Remote Care Research Articles

Algorithm-Driven Tele-otoscope for Remote Care for Patients With Otitis Media.

The COVID-19 pandemic has spurred a growing demand for telemedicine. Artificial intelligence and image processing systems with wireless transmission functionalities can facilitate remote care for otitis media (OM). Accordingly, this study developed and validated an algorithm-driven tele-otoscope system equipped with Wi-Fi transmission and a cloud-based automatic OM diagnostic algorithm. Prospective, cross-sectional, diagnostic study. Tertiary Academic Medical Center. We designed a tele-otoscope (Otiscan, SyncVision Technology Corp) equipped with digital imaging and processing modules, Wi-Fi transmission capabilities, and an automatic OM diagnostic algorithm. A total of 1137 otoscopic images, comprising 987 images of normal cases and 150 images of cases of acute OM and OM with effusion, were used as the dataset for image classification. Two convolutional neural network models, trained using our dataset, were used for raw image segmentation and OM classification. The tele-otoscope delivered images with a resolution of 1280 × 720 pixels. Our tele-otoscope effectively differentiated OM from normal images, achieving a classification accuracy rate of up to 94% (sensitivity, 80%; specificity, 96%). Our study demonstrated that the developed tele-otoscope has acceptable accuracy in diagnosing OM. This system can assist health care professionals in early detection and continuous remote monitoring, thus mitigating the consequences of OM.

Distance follow-up by a remote medical care centre improves adherence to CPAP in patients with obstructive sleep apnoea over the short and long term.

Adherence to continuous positive air pressure (CPAP) in patients with obstructive sleep apnoea (OSA) has remained invariably low over the last decades. Remote monitoring of the nocturnal CPAP treatment, within telemedicine (TM)-based follow-up programs, in these patients has been suggested as a potential tool to improve adherence and release the workload of sleep units. The aim of this study was therefore to assess whether a follow-up program carried out by a Remote Medical Care Centre (RMCC), outside the sleep unit, improves adherence to CPAP in the short and long term in patients with OSA. In this pilot protocol, we enrolled 37 patients starting CPAP in our Sleep Centre (SC). After three months of standard care in our SC, patients initiated a six-month remote follow-up carried out by the RMCC, functioning as an intermediary between patients and SC. Monthly reports and indication for face-to-face visits were sent to the SC for six months. After this period patients returned to usual care for one year. Results were compared with those obtained in 38 patients (controls) followed with usual care over the same time range. Mean nightly use of CPAP increased from 3.2 ± 2.4 h pre-RMCC to 5.2 ± 1.9 h post-RMCC (p < 0.0001). Nights/month of CPAP use improved from 19.8 ± 9.2 to 25.2 ± 2.5 (p < 0.05) and nights/month with CPAP use >4 h from 12.5 ± 10 to 21.03 ± 8.9 (p < 0.05). This improvement remained stable after 12 months from the return of patients to usual care. No significant changes in CPAP use were observed in controls over the time. A six-month follow-up through a remote facility can significantly improve adherence to CPAP in the short and long term. This pilot study provides a solid base for the design of multicentre randomized trials focusing on new models which are able to increase the long-term efficacy of TM programs.

Intelligent pet cat care residence design based on cloud platform

In order to provide an intelligent living environment for pet cats, so that owners can understand and control the daily life of pet cats, and communicate and interact with them through voice, a remote pet cat care system was designed. The system uses a remote monitoring function that combines a cloud platform and a camera, allowing owners to keep an eye on their pet cats' movements even when they are away from home. This system uses PLC as the main control unit and STM32 single chip microcomputer as the slave, which can not only collect temperature, humidity, light intensity, pressure and other signals, but also carry out real-time control of the controllable hardware in the system, and transmit the collected data to the cloud platform. 4G communication technology is adopted, and users can remotely complete the intelligent control of all equipment in the system through the cloud platform. To realize real-time monitoring and interaction of pet cats in all aspects; According to the pet cat daily diet, drinking water, exercise and other important data to determine whether the physical health. This can improve the service level of the pet cage industry and inject technological power to make pet cages more intelligent.

