Challenges Of Telemedicine Research Articles

Telemedicine dan Kesehatan: Memahami Dampak Teknologi Kedokteran di Era Digital dalam Konteks Ajaran Islam

In the digital era, telemedicine has revolutionized healthcare by providing faster and more accessible remote medical services. This article explores the transformative impact of this technology on the quality and accessibility of healthcare services, while also examining its compatibility with Islamic values. From an Islamic perspective, telemedicine is reviewed in relation to ethical principles such as the preservation of life, the ease of access to treatment, and respect for patient privacy. The article aims to highlight how telemedicine can serve as an innovative solution that not only supports modern healthcare advancements but also aligns with ethical guidelines within Islamic teachings. This study offers fresh insights into the opportunities and challenges of telemedicine in healthcare, particularly within Muslim communities, and its implications for ethical medical decision-making.

Adaptive Approaches to Physical Pain Treatment Modalities During the COVID-19 Pandemic: A Qualitative Analysis.

Background and Purpose: Despite the lack of proven efficacy, opioids historically have been used for the treatment of noncancer back pain. A variety of other effective therapeutic options for pain management are becoming more available over time. In 2016, Oregon implemented a unique and novel policy to improve evidence-based back pain care and promote safer and more effective opioid prescribing through the state's Medicaid program, the Oregon Health Plan. This article examines the ways providers adapted to providing care for patients with back pain in the context of COVID-19 and to better understand the challenges faced by and adaptations made by providers. Methods: We conducted focus groups with clinicians and physical pain treatment modality practitioners (PPTMPs). In total, 129 providers participated in one of six focus groups, including 74 clinicians (54%) and 55 PPTMPs (42%). Reflexive thematic analysis was used to construct themes or units of meaning across data. Results: Focus groups revealed concerns about PPE shortages, telemedicine challenges, communication barriers, and profession-specific responses to COVID-19, which hindered patient care and referrals. Focus groups also highlighted some advantages related to increased insight into patients' lives, which enhanced treatment. Care during COVID-19 has resulted in continued patient interest in telehealth and telemedicine. Conclusion: Optimizing use of these technologies for health conditions, such as back pain, adds to treatment options for patients and gives providers a more holistic understanding of patients' lives, the challenges they may face, and how that impacts their treatment.

Safeguarding Patient Confidentiality in Telemedicine: A Systematic Review of Privacy and Security Risks, and Best Practices for Data Protection

The COVID-19 pandemic accelerated telemedicine adoption, showcasing its potential in improving healthcare delivery. However, privacy and security risks pose challenges, impeding widespread acceptance. The aim is to investigate the integration of data analytics, data analysis, and data cleaning in telemedicine, focusing on patient data privacy and security, with the goal of proposing strategies to mitigate risks and uphold confidentiality. Utilizing a qualitative approach, privacy and security challenges in telemedicine were investigated. Multiple databases, including PubMed, Embase, and Cochrane Library, were searched from 2018-2023. Inclusion criteria involved English-language, peer-reviewed empirical studies focusing on telemedicine privacy and security. Out of 770 unique records screened, eight studies were included. Full-text review and risk of bias assessment were conducted using CASP tool. Privacy and security, technology hurdles for providers, patient trust, professional training, physical assessment challenges, and disparities among special populations were identified. Environmental, technological, and operational factors contribute to privacy and security risks in telehealth. Technology challenges like restricted access to telehealth tools and poor internet hinder adoption. Data analytics in telemedicine facilitates healthcare transformation, addressing privacy and security while optimizing patient outcomes through advanced analytics techniques and structured data analytics lifecycles. The integration of data analytics in telemedicine shows promise for healthcare transformation by providing insights into patient behavior and policy impacts, while ensuring data privacy and security. Addressing barriers, accelerated by the COVID-19 pandemic, requires infrastructure enhancements and global research efforts for inclusive telehealth ecosystems.

