperfusion therapy and the absence of a coordinated system of care. Primary angioplasty is the reperfusion method recommended by the guidelines, but requires multiple conditions that are not reached at all times. Early pharmacological reperfusion of the culprit coronary artery and early coronary angiography (pharmacoinvasive strategy) can be the solution to the logistical problem that primary angioplasty rises...
February 3, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28056832/telemedicine-and-primary-care-obesity-management-in-rural-areas-innovative-approach-for-older-adults
#10
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/28002689/design-and-implementation-of-a-telepediatric-primary-level-and-low-cost-system-to-reduce-unnecessary-patient-transfers
#11
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
#12
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: The Department of Veterans Affairs 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. The Veterans Affairs 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 primary care provider participation in VA-ECHO was associated with hepatitis C treatment and sustained virologic response...
December 18, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27998380/the-past-is-prologue-the-future-of-sleep-medicine
#13
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...
January 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27909208/evaluation-of-a-national-telemedicine-initiative-in-the-veterans-health-administration-factors-associated-with-successful-implementation
#14
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
#15
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/27557039/mixed-methods-study-of-uptake-of-the-extension-for-community-health-outcomes-echo-telemedicine-model-for-rural-veterans-with-hiv
#16
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
#17
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
#18
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
#19
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
#20
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
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