Managed Care Research Articles

Atypical Electrodiagnostic Findings in a Patient with Immune-Mediated Necrotizing Myopathy: A Case Study

Autoimmune Necrotizing Myositis (NAM)/Immune-Mediated Necrotizing Myositis (IMNM), a progressive myopathy, lacks skin lesions and exhibits unique pathologic traits. Risk factors like statin use and malignancy are implicated, while most IMNMs are idiopathic. Manifesting as insidious proximal muscle weakness, they often lead to difficulties in functional tasks early in the disease. This article presents a case of a 65-year-old male with Immune-Mediated Necrotizing Myopathy exhibiting atypical needle electromyography findings with widespread denervation in multiple limbs in a proximal distribution. The patient complained of bilateral hip/thigh weakness and symmetric numbness in the feet, among other symptoms. Evaluation revealed significant findings including elevated creatine kinase (CK) levels, Anti 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) antibodies, and abnormal electromyography indicating motor axon/myopathic involvement. Urgent referrals led to diagnosis confirmation and subsequent immunotherapy. This case highlights the challenges in diagnosing myopathies, emphasizing the importance of comprehensive patient history and clinical examinations. Electrodiagnostic studies complement clinical assessments, aiding in confirming myopathy and suggesting alternative diagnoses.Statin-induced necrotizing immune myopathy, associated with anti HMG-CoA antibodies, poses serious risks, warranting statin cessation and cancer screening.Recognizing when to refer patients promptly is crucial to minimize diagnostic delays.Prognosis for IMNM patients is challenging, with persistent weakness despite intensive treatment, emphasizing the need for a multifaceted approach in diagnosis, management,and patient care. Understanding clinical presentations, utilizing diagnostic tools judiciously, and recognizing risk factors are vital for optimizing outcomes in these complex neuromuscular disorders.

Fluid balance and clinical outcomes in patients with aortic dissection: a retrospective case-control study based on ICU databases

ObjectivesAortic dissection (AD) is a life-threatening condition that requires intensive care and management. This paper explores the role of fluid management in the clinical care of AD patients, which has...

Alveolar socket surface area as a local risk factor for MRONJ development in oncologic patients on polypharmacy

ObjectivesTo determine the impact of alveolar socket surface area and number of root extractions for developing medication-related osteonecrosis of the jaw (MRONJ) in polypharmacy patients following multiple tooth extractions.Materials and methodsA retrospective sample of 40 patients was recruited, including 20 polypharmacy patients (109 tooth extractions) who developed MRONJ in at least one of the extraction sites, matched with 20 controls (100 tooth extractions). Tooth-specific alveolar socket surface areas were assessed using CBCT scans from the control group to establish reference values for alveolar socket surface areas in polypharmacy patients with MRONJ. Correlations between the number of extracted tooth roots, alveolar socket surface area, and development of MRONJ were analysed within the polypharmacy group.Results40% of tooth extractions in polypharmacy patients undergoing multiple extractions resulted in the development of MRONJ, with a higher prevalence observed in the mandible (44%). Among the extracted mandibular tooth roots, half were susceptible to MRONJ, and 45% of the exposed socket surface area was affected. Both jaws showed an increased risk (20%) of MRONJ following molar extraction. A strong positive correlation existed between extraction sites that developed MRONJ and both the number of mandibular tooth roots extracted (r = + 0.861; p < 0.001) and the total exposed alveolar socket surface area (r = + 0.757; p < 0.001). However, no significant correlations were observed in the upper jaw.ConclusionsThis study is the first to demonstrate that both mandibular alveolar socket surface area and number of extracted tooth roots are positively related to extraction sites developing MRONJ in polypharmacy patients undergoing multiple tooth extractions.Clinical relevanceIdentifying high-risk patients and implementing preventive strategies can reduce MRONJ incidence, underscoring the need for careful management of polypharmacy patients, especially those undergoing mandibular tooth extractions.