Assessment of the Use of Telemedicine by Brazilian Otolaryngologists through an Online Questionnaire.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has prompted a transformation in medical practice, including the adoption of telemedicine in Brazil and globally. Otorhinolaryngology, a field at high risk of viral transmission, has witnessed an increasing use of telemedicine tools. However, the extent and challenges of telemedicine in this field in Brazil are not well understood. In the present study, we applied a questionnaire to Brazilian otorhinolaryngologists during the pandemic to assess telemedicine's advantages and challenges, shedding light on its integration and persistent issues in the field. Objective To assess the usage profile of telemedicine in the clinical practice of otolaryngology in Brazil. Methods The present was a cross-sectional observational study with convenience sampling. It was conducted as a web-based questionnaire distributed and advertised to Brazilian otorhinolaryngologists through social media posts on WhatsApp (Meta Platforms, Inc., Menlo Park, CA, USA), Instagram (Meta Platforms, Inc.), Facebook (Meta Platforms, Inc.), as well as direct messaging and email. Results The sample size was 186 participants. A total of 69% of them had already provided or were currently providing telemedicine services, and 34% considered it a frequent or very frequent form of work at the time of data collection. In total, 90% of the respondents considered the lack of physical examination a problem in otolaryngological teleconsultations, while 64% reported frequently or very frequently resolving patient problems through teleconsultations. Conclusion Telemedicine emerged in the context of the COVID-19 pandemic as a promising tool for remote patient care. More studies are needed to elucidate its role in the context of limited physical examination.

Secure Euclidean random distribution for patients’ magnetic resonance imaging privacy protection

Patients’ information and images transfer among medical institutes represent a major tool for delivering better healthcare services. However, privacy and security for healthcare information are big challenges in telemedicine. Evidently, even a small change in patients’ information might lead to wrong diagnosis. This paper suggests a new model for hiding patient information inside magnetic resonance imaging (MRI) cover image based on Euclidean distribution. Both least signification bit (LSB) and most signification bit (MSB) techniques are implemented for the physical hiding. A new method is proposed with a very high level of security information based on distributing the secret text in a random way on the cover image. Experimentally, the proposed method has high peak signal to noise ratio (PSNR), structural similarity index metric (SSIM) and reduced mean square error (MSE). Finally, the obtained results are compared with approaches in the last five years and found to be better by increasing the security for patient information for telemedicine.

Remote mobile health monitoring frameworks and mobile applications: Taxonomy, open challenges, motivation, and recommendations

Advancements in mobile technology have propelled the rapid progress of remote health monitoring, particularly in the domain of mobile health (mHealth). This progress is underscored by sophisticated smart health monitoring applications designed for mobile devices. mHealth monitoring, a standout area within remote health monitoring, excels in providing continuous health monitoring for patients and enabling remote observation by physicians. These applications cater to ambulatory patients with chronic diseases, offering essential features such as Telemedicine services, doctor availabilitys, and emergency ambulance services. Despite the development of various frameworks for mHealth monitoring, existing review papers often fall short in addressing critical parameters and issues related to Telemedicine. Many reviews provide a broad overview but lack the depth needed to dissect intricate aspects like implementation challenges in Telemedicine, nuances in decision-making applications, and the dynamics of mobility for both patients and healthcare providers. Patient rescue protocols, especially in diverse locations, are also underexplored. To fill this gap, our research delves into these dimensions, providing a nuanced understanding of challenges and opportunities in mobile health monitoring, particularly within the Telemedicine context. Leveraging a comprehensive literature review, we meticulously selected over 100 research articles from reputable databases like ScienceDirect, IEEE Xplore, and Springer. We have assessed and ranked the significance of each article. The study aims to address open issues in telemedicine, contributing valuable insights to enhance remote health monitoring.

Reviewing the evolution of U. S. telemedicine post-pandemic by analyzing its growth, acceptability, and challenges in remote healthcare delivery during Global Health Crises

