Telemedicine Support Research Articles

AI-Driven Progressive Web Application for Enhancing Emergency Healthcare Decision-Making

The "Emergency Lifeline: Instant Hospital Info for Critical Moments" mobile application aims to revolutionize emergency healthcare by providing real-time hospital information, medical guidance, and optimized routing during critical situations. The application integrates advanced technologies such as Artificial Intelligence (AI), Geolocation, Telemedicine, and Multilingual Support to offer a comprehensive emergency solution. By leveraging AI for symptom analysis and hospital recommendations, GPS for real- time location tracking and optimized routing, and telemedicine for remote consultations, the app ensures that users can access medical assistance quickly and effectively. The inclusion of multilingual support, along with voice recognition and text-to- speech capabilities, ensures accessibility for a diverse user base, including those with disabilities or literacy challenges. This innovative approach enables users to make informed decisions, minimize response times, and improve healthcare outcomes in emergency scenarios. The system's design focuses on user experience, data security, and collaboration with healthcare providers to ensure accurate, up-to-date information. Overall, the app aims to enhance the efficiency and accessibility of emergency healthcare, making it a vital tool for individuals facing critical health situations. Keyword - Emergency healthcare, mobile application, Artificial Intelligence (AI), Geolocation, Telemedicine, Multilingual support, Real-time hospital information, Symptom analysis, Routing optimization, Text-to-speech, Voice recognition, Healthcare accessibility, Critical moments, Medical guidance, User experience, Data security.

Challenges Faced by Family Caregivers of Individuals Living with Dementia in Japan During the COVID-19 Pandemic.

This study investigates the challenges faced by family caregivers of individuals with dementia in Japan, particularly in the context of the COVID-19 pandemic. We conducted a cross-sectional survey of 500 family caregivers of patients with dementia. 56.4% of caregivers reported an increased caregiving burden, primarily due to extended caregiving hours, reduced access to public services, and restrictions on social interactions. This study found a strong preference for formal support, with 75.4% of caregivers desiring access to more comprehensive services. However, 19.4% of dementia patients were not utilizing any public services, largely due to a mismatch between available services and caregivers' actual needs, as well as societal resistance to inviting formal support into the home. Informal support systems, such as dementia family groups and cafes, were well-known, but participation rates remained low (5.4% and 5.8%, respectively), despite the potential benefits for reducing stress and providing emotional support. Key barriers included privacy concerns, reluctance to engage, and logistical challenges such as inconvenient access and time constraints. To mitigate the above challenges, this study recommends expanding telemedicine and remote support services, improving awareness of available resources, and offering flexible, tailored solutions to meet diverse caregiving needs. Additionally, increasing financial support, enhancing public recognition of caregiver roles, and providing psychological counseling and stress management programs are essential to alleviating both the emotional and economic burdens placed on family caregivers during the pandemic.

Innovations in coeliac disease diagnosis and treatment

This article provides healthcare professionals, particularly gastroenterology nurses, with a forward-looking perspective on the management of coeliac disease that emphasises an evolving, patient-centred approach. This article also examines emerging advancements in diagnosis, treatment and management, alongside their implications for nursing practice. Current diagnostic methods, while considered the gold standard, remain invasive and burdensome for patients. However, recent innovations, including no-biopsy strategies and biomarkers such as serum interleukin-2 (IL-2) and HLA-DQ–gluten tetramers, present less invasive alternatives. Advances in imaging techniques and artificial intelligence promise to further enhance diagnostic accuracy. Therapeutic developments, such as enzyme-based treatments and immune modulators, offer potential to reduce dependency on a strict gluten-free diet, thereby improving patients’ quality of life. The integration of digital health tools, telemedicine and psychological support highlights the importance of a holistic, patient-centred care model. Gastroenterology nurses play a pivotal role in implementing these advancements, particularly through education, community engagement and multidisciplinary collaboration. This article also addresses critical ethical considerations, including equitable access to care and the psychological impact of genetic screening, to ensure that all patients can benefit from these innovations.

Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization

BackgroundThe reduction of processing times in the treatment of acute ischemic stroke is of outstanding importance. Our objective is to analyze the acute stroke care chain from onset to treatment in a city in Germany comprising three stroke units. Additionally, we discuss solutions for detected treatment delays.MethodsWe conducted an in-depth analysis of acute stroke care processing times across three local stroke centers in Düsseldorf among all emergency services transportations for suspected stroke. Isochrone mapping was performed to identify areas with prolonged transportation times.ResultsAmong the 1,714 transportations, 943 patients had confirmed strokes. Prehospital care constituted 58% of total emergency care time until imaging. Patients with confirmed stroke had reduced in-hospital times while patients receiving treatment experienced faster in-hospital times. Isochrone mapping revealed disparities in transportation times within the city.ConclusionsIn conclusion, we identified confirmation of stroke symptoms as pre- and in-hospital and treatment eligibility as in-hospital process accelerators in stroke care. We propose the introduction of an in-ambulance video consulting model to accelerate contact to stroke-experts and accelerate processing times for patients eligible for treatment. Furthermore, we discuss the combination of in-ambulance video consulting with imaging and starting treatment outside traditional stroke centers, followed by transportation to a stroke center during thrombolysis, which might further accelerate treatment in specific cases.

Effect of Telemedicine Support for Intraoperative Anaesthesia Care on Postoperative Outcomes: The TECTONICS Randomised Clinical Trial.

Novel applications of telemedicine can improve care quality and patient outcomes. Telemedicine for intraoperative decision support has not been rigorously studied. This single centre randomised clinical trial (RCT, clinicaltrials.gov NCT03923699 ) of unselected adult surgical patients was conducted between 2019-07-01 and 2023-01-31. Patients received usual-care or decision support from a telemedicine service, the Anesthesiology Control Tower (ACT). The ACT provided real-time recommendations to intraoperative anaesthesia clinicians based on case reviews and physiologic alerts. ORs were randomised 1:1. Co-primary outcomes of 30-day all-cause mortality, respiratory failure, acute kidney injury (AKI), and delirium in the Intensive Care Unit (ICU) were analysed as intention-to-treat. The trial completed with 71927 surgeries (35302 ACT; 36625 usual care). The ACT performed 11812 case reviews and communicated alerts regarding 2044 intervention-group patients. There was no significant effect of the ACT vs. usual care on 30-day mortality [630/35302 (1.8%) vs 649/36625 (1.8%), RR 1.01 (95% CI 0.87 to 1.16), p=0.98], respiratory failure [1071/33996 (3.2%) vs 1130/35236 (3.2%), RR 0.98 (95% CI 0.88 to 1.09), p=0.98], AKI [2316/33251 (7.0%) vs 2432/34441 (7.1%), RR 0.99 (95% CI 0.92 to 1.06), p=0.98] or delirium [1264/3873 (32.6%) vs 1298/4044 (32.1%), RR 1.02 (95% CI 0.94 to 1.10), p=0.98]. There were no significant differences in secondary outcomes or sensitivity analyses. In this large RCT of intraoperative telemedicine decision support using real-time alerts and case reviews, we found no significant differences in postoperative outcomes. Large-scale intraoperative telemedicine is feasible, and we suggest avenues where it may be more impactful.

Telemedicine-assisted cardiac rehabilitation: A controlled cohort clinical trial

Introduction. The traditional method of cardiac rehabilitation (CR) recommends continuing physical training at home, but many patients do not follow these instructions and the effectiveness of the rehabilitation program decreases. Thanks to the use of telemedicine technologies, the doctor can remotely monitor the patient’s condition, ensuring the safety and effectiveness of training.Aim. To test the method of organizing telemedicine support for CR of patients who have suffered a myocardial infarction.Materials and methods. During the study, 27 patients underwent CR with telemedicine support, and 26 patients underwent traditional CR. To assess the effectiveness of using telemedicine technologies in CR, the results of the six-minute walk test under the control of an electrocardiogram were assessed using the Accordix telemedicine system (Neurosoft LLC, Ivanovo) before and after the rehabilitation program.Results. After the end of the CR, in the group of patients with telemedicine support, during the six-minute walk test, reliable indicators of an increase in the distance covered were revealed compared to the results of patients in the control group (72 [52; 99.5] m vs. 45 [0.75; 51] m, p < 0.05), restoration of tolerance to physical activity (the ratio of the distance covered to the expected 15 [11.5; 18.5]% vs. 3 [-1.75; 8.75]%, p < 0.05), as well as an increase in the time the pulse stays in the training corridor (15% vs. 0.04%, p < 0.05). Also, in patients in the telemedicine CR group, the number of workouts was significantly higher (14.5 [12.5; 17] vs. 8.5 [4.5; 11.5], p < 0.05).Conclusion. The presented method of conducting CR using telemedicine technologies has shown greater efficiency compared to the traditional approach. Changes recorded using ECG are analyzed by the telemedicine system, ensuring control and safety of physical activity. The use of telemedicine technologies allows the patient to reduce the fear of repeated myocardial infarction and increase adherence to CR.