How do managers support a pedagogical perspective in relation to the cultivation of a positive living and working climate in residential youth care services?

ABSTRACT In the literature, the significance of elaborating a positive living and working climate in residential youth care as a fundamental right, essential for addressing youngsters’ basic needs and establishing effective care, is widely acknowledged. However, various organizational and societal challenges exert pressure in practice. This research aims to investigate how residential care managers address these challenges. Specifically, we aim to clarify: (1) the prevailing pedagogical perspectives in relation to the elaboration of a positive living and working climate, and (2) the obstacles that managers encounter in doing so. Two focus groups were convened, comprising 16 managers representing 14 distinct residential youth care services in Flanders. The findings are presented in terms of tensions, highlighting the managerial struggles inherent in advancing a basic pedagogy. Across the principal themes, the tension between fostering a reflexive versus normative approach becomes evident. The results underscore the formidable task faced by managers in grappling with micro- and meso-level challenges to establish a fundamental pedagogical framework amidst the complexities of contemporary societal dynamics.

Liposomal amphotericin-B-induced atrial fibrillation with hypomagnesaemia in acute invasive mucormycosis of the right maxillary sinus

Liposomal amphotericin B (LAmB) is the preferred drug for treating mucormycosis, a dangerous opportunistic infection caused by fungal pathogens. This case report details the medical history and treatment of a female patient who had type 2 diabetes, pulmonary artery hypertension and congenital heart disease. She was diagnosed with acute invasive mucormycosis in her right maxillary sinuses and underwent right endoscopic debridement. Throughout her treatment, she received 50 mg of injection LAmB. However, her magnesium levels decreased, and on the 10th day of treatment, she developed abnormal heart rhythms, specifically atrial flutter. This condition was successfully managed with an injection of digoxin (0.25 mg). Thus, continuous monitoring of magnesium and potassium levels, as well as electrocardiogram monitoring, is crucial in these cases. Failure to correct low potassium and magnesium levels in patients with congenital heart disease may result in heart rhythm disturbances or artery spasms. In our case, they treated it with syrup potassium chloride, and an injection of magnesium was given as a stat doses. Careful management and close monitoring are required to treat some cardiac-related effects of drugs and to achieve optimal outcomes in complex cases of mucormycosis treated with LAmB in our case continuous monitoring helped us with the achievement of treatment.

Clinician Perspectives of Barriers and Enablers to Quality Cardiogenic Shock Care: A Focus Group Study.

Cardiogenic shock is a medical emergency that is associated with high mortality rates. It is a resource-intensive and costly condition that is complicated by comorbidities and clinical deterioration. However, the barriers and enablers to quality cardiogenic shock care are relatively unknown from the perspective of Australian clinicians. This study aimed to i) To explore clinicians' perspectives on the barriers to delivering these best practice care and optimal outcomes for patients with cardiogenic shock; and ii) To understand priorities to overcome these barriers, with the intent of using the findings to inform the development and implementation of a clinical trial for cardiogenic shock management-ESCAPE-CS: Evaluation of a Standardised ClinicAl Pathway to improve Equity and outcomes in Cardiogenic Shock (ESCAPE-CS). A qualitative focus group study was conducted via videoconference with experienced clinicians, and audio-recorded and transcribed verbatim. Data were analysed using thematic analysis in NVivo. Five focus groups were conducted, including 19 participants (11 male and eight female), comprising seven intensive care unit physicians, seven nurse consultants/educators, three cardiologists, and two emergency department physicians working in metropolitan and rural, regional, or remote health settings. Five themes were identified: CONCLUSIONS: This study provided critical insights into the barriers and possible enablers to delivering best practice care and optimal outcomes for patients with cardiogenic shock. There is scope for an improved model of care in cardiogenic shock management to address inequalities emerging from multifactorial complexities.

A Roadmap for Disaster Risk Reduction and Management in Kidney Care: A Scoping Review and Content Analysis.