This study provides a comprehensive analysis of the evolution, growth, acceptability, and challenges of telemedicine in the United States, particularly in the post-pandemic era. The primary objective was to understand the impact of telemedicine on healthcare delivery, technological advancements, and policy implications. Utilizing a systematic literature review and content analysis methodology, the study sourced data from electronic databases such as PubMed, Scopus, and Web of Science, focusing on peer-reviewed articles published between 2010 and 2023. Key findings indicate that telemedicine experienced significant growth during the COVID-19 pandemic, transitioning from a supplementary healthcare service to a primary mode of healthcare delivery. This growth was facilitated by advancements in digital technologies and necessitated by the need for remote healthcare services. The study identified challenges in telemedicine, including technological barriers, regulatory issues, and concerns regarding equitable access. Despite these challenges, telemedicine has shown potential in enhancing healthcare accessibility, efficiency, and patient-centered care. The study concludes that telemedicine is poised to play a crucial role in the future of healthcare, with opportunities for further integration into routine healthcare practices. However, this requires robust regulatory frameworks, stakeholder engagement, and continued technological innovation. Recommendations for healthcare leaders and policymakers include developing comprehensive telemedicine policies and investing in infrastructure to support telehealth services. Future research directions involve exploring long-term outcomes of telemedicine interventions and its economic impact on healthcare systems.

Ethical assessment of virtual consultation services: scoping review and development of a practical ethical checklist.

Introduction The use of telephone and video consultations has vastly increased since the onset of the COVID-19 pandemic. Health care providers in traditional clinical practices have embraced these virtual consultations as an alternative to face-to-face consultations, but there has also been a simultaneous increase in services offered directly to consumers via commercial entities. One of the main challenges in telemedicine (and the broader field of digital health) is how to conduct a meaningful ethical assessment of such services. Aim This article presents a novel framework for practical ethical analysis of direct-to-consumer virtual general practitioner consultation services in Aotearoa New Zealand. Methods First, a scoping review of academic and policy documents identified the core ethical challenges arising from virtual consultations. Second, a qualitative analysis was conducted to translate the main ethical themes and subthemes into practical questions to assess virtual general practice services. Results A total of 49 relevant documents were selected for review. The six key ethical themes related to telemedicine were: privacy, security, and confidentiality; equity; autonomy and informed consent; quality and standards of care; patient empowerment; and continuity of care. A practical ethical checklist consisting of 25 questions was developed from these themes and their subthemes. Discussion The checklist provides an accessible way of incorporating ethics into technology assessment and can be used by all relevant stakeholders, including patients, health care providers, and developers. Application of the framework contributes to improving the quality of virtual consultation services with a specific focus on ethics.

Applications and Challenges of Telemedicine: Privacy-Preservation as a Case Study.

Today, technology has an important impact on the development of medical services, especially during the outbreak of COVID-19. Telemedicine, known by terms such as telehealth and digital health, refers to the utilization of technology to provide health care services at a distance that leads to improved monitoring, detecting and treatment of disease, and provision of individual care. It has been considered in various fields such as radiology, cardiology, pulmonology, psychiatry, emergency care and surgery. The most important advantages of using telemedicine are saving time for the doctor and the patient, reducing the cost of multiple visits to the doctor, reducing the spread of contagious diseases and caring for patients who cannot see a doctor, such as the elderly. In this paper, we review the research in the field of applying telemedicine, as well as its advantages and disadvantages. Next, we discuss the challenges in the field of using telemedicine which are privacy preserving, data security, cost of infrastructures, lack of physical examination and responsibility for patients' compensation. One of the most important challenges is privacy preserving of patients' information during transmission and process. We categorize and compare the various methods that have been proposed to protect peoples' privacy.

Development of telemedicine in the Czech Republic from patients' and other key stakeholders' perspective.

Telemedicine is a way to improve healthcare outcomes with greater efficiency for both patients and care providers. The great potential of digital technologies also lies in strengthening the patient-centered approach. The early successes and benefits of telemedicine in the Czech Republic, amplified by the COVID-19, have contributed to the fact that wider implementation of telemedicine is already generally supported at the expert and public levels. Our research focuses on the identification of key issues in the implementation of telemedicine and the challenges of telemedicine in the future, from the perspective of patients and other stakeholders. The study is based on a qualitative research approach, combining focus groups with key stakeholders, patient panels and expert panels (2021-2022). The lack of rules and uncoordinated development of various activities proved to be the main barriers to the integration of telemedicine in the health system. This regulatory uncertainty can generate a number of problems in the patient-doctor relationship in practice, including ethical ones, and can also lead to inequalities in access to healthcare and affect the overall quality of care provided. Furthermore, it has been shown that patients' interests in the implementation of telemedicine are: 1. a predictable and reliable framework that guarantees them certainty and security in the provision of telemedicine services, 2. telemedicine solutions that increase the availability and efficiency of the care provided while bringing comfort, and 3. user-friendly and simple solutions. At the same time, patients want to understand the new environment and be active participants in the process of digital innovation, including the practical implementation of telemedicine. The research team has developed recommendations for further developments in the implementation of telemedicine that reflect the patient's interest and can be implemented at three levels - the health system, institutional, and community level. In countries with a well-developed and institutionalized patient movement, the community level can be represented by patient organizations, thus becoming the link between telemedicine policy making and implementation at the individual level of healthcare provision. For the further development of telemedicine, the development of a national strategy involving all key stakeholders, including patients, in the implementation has proven essential.

