Implementation Of Telehealth Research Articles

Factors influencing telehealth adoption among consumers in Malaysia

This study investigates the factors influencing the adoption of telehealth among consumers in Malaysia, aiming to understand the impact of effort expectancy, performance expectancy, computer self-efficacy, and trust on the intention to use telehealth, building on the Unified Theory of Acceptance and Use of Technology (UTAUT). A quantitative descriptive methodology was used, collecting data from 390 Malaysian consumers via an online survey. The data were analyzed using IBM SPSS software to evaluate the relationships between the variables. The analysis revealed significant positive relationships between all examined factors and the adoption of telehealth. Performance expectancy was the most influential factor, followed by trust, effort expectancy, and computer self-efficacy. The multiple regression model indicated that these variables collectively explain 82.1% of the variance in telehealth adoption intention. The findings provide valuable insights for providers and marketers, suggesting that telehealth platforms should focus on performance expectancy, trust, and ease of use. Additionally, the study emphasizes the need for supportive policies from the Malaysian government to enhance telehealth adoption. The results contribute to the literature on healthcare technology adoption, offering practical implications for improving telehealth implementation in Malaysia.

National implementation of telehealth in Denmark: A case study

Abstract Background With a growing number of chronic patients and a shortage of healthcare professionals, modern health systems face mounting economic pressures. Telehealth has emerged as a promising solution to address these challenges and is considered a critical component of future healthcare provision. However, implementing telehealth on a large scale is complex and challenging. To fully grasp these challenges, it is essential to look beyond the technology and delve into the processes and actors involved in its implementation. Actors on a political-administrative level are pivotal in large-scale implementation, yet this level remains understudied. Thus, this study investigates the dynamics of large-scale implementation at a political-administrative level through a case study of the national implementation of TeleCOPD in Denmark - a home-monitoring intervention targeting patients with Chronic Obstructive Pulmonary Disease (COPD). Methods An in-depth qualitative study of the implementation process at the political-administrative level was undertaken. Data consisted of comprehensive documentary material, including policy documents and meeting minutes and 12 semi-structured interviews with 16 key stakeholders across all levels of the implementation process. Data was analysed in accordance with thematic analysis using an abductive strategy. Results The analysis shows that large-scale implementation of telehealth is a profoundly complex process, necessitating the collaboration of various stakeholders across organisational hierarchies. Substantial translational work is required at the political-administrative level to implement telehealth across diverse organisational contexts. Moreover, understanding the role of context in this translation process is essential. Conclusions This study generates valuable knowledge about large-scale implementation of telemedicine in addition to insights into the role of the political-administrative level in the implementation process. Key messages • Implementing telehealth nationally involves intricate translation processes at multiple levels. • Balancing local adjustments with degrees of fidelity is crucial in large-scale implementation.

Telehealth Outreach Program for Child Traumatic Stress: Strategies for Long-Term Sustainability.

There are high documented rates of exposure to traumatic events and mental health disorders among youths yet existing disparities in access to care for racial and ethnic minority youths and youths in rural communities. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based behavioral health therapy for children. The delivery of TF-CBT via telehealth can decrease access to care barriers. An interdisciplinary clinical team developed a training program to guide clinicians to effectively provide TF-CBT via telehealth. The goal of this study was to describe variation in implementation processes of the telehealth TF-CBT program and identify barriers and facilitators to program implementation post-training, which were utilized to develop implementation strategies for intervention sustainability. Using a mixed-methods approach, data were collected on telehealth implementation processes and facilitators and barriers to the delivery of telehealth TF-CBT. This study was guided by an adapted implementation science framework, namely the Exploration, Preparation, Implementation, Sustainment model. Interviews and surveys were completed with clinical site leaders who had participated in the telehealth TF-CBT training. Throughout clinical sites, there was varied adoption and penetration of the telehealth TF-CBT program. Facilitators to implementation included leadership and site staff buy in, community needs, and training resources, while barriers included funding, available logistical resources, and child and family involvement. The feedback gained from this project assisted in the development of implementation strategies for increased adoption and sustainment of TF-CBT delivered via telehealth. Strategies include ongoing interactive assistance and resource support, enhanced training for stakeholders, and program adaptations, with the goal to increase access to quality mental health care for underserved populations.