Application of the Transtheoretical Model to Physical Activity and Health-related Quality of Life Among Older People Living With Frailty in the Community: The Fitness and Nutrition Program for Seniors (FANS) Study Protocol

Background: When the COVID-19 pandemic is combined with frailty, not only are older people's types of activities and willingness to be active limited, but also issues and hidden concerns about health care arise. However, the effectiveness of health promotion strategies incorporating remote care technologies remains to be explored. Therefore, the purpose of this study was to develop a hybrid learning approach based on a fitness and nutrition program for seniors (FANS). Simultaneously, the FANS follows the Transtheoretical Model (TTM) as an overall framework to design blended learning in in-person and telecare modalities for older people living with frailty in the community.Methods: This study is a non-randomized, control-group, pretest–posttest design. A total of 84 older participants living with frailty will be assigned to two groups. The intervention group will receive the 6-month, 9-session FANS through hybrid learning, which includes in-person physical activity (PA) training, nutritional guidance led by a nurse, and group discussions. The official account of the FANS and the group chat will provide individuals with online home practice at the current TTM stage, session time and home practice reminders, video reviews, consultations, and tutoring for telecare. The waitlist control group will maintain regular health promotion activities. Three repeated assessments (one pre-test and two post-training tests conducted after 3 months and after 6 months) will be conducted. The primary outcome measures will include frailty status, PA, and health-related quality of life (HRQoL), and the secondary outcome measures will be health-related data. Statistical analysis will include the Chi-squared test, Independent Sample t-test, and Generalized Estimating Equation (GEE).Discussion: This study will provide evidence that the FANS for older people living with frailty will have more positive and beneficial outcomes than the traditional method. Simultaneously, we hope the FANS will help the older population living with frailty in the community to transform their health difficulties in the future.Trial Registration: NCT05242549. Registered 22 February 2022.

Mental telehealth in a public child and adolescent psychiatry unit during the pandemic: a qualitative implementation study.

The COVID-19 pandemic led to a prompt implementation of remote care, especially in mental health care. The evidence supporting this modality of care is still emerging, with few qualitative studies describing its implementation in Latin American countries. This study aims to understand the perspectives of therapists and patients regarding the use of telehealth in a child and adolescent mental health unit of a Chilean public service. This is a qualitative study. Two focus groups were defined with 14 professionals, and 16 in-depth interviews were conducted with users of an outpatient child and adolescent psychiatry unit. The data were analyzed using the grounded theory model. In the group of therapists, four main categories emerged: background of mental telehealth, implementation, mental telehealth from the therapist's position, and projections. Three main categories emerged in the patient's group: implementation, evaluation of mental telehealth users, and projections. There are elements in common between the opinions of patients and therapists. Something to note within the patient's group is that, despite accepting remote care and recognizing its positive aspects, aside from the pandemic context, they prefer face-to-face or mixed care.

Current and Future Challenges for Rehabilitation for Inflammatory Arthritis.

This narrative review discusses the importance of rehabilitation in rheumatic and musculoskeletal diseases (RMDs), ultimately aiming to reduce their impact on individuals and society. It specifically emphasizes the need for rehabilitation in inflammatory arthritis (IA), particularly in cases where medical management is insufficient. It acknowledges that the complexity of rehabilitation demands a flexible approach. Thereby, it touches on the various models of rehabilitation, which may include multidisciplinary team care, extended practice models, shared care, remote care, and work rehabilitation. It discusses the challenges in research, practice, and policy implementation. In research, the need for innovative research designs is highlighted, whereas regarding clinical practice the importance of early detection of disability and patient engagement is underlined, as well as the role of telehealth and AI in reshaping the rehabilitation landscape. Financial barriers and work force shortages are identified as challenges that hinder the effective delivery of rehabilitative care. On the policy level, this paper suggests that the allocation of healthcare resources often prioritizes acute conditions over chronic diseases, leading to disparities in care. This paper concludes by emphasizing the critical role of evidence-based rehabilitation in improving the quality of life for people with RMDs, in particular for those with IA, and promoting their healthy aging. It also calls for tailored rehabilitation models and the early identification of persons with rehabilitation needs as future challenges in this field.

