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https://www.readbyqxmd.com/read/28611875/patient-perspectives-on-accessing-acute-illness-care
#1
Mary K Finta, Amy Borkenhagen, Nicole E Werner, Joyce Duckles, Craig R Sellers, Sandhya Seshadri, Denise Lampo, Manish N Shah
INTRODUCTION: Older adults use the emergency department (ED) at high rates, including for illnesses that could be managed by their primary care providers (PCP). Policymakers have implemented barriers and incentives, often financial, to try to modify use patterns but with limited success. This study aims to understand the factors that influence older adults' decision to obtain acute illness care from the ED rather than from their PCPs. METHODS: We performed a qualitative study using a directed content analysis approach from February to October 2013...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28559226/physician-s-perceptions-of-telemedicine-in-hiv-care-provision-a-cross-sectional-web-based-survey
#2
Kelly Anderson, Troy Francis, Francisco Ibanez-Carrasco, Jason Globerman
BACKGROUND: Telemedicine, or electronic interactive health care consultation, offers a variety of benefits to both patients and primary care clinicians. However, little is known about the opinions of physicians using these modalities. OBJECTIVE: The aim of this study was to examine physician perceptions, including challenges, risks, and benefits of the use of telemedicine in human immunodeficiency virus (HIV) patient care. METHODS: A Web-based, self-administered, anonymous, cross-sectional survey was sent to physicians known to be providing medical care to patients living with HIV in Ontario, Canada...
May 30, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/28545514/a-coordinated-pcp-cardiologist-telemedicine-model-pctm-in-china-s-community-hypertension-care-study-protocol-for-a-randomized-controlled-trial
#3
Lei Xu, Wei-Yi Fang, Fu Zhu, Hong-Guang Zhang, Kai Liu
BACKGROUND: Hypertension is a major risk factor for cardiovascular disease, and its control rate has remained low worldwide. Studies have found that telemonitoring blood pressure (BP) helped control hypertension in randomized controlled trials. However, little is known about its effect in a structured primary care model in which primary care physicians (PCPs) are partnering with cardiology specialists in electronic healthcare data sharing and medical interventions. This study aims to identify the effects of a coordinated PCP-cardiologist model that applies telemedicine tools to facilitate community hypertension control in China...
May 25, 2017: Trials
https://www.readbyqxmd.com/read/28545402/regional-variations-of-perceived-problems-in-ambulatory-care-from-the-perspective-of-general-practitioners-and-their-patients-an-exploratory-focus-group-study-in-urban-and-rural-regions-of-northern-germany
#4
H Hansen, N J Pohontsch, L Bole, I Schäfer, M Scherer
BACKGROUND: Patients from rural and urban regions should have equitable access to health care. In Germany, the physician-patient-ratio and the supply of medical services vary greatly between urban and rural areas. The aim of our study was to explore the regional variations of the perceived health care problems in ambulatory care from the perspective of affected professionals and laypersons i.e. general practitioners and their patients. METHODS: We conducted 27 focus groups with general practitioners (n = 65) and patients (n = 145) from urban areas, environs and rural areas in northern Germany...
May 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28521796/effects-of-nurse-telesupport-on-transition-between-specialized-and-primary-care-in-diabetic-patients-study-protocol-for-a-randomized-controlled-trial
#5
Ana Marina Moreira, Roberta Marobin, Dimitris Varvaki Rados, Camila Bergonsi de Farias, Sabrina Coelli, Bárbara Luiza Bernardi, Lívia de Almeida Faller, Laura Ferraz Dos Santos, Ana Maria Matzenbacher, Natan Katz, Erno Harzheim, Sandra Pinho Silveiro
BACKGROUND: According to the Global Diabetes Plan, a unified health system with preventive and educational strategies is essential to proper diabetes care and primary settings should be the main site of care. In Brazil, there is limited access to outpatient hospital diabetes services, while primary-care diabetes support is underutilized. Telemedicine can be a useful adjunct to support discharge of stable patients with type 2 diabetes to the primary care setting. In this paper, we present a randomized controlled trial (RCT) protocol designed to evaluate the effects of telehealth support for stable type 2 diabetes patients discharged from hospital outpatient diabetes clinics...
May 18, 2017: Trials
https://www.readbyqxmd.com/read/28520876/geographic-information-systems-mapping-of-diabetic-retinopathy-in-an-ocular-telemedicine-network
#6
Pooja D Jani, Lauren Forbes, Philip McDaniel, Anthony Viera, Seema Garg
Importance: Minimal information exists on the use of geographic information systems mapping for visualizing access barriers to eye care for patients with diabetes. Objective: To use geographic information systems mapping techniques to visualize (1) the locations of patients participating in the North Carolina Diabetic Retinopathy Telemedicine Network, (2) the locations of primary care clinicians and ophthalmologists across the state, and (3) the travel times associated with traveling to the 5 primary care clinics in our study...
May 18, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28520833/evaluation-of-diabetic-retinal-screening-and-factors-for-ophthalmology-referral-in-a-telemedicine-network
#7
Pooja D Jani, Lauren Forbes, Arkopal Choudhury, John S Preisser, Anthony J Viera, Seema Garg
Importance: Retinal telescreening for evaluation of diabetic retinopathy (DR) in the primary care setting may be useful in reaching rural and underserved patients. Objectives: To evaluate telemedicine retinal screenings for patients with type 1 or 2 diabetes and identify factors for ophthalmology referral in the North Carolina Diabetic Retinopathy Telemedicine Network. Design, Setting, and Participants: A preimplementation and postimplementation evaluation was conducted from January 6, 2014, to November 1, 2015, at 5 primary care clinics serving rural and underserved populations in North Carolina among 1787 adult patients with type 1 or 2 diabetes who received primary care at the clinics and obtained retinal telescreening to determine the presence and severity of DR...
May 18, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28484946/rural-asthma-current-understanding-of-prevalence-patterns-and-interventions-for-children-and-adolescents
#8
REVIEW
Robin Dawson Estrada, Dennis R Ownby
PURPOSE OF REVIEW: Asthma is the most common chronic illness of children and adolescents in the USA. While asthma has been understood to disproportionately affect urban dwellers, recent investigations have revealed rural pediatric asthma prevalence to be very similar to urban and to be more closely correlated with socioeconomic and environmental factors than geographic location or population density. RECENT FINDINGS: Rural children experience factors unique to location that impact asthma development and outcomes, including housing quality, cigarette smoke exposure, and small/large-scale farming...
June 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
April 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
#18
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
#19
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...
June 2017: 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
#20
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...
April 2017: American Journal of Medicine
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