Telehealth Solutions Research Articles

Telehealth innovations for cardiovascular disease management

Telehealth innovations and wearable technologies are revolutionizing the management of cardiovascular diseases (CVD), providing patients with more accessible and continuous care. The integration of remote monitoring tools and mobile health applications allows for real-time tracking of vital signs, such as heart rate, blood pressure, and oxygen levels, enabling early detection of abnormalities and timely medical interventions. These technologies empower patients to actively participate in their own health management, encouraging adherence to prescribed lifestyle changes, such as increased physical activity and improved dietary habits, which are essential for preventing and controlling CVD. Wearable devices, such as smartwatches and fitness trackers, play a critical role in the continuous monitoring of cardiovascular health. Combined with telehealth platforms, they offer personalized insights and facilitate communication between patients and healthcare providers, enhancing care coordination. This leads to improved patient outcomes, particularly in managing chronic conditions like hypertension and heart failure, where early intervention is key to preventing complications. Additionally, telehealth solutions reduce the need for frequent in-person visits, cutting healthcare costs and making care more convenient and accessible for patients in remote or underserved areas. As telehealth and wearable technologies continue to advance, they hold the potential to further transform cardiovascular care, contributing to more efficient healthcare delivery and better management of cardiovascular risk factors.

Adoption and Utilization of Telemedicine and Digital Health Services among Older Adults in Israel

Abstract Background As the population ages and the prevalence of long-term diseases rises, telecare is being used increasingly frequently to aid elderly people. Aims We aimed to explore the usage and adoption of 3 types of telehealth services among the senior population in Israel- prior, during, and after the COVID-19 pandemic rise in Israel. Methods We explored the usage characteristics of older adults (age 65 and above) belonging to ‘Clalit’, in the use of three types of telehealth services: digital services for administrative tasks, synchronous ‘online visits’ with the patient’s personal physician during clinic business hours, and ‘afterhours’ consultations during evenings, nights, and weekends. The data was collected and analyzed throughout three distinct time periods in Israel: before the COVID-19 pandemic, during the onset of the COVID-19 pandemic and following the COVID-19 ‘peak’. Results Data of 618850 patients who met the inclusion criteria was extracted. Telehealth services utilized for administrative purposes were the most popular. The older population significantly increased their use of all types of telehealth services during the COVID-19 period, and in the majority of types, this usage decreased after the COVID-19 peak, but to a level that was higher than the baseline level prior to the COVID-19 period. Prior to the COVID-19 period, 23.1% of the study population used ‘online visits’, and 2.2% used ‘afterhours’ consultations, at least once. The percentage of usage for these services increased during the COVID-19 period to 59.2% and 5.0%, and then decreased during the third period to 39.5% and 2.4%, respectively (P < 0.001). Multiple patient variables have been found to be associated with the use of the different telehealth services, in each time-period. Conclusions The senior population uses telehealth services, and can increase their consumption, when they are needed. Suitable and straightforward telehealth solutions tailored for this population should be created. Key messages • The senior population uses telehealth services, and can increase their consumption, when they are needed. • Suitable and straightforward telehealth solutions tailored for this population should be created.

Implementation of an algorithm for predicting exacerbations in telemonitoring: A multimethod study of patients’ and clinicians’ experiences