Evaluation of the use of telemedicine in pediatric intensive care units: a cluster-randomized trial

ABSTRACT Introduction Telemedicine has shown promising results, allowing specialists to provide rapid and effective care in remote locations. However, to our knowledge, current evidence is not robust enough to prove the effectiveness of this tool. This cluster-randomized trial (CRT) aimed to evaluate the impact of telemedicine on clinical care indicators in pediatric intensive care units (PICUs). Methods An open-label CRT was conducted in 16 PICUs within the Brazilian public health system. The trial took place from August 2022 to December 2023 and compared an intervention group, which received telemedicine support, with a control group, which received usual PICU care. The primary outcome was the PICU length of stay. The main secondary outcomes were mortality rate and ventilator-free days. Results A total of 1393 participants were included, 657 in the control group and 736 in the intervention group. The mean PICU length of stay was 10.42 (SD, 10.71) days for the control group and 11.52 (SD, 10.80) days for the intervention group. The overall mean of ventilator-free days was 6.82 (SD, 7.71) days. Regarding mortality, 7.54% of participants died in total. No significant difference was found in the outcomes between the groups. Conclusion Despite the potential benefits of telemedicine, its effective implementation in the Brazilian public health system faces considerable challenges, highlighting the continued importance of investigating and improving the role of telemedicine in pediatric critical care. Clinical trial registration ClinicalTrials.gov NCT05260710 and ReBEC – RBR-7×j4wyp.

Rethinking hospital postoperative resource use: A national analysis of pediatric appendectomy patients admitted to children’s hospitals

BackgroundThe increased use of remote monitoring and telemedicine support may help alleviate the need for some of the postoperative inpatient hospital care and reduce health care costs, but little is known about current postoperative hospital resource use patterns. We aim to describe hospital resources use patterns in pediatric patients postappendectomy for complicated appendicitis and to evaluate the potential of earlier discharge with remote monitoring. MethodsThis was a retrospective cohort study using the Pediatric Health Information System database for patients who underwent laparoscopic appendectomy for complicated appendicitis between 2016 and 2021. Health care use/costs (antibiotics, intravenous fluids [proxy for diet], analgesics, laboratory studies, and imaging tests) were determined using administrative billing data. Potentially avoidable days were defined as nondischarge days without codes for intravenous opioid pain medication or intravenous fluids. Descriptive statistics and logistic regression were used. ResultsIn total, 24,165 patients were included: 8,300 patients (34.3%) had at least 1 potentially avoidable hospitalization day, totaling 13,970 days or 14.2% of all hospitalization days. Median hospitalization cost was $19,434 [$15,658–$25,157], with accommodation and operating room being the greatest contributors. Public insurance and minority races and ethnicities were associated with greater odds of potentially avoidable days. More than 80% of hospitalized patients had intravenous antibiotics through 10 days postoperatively. More than 20% received opioids daily. ConclusionsMore than one third of the patients who underwent laparoscopic appendectomy for complicated appendicitis could have had at least 1 potentially avoidable hospitalization day. Remote monitoring and telemedicine support should be explored and could help with earlier discharge and lower costs.