Impact of telehealth implementation on medical non-consultant hospital doctors training experience

Telehealth is defined as the provision of health care services over a distance. Major health systems, including outpatient clinics and check-ups alike, turned to telehealth and teleconsultation amid the COVID19 pandemic. There are many recognized advantages of telehealth and its increasing implementation, however, not much is known about the specific impact of remote consultation on the quality of non-consultant hospital doctors (NCHD) training experiences in medicine. This study aimed to gain rich descriptive insights into the specific impact of remote consultation on the quality of medical NCHD training experiences and their perceptions, through purposeful sampling. Data was collected via semi-structured virtual interviews of fifteen NCHD participants. The interviews were recorded, transcribed and analysed using thematic analysis. The collective transcripts were analysed using NVIVO data software for common themes. The themes identified suggested that there were both advantages and disadvantages to telehealth and its impact on training across a spectrum of entities including; doctor-patient relationships, peer relationships, service provision, work morale, working hours, clinical skills experience and general feedback as a trainee. NCHD perspectives expressed were mixed across all themes. Further research is recommended to advance understanding of the potential impact of telehealth on current and prospective doctors in training. With a greater understanding of general insights, future changes, including telehealth training programmes, could be implemented to build confidence and familiarity with telehealth utilization and potentiate its conceivable benefits.

Proposal of Competencies in Telehealth: A Mixed-Methods Study in the Biobío Region, Chile

Introduction: Telehealth has become essential in the delivery of healthcare services, especially during the COVID-19 pandemic. Objective: This study aims to identify the specific competencies needed for the effective implementation of telehealth in Biobío, Chile.Methods: A qualitative and quantitative validation of competencies was conducted. The qualitative phase included a focus group with professionals from various health areas to discuss and refine the competencies. The quantitative phase used the Telehealth Competency and Preparedness Perception Scale (EPPCT), employing a non-probabilistic convenience sampling (n=48) among health professionals in the Biobío region, Chile.Results: The qualitative validation highlighted the importance of system efficiency and waitlist management, confidence, and education in the use of technologies, and continuous training. The quantitative validation identified two main dimensions: "Professional Excellence" and "Remote Clinical Approach," encompassing communication, ethical, legal, and technological aspects.Conclusions: The proposed competencies are suitable for telehealth, emphasizing the need for continuous evaluation and training. An additional quantitative study is recommended to confirm and adjust the model, ensuring that healthcare professionals are prepared to face the challenges of remote care

Patient-Centered Cost Saving and Positive Environmental Impact With the Introduction of Telehealth Services at a Single Center.

To establish the patient-specific cost and time savings associated with telemedicine with the secondary environmental benefits of virtual visits within a tertiary referral center sub-specialty urology clinic. An electronic health record query was made of all urology telehealth visits that have occurred between October 4, 2020 and October 10, 2020 at a single academic center. We evaluated the cost of travel for an in-person visit based on zip code data. To adjust for productivity loss, the cost of missed work was added as either full day or half day-based distance and average compensation per day based on zip code data. Environmental impact was calculated using average CO2 emissions per mile not traveled. There were 6444 patients seen in the urology clinic via telehealth during the 6-month period. Urology patients traveled on average 69 ± 148 miles round-trip for an appointment. The average cost savings per patient including the cost of the gas and time away from work was $152.78 ± $105.90. Overall, over a 6-month period, the total cost savings was $984,534.73 for the 6444 patients seen via telemedicine. There was also a significant environmental impact of the decreased travel burden with 153.36 metric tons of CO2 emissions eliminated. With the implementation of telehealth during the COVID-19 pandemic, patients have been able to save a substantial amount of time and money primarily driven by the decreasing work hours lost and cost of travel.

