Role Of Telehealth Research Articles

Telehealth in emergency medicine residency training: A model curriculum.

Emergency physicians are well-positioned to take a leadership role in telehealth, particularly in emerging categories such as triage, direct acute unscheduled care, and virtual observation. However, the growth of telehealth has outpaced curricular development in emergency medicine (EM) residency programs. This manuscript presents a model longitudinal telehealth curriculum, developed by the consensus of education experts, including representatives from the telehealth interest groups from EM's two primary specialty societies: the American College of Emergency Physicians and the Society for Academic Emergency Medicine. The curriculum describes overarching goals and components that may serve as a foundation for individual institutions seeking to train future operational and academic leaders in telehealth.

Health Care Use of ACA Marketplace Enrollees During the COVID-19 Pandemic.

The onset of the COVID-19 pandemic in March 2020 had a sudden and substantial impact on health care utilization for most, if not all, individuals. We study the impact the pandemic had on the population insured in the individual and small group markets under the Patient Protection and Affordable Care Act (ACA) of 2010, using administrative claims data from January 2019 through December 2021. Our results demonstrated how health care utilization differed between the acute phase (i.e., 2020) and the post-acute phase (i.e., 2021) compared with the pre-pandemic phase. We found that in the ACA markets, most spending and utilization categories decreased drastically during the initial months of the pandemic and recovered by the end of 2021. While the role of telehealth among office visits decreased substantially by the end of 2021, it remained the main mode of delivery for mental health services.

The Role of Telehealth in Rural Healthcare Access

This study investigates the effect of telehealth in reducing healthcare inequities in rural communities. Rural communities confront considerable challenges, including geographic isolation, provider shortages, and limited access to healthcare facilities, which exacerbate health inequities. Telehealth provides an innovative solution by allowing remote access to healthcare services, eliminating the need for travel, and improving healthcare results. This review looks at current telehealth adoption trends, successful case studies, and future potential to extend telehealth services in remote areas. Finally, telemedicine is a viable way to close the healthcare access gap in remote populations. Keywords: Telehealth, rural healthcare, healthcare disparities, geographic barriers, provider shortages.

Protecting the mental health of healthcare workers in Pakistan using telehealth during the COVID-19 pandemic

The role of telehealth and its effect on reducing mental health burden from COVID-19 is of pressing concern. It is pertinent that the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic must be recognized within the group of health care workers. Telemental health services are area that require imminent intervention for the support of health care workers in Pakistan, as they are applicable and practically feasible.

The role of telehealth in the delivery of oral and maxillofacial surgery services at a level 6 hospital in New South Wales Australia during COVID-19 - the John Hunter Hospital experience: a commentary, review and cautionary tale for the future.

The objective of this article is to understand the uptake in use of Telehealth services during the COVID-19 pandemic as a way to provide compelling impetus for further research and promotion of Telehealth in general. A data review of Outpatient Department data from 2020 to 2023, as compiled by the Surgical Outcomes improvement Unit. Telehealth was widely adopted during the COVID-19 pandemic for clinicians to provide healthcare to patients whilst adhering to strict lockdown guidelines aimed at limiting exposure and spread of the respiratory virus. There has been minimal analysis, however, of the ethical and legal implications of telemedicine. Whilst it seems that access to care is improved via telehealth, there are subtle, inherent barriers intrinsic to it. There was a significant increase in the use of audio and audiovisual aids in the delivery of Oral and Maxillofacial Outpatient care during the COVID-19 period. Further analysis and improvements need to be made to the system before it can be considered as sufficient and adequate. Where there is rapid adoption of Telehealth in the delivery of Oral and Maxillofacial Surgery Services, there must be concurrent rigorous review and update of systems in order to address the key areas of patient safety and accuracy of treatment.

The role of increasing synchronous telehealth use during the COVID-19 pandemic on disparities in access to healthcare: A systematic review.

The COVID-19 public health emergency led to an unprecedented rapid increase in telehealth use, but the role of telehealth in reducing disparities in access to care has been questioned. The objective of this study was to conduct a systematic review to summarize the available evidence on how telehealth during the COVID-19 pandemic was associated with telehealth utilization for minority groups and its role in health disparities. We conducted a systematic review focused on health equity and access to care by searching for interventional and observational studies using the following four search domains: telehealth, COVID-19, health equity, and access to care. We searched PubMed, Embase, Cochrane CENTRAL, CINAHL, telehealth.hhs.gov, and the Rural Health Research Gateway, and included any study that reported quantitative results with a control group. Our initial search yielded 1970 studies, and we included 48 in our final review. The most common dimensions of health equity studied were race/ethnicity, rurality, insurance status, language, and socioeconomic status, and the telehealth applications studied were diverse. Included studies had a moderate risk of bias. In aggregate, most studies reported increased telehealth use during the pandemic, with the greatest increase in non-minority populations, including White, younger, English-speaking people from urban areas. We found that despite rapid adoption and increased telehealth use during the public health emergency, telehealth did not reduce existing disparities in access to care. We recommend that future work measuring the impact of telehealth focus on equity so that features of telehealth innovation can reduce disparities in health outcomes.