Natural, technological and other disasters cause significant human suffering, and kidney patients are uniquely vulnerable. The safe provision of kidney replacement therapies necessitates the consistent provision of resources. Robust disaster risk reduction and management (DRRM) can mitigate risks associated with resource disruption. Individual kidney care programs may benefit from an organized approach to developing context-specific protocols. We aimed to synthesize contemporary literature in kidney care to create a roadmap in DRRM. We conducted a scoping review followed by a content analysis using the Framework Method. Literature that focused on lessons learned and proposed strategies or recommendations in DRRM was eligible. We contextualized this roadmap within the domains of disaster preparedness, response, and recovery. Of 3,973 titles and abstracts screened, 52 articles were included. We developed the following roadmap: 1) the 'ABC4s' of disaster preparedness: Assess needs, risks, and vulnerabilities (regional risks, patients at risk); Build a task force network; Capacity building (tangible resources, intangible resources, monetary considerations, transportation); Communication (network and protocol, patients' medical and dialysis information, contact information of all stakeholders, inclusive approach, reliable medium); Coaching (patients, caregivers, healthcare personnel, reinforce and repeat); Contingency planning (surge capacity, rationing care, resource distribution); and Strategic partnerships. 2) the 'DIAL' response: Damage and scope assessment; Initiate action plan (choose the plan, apply preparedness tenets, implications for receiving facilities); Appraise the action plan regularly (reassess, maintain ethical standards, address psychosocial needs); and Liaise, engage and update. 3) the 'ARC' to recovery: Assess damage; Return to the (new) norm; and Collect data to evaluate, improve, and share. We propose a roadmap to disaster preparedness, response and recovery that can guide individual kidney care programs globally to develop context-specific protocols aimed at building capacities and facilitating processes toward DRRM.

Near-infrared photobiomodulation therapy on HD10.6 human sensory neurons cell culture.

We investigated the molecular effects of near-infrared photobiomodulation therapy (PBMT) on HD10.6 human sensory neuron cell cultures. This study explores the utility of PBMT in modulating the functionality of sensory neurons in vitro with a potential translational effect on analgesia, a significant concern in clinical settings, particularly in pediatrics where non-invasive treatments are crucial. HD10.6 human sensory neuron cell model was employed in the study. The 800 and 970 PBMT was tested on the cells and mitochondria related parameters and TRP channel functionality were evaluated after irradiation. We found that PBMT affects mitochondrial dynamics and reduces oxidative stress, influenced calcium ion flow, pivotal in nociception signaling, and modified the expression of TRPV1 and TRPA1 receptors post-irradiation. This study observed a potential impact of PBMT on sensory neurons through various cellular mechanisms. These findings may contribute to the understanding of PBMT's mechanistic effects on human sensory neurons, not yet explored in in-vitro model, pointing to its potential utility as a supportive treatment for non-invasive pain management in pediatric care.

“An incomplete Kartagener syndrome presenting with recurrent exacerbation of bronchiectasis: a case report”

Background: Kartagener syndrome (KS), a rare subgroup of Primary Ciliary Dyskinesia (PCD) with an autosomal recessive pattern of inheritance is characterised by the clinical findings affecting the ciliary movement. It typically presents with a triad of sinusitis, bronchiectasis, and situs inversus, while cases lacking situs inversus are termed as incomplete KS posing diagnostic challenges. Case Presentation: A 42-year-old; non-smoker, non-alcoholic Nepalese male with a history of recurrent cough, nasal discharge and infertility was diagnosed with incomplete KS. His clinical examination revealed coarse crackles bilaterally and rhonchi while spirometry showed mixed obstruction &amp; restrictive patterns. His imaging findings clearly indicated infective bronchiectasis. Symptomatic management and multidisciplinary care were initiated for him. Discussion: This case reveals the complexity of diagnosing incomplete KS, a subgroup of PCD. The presence of post-infective bronchiectasis, recurrent sinusitis strongly supported the diagnosis. Successful medical intervention and ongoing multidisciplinary management are crucial for addressing the patient’s diverse clinical manifestations. Conclusion: This case highlights the importance of recognizing the varied presentations of KS and/or PCD and the need for a multidisciplinary approach to its management. Increased clinical awareness and timely diagnosis are essential for improving patient outcomes and effectively managing potential complications.

