Adoption Of Telemedicine Technology Research Articles

General practitioners’ perceptions of the roles of community pharmacists and their willingness to collaborate with pharmacists in primary care

BackgroundCommunity pharmacists (CPs) have the capacity to contribute to patient care given their expertise in medication and accessibility to residents in the community. However, multidisciplinary patient care programmes where CPs collaborate with general practitioners (GPs) in patient care is rare in Singapore despite increasing healthcare demand.ObjectivesThis study explores GPs’ perceptions of CPs’ current roles and GPs’ ideas for and attitudes towards interprofessional collaboration.MethodsSemi-structured qualitative interviews were conducted with 20 private GPs from August to December 2020 via an online video-chat platform. GPs were recruited from the Primacy Care Research Network (pcRn), primary care networks, and using snowballing strategies. All interviews were recorded, transcribed and coded thematically.ResultsCurrent working relationships between GPs and CPs appeared amicable but limited. GPs appreciate the existing roles of CPs: dispensing drugs not stocked in their practices and clarifying prescription details. Still, GPs appeared to rarely consider collaborative working. GPs acknowledged that CPs could enhance patient care with initiatives including medication reconciliation and advising on using medical devices. It was suggested that CPs could coordinate the purchase of drugs for primary care networks to improve GPs’ inventory management, but less enthusiasm was expressed for clinical collaborations with CPs. Major concerns about GP–CP clinical collaborations included direct competition with GPs’ own business interests, perceived low acceptability of pharmacy-led services by patients (citing extra time and cost), threat to continuity of care and the absence of a shared patient electronic health record system. Current funding mechanisms do not enable reimbursement of clinical services provided by CPs. Adoption of telemedicine technologies and governmental financial support were identified as possible enablers of GP–CP collaboration.ConclusionsGPs saw potential in CPs’ increased involvement in patient care, but perceived multiple barriers. Strategies focusing on overcoming these barriers could enable GP–CP collaboration to enhance patient care.

Telemedicine Services Provided to Medicare Beneficiaries by Otolaryngologists Between 2010 and 2018

Clinicians are increasingly adopting telemedicine in an effort to expand patient access and efficiently deliver care. However, the extent to which otolaryngologists provide telemedicine services is unclear. To characterize recent trends in the use of telemedicine by otolaryngologists to deliver care to Medicare beneficiaries. A retrospective cross-sectional analysis was conducted between January 1, 2010, and December 31, 2018, using publicly available Medicare Physician/Supplier Procedure Summary data on physicians practicing in the field of otolaryngology and benchmark specialties (dermatology and psychiatry) that provided telemedicine services to Medicare beneficiaries. Primary outcomes were the mean annual number of telemedicine services delivered per active physician and mean annual payment per active physician for these services. Secondary outcomes included the number, setting, and complexity of telemedicine services. Between 2010 and 2018, otolaryngologists provided 2127 total telemedicine services (7 unique service types) to Medicare beneficiaries and received $88 574 in total payment for these services. During this period, the mean number of telemedicine services increased at a compound annual growth rate (CAGR) of 11.0%, and the mean Medicare payment per otolaryngologist increased at a CAGR of 21.8%. In comparison, telemedicine use during this period generally increased at a higher rate in the fields of dermatology (mean number of services per active physician at CAGR of 13.0%; mean Medicare payment per active physician at CAGR of 12.5%) and psychiatry (mean number of services per active physician at CAGR of 25.8%; mean Medicare payment per active physician at CAGR of 26.6%). In 2018, outpatient evaluation and management visits accounted for most telemedicine services provided (337 of 353 [95.5%]) and the payments received ($17 542.13 of $18 470.47 [95.0%]) by otolaryngologists. In contrast, physicians in other specialties also provided substantial portions of telemedicine services in the inpatient (psychiatry, 18 403 of 198 478 [9.3%]; dermatology, 231 of 1034 [22.3%]) and skilled nursing facility settings (psychiatry, 14 690 of 198 478 [7.4%]; dermatology, 46 of 1034 [4.4%]). This study suggests that the extent to which otolaryngologists used telemedicine to deliver care to Medicare beneficiaries between 2010 and 2018 was rare. Although there was relative growth in the use of telemedicine by otolaryngologists during this period, absolute growth remained low. Policy makers and provider organizations should support otolaryngologists in the adoption of telemedicine technologies, especially while coronavirus disease 2019 (COVID-19) viral suppression efforts necessitate prolonged restriction of physical clinic throughput.

Is telemedicine best alternative to reaching last mile: Investigation in the context of rural India

Technology has played a role in the quality and assurance of life. Application of technology in the healthcare field has increased manifolds in past decade with the development of new devices and IT. Telemedicine-a technology for remote diagnosis of diseases provides health care facilities to the remote area. In the context of India, telemedicine can be an option to provide healthcare facilities to last mile, the interior villages with the help of technology. Although it is a conceptual paper, the paper investigates the enabler of telemedicine technology adoption and implementation and ends up with the proposed model with the constructs and constructs definitions with the proposed items which are useful for telemedicine implementation. Through the systematic literature review followed by one to one interaction with the physicians, patients and telemedicine experts who all are currently using the technology the propositions are made which are likely to affect the implementation and adoption of telemedicine technology. telemedicine is a useful technology, when it comes to the affordability, quality and reach of healthcare services in India. Private hospitals as well as government both have to work together to provide the better healthcare for better India.