A multimodal aftercare intervention improves the outcome after kidney transplantation – results of the KTx360° aftercare program using claims data

The after-care treatment project KTx360° aimed to reduce graft failure and mortality after kidney transplantation (KTx). The study was conducted in the study centers Hannover, Erlangen and Hannoversch Muenden from May 2017 to October 2020 under the trial registration ISRCTN29416382. The program provided a multimodal aftercare program including specialized case management, telemedicine support, psychological and exercise assessments, and interventions. For the analysis of graft failure, which was defined as death, re-transplantation or start of long-term dialysis, we used longitudinal claims data from participating statutory health insurances (SHI) which enabled us to compare participants with controls. To balance covariate distributions between these nonrandomized groups we used propensity score methodology, in particular the inverse probability of treatment weighting (IPTW) approach. In total, 930 adult participants were recruited at three different transplant centres in Germany, of whom 320 were incident (enrolled within the first year after KTx) and 610 prevalent (enrolled >1 year after KTx) patients. Due to differences in the availability of the claims data, the claims data of 411 participants and 418 controls could be used for the analyses. In the prevalent group we detected a significantly lower risk for graft failure in the study participants compared to the matched controls (HR=0.13, 95% CI=0.04-0.39, p=0.005, n=389 observations), whereas this difference could not be detected in the incident group (HR=0.92, 95% CI=0.54-1.56, p=0.837, n=440 observations). Our findings suggest that a multimodal and multidisciplinary aftercare intervention can significantly improve outcome after KTx, specifically in patients later after KTx. For evaluation of effects on these outcome parameters in patients enrolled within the first year after transplantation longer observation times are necessary. The study was funded by the Global Innovation fund of the Joint Federal Committee of the Federal Republic of Germany, grant number 01NVF16009.

Effect of Machine Learning on Anaesthesiology Clinician Prediction of Postoperative Complications: The Perioperative ORACLE Randomised Clinical Trial.

Anaesthesiology clinicians can implement risk mitigation strategies if they know which patients are at greatest risk for postoperative complications. Although machine learning models predicting complications exist, their impact on clinician risk assessment is unknown. This single-centre randomised clinical trial enrolled patients age ≥18 undergoing surgery with anaesthesiology services. Anaesthesiology clinicians providing remote intraoperative telemedicine support reviewed electronic health records with (assisted group) or without (unassisted group) also reviewing machine learning predictions. Clinicians predicted the likelihood of postoperative 30-day all-cause mortality and postoperative acute kidney injury within 7 days. Area under the receiver operating characteristic curve (AUROC) for the clinician predictions was determined. Among 5,071 patient cases reviewed by 89 clinicians, the observed incidence was 2% for postoperative death and 11% for acute kidney injury. Clinician predictions agreed with the models more strongly in the assisted versus unassisted group (weighted kappa 0.75 versus 0.62 for death [difference 0.13, 95%CI 0.10-0.17] and 0.79 versus 0.54 for kidney injury [difference 0.25, 95%CI 0.21-0.29]). Clinicians predicted death with AUROC of 0.793 in the assisted group and 0.780 in the unassisted group (difference 0.013, 95%CI -0.070 to 0.097). Clinicians predicted kidney injury with AUROC of 0.734 in the assisted group and 0.688 in the unassisted group (difference 0.046, 95%CI -0.003 to 0.091). Although there was evidence that the models influenced clinician predictions, clinician performance was not statistically significantly different with and without machine learning assistance. Further work is needed to clarify the role of machine learning in real-time perioperative risk stratification. ClinicalTrials.gov NCT05042804.

Lessons Learned from Telemedicine in Adolescent Obesity: Results of a Pilot Study.

The rising prevalence of obesity in children calls for new strategies for the provision of effective care by a multidisciplinary team. Telemedicine has overall proven to be an effective tool for promoting a healthy lifestyle. The main objective of the current paper is to present the protocol of our ongoing CardioMetabolic Prevention (CAMP) study and compare its design with published studies on telemedicine in paediatric obesity. Additionally, we analysed the preliminary anthropometric and laboratory data to test the efficacy of our 12-week intensive program that combines in-person and telemedicine support. The program demonstrated a positive impact on body mass index (BMI) and its z-scores in 21 adolescents, and BMI in 18 participating parents. However, we found no effect on body composition, waist circumference, cardiometabolic parameters, or fitness evaluated via a 6-min walk test in adolescents. In conclusion, the combination of in-person and telemedicine intensive support over 35 h delivered by a multidisciplinary team can be beneficial not only for adolescents with obesity but also for their parents. The ongoing CAMP study serves as a platform for precision medicine in future decisions regarding anti-obesity medication in adolescents with obesity.