Exploring Quantitative Methodologies for Assessing the Environmental, Social, and Economic Impacts of Telemedicine: A Literature Review

The significant consumption of resources within the healthcare sector underscores the need to address both efficiency and sustainability concerns. Telemedicine has been identified as one of the most promising pathways for reducing the environmental impacts of the healthcare sector. However, a comprehensive sustainability assessment is still required. The main aim of the present study is to conduct a systematic literature review to explore approaches and methodologies employed for quantifying the environmental, social, and economic impacts of telemedicine. Moreover, the research seeks to determine whether the approaches focus on a single aspect or whether they allow for a comprehensive assessment including all three sustainability pillars. The searching phase was conducted in the Scopus and PubMed databases, considering last 10 years (i.e., 2013–2023). Keywords were related to remote care and sustainability impact fields. Following the PRISMA framework, out of 477 articles, 91 studies were included in the analysis. Primary findings highlighted that studies on telemedicine impacts predominantly focus on transport-related aspects, emphasizing direct emissions and associated costs that are avoided and time savings. Televisit emerged as the most investigated remote care activity. Database and conversion factors were mainly employed for analysis, while other methodologies were sporadically mentioned in the literature. Despite numerous papers addressing these issues, a standardized and comprehensive methodology still appears to be lacking. Future works should consider the entire life cycle process, including more stakeholders. A defined approach will be fundamental to move beyond theoretical discussions and provide actionable insights for healthcare practitioners, policymakers, and researchers.

Digitally enabled asynchronous remote medical management of anxiety and depression: A cohort study.

To evaluate the clinical outcomes of a remote mental health program for managing anxiety and depression, primarily using asynchronous digital communication. This retrospective cohort study examined U.S. adults seeking remote care for anxiety and depression from January 2021 to May 2022. The program involves clinician-led assessment, patient education, medication management, and ongoing monitoring, primarily via text. Anxiety and depression were measured using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scores. Outcomes examined were changes in scores, 50% score improvement rate, and remission rate (score <5) at 1, 3, and 6 months. During the period evaluated, 11,844 program participants met the inclusion criteria. Most were female (n = 8328, 70.3%); their age ranged from 18-82 years (median 31 years). At baseline, median PHQ-9 and GAD-7 scores were 13 (IQR 9-17); 67% and 69% met score criteria for depression and anxiety, respectively. Most participants (80%) were prescribed a selective serotonin reuptake inhibitor (SSRI). By one month, average PHQ-9 and GAD-7 scores decreased significantly by 9.2 and 9.1 points (both p < .01). At 1-month follow-up, the 50% score improvement rate was 66% for PHQ-9 and 69% GAD-7 (p < .01). Scores continued to decrease with follow-up. At 3 months, over half achieved remission (percent [95% CI]: 52% [51-54] for anxiety, 53% [52-55] for depression). Similar improvement was observed at 6 months and in sensitivity analyses accounting for loss to follow-up. Use of a remote mental health program with digital tools was associated with significant clinical improvement in anxiety and depression. Challenges remain in maintaining patient engagement and ensuring appropriate care quality monitoring in digital mental health programs. Additional research comparing remote digital care to traditional in-person models is warranted. Studies should examine long-term outcomes, optimal care protocols, and the challenges to integrating these programs into existing healthcare systems and ensuring equitable access.

Telematic interview in telepharmacy: consensus document for farmacotherapeutic monitoring and informed drug delivery

Telepharmacy is defined as the practice of remote pharmaceutical care, using information and communication technologies. Given its growing importance in outpatient pharmaceutical care, the Spanish Society of Hospital Pharmacy developed a consensus document, “Guía de entrevista telemática en atención farmacéutica,” as part of its strategy for the development and expansion of telepharmacy, with key recommendations for effective pharmacotherapeutic monitoring and informed dispensing and delivery of medications through telematic interviews.The document was developed by a working group of hospital pharmacists with experience in the field. It highlights the benefits of telematic interviewing for patients, hospital pharmacy professionals, and the healthcare system as a whole, reviews the various tools for conducting telematic interviews, and provides recommendations for each phase of the interview. These recommendations cover aspects such as tool/platform selection, patient selection, obtaining authorization and consent, assessing technological skills, defining objectives and structure, scheduling appointments, reviewing medical records, and ensuring humane treatment.Telematic interview is a valuable complement to face-to-face consultations but its novelty requires a strategic and formal framework that this consensus document aims to cover. The use of appropriate communication tools and compliance with recommended procedures ensure patient safety and satisfaction. By implementing telematic interviews, healthcare institutions can improve patient care, optimize the use of resources and promote continuity of care.

