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telemedicine "primary care"

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
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
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
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
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 & AIMS: The Department of Veterans Affairs (VA) 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 (PCPs). The VA-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 PCP participation in VA-ECHO was associated with hepatitis C treatment and sustained virologic response...
December 17, 2016: American Journal of Medicine
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
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
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
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...
December 2016: Research in Nursing & Health
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
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
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
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
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...
November 2016: Prehospital Emergency Care
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
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
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
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
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
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