Recent Directions in Telemedicine: Review of Trends in Research and Practice.

PH Professional Network: The Benefits and Challenges in Delivering Telehealth in Pediatric Pulmonary Hypertension

NIH Launches Emergency Care Research Office: Coordinating Center Lauded but Challenges Noted

Most adults and children in the United States fail to receive timely care for mental health symptoms, with even worse rates of care access for individuals who belong to racial and ethnic minority groups. Digital (ie, app-based) care has proven to be an efficacious and empirically supported treatment option with the potential to address low rates of care and reduce care disparities, yet little is known about the relative preference for such treatment. Furthermore, the rapid adoption of telehealth care during the COVID-19 pandemic may have shifted care preferences. This study aimed to examine relative treatment preferences for 4 different types of mental health care: in-person psychological care, telehealth psychological care, digital treatment, or pharmacologic care. Care preferences were also examined relative to potential predictors of care use (ie, gender, race, age, stigma, discrimination, and level of shame). In this cross-sectional online survey study of adults (N=237, mean age 35 years, range 19-68 years), we ranked 4 mental health care modalities based on care preference: (1) in-person care, (2) telehealth care, (3) digital care, and (4) pharmacologic care. Preference for treatment modality was assessed based on vignette presentation for generalized anxiety disorder and insomnia. In addition, participants completed self-report questionnaires for demographics, symptom severity, and psychological and stigma-related variables. We found no difference in overall preference for in-person versus both telehealth and digital care. For both generalized anxiety disorder and insomnia, participants preferred in-person care to telehealth care, although this finding was attenuated amongst older participants for insomnia treatment. Participants' depressed mood was associated with a greater relative preference for pharmacologic care. There was no evidence of differential preference for digital care according to demographics, symptom severity, or psychological and stigma-related variables. These results indicate that digital care now competes well in terms of treatment preference with in-person, telehealth, and pharmacologic treatment options.

Purpose: This study sought to provide an overview of the main topics and trends in contemporary research on successful non-clinical interventions for preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs). Methods: A systematic electronic search (English and French) was performed in ten scientific databases using keywords and descriptors. After screening the identified titles and abstracts using specific sets of criteria, categorical and thematic analyses were performed on the retained articles. Results: Five main topics appear to dominate the research: (1) risk factors and determinants; (2) effectiveness of interventions (programmes, specific components, strategies and policies); (3) viewpoints, experiences and perceptions of specific actors involved in the intervention process; (4) compensation issues; and (5) measurement issues. A currently widespread trend is early screening to identify risks factors for appropriate intervention and multidisciplinary, multimodal approaches. Morover, workplace-related psychosocial and ergonomic factors are considered vital to the success and sustainability of return-to-work (RTW) interventions. Finally, involving workplace actors, and more specifically, affected workers, in the RTW process appears to be a powerful force in improving the chances of moving workers away from disabled status. Conclusions: The findings of this literature review provide with information about the main topics and trends in research on rehabilitation interventions, revealing some successful modalities of intervention aimed at preventing prolonged work disability.Implications for RehabilitationSuccessful intervention for preventing prolonged work disability in workers compensated for WRMSDs address workplace issues: physical and psychosocial demands at work, ability of the workers to fill these demands, work organization and support of the worker, and worker’ beliefs and attitudes related to work.Successful intervention promotes collaboration, coordination between all actors and stakeholders involved in the process of rehabilitation.Strategies able to mobilize the employees, employers, insurers and health care providers are still needed to be implemented.