BackgroundPrediction algorithms may improve the ability of telehealth solutions to assess the risk of future exacerbations in patients with chronic obstructive pulmonary disease. Learning from patients’ and clinicians’ evaluations and experiences about the use of such algorithms is essential to evaluate its potential and examine factors that could potentially influence the implementation and sustained use. ObjectiveTo investigate the patients’ and clinicians’ perceptions and satisfaction with an algorithm for predicting exacerbations in patients with chronic obstructive pulmonary disease. DesignMultimethod study. SettingThree community nursing sites in Aalborg Municipality, Denmark. ParticipantsOne hundred and eleven adults with chronic obstructive pulmonary disease and four clinicians (three nurses and one physiotherapist) specialized in telehealth monitoring of the disease. MethodsThe study was performed from November 2021 to November 2022 alongside a clinical trial in which a prediction algorithm was integrated into an existing telehealth system. The patients’ perspectives were investigated using a self-constructed questionnaire. The clinicians’ perspective was explored using semistructured individual interviews. ResultsMost patients (84.0%–90.8%) were satisfied with the algorithm and the additional measurements required by the algorithm. Approximately 71.7%–75.9% found that the algorithm could be a useful tool for disease assessment. Patients elaborated that they could see an exacerbation prevention potential in the algorithm. Patients trusted the algorithm and found an increased sense of security. The clinicians showed a positive response toward the algorithm and its user-friendliness. However, they were concerned that the additional measurements could be too demanding for some patients and questioned the accuracy of the measurements. Some felt that the algorithm could risk being time-consuming and harm the overall assessment of the individual patient. They expressed a need for continuous information about the algorithm to understand its functions and alarms. ConclusionsOptimal use of the algorithm would require that patients perform additional pulse and oxygen saturation measurements. Furthermore, it will require in-depth insight among clinicians regarding the algorithm's functions and alarms. RegistrationThe study was performed alongside a clinical trial, which was first registered September 9, 2021, at clinicaltrials.gov (registration number NCT05218525). Date of first recruitment was September 28, 2021.

Abstract A150: Improving FIT and colonoscopy animated videos for colorectal cancer screening: An application of learner verification and revision

Abstract Latino adults in the U.S. have low rates of colorectal cancer (CRC) screening. Using at-home fecal immunochemical tests (FIT) can improve screening rates. This study builds upon three-minute instructional animated videos originally created by the Colorectal Cancer Prevention Network that our team previously translated into Spanish. In the current study, we employed a user-centered approach, known as learner verification and revision (LV&R), to elicit patients’ input on the videos. These videos will be used as part of a text-based intervention aimed at increasing FIT use among Latino adults aged 45-54. This study was part of a larger trial, Community Partnership for Telehealth Solutions to Counter Misinformation and Achieve Equity (PRIME), which aims to test an intervention that integrates the videos with social-needs navigation to boost CRC screening within Latino communities. LV&R integrates theories of health communication and qualitative research to tailor interventions to the needs of target populations. To solicit feedback on the two videos (one on FIT, one on colonoscopy), we interviewed 24 patients (46% male) from a large urban community clinic in Los Angeles. Patients were age-eligible for CRC screening, had been mailed a FIT, texted a link to the videos, and spoke English or Spanish (54% preferred Spanish). Interviews asked about acceptability, comprehension, actionability, and cultural relevance of the videos among our target audience. Interviews were recorded, transcribed, and summarized using rapid qualitative analysis techniques. Interviews revealed positive perceptions of both videos' accessibility, content, and appeal. Participants appreciated the videos’ straightforward language and clear instructions, which were found to be culturally and linguistically acceptable across English and Spanish-speakers. The videos were viewed as informative and persuasive, motivating participants to consider or complete CRC screening and share videos with others. The videos aided in dispelling misinformation related to screening with FIT and/or colonoscopy, particularly for those who had never screened for CRC. Participants liked the length of the videos along with use of appropriate humor to convey complex steps in the screening process. Participants suggested minor improvements such as adding language related to bowel prep, screening guidelines, communication of results, and reassuring language to help with fears to enhance the videos' effectiveness. Overall, these findings underscore the importance of culturally responsive, informative, and engaging materials in promoting CRC screening awareness and participation. Latino patients reported high acceptability, persuasiveness, helpfulness, and cultural appropriateness of animated videos sent via text to educate patients about FIT and colonoscopy. Suggestions for improvement centered on providing more facts about CRC, emphasizing that both men and women are at risk, adding reassuring language to encourage individuals to overcome any fears, and providing more resources for further information. Citation Format: Jennifer S. Rivelli, Jennifer L. Schneider, Blake W. Locher, Katherine A. Vaughn, Meagan C. Shaw, Gloria D. Coronado, Esmeralda Ruiz, Jamie H. Thompson, Anne Escaron. Improving FIT and colonoscopy animated videos for colorectal cancer screening: An application of learner verification and revision [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A150.