Management of volume load for patients undergoing hemodialysis via WeChat and home monitoring in China: a protocol for a cluster-randomized trial

BackgroundVolume overload is a major mortality risk in hemodialysis (HD) patients. Drug therapy and conventional dialysis limitations underscore the importance of managing volume load through effective lifestyle interventions. In this regard, WeChat, along with its built-in self-monitoring function, has demonstrated considerable potential for application. WeChat, a versatile social media platform in China, integrating Facebook, WhatsApp, Twitter, and PayPal functionalities, shows potential in managing volume load, especially when paired with home monitoring. This method may also reduce adverse events and improve patient outcomes.MethodThe study will be conducted at the Hemodialysis Center of the Hospital of Chengdu University of Traditional Chinese Medicine, recruiting 135 participants. All patients will be cluster randomly assigned to three group according to their HD schedules. The control group will receive standard care. The WeChat group will receive volume load management via WeChat message in addition to standard care. The home monitoring-feedback group will be required to monitor their blood pressure and weight at home, and upload the number to WeChat subscription account “Health Dialysis” in addition to standard care and volume load management via WeChat message. Data will be collected during the baseline period, one, two, and three months after the intervention starts, and three months after the intervention ends to evaluate the effectiveness of this intervention measure.DiscussionThis study aims to effectively manage the volume load of HD patients and enhance their quality of life through a combination of intervention methods utilizing the WeChat platform and home monitoring. If this intervention measure proves effective, it will not only provide empirical evidence for managing HD patients through the WeChat platform but also serve as a reference model for other HD centers in addressing patient volume load issues. What’s more, if significant differences are observed between the results of the WeChat groups and the home monitoring-feedback group, this will further substantiate the importance and impact of home monitoring in volume load management.Trial registrationClinicalTrials.gov (NCT06333574). Registered 13 March 2024.

Synergistic effect of ZnO-ZnFe2O4 heterostructures for enhanced surface catalytic activity in Cr(VI) reduction, green H2 generation and CO sensing: an experimental study supported by DFT.

Increasing energy demand is an indication of progress, but it necessitates careful management of environmental pollution for maintaining a healthy life and ensuring a better planet for future generations. Heterostructure material-based catalysts have emerged as a comprehensive solution to combat the diverse challenges related to energy and environment. Herein, an n-n-type ZnO-ZnFe2O4 heterostructure was synthesized via a simple reflux followed by a co-precipitation technique for the same. Detailed photocatalytic and gas sensing studies revealed that a 50% ZnO-50% ZnFe2O4-based sample (ZZF-11) showed the highest Cr(VI) degradation with a rate constant of ∼159 × 10-4 s-1, which was ∼23 times higher than that of pristine ZnO and 6.4 times higher than that of pristine ZnFe2O4. Additionally, the ZZF-11 sample produced ∼550 μmol g-1 of H2 within a 300 minute interval via a photocatalytic water-splitting reaction. The ZZF-11 sensor also showed a significantly high response to 1 ppm CO gas (S = 29.4%) compared to all other pure and composite samples. The formation of the heterostructure and transfer of charges through the interface played an important role here. The most possible mechanism for the enhanced surface catalytic performance of ZZF-11 was critically analysed by corroborating the experimental results with DFT results. This study demonstrates a unified pathway to enhance the various surface catalytic processes by tuning different parameters of the heterostructure material to simultaneously overcome environment- and energy-related issues.