A worldwide look into long COVID-19 management: an END-COVID survey.

Long COVID is a heterogeneous clinical syndrome characterised by a variety of reported symptoms and signs. Its clinical management is expected to differ significantly worldwide. A survey-based study investigating long COVID-related standard operating procedures (SOPs) has been conducted by the European Respiratory Society (ERS) END-COVID clinical research collaboration with the support of other international societies (ALAT, APSR, CHEST, ESCMID and PATS). A global analysis of the results is provided here, alongside sub-population analysis based on continents, national income levels, type of involved healthcare professional and inclusion or exclusion of paediatric patients. 1015 healthcare professionals from 110 different countries worldwide participated in this study, the majority of them being respiratory physicians (60.6%). A dedicated long COVID programme was present in 55.4% of the investigated institutions, with hospital admission during the acute infection being the main inclusion criteria to access them. Consistent differences in long COVID-related procedures were identified among centres, mainly regarding the multidisciplinary approach, the availability of telemedicine and psychological support, the type of requested exams and the total amount of visits in the centre. Long COVID management shows important differences related to geographical areas and national income levels. SOPs were significantly different when centres were managed by a pulmonologist or when paediatric patients were included.

Randomized Controlled Trial of Telementoring During Resource-Limited Patient Care Simulation Improves Caregiver Performance and Patient Survival.

To determine the impact of telementoring on caregiver performance during a high-fidelity medical simulation model (HFMSM) of a critically ill patient in a resource-limited setting. A two-center, randomized, controlled study using a HFMSM of a patient with community-acquired pneumonia complicated by acute respiratory distress syndrome. A notional clinic in a remote location staffed by a single clinician and nonmedical assistant. Clinicians with limited experience managing critically ill patients. Telemedicine (TM) support. The primary outcome was clinical performance as measured by accuracy, reliability, and efficiency of care. Secondary outcomes were patient survival, procedural quality, subjective assessment of the HFMSM, and perceived workload. TM participants (N = 11) performed better than non-TM (NTM, N = 12) in providing expected care (accuracy), delivering care more consistently (reliability), and without consistent differences in efficiency (timeliness of care). Accuracy: TM completed 91% and NTM 42% of expected tasks and procedures. Efficiency: groups did not differ in the mean (± sd) minutes it took to obtain an advanced airway successfully (TM 15.2 ± 10.5 vs. NTM 22.8 ± 8.4, p = 0.10) or decompress a tension pneumothorax with a needle (TM 0.7 ± 0.5 vs. NTM 0.6 ± 0.9, p = 0.65). TM was slower than NTM in completing thoracostomy (22.3 ± 10.2 vs. 12.3 ± 4.8, p = 0.03). Reliability: TM performed 13 of 17 (76%) tasks with more consistent timing than NTM. TM completed 68% and NTM 29% of procedural quality metrics. Eighty-two percent of the TM participants versus 17% of the NTM participants simulated patients survived (p = 0.003). The groups similarly perceived the HFMSM as realistic, managed their patients with personal ownership, and experienced comparable workload and stress. Remote expertise provided with TM to caregivers in resource-limited settings improves caregiver performance, quality of care, and potentially real patient survival. HFMSM can be used to study interventions in ways not possible with real patients.

Can the Use of Telemedicine in the Management of Continuous Positive Airway Pressure for the Treatment of Obstructive Sleep Apnea Reduce Clinical Time and Additional Appointments: A Randomized Controlled Trial.