Healthcare professional and manager perceptions on drivers, benefits, and challenges of telemedicine: results from a cross-sectional survey in the Italian NHS

BackgroundThe Covid-19 pandemic provided new challenges and opportunities for patients and healthcare providers while accelerating the trend of digital healthcare transformation. This study explores the perspectives of healthcare professionals and managers on (i) drivers to the implementation of telemedicine services and (ii) perceived benefits and challenges related to the use of telemedicine across the Italian National Health Service.MethodsAn online cross-sectional survey was distributed to professionals working within 308 healthcare organisations in different Italian regions. Quantitative and qualitative data were collected through a self-administered questionnaire (June-September 2021). Responses were analysed using summary statistics and thematic analysis.ResultsKey factors driving the adoption of telemedicine have been grouped into (i) organisational drivers (reduce the virus spread-80%; enhance care quality and efficiency-61%), (ii) technological drivers (ease of use-82%; efficacy and reliability-64%; compliance with data governance regulations-64%) and (iii) regulatory drivers (regulations’ semplification-84%). Nearly all respondents perceive telemedicine as useful in improving patient care (96%). The main benefits reported by respondents are shorter waiting lists, reduced Emergency Department attendance, decreased patient and clinician travel, and more frequent patient-doctor interactions. However, only 7% of respondents believe that telemedicine services are more effective than traditional care and 66% of the healthcare professionals believe that telemedicine can’t completely substitute in-person visits due to challenges with physical examination and patient-doctor relationships. Other reported challenges include poor quality and interoperability of telemedicine platforms and scarce integration of telemedicine with traditional care services. Moreover, healthcare professionals believe that some groups of patients experience difficulties in accessing and using the technologies due to socio-cultural factors, technological and linguistic challenges and the absence of caregivers.ConclusionsRespondents believe that telemedicine can be useful to complement and augment traditional care. However, many challenges still need to be overcome to fully consider telemedicine a standard of care. Strategies that could help address these challenges include additional regulations on data governance and reimbursements, evidence-based guidelines for the use of telemedicine, greater integration of tools and processes, patient-centred training for clinicians, patient-facing material to assist patients in navigating virtual sessions, different language options, and greater involvement of caregivers in the care process.

Evaluation of Telemedicine systems for ECG analysis: Advances in the design of RF schemes

The monitoring and transmission of biomedical signals, particularly ECG is essential in the post-pandemic era. In this research, an RF transmission with a carrier frequency of 2.45 GHz for ECG is used. A testbed for variable n-QAM schemes is developed with a low noise amplifier characterized in its linear region based on its P1dB, to guarantee a low level of induced non-linearities. The system includes an acquisition stage using the Olimex module and electrodes with an Ag/AgCl type sensor, and an algorithm is developed for detecting peaks in heart signals, heart rate and calculation of sample-based heart rate. The transceiver has total control of the transmitted tones, and a signal demodulation process is carried out in the receiver, one of the main challenges in Telemedicine is to ensure the fidelity of a signal, an EVMRMS of 8.36 is obtained for fifteen OFDM symbol frames. The developed system as a Telemedicine proposal provides versatility for signal acquisition, digitalization, data storage and a multivariable n-QAM scheme, which makes it viable for Telemedicine and classification processes.