Using bibliometric analysis, the objective of this study was to identify research hotspots and trends on multimorbidity and mental health in older adults. This could help guide future research on this topic. We searched the Web of Science Core Collection for eligible studies. Type of publications were not restricted and the timeframe was set between 2002 and 2022. Knowledge maps were created using CiteSpace to visualize publications, nations, journals, institutions, authors, cited references, and keywords. Microsoft Excel displayed pertinent tables. A total of 216 studies were collected for analysis. The annual publication over the past 20 years demonstrated an upward trend. The main contributors in publications were in North America, Europe, Asia, and Oceania, of which aging was a primary issue. However, collaboration between countries, institutions, and authors were relatively sparce. Cluster analysis and co-citation analysis of references and keywords revealed that the research field could be subdivided into four themes: social psychology as the fundamental disciplinary base, Prevalence of mental disorders and multimorbidity in older adults, pertinent health conditions, and effective interventions. Research trends at present lies in health status, risk factors of prognoses, and effective interventions for prevention and management. The results revealed a reciprocal risk relationship between mental health and multimorbidity. Mental disorders such as depression and anxiety in older adults with multimorbidity garnered considerable interest in the defined population, and further exploration is still promising. Substantial studies on evidence-based prevention and treatment strategies are warranted for improved prognoses.

Problem definition: This paper studies a multichannel healthcare system where physicians diagnose patients and prescribe treatment in-person or through asynchronous telemedicine (AT), a widely adopted yet relatively under-explored form of telemedicine. In collaboration with physicians at the Veterans Healthcare Administration (VHA), we examine the impact of introducing an AT channel on the existing in-person channel and on overall system performance. Methodology/results: VHA implemented AT at select clinics in the state of Georgia in 2012. Using a difference-in-differences design, we find that the introduction of the AT channel led to a sorting process whereby more complex patients were seen in the in-person channel. AT implementation led to a 20% increase in recommended visit time and an 8.5% increase in required clinical resources for in-person consultations. In addition, the adoption of AT resulted in higher throughput—more patients seen by the specialists per month across both channels. Using a fixed-effects model we find a reduction in average wait time for in-person referrals (37.5%), and for the most common medically necessary procedure (43%) despite an increase in the total number of consultations at the specialist clinic. We attribute the improved efficiency to early patient triage, better match between patient needs and treatment modality, and reduction of setup and switching costs in physicians’ workflow. Managerial implications: This paper contributes to our understanding of a rapidly expanding form of healthcare delivery: multichannel healthcare with in-person and AT channels. Our results suggest that healthcare managers and physicians can adopt AT to improve overall system efficiency. At the same time, they should take into account the additional impact of AT on the in-person channel when making capacity decisions and developing guidance on patient referrals. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0235 .

BackgroundResearch on Graves ophthalmopathy has increased remarkably over the last 2 decades; however, few statistical analyses of the data presented in these publications have been conducted.ObjectiveThis study aims to detect and analyze emerging trends and collaboration networks in Graves ophthalmopathy research.MethodsGraves ophthalmopathy–related publications from 1999 to 2019 were collected from the Web of Science Core Collection Database. Collected publications were restricted by category (article or review) and language (English). Bibliometric analyses included changes in the annual numbers of publications, journals, authors, countries, institutions, keywords, and references.ResultsIn total, 3051 publications that met the criteria were collected. The number of annual publications has exhibited an increasing trend over the last 20 years. The journal Thyroid ranked first, publishing 183 Graves ophthalmopathy–related studies. There was no evidence of a relationship between impact factor (IF) and the number of publications (P=.69). The author Smith TJ had the largest number of publications on Graves ophthalmopathy (n=83). Of the countries that had published Graves ophthalmopathy–related articles, the United States had the largest number (n=784) and the highest centrality (0.18). Among institutions, the University of Pisa (Italy) contributed the most Graves ophthalmopathy–related articles (n=114). The most recent burst keywords (proliferation, rituximab, and selenium) and references may provide clues on emerging trends in research and clinical practice.ConclusionsThis bibliometric analysis highlights countries, institutions, and authors who contributed to Graves ophthalmopathy–related publications. Emerging trends in Graves ophthalmopathy research, based on burst keywords and references, may provide clues relevant to clinical practice and future research.