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.

The Role of Telehealth in Suicide Prevention: A Practice Framework for Primary Care

Globally, there are more than 700,000 suicide completions every year. With the continued shortage of mental health professionals, people are increasingly seeking care for mental health concerns in primary care settings. With the expansion of telehealth since the COVID-19 pandemic, more patients and providers are connecting virtually for appointments and are increasingly familiar with asynchronous tools to connect outside of appointments. Practitioners in primary care settings have an important role in identifying and mitigating risk of suicide regardless of the treatment modality. Utilization of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model for suicidal patients is both necessary and feasible in the current hybrid healthcare environment. This manuscript addresses the practical and procedural considerations for assessing for suicide and developing effective safety planning interventions when using telehealth as part of care.

The Role of Telehealth in Transforming Nursing Care: Opportunities and Challenges

The global healthcare sector is experiencing significant transitions, with the emergence of telehealth into the nursing profession at the cutting edge of this development. The emergence of telehealth technology has not only changed the way healthcare is administered, but it has also given nursing practitioners with new potential and difficulties. Telehealth has eliminated geographical restrictions, allowing nurses to remotely supervise and care for patients in the privacy of their own homes. This interdependence provides real-time health evaluations, rapid treatments, and ongoing patient interaction possible. Nurses can reach underprivileged groups by using the potential of telehealth, making healthcare more accessible and inclusive than ever before [1]. 
 The use of telehealth technologies improves nursing operations, lowering administrative hassles and allowing for more effective resource utilization. Nurses may now use digital platforms to conduct virtual consultations, remote patient monitoring, and manage electronic health records. This not only speeds up and increases the accuracy of information sharing, but it also allows nurses to focus more on direct patient care. As telehealth becomes more integrated into nursing practice, ethical concerns emerge. Patient privacy, data security, and the possibility of a digital divide must all be properly handled. Nurses must manage these ethical difficulties while maintaining patient confidentiality and ensuring that technology is used to empower rather than divide [2]. 
 While telehealth has great potential, there are obstacles to overcome, such as the digital divide, technological literacy, and access concerns. Nurses are critical in bridging these gaps, pushing for fair access to telehealth services, and educating both healthcare professionals and patients. In the future, nurses' roles in a digital healthcare landscape will continue to expand. To educate nurses with the skills needed to understand and exploit the promise of telehealth technology, continuous education and training will be critical. Nurse leaders must advocate an innovation culture, ensuring that the profession adapts to new technology while upholding the profession's essential principles of compassion and patient-centered care [3]. 
 In conclusion, the use of telehealth into nursing care gives an enormous amount of potential to improve patient outcomes, increase efficiency, and reinvent healthcare delivery. To take advantage of all these benefits, however, nurses must actively participate in creating the future of telehealth, resolving ethical concerns, and pushing for technology that promotes healthcare justice. Let us welcome the promise of telehealth to elevate the nursing profession and, more significantly, to improve the well-being of those we serve as we start on this revolutionary journey.

Acceptability of human papillomavirus self-collection and the role of telehealth: a prospective, randomized study stratified by menopausal status

ObjectiveWe investigated the utility of telehealth instruction versus mail-based written instruction in facilitating high-risk human papillomavirus (hrHPV) self-collection among post-menopausal patients compared with pre-menopausal patients, as well as the impact...

The Role of Telehealth in Promoting Equitable Abortion Access in the United States: Spatial Analysis.