CardioGuard: AI-driven ECG authentication hybrid neural network for predictive health monitoring in telehealth systems

The increasing integration of telehealth systems underscores the importance of robust and secure methods for patient data management. Traditional authentication methods, such as passwords and PINs, are prone to breaches, underscoring the need for more secure alternatives. Therefore, there is a need for alternative approaches that provide enhanced security and user convenience. Biometric-based authentication systems uses individuals unique physical or behavioral characteristics for identification, have emerged as a promising solution. Specifically, Electrocardiogram (ECG) signals have gained attention among various biometric modalities due to their uniqueness, stability, and non-invasiveness. This paper presents CardioGaurd, a deep learning-based authentication system that leverages ECG signals—unique, stable, and non-invasive biometric markers. The proposed system uses a hybrid Convolution and Long short-term memory based model to obtain rich characteristics from the ECG signal and classify it as authentic or fake. CardioGaurd not only ensures secure access but also serves as a predictive tool by analyzing ECG patterns that could indicate early signs of cardiovascular abnormalities. This dual functionality enhances patient security and contributes to AI-driven disease prevention and early detection. Our results demonstrate that CardioGaurd offers superior performance in both security and potential predictive health insights compared to traditional models, thus supporting a shift towards more proactive and personalized telehealth solutions.

Validating a Portable, Camera-Based System to Scale the Clinical Gait Assessment as a Tele-Health Solution

Validating a Portable, Camera-Based System to Scale the Clinical Gait Assessment as a Tele-Health Solution

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

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

Evaluating the Usability of a Telehealth System for People with COPD: A Cross Sectional Study.

Pulmonary Disease (COPD) exacerbations. However, the effect of telehealth for COPD remains uncertain, which may be due to a lack of attention to usability during the development of telehealth solutions. The aim was to evaluate the usability of a telehealth system for COPD using the Danish Telehealth Usability Questionnaire. A total of 96 people with COPD, who were already using a telehealth system consisting of weekly measurements of physiological parameters and symptom-related questionnaires, were included. The D-TUQ was used to assess the usability of the telehealth system. The overall experience with the usability of the telehealth system was mainly positive, but there was room for improvement.

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

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

Adapting a group-based, multimodal aphasia treatment for telehealth – co-design of M-MAT Tele

Multi-Modality Aphasia Treatment (M-MAT) is an effective group intervention for post-stroke aphasia. M-MAT employs interactive card games and the modalities of gesture, drawing, reading, and writing to improve spoken language. However, there are challenges to implementation of group interventions such as M-MAT, particularly for those who cannot travel or live in rural areas. To maximise access to this effective treatment, we aimed to adapt M-MAT to telehealth format (M-MAT Tele). The Human-Centred Design Framework was utilized to guide the adaptation approach. We identified the intended context of use (outpatient/community rehabilitation) and the stakeholders (clinicians, people with aphasia, health service funders). People with aphasia and practising speech pathologists were invited to co-design M-MAT Tele in a series of iterative workshops, to ensure the end product was user-friendly and clinically feasible. The use of co-design allowed us to understand the hardware, software and other constraints and preferences of end users. In particular, clinicians (n = 3) required software compatible with a range of telehealth platforms and people with aphasia (n = 3) valued solutions with minimal technical demands and costs for participants. Co-design within the Human-Centred Design Framework led to a telehealth solution compatible with all major telehealth platforms, with minimal hardware or software requirements. Pilot testing is underway to confirm acceptability of M-MAT Tele to clinicians and people with aphasia, aiming to provide an effective, accessible tool for aphasia therapy in telehealth settings.