Risks and Challenges in Telemedicine: Introduction to the Institute for Healthcare Improvement’s White Book Telemedicine: Ensuring Safe, Equitable, Person-centered Virtual Care

<p>遠距醫療在各國有不同的發展進程，國際間也不斷探討遠距醫療難以發展或被廣泛使用的原因，其不外乎受科技基礎建設、社會進步程度、醫療環境、政策、保險制度的差異、民眾需求與就醫習慣及文化背景等因素之影響。2021年，美國健康照護促進協會（Institute for Healthcare Improvement, IHI）發布一份有關遠距醫療發展建議的白皮書，提供一個高品質的虛擬照護模式，並擬定一個確保安全、公平、以人為本的遠距醫療架構，其中包含了六個要素：「可近性」、「隱私」、「診斷準確性」、「溝通」、「安全感」及「人因與系統設計」，並提出相關執行建議。遠距醫療已成為各國後疫情時代的新醫療常態，遠距醫療發展過程中，醫療照護體系和醫療服務提供者除維持照護品質外，更應重視虛擬照護獨特且潛在地意外和風險。期待透過本文的分享，可以讓醫療照護體系及單位重視並建立安全、公平、以人為本的遠距醫療制度。</p> <p> </p><p>Telemedicine has been developed in different processes in each country. International academic circles have discussed the causes of difficulty in developing or spreading the use of telemedicine, which is affected by factors such as technological infrastructure, social progress, medical environment, policies, differences in insurance systems, public needs, medical habits, and cultural backgrounds. In 2021, the Institute for Healthcare Improvement from the United States of America published a white book on telemedicine development. The white book advocates for providing a high-quality virtual care model and developing a safe, equitable, and person-centered telemedicine framework. The framework consists of 6 elements: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design. The white book also provides practical suggestions on telemedicine. Telemedicine has become a new medical normal for various countries in the post-COVID era. In developing telemedicine, healthcare systems and providers must not only maintain the quality of care, but also pay attention to the unique and potential accidents and risks involved in virtual care. The results of this study provide a key reference to health care systems and personnel in establishing a safe, equitable, and person-centered telemedicine system.</p> <p> </p>

Experiences with telemedicine for HIV care in two federally qualified health centers in Los Angeles: a qualitative study

BackgroundThe SARS-CoV-2 pandemic has resulted in an increase in telemedicine utilization for routine HIV care. However, there is limited information on perceptions of and experiences with telemedicine from United States (U.S.) federally qualified health centers (FQHCs) offering HIV care. We sought to understand telemedicine experiences of stakeholders with various roles: people living with HIV (PLHIV), clinical (clinicians and case managers), programmatic (clinic administrators), and policy (policymakers).MethodsQualitative interviews about benefits and challenges of telemedicine (telephone and video) for HIV care were conducted with 31 PLHIV and 23 other stakeholders (clinicians, case managers, clinic administrators, and policymakers). Interviews were transcribed, translated to English if conducted in Spanish, coded, and analyzed for major themes.ResultsAlmost all PLHIV felt capable of engaging in telephone visits, with some expressing interest in learning how to use video visits as well. Nearly all PLHIV wanted to continue telemedicine as part of their routine HIV care, and this was also endorsed by clinical, programmatic and policy stakeholders. Interviewees agreed that telemedicine for HIV care has benefits for PLHIV, especially savings of time and transportation costs, which also reduced stress. Clinical, programmatic, and policy stakeholders expressed concerns around patients’ technological literacy and resources, as well as their access to privacy, and some felt that PLHIV strongly preferred in-person visits. These stakeholders also commonly reported clinic-level implementation challenges, including integrating telephone and video telemedicine into workflows and difficulty with video visit platforms.ConclusionsTelemedicine for HIV care, largely delivered via telephone (audio-only), was highly acceptable and feasible for both PLHIV, clinicians, and other stakeholders. Addressing barriers for stakeholders in incorporating video visits will be important for the successful implementation of telemedicine with video as part of routine HIV care at FQHCs.

A Qualitative Study of Primary Care Physicians' Experiences with Telemedicine during the COVID-19 Pandemic in North-Eastern Poland.