Introduction: Obstructive sleep apnea (OSA) is a common sleep breathing disorder and is associated with increased cardiovascular risk and daytime sleepiness. Continuous positive airway pressure (CPAP) is a treatment for OSA, which splints the airway open. The introduction of telemedicine in CPAP devices offers clinical staff an alternative method of reviewing patients, monitoring treatment, and reducing clinical time. Materials and Methods: A randomized control trial was conducted with patients randomized to one of three arms: Arm 1 (standard care), Arm 2 (modem and a virtual appointment), and Arm 3 (modem, smart device application DreamMapper™, and a virtual appointment). Ninety participants requiring treatment with CPAP following a diagnosis of OSA were recruited and data collected at baseline, 14 days, and 180 days. Additional contacts or appointments were also recorded. Results: Ninety participants (n = 90) were recruited (68% males and 32% females) with an average age of 52.0 ± 13.13 years and apnea/hypopnea index (AHI) 43.5 ± 21.92 (events/h). There was a statistically significant difference between the three arms in the average clinical time taken for the first follow-up appointment (p = 0.001). There was a statistically significant difference between the three arms in the number of additional appointments or contacts required (p = 0.03). Discussion and Conclusion: Telemedicine reduced clinical time at first follow-up, and in patients who received standard care or a smart device application to monitor their own CPAP treatment, there were significantly less additional appointments required when compared with telemedicine support in the form of a modem alone.

Comparative Effectiveness of Complex Telemedicine Support in Prevention of Hospitalizations and Mortality in Patients with Heart Failure: A Systematic Review and Meta-Analysis.

To estimate the effect of telemedicine support on hospitalization and mortality in patients with heart failure. The literature search was conducted in databases Google Scholar, MedLine, Clinical Trials, PubMed, Embase, and Crossref with the following key words: "heart failure", "telemedicine", "telemonitoring", "hospitalisation (hospitalization)", "mortality". We included studies that were conducted during the last 10 years. In total, we analyzed 1151 records. After screening, 14 randomized control trials were included in the final analysis. The conducted meta-analysis showed that telemedicine support is accompanied by a decrease in heart failure-related hospitalizations (risk ratio (RR) 0.78 (95% confidence interval (CI) 0.68-0.89)) and a decrease in all-cause mortality (RR 0.84 (95% CI 0.75-0.94)). We did not find a significant association between telemedicine support and all-cause hospitalizations. We did not analyze heart failure-related mortality because of insufficient data. Telemedicine support is accompanied by a decrease in heart failure-related hospitalizations and a decrease in all-cause mortality in patients with heart failure.

Evaluation of Telemedicine Support for Medics from the Perspective of Course Instructors.

Health services in the theater/district areas often contain difficulties. Although telemedicine has a huge potential to support medics in the area, there are challenges as well. Our aim is to evaluate the telemedicine support that can be provided to the medics from the perspective of course instructors. Our study was carried out in The University of Health Sciences, Türkiye. All of the instructors of a medic course were asked to fill a 13-question questionnaire and Likert-type scale, sent via e-mail. Among 79 instructors, 71 of them (55 physicians, 16 nonphysicians) responded and were included in the study. The distributions of the categorical variables in the groups were analyzed with the Pearson Chi-square. Of the 71 participants, 37 (52.11%) stated that there is a need for legal and ethical regulations for telemedicine (medical liability, malpractice, obtaining consent from the casualties, civilians, cross border missions, and rank-related problems) and patients' rights, additionally, to clarify the responsibilities of the doctors giving telemedicine support and the medics in the area. It was observed that physicians' and nonphysician group's opinions about the telepsychotherapy were statistically significantly different (χ2 = 8.675, P = .013). Most of the instructors believed that telemedicine could carry the knowledge and skills of specialist physicians to the field of operation. Access to high-quality health services in a short time through telemedicine support can increase the courage and commitment of the personnel. It is thought that with telemedicine, medics will not feel alone in the field, their worries about making wrong decisions will decrease, and their knowledge and skills will increase. Participants were particularly concerned about who will be held responsible for problems arising from interventions carried out using telemedicine, and strict legal and medical regulations are needed.

