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telehealth "primary care"

Diane M Flynn, Linda H Eaton, Honor McQuinn, Ashley Alden, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos
Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation...
December 2017: Contemporary Clinical Trials Communications
Leah L Zullig, Felicia McCant, Mina Silberberg, Fred Johnson, Bradi B Granger, Hayden B Bosworth
Relatively few successful medication adherence interventions are translated into real-world clinical settings. The Prevention of Cardiovascular Outcomes in African Americans with Diabetes (CHANGE) intervention was originally conceived as a randomized controlled trial to improve cardiovascular disease-related medication adherence and health outcomes. The purpose of the study was to describe the translation of the CHANGE trial into two community-based clinical programs. CHANGE 2 was available to Medicaid patients with diabetes and hypertension whose primary care homes were part of a care management network in the Northern Piedmont region of North Carolina...
March 1, 2018: Translational Behavioral Medicine
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
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
Dhanashri D Kohok, Jason J Sico, Fitsum Baye, Laura Myers, Jessica Coffing, Masoor Kamalesh, Dawn M Bravata
Many ischemic stroke patients do not achieve goal blood pressure (BP < 140/90 mm Hg). To identify barriers to post-stroke hypertension management, we examined healthcare utilization and BP control in the year after index ischemic stroke admission. This retrospective cohort study included patients admitted for acute ischemic stroke to a VA hospital in fiscal year 2011 and who were discharged with a BP ≥ 140/90 mm Hg. One-year post-discharge, BP trajectories, utilization of primary care, specialty and ancillary services were studied...
February 2018: Journal of Clinical Hypertension
Claudia Der-Martirosian, Anne R Griffin, Karen Chu, Aram Dobalian
Background Like other integrated health systems, the US Department of Veterans Affairs has widely implemented telehealth during the past decade to improve access to care for its patient population. During major crises, the US Department of Veterans Affairs has the potential to transition healthcare delivery from traditional care to telecare. This paper identifies the types of Veterans Affairs telehealth services used during Hurricane Sandy (2012), and examines the patient characteristics of those users. Methods This study conducted both quantitative and qualitative analyses...
January 1, 2018: Journal of Telemedicine and Telecare
Gregory J Norman, Kristann Orton, Amy Wade, Andrea M Morris, Jill C Slaboda
BACKGROUND: Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC...
January 27, 2018: BMC Health Services Research
Emily Gard Marshall, Sacha Nadeau, Beverly Lawson, Richard J Gibson, Imhokhai Ogah
OBJECTIVES: To determine whether socio-economic status (SES) and presence of a chronic condition are associated with the response a prospective patient receives when seeking a family physician (FP). METHODS: Scripted telephone calls (indicating higher or lower SES and presence or absence of a chronic condition) were made to all 327 FP offices in Nova Scotia (NS) requesting an appointment. The main outcome measures were the responses to callers seeking a FP: being accepted for an appointment or being offered further assistance if not accepted (e...
January 22, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Mary Paterson, Alison McAulay, Brian McKinstry
BACKGROUND: The implementation of telemonitoring at scale has been less successful than anticipated, often hindered by clinicians' perceived increase in workload. One important factor has been the lack of integration of patient generated data (PGD) with the electronic medical record (EMR). Clinicians have had problems accessing PGD on telehealth systems especially in patient consultations in primary care. OBJECTIVE: To design a method to produce a report of PGD that is available to clinicians through their routine EMR system...
November 17, 2017: Journal of Innovation in Health Informatics
Andrew S Winburn, Juliana J Brixey, James Langabeer, Tiffany Champagne-Langabeer
Objective There has been moderate evidence of telehealth utilization in the field of emergency medicine, but less is known about telehealth in prehospital emergency medical services (EMS). The objective of this study is to explore the extent, focus, and utilization of telehealth for prehospital emergency care through the analysis of published research. Methods The authors conducted a systematic literature review by extracting data from multiple research databases (including MEDLINE/PubMed, CINAHL Complete, and Google Scholar) published since 2000...
January 1, 2017: Journal of Telemedicine and Telecare
R Kulkarni
Advances in technology such as telemedicine (TM) have made access to cost-effective, quality health care feasible for remote patients. TM is especially well suited for patients with chronic disorders such as haemophilia and related haemostatic disorders that benefit not only from more frequent interaction with care providers at a specialized haemophilia treatment center but also from consultations with other specialists. Telehealth refers to a broader application of TM and includes non-clinical services such as education, provider training, administrative meetings etc...