Abstract C125: Improving access to genetic counseling and testing for underserved populations through telehealth

Abstract Introduction: A lack of access to genetic counseling for hereditary cancer risk in rural and underserved areas is well-documented and can exacerbate disparities in cancer risk reduction and early detection. Telehealth has the potential to bridge this gap, providing remote access to specialized care. The COVID-19 pandemic accelerated telehealth availability, allowing estimation of the causal effects of shifting to a model of virtual care delivery for genetic counseling services. Methods: The Stanford Cancer Genetic Counseling Clinic provided solely in-person care at two clinical sites (Palo Alto and San Jose, CA) until March 2020, and solely virtual care from April 2020 onward. We performed a regression discontinuity design, allowing outcomes comparison before and after the threshold of early 2020, to evaluate the impact of telehealth genetic counseling on access to care for patients living in areas of higher deprivation. The assignment variable (the exposure measured before versus after the threshold) was the three-month period during which the patients were seen, with the March-May 2020 quarter excluded because of disruption of care during the early COVID-19 pandemic. The primary endpoint was proportion of patients whose primary residence zip code had a state area deprivation index of at least 4. Secondary endpoints included driving distance to the primary clinic location in Palo Alto, CA, insurance type, race/ethnicity, and primary language. Results: The study included N=5,957 patients seen in the Stanford Cancer Genetics Program between January 2017 and February 2020, and N=9,469 patients seen between June 2020 and April 2024. The regression discontinuity analysis revealed a significant discontinuity at the threshold for telehealth in access for patients living in areas of higher deprivation, who accounted for 22% of patients seen just prior to telehealth implementation and 27% just after telehealth implementation, a proportional increase of 21% (p=0.006). Mean driving distance to Palo Alto, CA also increased, from 49 minutes just prior to the threshold to 56 minutes just after (p=0.003). There were no significant differences in insurance type, race/ethnicity, or primary language across the threshold. Conclusion: The implementation of telehealth services at the Stanford Cancer Genetic Counseling Clinic significantly improved access to genetic counseling for patients from areas with higher deprivation, as evidenced by a 21% increase in the proportion of such patients among those seen. These results quantify the effectiveness of telehealth in reducing geographical and socioeconomic barriers to specialized genetic counseling and testing services. Citation Format: Jennifer L. Caswell-Jin, Hao Tang, Mina Satoyoshi, Kerry Kingham, Allison W. Kurian. Improving access to genetic counseling and testing for underserved populations through telehealth [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C125.

Macrodominios de competencias en telesalud de los profesionales del área de la salud

In response to the increasing worldwide implementation of telehealth with the intent of closing the gaps in access to health, the World Health Organization (WHO) stresses the importance of defining competencies for health professionals in this field. This article presents the results of a literature review that identifies telehealth competency domains that strengthen the skills of health professionals. The results were analysed by categorizing the competency domains systematically into macrodomains that encompasskeyaspectsoftelehealthpractice; suchas applicability, remote clinical care, communication, networking, management, professionalism, information technologies, and ethical and legal aspects. These findings, supported by WHO recommendations, provide a solid basis for designing telehealth training programs and can be adapted to local contexts, facilitating the development of policies and strategies to improve the quality and accessibility of health care in remote or underserved settings.

Assessing Telehealth in Palliative Care: A Systematic Review of the Effectiveness and Challenges in Rural and Underserved Areas.