Navigating Chronic Disease Management with Digital Healthcare Solutions amidst the COVID-19 Pandemic: A Systematic Literature Review

Purpose: The purpose of this paper is to critically evaluate data collected from various studies on Chronic Disease Management during the COVID-19 pandemic and the emergence of Digital Healthcare as a means of providing innovative approaches to manage chronic diseases. Methodology: A systematic literature review was applied. Studies were found after a search in the Pubmed database with no publication date time limit, given that COVID–19 emerged in 2019. A Prisma diagram was created to record the way and the criteria by which we included and excluded studies for our research. Out of the 567 records identified through various sources 85 were used for a qualitative synthesis. Results: During the first wave of the pandemic, a significant reduction or complete cancellation of scheduled health appointments was observed. Shortages of medication used to manage chronic conditions were also observed at the beginning of the COVID-19 pandemic due to global supply chain disruptions. Governments acted rapidly at the beginning of the pandemic to promote the use of teleconsultations by introducing enabling legislation and revising laws ensuring continuity of care for people with chronic diseases, thus transitioning rapidly to remote care and monitoring. Conclusion: Telemedicine and involving community pharmacists in chronic patient management are key for sustained adherence. Long-term policies are vital to prevent pandemic-driven health disparities. Lessons should be derived for future preparedness, managing subsequent waves, and ensuring testing in primary care.

Capacity building to address antimicrobial resistance in remote Australia: The inaugural HOT NORTH Antimicrobial Academy

BackgroundRates of antimicrobial resistance (AMR) for some pathogens in Australia are considerably higher in rural and remote compared to urban regions. The inaugural Hot North Antimicrobial Academy was a 9-month educational programme aimed to build workforce knowledge and capacity in antimicrobial use, audit, stewardship, surveillance and drug resistance in remote primary health care. MethodsThe Academy was advertised to Aboriginal and Torres Strait Islander, regional and remote healthcare workers. Participants were Aboriginal health practitioners, nurses, pharmacists and doctors from Queensland, Northern Territory, South Australia and Western Australia working in remote primary health care with a focus on Indigenous health. Due to COVID-19 restrictions, the Academy ran virtually from February–November 2021 using Microsoft Teams. The Academy was evaluated using surveys and yarning circles to assess impact and knowledge gain. ResultsParticipants and faculty from across Australia attended 19 lectures and mentorship sessions. Eleven participants commenced and eight (73%) completed the Academy. The Academy raised participants awareness of AMR guidelines, governance and generating change; built confidence in advocacy; grew knowledge about drug resistant infections; and created a community of AMR champions in Indigenous health. ConclusionThe evaluation confirmed the Academy met the needs of participants, provided opportunities to move stewardship from tertiary hospitals into Indigenous and remote clinics and developed skills in research, audit, stewardship and advocacy for all involved. All sessions were recorded for future use, with facilitation by the National Aboriginal Community Controlled Health Organisation (NACCHO) in future years.