Supporting primary care clinicians in caring for patients with alcohol use disorder: study protocol for Records for Alcohol Care Enhancement (RACE), a factorial four-arm randomized trial

BackgroundUnhealthy alcohol use, a spectrum of use inclusive of risky consumption and alcohol use disorder (AUD), is a leading cause of preventable death in the United States. Most people with unhealthy alcohol use do not receive evidence-based treatment. This four-arm factorial design randomized trial will assess whether population health management (PHM) and clinical care management (CCM) support for primary care providers (PCPs) are associated with improved AUD treatment engagement among their patients, beyond electronic health record (EHR) prompting and decision support alone.MethodsPCPs from an urban safety-net hospital-based primary care clinic are randomized to one of four groups (1) EHR best practice advisory (BPA) and clinical decision support tools for unhealthy alcohol use (BPA), (2) BPA plus population health manager support, (3) BPA plus clinical care manager support, and (4) all three. All PCPs will have access to the EHR BPA and decision support tools which provide chart-based advisories and order set navigation. PCPs assigned to receive PHM support will receive quarterly panel-level feedback on AUD treatment metrics for their patients. PCPs assigned to receive CCM support will receive CCM facilitation of AUD treatment processes including medication counseling, referrals, and support through direct patient interactions. The primary outcome will be the percent of patients engaged in AUD treatment among those with a new AUD diagnosis on a PCP’s panel. Secondary outcomes include the percent of patients with a new diagnosis of AUD who (1) initiated AUD treatment, (2) were prescribed AUD medications within 90 days, and (3) numerical counts of a range of AUD health services (outpatient encounters, specialty AUD care encounters, referrals, and acute healthcare utilization) in this sample. We will assess the primary outcome and the acute healthcare utilization secondary outcomes using Medicaid claims; the remaining secondary outcomes will be assessed using EHR data.DiscussionThe study will evaluate how a targeted EHR innovation alone, compared with population health and care management enhancements alone or in combination, impact engagement in AUD treatment, a national quality of care measure. Findings will advance understanding of supports needed to improve systems of care for AUD in general settings.Trial registrationClinicalTrials.gov identifier/registration number (NCT number): NCT05492942

The Role of Nutritional Interventions in Integrated Care for Malaria and Anemia Management

Malaria and anemia are interrelated public health challenges that disproportionately affect vulnerable populations in sub-Saharan Africa, particularly children and pregnant women. The dual burden of these conditions requires integrated care strategies to effectively manage and reduce their prevalence. Nutritional interventions, such as dietary improvements and iron supplementation, are essential in this context, as they address iron deficiencies, bolster immune function, and mitigate the severity of both conditions. This review explores the role of nutritional interventions in managing malaria and anemia, evaluating the effectiveness of dietary programs and iron supplementation within African public health frameworks. It examines the complexities of integrating nutritional strategies with malaria control measures and highlights the challenges, including resource limitations, cultural barriers, and fragmented policies. The review underscores the importance of coordinated policy frameworks, community engagement, and increased resource allocation to optimize the impact of integrated care strategies. Recommendations for strengthening these approaches are provided to enhance health outcomes and reduce the disease burden in malaria-endemic regions. Keywords: Malaria, Anemia, Nutritional Interventions, Iron Supplementation, Public Health Strategies.

The Role of Wearable Health Technology in Monitoring and Managing Chronic Conditions

Wearable health technology has emerged as a transformative tool in healthcare, offering continuous monitoring and management of chronic conditions. These devices, ranging from fitness trackers to advanced biosensors, collect real-time data on parameters such as heart rate, glucose levels, and physical activity. This paper investigates the potential of wearable health technology to enhance self-management, improve clinical outcomes, and reduce healthcare disparities. Key case studies demonstrate their efficacy in chronic condition management, while challenges such as data privacy, accessibility, and integration with existing healthcare systems are addressed. Future advancements, including AI integration and improved usability, could further revolutionize chronic disease management and patient care. Keywords: Wearable health technology, chronic disease management, biosensors, patient monitoring, digital health.