The integration of telehealth into palliative care has garnered significant attention due to its potential to enhance both access and quality of care, particularly for patients in rural and underserved areas. This interest stems from the need to address geographical and logistical barriers that traditionally hinder palliative care delivery. Despite its potential benefits, the effectiveness of telehealth and the challenges associated with its implementation remain underexplored, necessitating further investigation. This study aims to critically evaluate the effectiveness of telehealth in palliative care by focusing on several key areas: its impact on access to care, symptom management, patient satisfaction, and cost-effectiveness. To achieve this, a systematic review was conducted, synthesizing data from various studies that investigated telehealth interventions within palliative care settings. The review employed a comprehensive search strategy across electronic databases, concentrating on randomized controlled trials (RTCs) published between 2014 and 2024. To ensure the reliability of the findings, low-quality and unrelated studies were excluded, and the remaining studies were meticulously analyzed for bias and methodological quality. The review's findings indicate that telehealth significantly enhances access to palliative care, allowing patients to receive timely and appropriate care without the need for extensive travel. It also improves symptom management and patient satisfaction, aligning to provide patient-centered care. Additionally, telehealth is cost-effective by reducing expenses associated with travel and in-person visits. These benefits highlight telehealth's potential to address some of the critical challenges in palliative care delivery. Despite its advantages, implementing telehealth in palliative care is not without challenges. Technological barriers, such as inadequate infrastructure and device limitations, pose significant hurdles. Integration issues, including the need for seamless incorporation into existing care systems, and varying levels of digital literacy among patients and caregivers, also impact the effectiveness of telehealth. Addressing these challenges is crucial for optimizing telehealth's implementation. Ensuring that telehealth solutions are accessible, user-friendly, and well-integrated into care practices is essential for fully leveraging its potential benefits.

Factors critical for the successful delivery of telehealth to rural populations: a descriptive qualitative study

BackgroundThe use of telehealth has proliferated to the point of being a common and accepted method of healthcare service delivery. Due to the rapidity of telehealth implementation, the evidence underpinning this approach to healthcare delivery is lagging, particularly when considering the uniqueness of some service users, such as those in rural areas. This research aimed to address the current gap in knowledge related to the factors critical for the successful delivery of telehealth to rural populations.MethodsThis research used a qualitative descriptive design to explore telehealth service provision in rural areas from the perspective of clinicians and describe factors critical to the effective delivery of telehealth in rural contexts. Semi-structured interviews were conducted with clinicians from allied health and nursing backgrounds working in child and family nursing, allied health services, and mental health services. A manifest content analysis was undertaken using the Framework approach.ResultsSixteen health professionals from nursing, clinical psychology, and social work were interviewed. Participants mostly identified as female (88%) and ranged in age from 26 to 65 years with a mean age of 47 years. Three overarching themes were identified: (1) Navigating the role of telehealth to support rural healthcare; (2) Preparing clinicians to engage in telehealth service delivery; and (3) Appreciating the complexities of telehealth implementation across services and environments.ConclusionsThis research suggests that successful delivery of telehealth to rural populations requires consideration of the context in which telehealth services are being delivered, particularly in rural and remote communities where there are challenges with resourcing and training to support health professionals. Rural populations, like all communities, need choice in healthcare service delivery and models to increase accessibility. Preparation and specific, intentional training for health professionals on how to transition to and maintain telehealth services is a critical factor for delivery of telehealth to rural populations. Future research should further investigate the training and supports required for telehealth service provision, including who, when and what training will equip health professionals with the appropriate skill set to deliver rural telehealth services.

Evaluating perceived technology self-efficacy and telehealth acceptance in optometry students