Even preceding the Supreme Court's 2022 Dobbs v. Jackson Women's Health Organization decision, patients in the United States faced exceptional barriers to reach abortion providers. Abortion restrictions disproportionately limited abortion access among people of color, young people, and those living on low incomes. Presently, clinics in states where abortion remains legal are experiencing an influx of out-of-state patients and wait times for in-person appointments are increasing. Direct-to-patient telehealth for abortion care has expanded since its introduction in the United States in 2020. However, the role of this telehealth model in addressing geographic barriers to and inequities in abortion access remains unclear. We sought to examine the amount of travel that patients averted by using telehealth for abortion care, and the role of telehealth in mitigating inequities in abortion access by race or ethnicity, age, pregnancy duration, socioeconomic status, rural residence, and distance to a facility. We used geospatial analyses and data from patients in the California Home Abortion by Telehealth Study, residing in 31 states and Washington DC, who obtained telehealth abortion care at 1 of 3 virtual abortion clinics. We used patients' residential ZIP code data and data from US abortion facility locations to document the round-trip driving distance in miles, driving time, and public transit time to the nearest abortion facility that patients averted by using telehealth abortion services from April 2021 to January 2022, before the Dobbs decision. We used binomial regression to assess whether patients reported that telehealth was more likely to make it possible to access a timely abortion among patients of color, those experiencing food insecurity, younger patients, those with longer pregnancy durations, rural patients, and those residing further from their closest abortion facility. The 6027 patients averted a median of 10 (IQR 5-26) miles and 25 (IQR 14-46) minutes of round-trip driving, and 1 hour 25 minutes (IQR 46 minutes to 2 hours 30 minutes) of round-trip public transit time. Among a subsample of 1586 patients surveyed, 43% (n=683) reported that telehealth made it possible to obtain timely abortion care. Telehealth was most likely to make it possible to have a timely abortion for younger patients (prevalence ratio [PR] 1.4, 95% CI 1.2-1.6) for patients younger than 25 years of age compared to those 35 years of age or older), rural patients (PR 1.4, 95% CI 1.2-1.6), those experiencing food insecurity (PR 1.3, 95% CI 1.1-1.4), and those who averted over 100 miles of driving to their closest abortion facility (PR 1.6, 95% CI 1.3-1.9). These findings support the role of telehealth in reducing abortion-related travel barriers in states where abortion remains legal, especially among patient populations who already face structural barriers to abortion care. Restrictions on telehealth abortion threaten health equity.

Accessing voluntary assisted dying in regional Western Australia: early reflections from key stakeholders.

Most Australian jurisdictions have passed voluntary assisted dying (VAD) laws, with some regimes already in operation. Inequitable access to assisted dying in regional communities has been described internationally. Although regional access to VAD has been identified as a concern in Australia, to date it has been understudied empirically. Western Australia (WA) was the second Australian jurisdiction to pass and implement VAD laws. Due to the vast geography of WA (and the potential for such geography to exacerbate regional access inequities) several initiatives were introduced to try to mitigate such inequities. This article aims to explore the effectiveness of these initiatives, and report on regional provision of VAD in WA more generally, by drawing on the early experiences and reflections of key stakeholders. A total of 27 semi-structured interviews were conducted with 29 participants belonging to four main stakeholder groups: patients and families, health practitioners, regulators and VAD system personnel, and health and professional organisation representatives. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Data analysis led to the description of four main themes: the importance of the Regional Access Support Scheme, the need for local providers, the role of telehealth in VAD provision and the impact of distance. Early experiences and reflections of key stakeholders suggest that while many of the regional initiatives implemented by WA are largely effective in addressing regional access inequities, challenges for regional VAD provision and access remain.

5 Acceptability of HPV self-collection and the role of telehealth: a prospective, randomized study stratified by menopausal status

5 Acceptability of HPV self-collection and the role of telehealth: a prospective, randomized study stratified by menopausal status

The role of telehealth in pediatric emergency care.

In 2006, the Institute of Medicine published a report titled "Emergency Care for Children: Growing Pains," in which it described pediatric emergency care as uneven at best. Since then, telehealth has emerged as one of the great equalizers in care of children, particularly for those in rural and underresourced communities. Clinicians in these settings may lack pediatric-specific specialization or experience in caring for critically ill or injured children. Telehealth consultation can provide timely and safe management for many medical problems in children and can prevent many unnecessary and often long transport to a pediatric center while avoiding delays in care, especially for time-sensitive and acute interventions. Telehealth is an important component of pediatric readiness of hospitals and is a valuable tool in facilitating health care access in low resourced and critical access areas. This paper provides an overview of meaningful applications of telehealth programs in pediatric emergency medicine, discusses the impact of the COVID-19 pandemic on these services, and highlights challenges in setting up, adopting, and maintaining telehealth services.

Narrowing the Divide: The Role of Telehealth in Type 1 Diabetes Care for Marginalized Communities.