Knowledge-based modelling applied to synucleinopathies

The adoption of telemedicine technologies has enabled collaborative programs involving a variety of links among distributed medical structures and health officials and professionals. The use for telemedicine for transmission of medical data and the possibility for several distant physicians to share their knowledge on given medical cases provides clear benefits, but also raises several unsolved conceptual and technical challenges. The seamless exchange and access of medical information between medical structures, health professionals, and patients is a prerequisite for the harmonious development of this new medical practice. This paper proposes a new approach of semantic interoperability for enabling mutual understanding of terminologies and concepts used. The proposed semantic interoperability approach is based on conceptual graph to support collaborative activities by describing how different health specialists can apply appropriate strategies to eliminate differential medical diagnosis. Intelligent analysis strategies are used to narrow down and pinpoint medical disorders. The model proposed is fully verified by a case study in the context of elderly patients and specifically dealing with synucleinopathies, a group of neurodegenerative diseases that include Parkinson's disease (PD), dementia with Lewy bodies (DLB), pure autonomic failure (PAF) and multiple system atrophy (MSA).

TREATMENT PATTERNS PRIOR TO INITIATING DEPOT TYPICAL ANTIPSYCHOTICS FOR NON-ADHERENT SCHIZOPHRENIA PATIENTS

The adoption of telemedicine technologies has enabled collaborative programs involving a variety of links among distributed medical structures and health officials and professionals. The use for telemedicine for transmission of medical data and the possibility for several distant physicians to share their knowledge on given medical cases provides clear benefits, but also raises several unsolved conceptual and technical challenges. The seamless exchange and access of medical information between medical structures, health professionals, and patients is a prerequisite for the harmonious development of this new medical practice. This paper proposes a new approach of semantic interoperability for enabling mutual understanding of terminologies and concepts used. The proposed semantic interoperability approach is based on conceptual graph to support collaborative activities by describing how different health specialists can apply appropriate strategies to eliminate differential medical diagnosis. Intelligent analysis strategies are used to narrow down and pinpoint medical disorders. The model proposed is fully verified by a case study in the context of elderly patients and specifically dealing with synucleinopathies, a group of neurodegenerative diseases that include Parkinson's disease (PD), dementia with Lewy bodies (DLB), pure autonomic failure (PAF) and multiple system atrophy (MSA).

Wound care 2010 – a clinician’s perspective!

When deciding on a subject matter for my editorial, my creative thoughts turned to what might the wound healing world look like by the end of this current decade – a point in time not that far away. The past decade has seen the evolution of wound care from ‘art’ to science. It is now in most environments regarded as a specialty, but we still has some way to go before we routinely find ‘woundologists’ in every clinical environment with the routine referral of patients to such individuals from clinical colleagues. So what will the next few years bring to the wound care arena from a clinical perspective? There are a number of areas where we could see significant progress: clinical service provision; better, more accessible Continuing Medical Education (CME) offerings; better clinical reach through both management software and telemedicine. These are a few of the active arenas centred on the deliver of medical treatment in the management of wounds. The biggest challenge remaining is ‘engagement’. How do we stimulate others to be interested in wounds and the management of those patients presenting with chronic wounds? Education – Education – Education has to be the primary route to stimulate interest. The evolution of CME and the Internet has been the biggest influence on ‘engagement’. This has occurred through a push–pull relationship where peers push concepts through CME and patients pull concepts from the Internet – often presenting them back to their clinician. This will continue and proliferate over the coming few years with the continued development of wound care ‘information’ on the Internet and newer more easily accessible (through the Internet) CME offerings. The main area of change will be the advent of professional wound care services where patients can guarantee they will see clinicians with an interest and expertise in this area. There is also an increasing awareness amongst policy-makers, health-care planners, clinicians and patients that wounds cost all health-care systems large sums of money and the current provision is so variable, in both quality and quantity and that many patients are denied access to good care. The major challenge will be the design and validation of the many economic models required to demonstrate cost-effectiveness. However, with more appropriate assessment and diagnosis this task will be more easily undertaken. Ultimately with a more structured, tailored approach savings are inevitable. This access to care will be the next main element of the maturing of ‘wound healing’ as a clinical specialty. Access to both care and information will be a major theme for the next few years. This will proliferate rapidly with the adoption of telemedicine technologies. These will remove the communication barriers and in particular reduce the time and cost to access specialised consultation. These major events will shape wound care in the coming few years. By the end of the decade our evolution into true clinical specialists will have taken a significant step forward – probably the largest in our history.

Adoption of Telemedicine Technology by Health Care Organizations: An Exploratory Study

Recent advances in information and biomedicine technology have significantly increased the technical feasibility, clinical viability, and economic affordability of telemedicine-enabled service collaboration and delivery. Health care organizations around the world have become increasingly interested in acquiring and implementing telemedicine technology to improve or extend existing patient care and services. The ultimate success of telemedicine in an adopting organization requires adequate attention to both technological and managerial issues. This study examined organizational technology adoption, an essential management issue facing many health care organizations interested in or currently evaluating telemedicine. On the basis of a framework proposed by Tornatzky and Fleischer [1], we developed a research model for targeted technology adoption and empirically evaluated it in a survey study that involved most of the public health care organizations in Hong Kong. Results from our exploratory study suggest that the model exhibits reasonable significance and explanatory utility to differentiate between adopting and nonadopting organizations. Specifically, the collective attitude of medical staff and perceived service risks were found to be significant determinants of targeted technology adoption. Several research and management implications that emerged from our study findings are also discussed.