ABSTRACT Clinical relevance Constant technological improvements require practitioners to be open to adopting technologies such as telehealth for enhanced patient care. Understanding the barriers and facilitators of telehealth adoption will guide stakeholders in making decisions for safe and effective implementation of telehealth. Background Effective use of telehealth improves patient outcomes. It is unclear if optometry students feel supported in using and/or are accepting of telehealth. This study evaluated telehealth acceptance of optometry students, its association with their technology self-efficacy, and whether telehealth training alters this relationship. Methods Final-year optometry students at the University of Melbourne were invited to participate in a telehealth course. A 22-item online survey adapted from the Technology Proficiency Self-Assessment for twenty-first Century Learning was used to evaluate technology self-efficacy pre- and post-learning. Telehealth acceptance was evaluated using a 34-item survey according to the Unified Theory of Acceptance and Use of Technology-2. A 5-point Likert scale was used for each item, yielding two total scores. Respondent demographics, frequency of usage and number of devices were recorded. Descriptive statistics, ANOVA and Pearson correlation were used to analyse demographic variables and relationship between technology self-efficacy and telehealth acceptance. Results 58 (68%) and 49 (58%) students participated in the pre- and post-learning surveys. Majority were 20–29-year-old females. Students used between two and four devices for online activities, with 62% being online at least hourly. Technology self-efficacy scores (average ± SD) pre- and post-learning were 83.8% ± 8.2 and 87.8% ± 7.1. Telehealth acceptance scores pre- and post-learning were 66.1% ± 9.6 and 73.98% ± 9.9. There was no association with gender, number of devices and frequency of online use for all scores. Correlation between technology self-efficacy and telehealth acceptance was insignificant pre-learning (p = 0.3) but was significant post-learning (p = 0.04). Conclusion Optometry students demonstrated high technology self-efficacy compared to telehealth acceptance. Telehealth training resulted in marked improvement in telehealth acceptance.

Mental health and telehealth quality perception: a mediation model analysis

Telehealth services have emerged as a revolutionary approach to healthcare delivery. However, patients’ perception of telemedicine is influenced by multifactorial factors, among which the relationship between mental health and telemedicine remains largely underexplored. Drawing from the Health Information National Trends Survey 6 (HINTS 6) data, this study seeks to shed light on this intricate relationship, especially examining the mediating effects of confidence in health management while considering the privacy concerns, technical challenges, and perception of isolation using the Hayes PROCESS macro model. We found that individuals with mental health challenges frequently feel isolated, face telehealth technical issues, and have heightened privacy concerns. These challenges influence their self-confidence in managing health, directly affecting telehealth service perception. Interestingly, while mental health and feelings of isolation are closely tied, isolation doesn’t directly impede telehealth quality perceptions. Instead, its impact is seen through its association with self-care confidence, emphasizing the need for holistic strategies in telehealth implementations that address both technical and psychological factors.

Telehealth development in the WHO European region: Results from a quantitative survey and insights from Norway

BackgroundThe COVID-19 pandemic sent shock waves through societies, economies, and health systems of Member States in the WHO European Region and beyond. During the pandemic, most countries transitioned from a slow to a rapid adoption of telehealth solutions, to accommodate the public health and social measures introduced to mitigate the spread of the disease. As countries shift to a post-pandemic world, the question remains whether telehealth’s importance as a mode of care provision in Europe continues to be significant. ObjectiveThis paper aims to present, synthesize, and interpret results from the Telehealth Programmes section of the 2022 WHO Survey on Digital Health (2022 WHO/Europe DH Survey). We specifically analyze the implementation and use of teleradiology, telemedicine, and telepsychiatry. Norwegian telehealth experiences will be used to illustrate survey findings, and we discuss some of the relevant barriers and facilitators that impact the use of telehealth services. MethodsThe survey tool was revised from the 2015 WHO Global Survey on eHealth, updated to reflect recent progress and policy priorities.The 2022 WHO/Europe DH Survey was conducted by WHO and circulated to Member States in its European Region from April to October 2022. ResultsThe data analysis revealed that teleradiology, telemedicine, and telepsychiatry are the telehealth services most commonly used in the WHO European Region in 2022. Funding remains the most significant barrier to the implementation of telehealth in the Region, followed by infrastructure and capacity/human resources. The survey results highlighted in this study are presented in the following sections: (1) telehealth strategies and financing, (2) telehealth programmes and services offered by Member States of the WHO European Region, (3) barriers to implementing telehealth services, and (4) monitoring and evaluation of telehealth. ConclusionBased on WHO’s 2022 survey, the use of telehealth in the WHO European Region is on the rise. However, merely having telehealth in place is not sufficient for its successful and sustained use for care provision. Responses also uncovered regional differences and barriers that need to be overcome. Successful implementation and scaling of telehealth requires rethinking the design of health and social care systems to create robust, trustworthy, and person-centred digital health and care services.