(1) Background: Due to the COVID-19 pandemic, primary care clinics quickly moved to provide medical consultations via telemedicine, however, information about primary care professionals' perspectives is limited. (2) Methods: Thirty semi-structured interviews with primary care professionals working in north-eastern Poland were conducted to assess their perspectives regarding the benefits and challenges of telemedicine. (3) Results: Primary care professionals highlighted that telemedicine increases access to medical services and reduces travel inconvenience. Remote consultation is not as time-consuming as in-person visits, which enables the provision of medical services to a greater number of patients which is particularly important in primary care. The inability to see patients and loss of non-verbal communication represent a significant difficulty in providing remote care. Primary care professionals indicated patients are not always able to express themselves sufficiently in a telephone call, which leads to performing medical consultations inefficiently. Physicians also pointed out that in particular medical cases, physical contact is still necessary to reach an accurate diagnosis and give the necessary treatment. Statements of the study participants also show that primary care professionals are satisfied with providing medical advice with telemedicine and show their interest in continuing remote consultation in the post-COVID era. (4) Conclusions: Primary care professionals have moved towards incorporating telemedicine into their daily routines due to the COVID-19 pandemic. Despite the many difficulties encountered, healthcare professionals have also noticed the benefits of telemedicine, especially during challenging circumstances. The study shows telemedicine to be a valuable tool in caring for patients, although it should be emphasized that face-to-face consultations cannot be fully replaced by remote consultations.

Older people's perceptions of teleconsultation via telephone during the COVID-19 pandemic: a qualitative study

Objectives: In March/2020, our geriatric outpatient clinic implemented teleconsultation via telephone due to the COVID-19 pandemic. This study aimed to understand older patients’ perceptions of this experience through their narratives. Methods: A qualitative study with Thematic Oral History and thematic analysis. We conducted open-ended interviews in which older patients narrated their perceptions of this experience. Results: Twelve patients were interviewed from December/2021 to January/2022, and 2 themes emerged: older patients’ experience of teleconsultation and possibilities and challenges of telemedicine. Some patients did not identify the call as a teleconsultation. Regarding possibilities, patients reported satisfaction and convenience in specific circumstances. As for challenges, patients reported concerns about the effectiveness of communication and need for physical examination. Conclusion: Teleconsultation is well accepted, as long as situations that require face-to-face interactions are considered. Considering person-centered medicine, listening to the narratives of older people contributes to a better structuring of telemedicine services in geriatrics.

Telemedicine: Transforming healthcare in India

Background: Telemedicine is useful for providing and supporting healthcare when distance separates the participants.Telemedicine may even be useful in developing more cost-effective methods of providing healthcare in private clinics or organizations that present difficult computer integration and communication challenges because of their size and geographic distribution. This review article aims to provide a broad insight into the history, applications, barriers, and challenges of telemedicine, especially from the Indian perspective. Methodology: In this article, we reviewed the Indian and global scenario about history and guidelines for the application of telemedicine. Articles with keywords such as 'telemedicine' and 'telehealth' in the title or abstract were searched on PubMed and Google Scholar. Only the articles in English and freely available full text were reviewed. Results: It was observed that the Government of India recognized the potential of telemedicine as a novel, advanced, and evolving frontier in health care, which may facilitate and provide essential medical care to people living even in the remotest areas. Along with government's imperfect telemedicine guidelines, India faces the dual challenge of a vast and widely diverse population coupled with deficient and unevenly distributed health resources. Conclusion:Increasing awareness among healthcare providers and government initiatives coupled with cautious and responsible practices will facilitate a successful transition to a mixed approach. Incorporating telemedicine with time and deliberation, the current guidelines can be perfected and refined to deal with medico-legal aspects.

Patients' Perspectives on the Shift to Telemedicine in Primary and Behavioral Health Care during the COVID-19 Pandemic.