Telemedicine care coordination and visit frequency in pediatric patients with type 1 diabetes in Oregon

IntroductionChildren with type 1 diabetes require close monitoring with visits every 3–4 months. COVID-19-induced telemedicine expansion may alleviate the challenge of high visit frequency that children with type 1 diabetes face. However, telemedicine’s impact on access to care may be limited if patients lack adequate support for telemedicine. The purpose of this study was to evaluate the impact of telemedicine care coordination services on visit frequency in an urban medical center without care coordination services versus a rural outreach program with established care coordination services serviced by the same providers. MethodsWe evaluated EHR data from 790 children receiving care between July 2018 and December 2021 at a single academic center in Oregon. We estimated differences in likelihood of adequately timed monitoring care over time by patient care coordination services status using Generalized Estimating Equations. ResultsJust prior to telemedicine expansion, patients receiving care coordination services were 25.6 % less likely to receive adequately timed monitoring care (95 % CI: 51.6 %, 114 %). Following telemedicine expansion, likelihood of adequately timed monitoring care increased from 28.8 % to 58.2 % among those receiving care coordination services and decreased from 38.7 % to 22.0 % among those not receiving care coordination services; increases in adequately timed monitoring care were 3.55 times greater in patients receiving care coordination services relative to those not (95 % CI: 2.10, 6.01). DiscussionFor pediatric patients with type 1 diabetes, telemedicine care coordination may be an important factor for increasing visit adherence and may increase the number of patients meeting goal visit frequency beyond levels seen prior to widespread telemedicine availability.

Patient and health professional attitudes towards the use of telemedicine for abortion care in Britain: Findings from the SACHA study.

Use of telemedicine in abortion care is safe and effective. Patient satisfaction with telemedically supported abortion is high, but as use expands in Britain, little is known about patients' or health professionals' views on how it is best used. We sought the views of both groups on telemedicine's role in abortion provision and how its use might be optimised. We administered a structured survey with an additional free-text response option to a range of health professionals from services identified via clustered random sampling. We conducted semi-structured interviews with patients with recent experience of abortion, purposively sampled from abortion services. Participants were recruited from England, Scotland and Wales. We analysed qualitative data using thematic analysis alongside framework analysis. Support for telemedicine was high among participants, which included 771 health professionals from a range of services and 48 patients. Among health professionals, 23% opposed the use of telemedicine in abortion provision. Opposition was highest among those uninvolved, or who did not feel skilled, in remote provision. Reported benefits included patient convenience and comfort. Patient concerns centred on adequate provision of emotional support. Participants made suggestions for augmenting and extending the use of telemedicine to meet some patients' needs, including combining telemedical consultation with in-person care and providing information and follow-up via digital methods. Acceptability of telemedically supported abortion, which offers logistical and emotional benefits to patients, is high in Britain. Novel ways of providing telemedical support should be explored to enhance remote abortion provision. In-person care should remain an option for patients.

Recent Developments and Challenges in COVID-19 Care

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has fundamentally transformed global health care, revealing both critical vulnerabilities and significant innovations in patient care. This review delves into the latest advancements in COVID-19 care, with a particular focus on the evolution of therapeutic strategies, the rapid and widespread adoption of telemedicine, and the pressing challenges in addressing mental health during the pandemic. Key developments include significant progress in antiviral and immunomodulatory treatments, which have proven essential in managing severe COVID-19 cases. Concurrently, telemedicine has emerged as a revolutionary tool in health-care delivery, enabling the continuity of care despite widespread disruptions. The pandemic’s profound psychological impact has necessitated the creation of new crisis intervention models, highlighting the importance of adaptable and accessible mental health services. The existing research for this review was conducted using comprehensive searches of databases such as PubMed, Springer, and other reputable sources. This approach ensured that the most current and relevant studies on COVID-19 care, therapeutic advancements, telemedicine, and mental health support were included in the analysis. In conclusion, the ongoing adaptation and application of these innovations will be crucial in determining the resilience and effectiveness of health-care systems in future crises. The lessons learned from the COVID-19 pandemic will continue to inform and shape the evolution of global health-care strategies.

SAFE TELECONSULTATION CHECK LIST

This article explores the role of telemedicine, a discipline that integrates the foundations of traditional medical practice with communications technology to provide healthcare at a distance. It examines the associated challenges, the opportunities offered and the future perspectives of medical propaedeutics in an increasingly digital scenario. Based on these aspects, the article proposes the use of a checklist as fundamental support for telemedicine. In summary, teleconsultation supported by a didactic and safe tool represents not only an evolution in the provision of healthcare, but also a testimony to the technology’s ability to provide an effective and patient-centered clinical experience. This new paradigm not only addresses the complexities of virtual consultation, but also shapes the future of medicine by embracing the potential of safe use of technology.