The marital therapy literature through August, 1972, was content‐analyzed to examine trends in the research and clinical practice of marital therapists. Analyses of a 415‐item Marital Therapy Bibliography revealed that: (a) The literature experienced the beginning of its major growth spurt after 1960, with about half of the marital therapy publications appearing since 1967; (b) Journals contributing the most to the development of marital therapy form a heterogeneous mixture of professional disciplines, with multidisciplinary journals demonstrating the greatest impact; (c) The nature of much of marital therapy research and practice is rapidly changing, with a growing interest in empirical and methodological issues. Implications of these emerging trends in research and practice are discussed in terms of the future of marital therapy.

There is a current escalating need for telehealth (TH) options in family mental health services. In the absence of replicated evidence, TH guidelines from peak bodies are largely based on assumptions of the effectiveness of TH methods. New investments in TH would optimally be based in evidence of clinical efficacy. To this end, we conducted three studies in which we (1) systematically reviewed eight professional guidelines for TH family therapy, (2) examined replicated evidence for the efficacy of TH family therapy through systematic review of 20 studies and meta-analyses of 13 effects, and (3) synthesised clinical accommodations to TH methodology from a study of 12 experienced TH family therapists. The studies found (1) a predominant focus in existing TH guidelines on operational matters pertaining to TH and relative neglect of therapeutic process; (2) meta-analyses of efficacy for child behavioural problems (k = 8) and parental depression (k = 5) showed equivalent outcomes in TH and face-to-face therapy and enhanced outcomes in TH relative to treatment as usual, resource provision (i.e. written materials), or wait-list control. Narrative review of 20 studies for a range of relational and mental health outcomes aligned with these findings; and (3) therapists defined clear conditions for enhanced engagement and therapeutic process via TH and reflected on cautions and accommodations for purposes of rapport building and mitigating risk. Given moderate-strong evidence for the efficacy of TH methods of family therapy for a range of conditions, we offer recommendations for future implementation of TH for family therapy.Supplementary InformationThe online version of this article (10.1007/s10567-020-00340-2) contains supplementary material, which is available to authorized users.

Telemedicine (TM) involves the use of technology to overcome the patient care barriers of distance and time. Asynchronous TM can be used to monitor patients remotely and for providers and patients to communicate with each other without needing to be online at the same time. Synchronous TM can include direct-to-consumer visits in which patients use their own equipment to communicate with a provider or facilitated visits in which a patient travels to a clinic to use the clinic's equipment with a facilitator. The advantage of the latter is that a physical examination can be performed. Although some patients and providers may prefer in-person visits, patients who are seen by TM report satisfaction that it is as good as or better than that of an in-person visit. TM can be used in the outpatient setting, in the hospital to perform consults, or in the school. The convenience of TM makes it likely that more patients will adopt TM as their preferred mode of obtaining health care. It is important for allergists to become familiar with this new technology because patients will demand it.

Construction 4.0 represents the exploration of new technologies in the architecture, engineering, and construction (AEC) industry. The development of digital technologies is rapid and the adoption of them significantly impacts construction projects, for example, leading to a reduction in change orders, better decision making, and improvements in quality of work. However, stakeholders may find it challenging to determine the promising technologies within the context of the AEC industry. This paper presents an exploratory study to investigate the potentially applicable technologies and their research and practice trends in the AEC industry. A scoping review was the method utilized to perform a quantitative analysis of over five thousand journals papers published from 2010 onward based on two academic databases (Scopus and CNKI). The results present the top 10 construction 4.0 technologies, including building information modelling (BIM), artificial intelligence (AI), 3D printing, machine learning, internet of things (IoT), geographic information systems (GIS), virtual reality (VR), big data, robotics, and augmented reality (AR). Subsequently, 145 industry professionals were invited to select the most used construction 4.0 technologies in their projects via a questionnaire survey. Mobile devices, BIM, and Digital signature are mostly adopted on-site. The findings of this study can enhance the awareness of stakeholders toward construction 4.0 technologies and may help them make better decisions in selecting and implementing the promising technologies.