Questionnaire Survey on Perception and Attitude Toward of Remote Treatment by Korean Medicine Doctors

Objectives: Following the global COVID-19 pandemic, with the escalation of remote medical care formalization in Korea, there is a pressing need for objective data in the Korean medicine field to respond to remote treatment medical care policies. This study aims to investigate the perceptions and acceptance of remote treatments among Korean Medicine Doctors (KMDs).Methods: After expert reviews and pilot testing, the 31-question survey covered participant characteristics, experiences, forms, intentions, and perceptions related to Remote Treatments. The survey was electronically distributed to members of the Association of Korean Medicine, and 662 clinical KMDs provided valid responses.Results: Among respondents, 76.1% engaged in remote treatments, utilizing various platforms. Those with experience in Remote Treatments showed a significantly higher willingness to continue participating during the institutionalization process (p&lt;0.001). 49.7% of respondents stated that traditional Korean medicine is competitive in remote treatments, with the main reasons being the ability for regular management after herbal medication(26.1%) and increased patient satisfaction due to sufficient counseling compared to Western medicine(25.2%). Respondents preferred Remote Treatment conditions with a treatment time of less than 10 minutes(47.6%) and equivalent fees to in-person visits(45.6%). Regarding suitable intervention tools during Remote Treatment, respondents favored non-covered herbal prescriptions(39.0%), covered herbal granules(24.6%), and non-covered herbal granules(23.0%).Conclusion: This study investigated the perceptions and acceptance of KMDs regarding remote treatments. These findings provide valuable insights for policymakers aiming to establish effective policies for Remote Treatments suitable for the Korean medicine healthcare environment.

Midwives’ experience of telehealth and remote care: a systematic mixed methods review

IntroductionIncreasing the midwifery workforce has been identified as an evidence-based approach to decrease maternal mortality and reproductive health disparities worldwide. Concurrently, the profession of midwifery, as with all healthcare professions,...

Promoting equitable and patient-centred care: an analysis of patient satisfaction in urban, rural and remote primary care sites in the Philippines

ObjectivesThis study measured changes in patient satisfaction levels before and after the introduction of primary care system strengthening interventions in urban, rural, and remote sites in the Philippines.MethodsA previously validated...

Cloud-Based Machine Learning Platform to Predict Clinical Outcomes at Home for Patients With Cardiovascular Conditions Discharged From Hospital: Clinical Trial.

Hospitalizations account for almost one-third of the US $4.1 trillion health care cost in the United States. A substantial portion of these hospitalizations are attributed to readmissions, which led to the establishment of the Hospital Readmissions Reduction Program (HRRP) in 2012. The HRRP reduces payments to hospitals with excess readmissions. In 2018, >US $700 million was withheld; this is expected to exceed US $1 billion by 2022. More importantly, there is nothing more physically and emotionally taxing for readmitted patients and demoralizing for hospital physicians, nurses, and administrators. Given this high uncertainty of proper home recovery, intelligent monitoring is needed to predict the outcome of discharged patients to reduce readmissions. Physical activity (PA) is one of the major determinants for overall clinical outcomes in diabetes, hypertension, hyperlipidemia, heart failure, cancer, and mental health issues. These are the exact comorbidities that increase readmission rates, underlining the importance of PA in assessing the recovery of patients by quantitative measurement beyond the questionnaire and survey methods. This study aims to develop a remote, low-cost, and cloud-based machine learning (ML) platform to enable the precision health monitoring of PA, which may fundamentally alter the delivery of home health care. To validate this technology, we conducted a clinical trial to test the ability of our platform to predict clinical outcomes in discharged patients. Our platform consists of a wearable device, which includes an accelerometer and a Bluetooth sensor, and an iPhone connected to our cloud-based ML interface to analyze PA remotely and predict clinical outcomes. This system was deployed at a skilled nursing facility where we collected >17,000 person-day data points over 2 years, generating a solid training database. We used these data to train our extreme gradient boosting (XGBoost)-based ML environment to conduct a clinical trial, Activity Assessment of Patients Discharged from Hospital-I, to test the hypothesis that a comprehensive profile of PA would predict clinical outcome. We developed an advanced data-driven analytic platform that predicts the clinical outcome based on accurate measurements of PA. Artificial intelligence or an ML algorithm was used to analyze the data to predict short-term health outcome. We enrolled 52 patients discharged from Stanford Hospital. Our data demonstrated a robust predictive system to forecast health outcome in the enrolled patients based on their PA data. We achieved precise prediction of the patients' clinical outcomes with a sensitivity of 87%, a specificity of 79%, and an accuracy of 85%. To date, there are no reliable clinical data, using a wearable device, regarding monitoring discharged patients to predict their recovery. We conducted a clinical trial to assess outcome data rigorously to be used reliably for remote home care by patients, health care professionals, and caretakers.