January 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Linda H Eaton, Dale J Langford, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos
Individuals with chronic pain who live in rural communities often lack access to pain specialists and rely on primary care providers who may be less prepared. Research has indicated that rural residents with chronic pain are more likely to receive an opioid prescription than nonrural residents. Although self-management approaches are available for chronic pain management, it is unclear to what extent rural residents use these interventions. This study compares usage of self-management interventions and opioid-based analgesics for chronic pain management between rural and nonrural residents...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Milena Soriano Marcolino, Thales Matheus Mendonça Santos, Fernanda Cotrim Stefanelli, João Antonio de Queiroz Oliveira, Maíra Viana Rego Souza E Silva, Diomildo Ferreira Andrade, Grace Kelly Matos E Silva, Antonio Luiz Ribeiro
BACKGROUND: Electrocardiograms (ECGs) are an essential examination for identification and management of cardiovascular emergencies.The aim of this study was to report on the frequency and recognition of cardiovascular emergencies in primary care units. DESIGN AND SETTING: Observational retrospective study assessing consecutive patients whose digital ECGs were sent for analysis to the team of the Telehealth Network of Minas Gerais. METHODS: Data from patients diagnosed with cardiological emergencies in the primary care setting of 750 municipalities in Minas Gerais, Brazil, between March and September 2015, were collected via telephone contact with the healthcare practitioner who performed the ECG...
September 2017: São Paulo Medical Journal, Revista Paulista de Medicina
Zachary Pancer, Malcolm Moore, John T Wenham, Maelynn Burridge
OBJECTIVE: To examine clinical service activity amongst patients of the Royal Flying Doctor Service South Eastern Section in Far West New South Wales and to evaluate the management of chronic disease among frequent users of evacuation services. DESIGN: A retrospective audit of the Royal Flying Doctor Service South Eastern Section patient database inclusive of patients within the geographical study area who accessed a clinical or remote consultation, or evacuation service at least once between 1 July 2008 and 30 June 2013...
November 8, 2017: Australian Journal of Rural Health
Lori Raney, David Bergman, John Torous, Michael Hasselberg
PURPOSE OF REVIEW: Widespread implementation of integrated primary care and behavioral health is possible, but workforce shortages, competencies to deliver evidence-based approaches, and sufficient reimbursement are lacking. There are numerous telehealth solutions that could be utilized to assist with integration efforts that have the potential to be successfully used alone or in combination. This will require that the developers of such technologies understand the current evidence base for effective integration efforts and apply this knowledge to new solutions...
September 30, 2017: Current Psychiatry Reports
James Shaw, Trevor Jamieson, Payal Agarwal, Bailey Griffin, Ivy Wong, R Sacha Bhatia
Background The development of new virtual care technologies (including telehealth and telemedicine) is growing rapidly, leading to a number of challenges related to health policy and planning for health systems around the world. Methods We brought together a diverse group of health system stakeholders, including patient representatives, to engage in policy dialogue to set health system priorities for the application of virtual care in the primary care sector in the Province of Ontario, Canada. We applied a nominal group technique (NGT) process to determine key priorities, and synthesized these priorities with group discussion to develop recommendations for virtual care policy...
January 1, 2017: Journal of Telemedicine and Telecare
Anuradha Jetty, Miranda A Moore, Megan Coffman, Stephen Petterson, Andrew Bazemore
BACKGROUND: Telehealth has the potential to reduce health inequities and improve health outcomes among rural populations through increased access to physicians, specialists, and reduced travel time for patients. INTRODUCTION: Although rural telehealth services have expanded in several specialized areas, little is known about the attitudes, beliefs, and uptake of telehealth use in rural American primary care. This study characterizes the differences between rural and urban family physicians (FPs), their perceptions of telehealth use, and barriers to further adoption...
August 14, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Charlotte Elizabeth Harrison, Karen Wild
Telehealth is a recent concept in hypertension management, and involves using electronic technology to monitor patients' vital signs, such as blood pressure, in their homes. This article presents the findings of a literature review that explored the issues associated with implementing telehealth in the primary care setting. It outlines the challenges associated with telehealth, as well as the potential benefits in terms of improving hypertension management. Aim To explore the usefulness of, and evidence for, telehealth in the management of hypertension in the primary care setting...
July 26, 2017: Nursing Standard
Malcolm Clarke, Joanna Fursse, Nancy E Brown-Connolly, Urvashi Sharma, Russell Jones
OBJECTIVE: To evaluate the cost-effectiveness of a pilot telehealth program applied to a wide population of patients with chronic obstructive pulmonary disease (COPD). DESIGN: Vital signs data were transmitted from the home of the patient on a daily basis using a patient monitoring system for review by community nurse to assist decisions on management. SETTING: Community services for patients diagnosed with COPD. PARTICIPANTS: Two Primary Care Trusts (PCTs) enrolled 321 patients diagnosed with COPD into the telehealth program...
January 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Jessica Hatton, Rachel Chandra, David Lucius, Elizabeth Ciuchta
PURPOSE: Patient satisfaction with the use of telehealth in disease state management provided by pharmacists has not been fully studied. We hypothesized that patient satisfaction with pharmacist-provided consultations via clinical video teleconferencing (CVT) would not differ from face-to-face delivery. METHODS: Patients were recruited from 2 primary care provider sites from September 2015 to May 2016. Patients completed a survey to evaluate their satisfaction and quality of provider-patient communication with the method in which consultation with a pharmacist was provided...
January 1, 2017: Journal of Pharmacy Practice
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