The mental health issues among children and adolescents have become a focal point of attention in today's society. This paper reviews and analyzes the current trends in research on the mental health of children and adolescents. The results indicate that future research will exhibit characteristics of interdisciplinary collaboration, technological applications, and innovative psychological intervention strategies. To promote overall improvement in the mental health of children and adolescents, it is necessary to enhance the qualifications of professionals, provide social support, and establish collaborative networks. By implementing these measures, we can create a better psychological environment for children and adolescents.

Background Education and feedback interventions improve antibiotic prescribing practices in outpatient settings. Studies evaluating equitable impact of such interventions across patient groups and care modalities, such as telemedicine, are limited.Table 1.Patient, Visit, and Prescription Characteristics Comparing Study PeriodsFigure 1.Prescribing Modality for Antibiotics Prescribed by PCN Providers by Study Periods Methods Antibiotics prescriptions in a large PCN were extracted pre and post implementation of a QI feedback initiative focusing on antibiotic utilization. Total synchronous (clinic and synchronous telemedicine (ST)) visits were extracted. Antibiotic prescriptions from synchronous encounters were disaggregated by prescription mode (clinic or ST) and patient sociodemographic parameters, matched with appropriately disaggregated visit denominators, and prescription rates calculated. Antibiotics prescribed via asynchronous telemedicine (AST - patient portal/telephone) were evaluated independently. Analysis was performed with Χ2, Z test, and logistic regression in GraphPad and R v4.4.3. Results Total 267,572 network registry patients incurred 277,940 synchronous visits and received 42,301 antibiotic prescriptions (Table 1), with reduction in overall antibiotic prescribing rate from 17.4 to 13.4 /100 visits (p < 0.000001) and shift away (Figure 1) from AST as most common prescribing modality post intervention (OR 0.69 [0.63-0.77], p< 0.000001). Men and Persons of Color (POC) were less likely to receive antibiotics during synchronous visits (OR 0.71 [0.65-0.78], p < 0.000001 and OR 0.54 [0.45-0.64] p < 0.000001), including clinic (OR .71 [0.64-0.77] p< 0.000001) and (OR 0.53 [0.44-0.64] p < 0.000001), respectively. Among patients receiving antibiotics, POC were more likely to be prescribed by telemedicine, but were still less likely to receive any antibiotic via ST (OR 0.59 [0.36-0.92], p=0.028) compared to other groups. Men (OR 0.6, [0.56-0.65] p< 0.000001), older than 65 (OR 0.6 [0.52-0.68] p< 0.000001), and Medicare patients (OR 0.78 [0.7-0.89] were less likely to access ST as a care modality. Conclusion An educational intervention, combined with prescribing feedback, resulted in reduction of antibiotic rates and a shift away from asynchronous prescribing. Differences between antibiotic prescription rates and modalities exist based on race and sex. Further work must be done to investigate possible drivers of inequities. Disclosures All Authors: No reported disclosures

MP32-02 TELEMEDICINE UTILIZATION IN PEDIATRIC UROLOGY AND BEYOND

Maintenance contributes to gaining high business performance, guarantees system availability and reliability as well as safe and sustainable operations. Maintenance activity effectiveness depends on competences and the skills of operators whose performance strongly affects maintenance and production operations. The research field of human issues in industrial maintenance was deeply addressed in the literature; however, the current industrial paradigm, which focusses on the integration of new technologies in conventional manufacturing operations to support human performance, sheds light on new challenges for enterprises and opportunities for research in this field. While some literature reviews in the field of human errors and human factors are available, no study investigated the main topics, research trends and challenges related to the role of maintenance operators in manufacturing systems. This paper addresses the current state-of-the-art role of maintenance operators in manufacturing systems, providing an overview of the main studies. A systematic literature review was carried out to identify significant papers. Then, a topic modelling algorithm was used to detect the main topics of the selected papers to provide the research trends of the subject. The identified topics provided interesting research insights on the human role in industrial maintenance. Research trends and further research opportunities were defined.