Widespread uptake of telehealth in response to the COVID-19 pandemic has highlighted geographic, demographic, and economic disparities in access to virtual care. However, research studies and clinical programs that predate the pandemic demonstrate the potential for telehealth-based interventions to improve access to and outcomes of type 1 diabetes (T1D) care for individuals in geographically or socially marginalized communities. In this expert commentary, we discuss telehealth-based care models that have been successful in improving care for marginalized T1D populations. We also outline the policy changes needed to expand access to such interventions to reduce established disparities in T1D care and promote better health equity among people living with T1D.

Effect of Telerehabilitation Versus In-Clinic Rehabilitation Delivery on Self-Efficacy in Breast Cancer–Related Lymphedema

Background: Individuals with breast cancer–related lymphedema (BCRL) require self-management strategies to reduce risk of infection, exacerbation, and/or progression of lymphedema. The coronavirus pandemic thrust the medical field into the world of telehealth; both patients and providers were forced to reduce in-person treatments and engage in this new platform of rehabilitation delivery. The role of telehealth in promotion of self-management for BCRL is unknown. Purpose: This study examines self-efficacy during cancer rehabilitation for in-clinic versus telehealth visits among individuals with BCRL during the pandemic quarantine April to November 2020. Methods: Forty women who recently completed oncology rehabilitation for BCRL were asked to complete demographics and 2 Likert surveys, including the Exercise Self-Efficacy Scale (ESES) and the Self-Care Self-Efficacy Scale (SCSE), to compare the efficacy of telehealth versus in-person treatment modalities. Results: Thirty-two participants completed the survey and indicated that the percentage of telehealth visits was less than face-to-face visits. Despite this, the participants indicated numerous positive moderately strong correlations between self-care self-efficacy and exercise self-efficacy for both types of visits (P < .05). Limitations: Self-report surveys by a convenience sample, multifactorial characteristics of rehabilitation treatment across modes, and varying severity of lymphedema may limit study findings. Conclusion: Telehealth provided safe and effective care to participants and bolstered confidence in self-care and self-management of BCRL. Data support that telehealth visits can be considered an essential part of comprehensive cancer rehabilitation care. Future research is needed to establish and optimize practice guidelines in both health delivery systems.

PERCEPTIONS OF NURSES DELIVERING NURSING HOME VIRTUAL CARE SUPPORT: A QUALITATIVE PILOT STUDY

Abstract Avoidable hospitalizations among nursing home residents result in poorer health outcomes and excess costs. Consequently, efforts to reduce avoidable hospitalizations have been a priority over the recent decade. However, many potential interventions are time-intensive, require dedicated clinical staff, and nursing homes are chronically understaffed. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project was one of seven sites selected by CMS as "enhanced care & coordination providers" and was implemented from 2012 to 2020. A virtual program based on the principles of OPTIMISTIC was developed in the spring of 2020 with the goal of expanding the reach of the program’s services. This qualitative study explores the perceptions and experiences of the nurses that piloted a virtual care support project in 11 nursing homes in a midwestern state, and identified the nurses’ perceived facilitators of, and barriers to, the effectiveness of delivering a novel virtual care support program. A key finding from this analysis is that relationships, communication, and access to information were identified as common themes facilitating or impeding the perceived effectiveness of implementation of virtual care support programs within nursing homes, from the perspective of the nurses delivering the services. The experiences and recommendations of the program nurses provide insights into crucial elements important to the implementation of similar virtual care support models, and the role of telehealth in bridging healthcare workforce gaps.

The role of telehealth on quality of life of palliative care patients during the COVID-19 pandemic: an integrative review.

Telehealth looks to be a viable tool to meet patients' expectations and requirements during home treatment; however, there are obstacles to overcome. Palliative care has been described as 'high touch' rather than 'high tech', which may restrict healthcare workers' enthusiasm in integrating technological advances into the development and refinement of interventions. As a result, the goal of this integrative review was to map and evaluate existing research on the use of telemedicine and telehealth in palliative care patients during the COVID-19 outbreak. This review was guided using the PRISMA Model and CASP guidelines. A total of 17 articles on the use of telehealth in palliative care satisfied the inclusion and exclusion criteria of the review. This integrative review provided more evidence for the function and application of telehealth in palliative care. It demonstrated the resiliency of individuals in swiftly adjusting to a new system or application and the adaptability of healthcare systems and providers in establishing an alternate means of providing treatment to patients during a crisis.

(204) The Role of Telehealth in an Obstetric-Psychiatry Clinic: Patient Perceptions

(204) The Role of Telehealth in an Obstetric-Psychiatry Clinic: Patient Perceptions

Poprawa bezpieczeństwa pacjentów i personelu medycznego poprzez wykorzystanie możliwości telemedycyny w kardiologii

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