The Impact of Telehealth Implementation on Increasing Antenatal Care Visits: A Literature Review

Antenatal care is an essential service in reducing maternal mortality. However, several studies have shown that distance, cost, time and quality of service affect the decline in ANC visits. For this reason, technology-based innovation (telehealth) is needed to overcome this. The aim was to evaluate the impact of using telehealth on increasing the number of antenatal care visits. The method used was PRISMA from electronic databases: Scopus, Clinical Key Nursing, Science Direct and Proquest. The results showed that telehealth can expand the range of services, is effective, efficient and flexible in terms of cost and time, and there is no significant difference in the quality of the examination results. In conclusion, through easy access and more efficient costs offered by telehealth, it has a positive impact on increasing the number of antenatal care visits. This also has implications for the world of nursing, not only expanding maternity services but continuing to adapt to the massive development of technology to welcome the era of Society 5.0

Exploring physicians’ expectations of telehealth services implementation in primary care: An application of the social cognitive theory

ABSTRACT Background: Understanding healthcare professionals’ expectations in telehealth is crucial for successful implementation. The present study used an adaptation of the antecedents-expectations model, supported by the social cognitive theory to evaluate physicians’ expectations regarding the implementation of telehealth in primary healthcare (PHC) and to investigate the potential influence, on expectations, of a prior telehealth experience (antecedents) during the Coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: A questionnaire-based survey was conducted online, targeting PHC physicians. Expectations covered four telehealth performance domains including public health and health promotion, Care Quality and Workflow Organization, Patient’s Convenience and Engagement and Providers’ Value and Training. Antecedents included six domains including gain in self-efficacy, gain in knowledge, gain in participation/engagement, gain in experience, enjoyment and satisfaction. Stepwise linear regression was performed to analyse the effect of antecedents on overall expectations. Results: A total of 54 physicians participated in the study. The mean expectation score was 114.15/154 (SD = 28.26), with highest expectations concerning cost-effectiveness, care timeliness and patients’ convenience. A previous experience with smart apps and dedicated telehealth platforms was associated with lower expectations scores. Expectations scores were positively correlated with antecedents scores; however, satisfaction was the sole independent factor of overall expectations (regression coefficient B = 4.40, 95%CI: 3.11–5.68). Conclusion: The findings highlight the significance of previous experience and various antecedents in shaping physicians’ expectations about telehealth. These insights can inform the development of strategies and interventions to enhance healthcare professionals’ expectations and facilitate the successful implementation of telehealth services.

Telehealth in Urology Beyond COVID-19

Introduction: Implementation of telehealth (TH) accelerated during the COVID-19 pandemic and has become a vital part of health care delivery. As we move toward the post-COVID-19 era, clinical practice has demonstrated a need for updated policies and quality improvement to solidify the role of TH in the urology care setting. The AUA Census data were used to explore trends, benefits, and barriers to urology TH implementation. Methods: The AUA Workforce Workgroup and Telehealth Taskforce analyzed data from the 2019-2022 AUA Census. Pertinent variables included utilization, patient satisfaction, care settings, quality, and diagnoses amenable to TH. Results: Pre-COVID-19 TH utilization increased from 11.9% to 81% during and after the COVID-19 pandemic. TH is predominately used in metropolitan academic centers, with usage increasing from 12.8% to 83% in these areas during the pandemic. Usage also increased in non-metropolitan areas from 3.8% to 61.2%. Overall, 76.7% reported increased ease of scheduling follow-ups, 62% ease of ordering tests, and 69.5% ease of accessing patient data in favor of audio visits vs in-person visits. TH utilization increased from 42.4% to 65% for initial visits and 66.8% to 82% for follow-up visits. Over 80% of practicing urologists younger than 54 years desire the use of telemedicine for follow-up visits. TH increased patient access to care by 51.6%, and 54% of urologists expressed desire to continue using or increase utilization of TH. The top 3 barriers of patient’s ability to receive telemedicine were 67.6% noting lack of knowledge in using patient portal/software needed for telemedicine visits, 49.6% had lack of adequate conferencing tools, and 43.9% lacked high-speed internet service to enable video visits. In total, 53.4% of urologists would absolutely or probably increase usage if payment parity of TH was comparable with that of in-office E/M services. Conclusion: TH implementation accelerated during the COVID-19 era. In the post-COVID-19 era, TH continues to be important across multiple areas including patient and physician satisfaction and increasing access to care, particularly in rural areas. Barriers exist, especially concerning payment parity, and could be eliminated through advocacy for policy updates and standardization of technology.