"Technology has allowed us to do a lot more but it's not necessarily the panacea for everybody": Family physician perspectives on virtual care during the COVID-19 pandemic and beyond.

Early in the COVID-19 pandemic, Canadian primary care practices rapidly adapted to provide care virtually. Most family physicians lacked prior training or expertise with virtual care. In the absence of formal guidance, they made individual decisions about in-person versus remote care based on clinical judgement, their longitudinal relationships with patients, and personal risk assessments. Our objective was to explore Canadian family physicians' perspectives on the strengths and limitations of virtual care implementation for their patient populations during the COVID-19 pandemic and implications for the integration of virtual care into broader primary care practice. We conducted semi-structured qualitative interviews with family physicians working in four Canadian jurisdictions (Vancouver Coastal health region, British Columbia; Southwestern Ontario; the province of Nova Scotia; and Eastern Health region, Newfoundland and Labrador). We analyzed interview data using a structured applied thematic approach. We interviewed 68 family physicians and identified four distinct themes during our analysis related to experiences with and perspectives on virtual care: (1) changes in access to primary care; (2) quality and efficacy of care provided virtually; (3) patient and provider comfort with virtual modalities; and (4) necessary supports for virtual care moving forward. The move to virtual care enhanced access to care for select patients and was helpful for family physicians to better manage their panels. However, virtual care also created access challenges for some patients (e.g., people who are underhoused or living in areas without good phone or internet access) and for some types of care (e.g., care that required access to medical devices). Family physicians are optimistic about the ongoing integration of virtual care into broader primary care delivery, but guidance, regulations, and infrastructure investments are needed to ensure equitable access and to maximize quality of care.

Impact of Glucagon-Like Peptide1 Agonist Deprescription in Type2 Diabetes in a Real-World Setting: A Propensity Score Matched Cohort Study.

Glucagon-like peptide1 receptor agonists (GLP-1) elicit substantial reductions in glycemia and body weight in people with type2 diabetes (T2D) and obesity, but existing data suggest the therapy must be continued indefinitely to maintain clinical improvements. Given the high cost and poor real-world persistence of GLP-1, an effective therapy that enables deprescription with sustained clinical improvements would be beneficial. Thus, the purpose of this real-world study was to assess the effect of GLP-1 deprescription on glycemia and body weight following co-therapy with carbohydrate restricted nutrition therapy (CRNT) supported via telemedicine in a continuous remote care model. A retrospective, propensity score matched cohort study among patients with T2D at a telemedicine clinic was conducted. Patients in whom GLP-1 were deprescribed (DeRx; n = 154) were matched 1:1 with patients in whom GLP-1 were continued (Rx). HbA1c and body weight at enrollment in clinic (pre-CRNT), at date of deprescription or index date (derx/ID), and at 6 and 12months (m) post-derx/ID were utilized in this study. No regression in weight was observed following deprescription with > 70% maintaining ≥ 5% weight loss 12m post-derx/ID. HbA1c rose 6m and 12m post-derx/ID in both DeRx and Rx cohorts, but most patients maintained HbA1c < 6.5%. HbA1c and body weight measured 6m and 12m following derx/ID did not significantly differ between cohorts and were improved at derx/ID and at follow-up intervals compared to pre-CRNT. These results demonstrate the potential for an alternate therapy, such as CRNT supported via telemedicine, to enable maintenance of weight loss and glycemia below therapeutic targets following discontinuation of GLP-1 therapy.