Research on the effectiveness of utilizing social workers in building a community-based society

Local welfare capabilities in Japan have reduced and this means that social problems are increasing. For example, the 8050 problem, double care and social exclusion are all on the rise. Action is required through a community-based approach to welfare. Associate Professor Takashi Kohno, Graduate School of Integrated Human and Social Sciences, Faculty of Integrated Human Studies and Social Sciences, Fukuoka Prefectural University, is interested in the benefits of a community-based society and how this can be achieved. Although the Japanese Government has proposed the realisation of a community-based society, there hasn’t been clarification on the role of social workers and other professionals in achieving this. Kohno believes it is necessary to refine care management methods that could adjust and provide appropriate services and social resources according to people’s needs. In one project, he explored the effectiveness of utilising social workers in building a community-based society and set out to clarify how social work practice can be effectively developed to realise this kind of society. Kohno and the team analysed the results of questionnaires from comprehensive support centres and municipal social welfare councils and found that the social work functions were care management, interprofessional work and the promotion of collaboration through leadership and facilitation. In addition to the micro level function of care management, through which formal and informal services and social resources that are tailored to client needs are provided, meso-level functions build a system for distributing resources and budgets and it’s crucial to organically develop these functions.

Interventions and Predictors of Transition to Hospice for People Living with Dementia: An Integrative Review.

Goal-concordant transition to hospice is an important facet of end-of-life care for people living with dementia. The objective of this integrative review was to appraise existing evidence and gaps focused on interventions and predictors of transition to hospice and end-of-life care for persons living with dementia across healthcare to inform future research. Using integrative review methodology by Whittemore and Knafl, five databases were searched (PubMed, CINAHL, Web of Science, Google Scholar, Cochrane Database for Systematic Reviews) for articles between 2000 and 2023. The search focused on dementia, hospice care, transitions, care management and/or coordination, and intervention studies. Fourteen articles met inclusion criteria after critical appraisal. Most were cross-sectional in design and conducted in nursing homes and hospitals in the U.S. persons living with dementia had multiple chronic conditions including cancer, diabetes, heart disease, and stroke. Interventions included components of hospice decision-making delivered through advance care planning, checklist-based care management for hospice transition, and palliative care for those with severe dementia. Predictors included increasing severity of illness including functional decline, organ failure, intensive care use, and the receipt of palliative care. Other predictors were related to insurance status, race and ethnicity, and caregiver burden. Overall, despite moderate to high-quality evidence, the studies were limited in scope and sample and lacked racial and ethnic diversity. Prospective, multisite randomized trials and population-based analyses including larger and diverse samples are needed for improved end-of-life dementia illness counseling and hospice care transitions for persons living with dementia and their caregivers.

Prior Authorization and Utilization Management for Post-Acute Home Health in Medicare Advantage

Abstract In 2024, 90% of Medicare Advantage (MA) enrollees were in a plan that required prior authorization of home health care. We conducted semi-structured interviews with 44 leaders of MA plans, post-acute care (PAC) management companies, and home health agencies (HHAs) across the country to understand their experiences with prior authorization and utilization management (UM) of post-acute home health care. Our analysis of these interviews revealed that representatives of MA plans and PAC management companies report varying motives and approaches to prior authorization for post-acute home health care, resulting in varying experiences for HHAs. Both MA plan and HHA representatives view prior authorization and UM of post-acute home health as burdensome, and each have taken distinct approaches to manage the process but have conflicting views on the utility of these approaches. HHA representatives report that prior authorization and UM requirements impact access to care, the way that care is delivered, and ultimately patients’ experiences. Our findings warrant additional research and policy attention so that MA plans’ UM techniques do not unintentionally cause patient harm, particularly among vulnerable patients in need of post-acute home health care.

Panic attacks

A panic attack is a sudden, intense episode of anxiety and fear that often occurs without warning. It may be accompanied by severe physical symptoms, such as a racing heart, rapid breathing and sweating. The exact cause of panic attacks is unknown, but risk factors have been identified. Recurring unexpected panic attacks over a period of 4 weeks is termed panic disorder. Panic attacks that occur in specific situations or scenarios are known as phobias, including agoraphobia and social phobia, and are commonly seen in patients with panic disorder. This article gives an overview of panic attacks, their assessment, criteria for diagnosis and an approach to management in primary care.