Evaluation of the use of telehealth in Dietetics’ practice during the COVID-19 pandemic in the Kingdom of Saudi Arabia

Telehealth, which involves the remote delivery of healthcare services through virtual technologies, has been shown to have benefits such as reducing hospitalisations and length of stay for patients (1,2). The global COVID-19 pandemic has greatly accelerated the adoption of telehealth among clinical nutritionists. For instance, in the USA, telehealth usage for nutritional care has increased from 37% to 78% among clinical nutritionists (3), while in Italy, the adoption of telenutrition services by Registered Dieticians (RDNs) has risen from 16% to 63% (4). These statistics highlight the rapid integration of telehealth into dietetics practices as a response to the global health crisis, reflecting a growing trend towards virtual care delivery as an effective method for providing nutritional care. While telehealth has made progress in Saudi Arabia (5), there is a research gap regarding its prevalence and effectiveness in dietetics practice. This study aims to evaluate the current implementation of telehealth in dietetics practice during the COVID-19 pandemic in Saudi Arabia.In this cross-sectional, a web-based online survey was used from mid-December 2022 to mid-May 2023. The study was distributed in several Saudi Arabian regions including (central, western, eastern, south, and north) and was completed by 306 clinical Registered Dietitians (RDNs) in public and private healthcare facilities who met the study’s inclusion criteria. The survey consisted of 28 questions divided into four sections, covering sociodemographic information, past or current experiences, obstacles and challenges of telehealth usage, and the future prospects of telehealth. In this study, participants were requested to reflect on their current observations and previous experiences pertaining to the utilisation of telehealth in the field of dietetics. To ensure the validity and relevance of the survey, it was reviewed by a panel of experienced dietitians in Saudi Arabia to obtain their feedback before being used to collect data.Our research findings reveal that 76% of RDNs in Saudi Arabia utilize telehealth in their practice. The most common obstacles reported by RDNs using telehealth include internet connectivity issues (21.9%), patient disengagement and lack of enthusiasm (21.3%), and difficulties in coordinating with patients (21%). Telehealth interventions used by RDNs primarily involve diet recall (33.7%), weight- related measurements (30.6%), lab findings (26%), and only 8% reported using telehealth for vital signs. A majority of participants (69.4%) believed that telehealth could improve patient accessibility and help reduce no-show rates (68.9%). Additionally, over 70% of participants agreed that telehealth offers them flexibility in inpatient consultations.In conclusion, telehealth is widely utilised among RDNs in Saudi Arabia, with potential benefits such as decreased no-show rates. Further research is needed to gain a better understanding of telehealth usage among RDNs in Saudi Arabia.

Telehealth-Delivered Allied Health Interventions: A Rapid Umbrella Review of Systematic Reviews.