Understanding social dynamics and patient experience in out of hospital care: validation of a co-responsibility questionnaire (CoReCare)

Patient experiences are commonly assessed through patient reported experience measures (PREMs). Ambulatory care models extend traditional care into the patients’ home, meaning that a triangle of health care professionals, patients, and their families need to be considered when assessing the remote care experience. These intertwined responsibilities are described by co-responsibility. Currently, PREMs don’t reflect how elements to remote care impact this remote care experience. Therefore, this study aimed to develop a questionnaire assessing perceived patient-partner co-responsibility as a PREM in remote care. A 30-item questionnaire was assessed among 1000 individuals aged between 18 and 65 years that tried to lose weight with a partner, friend or family member supporting them. Pairwise item correlations, Exploratory Factor Analysis, and Cronbach’s alpha were used for validation. 29-items were identified to reflect co-responsibility across 6 factors: empowerment and support, relational aspects, lack of sympathy, co-participation, accepting help and awareness. Cronbach’s alpha ranged between 0.66 and 0.93, showing good internal consistency. We present a validated CoReCare Questionnaire to understand the impact of social dynamics on achieving desired health outcomes in a remote care setting. The CoReCare Questionnaire extends current PREMs when aiming to assess and improve the patient experience of a care episode outside of the hospital.

Evaluating the Impact of Teledentistry on Patient Outcomes, Diagnostic Accuracy, and Satisfaction in a Prospective Observational Analysis.

Background Teledentistry, defined as the use of telecommunication technologies for dental care, has emerged as a transformative approach to oral health services. This prospective observational analysis aims to comprehensively assess the impact of teledentistry on patient outcomes and satisfaction, addressing key aspects such as diagnostic accuracy, longitudinal treatment outcomes, and economic and logistical considerations. Methods The study involved 242 participants selected from diverse dental clinics offering teledentistry services. Participants could choose between traditional in-person visits and teledentistry consultations. The teledentistry interventions included remote consultations, diagnostic evaluations, and treatment planning facilitated through virtual communication tools. Baseline assessments captured initial dental conditions, and follow-up assessments were conducted at three, six, and 12 months. Outcome measures included diagnostic accuracy, patient satisfaction, changes in dental conditions over time, and economic and logistical feedback. Results Descriptive statistics revealed baseline characteristics, with participants evenly distributed between in-person and teledentistry groups. However, the overall satisfaction with diagnoses was significantly lower in the teledentistry group as compared to the in-person group (p < 0.001). Longitudinal assessments demonstrated comparable changes in dental conditions between the two groups. Economic feedback highlighted a cost-saving advantage for teledentistry users, with 80% reporting reduced expenses. Conclusion This study highlights the transformative potential of teledentistry in expanding access to oral health services, reducing costs, and providing comparable treatment outcomes to traditional in-person care. Future efforts should focus on enhancing the teledentistry experience, addressing patient satisfaction concerns, and refining the delivery of remote dental care to maximize its benefits for both patients and healthcare systems.

Glycemic outcomes and patient satisfaction and self-management improves in transition from standard to virtual multidisciplinary care

AimsWith advances in cloud-based technologies, there has been a rise in remote T1D care. We hypothesized that transitioning T1DM care to a virtual, multidisciplinary clinic could improve measures beyond HbA1c. MethodsTo assess the impact of transitioning from standard to virtual T1DM care, we evaluated glycemic measures and patient reported outcomes. ResultsSixty-one adults with T1DM were included, with mean age 40.2 ± 13.5 years and diabetes duration 16.9 ± 9.0 years. Most patients were treated with insulin pumps and CGM. The number of annual diabetes care encounters rose from 2.1 ± 4.2 to 12.8 ± 5.5. Baseline HbA1c was 7.9 ± 1.6 %(63 ± 16.9 mmol/mol), declining to 7.3 ± 1.1 %(56 ± 8.5 mmol/mol) and 7.1 ± 1.0 %(54 ± 7.7 mmol/mol) at 6 and 12 months respectively (p < 0.001 for both). In parallel, TIR improved from 63.1 ± 19.3 % to 69.2 ± 13.8 % (p < 0.001) and 67.5 ± 19.4 % (p = 0.03) at 6 and 12 months respectively, while TBR declined. Scores from validated diabetes treatment and self-management questionnaires rose significantly and these rises were associated with a reduction in HbA1c, the latter score was also associated with increased TIR. There was a trend toward a correlation between encounter frequency and improvement in HbA1c and TIR. ConclusionsTransitioning from standard to virtual, coordinated, multidisciplinary T1DM care is associated with increased visit frequency, improving glycemic control, treatment satisfaction and self-care behaviors.