BackgroundStudies specifically focused on patients’ perspectives on telemedicine visits in primary and behavioral health care are fairly limited and have often focused on highly selected populations or used overall satisfaction surveys.ObjectiveTo examine patient perspectives on the shift to telemedicine, the remote delivery of health care via the use of electronic information and communications technology, in primary and behavioral health care in Federally Qualified Health Centers (FQHCs) during COVID-19.DesignSemi-structured interviews were conducted using video conference with patients and caregivers between October and December 2020.ParticipantsProviders from 6 FQHCs nominated participants. Eighteen patients and caregivers were interviewed: 6 patients with only primary care visits; 5 with only behavioral health visits; 3 with both primary care and behavioral health visits; and 4 caregivers of children with pediatric visits.ApproachUsing a protocol-driven, rapid qualitative methodology, we analyzed the interview data and assessed the quality of care, benefits and challenges of telemedicine, and use of telemedicine post-pandemic.Key ResultsRespondents broadly supported the option of home-based synchronous telemedicine visits in primary and behavioral health care. Nearly all respondents appreciated remote visits, largely because such visits provided a safe option during the pandemic. Patients were generally satisfied with telemedicine and believed the quality of visits to be similar to in-person visits, especially when delivered by a provider with whom they had established rapport. Although most respondents planned to return to mostly in-person visits when considered safe to do so, they remained supportive of the continued option for remote visits as remote care addresses some of the typical barriers faced by low-income patients.ConclusionsAddressing digital literacy challenges, enhancing remote visit privacy, and improving practice workflows will help ensure equitable access to all patients as we move to a new post-COVID-19 “normal” marked by increased reliance on telemedicine and technology.

Telemedicine and natural disasters: various services, requirements, challenges, and general framework

Providing early health care services in natural disaster is one of the essential applications of telemedicine. This narrative review aims to investigate the applications, advantages and challenges of telemedicine in natural disaster-stricken areas. Medline (through PubMed), Web of Science (WOS), and Scopus databases were searched for related articles published from beginning to 2022. The keywords used for the search included "telemedicine" and "natural disaster." After removing duplicate papers, irrelevant review articles and letters to editors, 44 relevant papers were selected and reviewed. Information sharing through audio, visual, and data-oriented services is among critical approaches that telemedicine services mainly use. Teleconsultation, tele-education, remote interpretation, tele-psychiatry, and tele-surgery are among measures that can be implemented in emergencies like earthquakes, fires, floods, storms, and drought. The fundamental requirements of a telemedicine-oriented system for providing emergency services in natural disasters include wireless scales, conversation tools, blood pressure monitor, respiratory rate monitor, spo2 sensor, glucometer, portable ultrasound unit, wearable thermometers, virtual stethoscopes, portable three leads electrocardiograph monitor, and digital otoscopes. Simple telemedicine systems can have many advantages in the natural disasters. However, the main challenge in this regard is to adapt the necessary communication systems to a telemedicine paradigm. Another critical challenge is to interpret and apply the summary of acquired information and the inevitable interaction outcomes at the required time and place.

Challenges of Telemedicine during the COVID-19 pandemic: a systematic review

BackgroundThe COVID-19 pandemic has prompted the decrease of in-person visits to reduce the risk of virus transmission. Telemedicine is an efficient communication tool employed between healthcare providers and patients that prevents the risk of exposure to infected persons. However, telemedicine use is not infallible; its users reported multiple issues that complicated the expansion of this technology. So, this systematic review aimed to explore the barriers and challenges of telemedicine use during the pandemic and to propose solutions for improving future use.MethodsA systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. PubMed, Scopus, Web of Science, Academic Search Complete, CINAHL, Embase, and Science Direct were used to look for articles addressing barriers and challenges, in addition to articles proposing solutions. Studies were screened by title and abstract, followed by a full-text review. Risk of bias assessment was done using Critical Appraisal Skills Program for qualitative studies, Newcastle–Ottawa Scale for cross-sectional studies, and A MeaSurement Tool to Assess Systematic Reviews for systematic reviews. After the extraction of data, a narrative synthesis and analysis of the outcomes were performed.ResultsAmong 1194 papers identified, only 27 studies were included. Barriers and challenges were assembled under 7 categories: technical aspects, privacy, data confidentiality and reimbursement, physical examination and diagnostics, special populations, training of healthcare providers and patients, doctor-patient relationship, and acceptability. Poor internet connection and lack of universal access to technology were among the technical barriers. Concerns about patient privacy and reimbursement hindered the use of telemedicine too. Physical examination and certain procedures were impossible to perform via telemedicine. Training both healthcare providers and patients was deficient. The doctor-patient relationship was troubled by telemedicine, and both healthcare providers and patients were reluctant to use telemedicine.ConclusionWidespread use of telemedicine is still hampered by various barriers and challenges. Healthcare providers should work with various stakeholders to implement the proposed solutions. More research and policy changes are essential to optimize telemedicine utilization.