Introduction: Telehealth is used by allied health professionals to deliver health care remotely. This umbrella review addressed the following questions: (1) What telehealth interventions have been implemented to deliver allied health care? (2) What are the reported clinical benefits, and challenges of the implementation of telehealth delivered allied health interventions? (3) What are the reported experiences of patients and clinicians? Methods: A rapid umbrella systematic review method was utilized. Following a search of five electronic databases, only systematic reviews reporting on telehealth-delivery allied health interventions published in the past 10 years were included. Reported outcomes included clinical effectiveness, implementation factors, and patient/clinician experiences. Methodological quality was established using the A MeaSurement Tool to Assess systematic Reviews 2. Results: After applying eligibility criteria to 571 studies, 26 studies were included. Findings indicate that telehealth-delivered allied health interventions may obtain similar clinical outcomes as compared with face-to-face appointments. Patients reported less stress and valued the reduced need to travel when telehealth was used. Patient satisfaction with telehealth delivered care was equal to face-to-face care, and no differences were noted in the capacity to build therapeutic alliance when using telehealth. Difficulties with technology use were reported by clinicians and patients. Clinicians were identified as needing increased time management skills. Cautious interpretation of findings is recommended due to the quality rating of low to critical low for the majority of individual reviews. Conclusions: Telehealth-delivered care might obtain similar clinical outcomes to face-to-face care; however, difficulties may arise during broad implementation. It is recommended that health services be strategic to overcome implementation barriers and provide targeted support to enable effective, equitable, and sustained allied health service delivery via telehealth.

Satisfaction with mode of delivery of genomic sequencing results in a diverse national sample of research participants through the Clinical Sequencing Evidence-Generating Research Consortium

PurposeResearch that includes diverse patient populations is necessary to optimize implementation of telehealth. MethodsAs part of a Clinical Sequencing Evidence-Generating Research Consortium cross-site study, we assessed satisfaction with mode of return of results (RoR) delivery across a diverse sample of participants receiving genetic testing results in person vs telemedicine (TM). ResultsNinety-eight percent of participants were satisfied with their mode of results delivery. Participants receiving results by TM were more likely to report a preference for receiving results in a different way and challenges with providers noticing difficulties with understanding. More than 90% reported satisfaction across all items measuring support and interaction during sessions. Participants self-reporting Hispanic/Latino or Black/African American race and ethnicity compared with White/European American, fewer years of education, and having lower health literacy were more likely to report challenges with understanding the information or asking questions. Participants who were White/European American, had more years of education, and higher health literacy reported higher communication scores, reflecting more positive evaluations of the communication experience. ConclusionTM is an acceptable mode of return of results delivery across diverse settings and populations. Research optimizing approaches for underrepresented populations, populations with lower levels of education and health literacy, and multilingual populations is necessary.

Perspectives on telehealth implementation in Australia: An exploratory qualitative study with practice managers and general practitioners

BackgroundThere is a lack of understanding regarding the impact of telehealth on clinical delivery and the feasibility of sustained implementation by health services. The COVID-19 pandemic provided an ideal opportunity to identify factors related to the implementation of telehealth. This study assessed factors that influenced telehealth implementation during COVID-19 in the Western region of Victoria, Australia, from the perspectives of practice managers and general practitioners (GPs). MethodsEmploying a qualitative approach, we conducted semi-structured interviews with 14 GPs and 11 practice managers across metropolitan and rural settings in the Western region of Victoria, Australia. Interviews were conducted between December 2021 to June 2022, which included periods during and beyond the peak of the COVID-19 pandemic. Themes were synthesised using the Consolidated Framework for Implementation Research, which comprised five domains: innovation, inner setting, outer setting, individuals and implementation process. An additional domain related to billing and finances was added. ResultsThe innovation domain revealed that telehealth was identified by both stakeholder groups as a critical tool for improving healthcare access for vulnerable patients. GPs highlighted the role of telehealth in follow-up care and the need for extended telephone consultation services. For the implementation process, both stakeholder groups identified a shift in attitudes among GPs from reluctance to acceptance of telehealth. In terms of outer setting, constant changes in regulations posed challenges to administrative staff. Practice managers faced difficulties in acquiring information on changes, but those with robust professional networks were well supported. Initial loss of incentive funding and government-imposed billing methods posed hurdles for clinics. Both stakeholder groups highlighted the need for education around videoconference and a standardised telehealth platform. ConclusionEvolving telehealth regulations during the emergence of COVID-19 posed financial, operational and administrative challenges to primary care clinics. To ensure sustainability, policymakers should improve stakeholder communication, set interoperability standards, and ensure sustainable funding for telehealth.