Clinical Outcomes of Gender-Affirming Surgery in Individuals With Connective Tissue Disorders

Introduction Gender-affirming surgery (GAS) is a complex process that often requires multiple surgical operations and carries a complication risk that could be exacerbated by connective tissue disorders (CTDs). This study aims to investigate the association between CTD diagnosis and GAS outcomes. Methods Using the Merative MarketScan Research Databases, patients with gender dysphoria diagnoses who underwent GAS between 2007 and 2022 were identified. Among these, patients with diagnosed CTDs were identified. Demographics, comorbidities, and postoperative complications were recorded. Chi-squared, Shapiro-Wilk, Wilcoxon-Mann-Whitney, and multivariate logistic regression testing was used for statistical analysis. Results Of 7575 patients meeting criteria (mean age 29 ±10 years), 300 (4%) had CTD diagnoses. One or more postoperative complications were recorded in 9.8% of patients, without statistically significant difference between CTD and non-CTD patients. Additional simultaneous GAS procedures [odds ratio (OR) 2.02; P &lt; 0.01], Elixhauser index scores of 3+ (OR 1.36; P = 0.010), and age &gt;45 years (OR 1.47; P = 0.02) increased odds of experiencing complications following the index GAS procedure, while CTD diagnoses (P = 0.52) did not affect odds of experiencing complications. However, CTD diagnoses did elevate odds of readmission (OR 1.47; P = 0.046), as did multiple simultaneous GAS procedures (OR 2.66), Elixhauser index scores of 3+ (OR 3.72), and smoking (OR 2.18) (P &lt; 0.01). Conclusions These findings suggest CTDs may impact some gender-affirming surgical outcomes, and careful preoperative evaluation and management of comorbidities is necessary to reduce the risk of complications and readmission in this population. Surgeons should continue to exercise caution when performing elective surgery on patients taking immunomodulatory medications.

Investigation into Application of AI and Telemedicine in Rural Communities: A Systematic Literature Review

Recent advances in artificial intelligence (AI) and telemedicine are transforming healthcare delivery, particularly in rural and underserved communities. Background/Objectives: The purpose of this systematic review is to explore the use of AI-driven diagnostic tools and telemedicine platforms to identify underlying themes (constructs) in the literature across multiple research studies. Method: The research team conducted an extensive review of studies and articles using multiple research databases that aimed to identify consistent themes and patterns across the literature. Results: Five underlying constructs were identified with regard to the utilization of AI and telemedicine on patient diagnosis in rural communities: (1) Challenges/benefits of AI and telemedicine in rural communities, (2) Integration of telemedicine and AI in diagnosis and patient monitoring, (3) Future considerations of AI and telemedicine in rural communities, (4) Application of AI for accurate and early diagnosis of diseases through various digital tools, and (5) Insights into the future directions and potential innovations in AI and telemedicine specifically geared towards enhancing healthcare delivery in rural communities. Conclusions: While AI technologies offer enhanced diagnostic capabilities by processing vast datasets of medical records, imaging, and patient histories, leading to earlier and more accurate diagnoses, telemedicine acts as a bridge between patients in remote areas and specialized healthcare providers, offering timely access to consultations, follow-up care, and chronic disease management. Therefore, the integration of AI with telemedicine allows for real-time decision support, improving clinical outcomes by providing data-driven insights during virtual consultations. However, challenges remain, including ensuring equitable access to these technologies, addressing digital literacy gaps, and managing the ethical implications of AI-driven decisions. Despite these hurdles, AI and telemedicine hold significant promise in reducing healthcare disparities and advancing the quality of care in rural settings, potentially leading to improved long-term health outcomes for underserved populations.