Improving efficiency through innovation in the ‘real-world’: Feasibility of a co-designed telehealth solution for individuals with aphasia

BACKGROUND: Research indicates that speech and language therapy for individuals with aphasia delivered via telehealth is acceptable and facilitates good outcomes. Although adoption of telehealth has increased following COVID-19, it has not been implemented broadly. Telehealth could assist services to meet the recommended intensity of therapy for individuals with aphasia. OBJECTIVE: The study aimed to investigate the barriers and facilitators to adopting telehealth for individuals with aphasia at two local NHS trusts; and to co-design a telehealth solution responding to these challenges. The feasibility of this solution was also investigated. A secondary objective is to highlight the value of real-world data (RWD) collection in evaluating clinical practice. METHODS: An experience-based co-design study was conducted, which developed and piloted a bespoke telehealth solution across service pathways at two NHS sites. Feasibility was evaluated qualitatively through interviews and quantitatively from RWD collected through the telehealth software. RESULTS: The telehealth solution incorporated outsourcing of the service to a specialist company, provision of hardware and software and regular support for individuals with aphasia and their carers. Take up was associated with a positive impact and the RWD revealed a substantial increase in the hours of therapy the individuals with aphasia received. CONCLUSION: Personalised telehealth solutions which respond to local and personal needs are feasible and an acceptable way to increase the intensity of speech and language therapy for some individuals with aphasia, bringing services more in line with evidence-based recommendations and optimising patient outcomes. Embedded RWD collection systems are valuable for evaluation.

Digitalization of hypertension management: a paradigm shift.

Hypertension, which stands as a leading global health challenge, demands a dynamic approach for its effective management. The traditional methods of managing hypertension, centered on periodic clinic visits for blood pressure measurement and pharmacological interventions, are increasingly being complemented and enhanced by digital technologies. The integration of wearable devices, mobile applications, personalized treatments, and telehealth solutions into healthcare system is reshaping traditional hypertension care. Digitalization of hypertension management extends to population health, in addition to individual patient benefits, aimed at preventing and controlling hypertension on a broader scale. However, this digital revolution in hypertension management brings forth challenges related to data security, data accuracy, equitable access, and standardization of devices by international regulatory agencies. Addressing these issues is equally important to ensure that the benefits of digital technologies are accessible to everyone, irrespective of socio-economic factors. This paper concludes with a forward-looking perspectives, emphasizing the potential of digitalization to modify the landscape of hypertension management.

Utilizing Telemedicine Applications in Celiac Disease and Other Gluten-Free-Diet-Dependent Conditions: Insights from the COVID-19 Pandemic.

Globally, approximately 1.4% of people have celiac disease (CD), induced by gluten sensitivity. If left untreated, it causes small intestinal inflammation and villous atrophy, which can result in failure to thrive, anemia, osteoporosis, malabsorption, and even malignancy. The only treatment option available is a gluten-free diet (GFD). Few studies have looked at the role and perception of telehealth in relation to CD and selective nutrition both before and after the COVID-19 pandemic. Our goal was to screen and investigate the research conducted both before and after the COVID-19 pandemic concerning the utilization of telehealth applications and solutions in CD and other GFD-dependent circumstances. We employed a narrative review approach to explore articles that were published in scholarly journals or organizations between the years 2000 and 2024. Only English-language publications were included. PubMed and Google Scholar searches were mainly conducted using the following keywords: telemedicine, telehealth, telecare, eHealth, m-health, COVID-19, SARS-CoV-2, celiac disease, and gluten-free diet (GFD). Manual searches of the references in the acquired literature were also carried out, along with the authors' own personal contributions of their knowledge and proficiency in this field. Only a few studies conducted prior to the COVID-19 outbreak examined the viewpoints and experiences of adult patients with CD with relation to in-person clinic visits, as well as other options such as telehealth. The majority of patients believed that phone consultations were appropriate and beneficial. Video conferencing and telemedicine became more popular during the COVID-19 pandemic, demonstrating the effectiveness of using these technologies for CD on a global basis. In recent years, urine assays for gluten identification have become accessible for use at home. These tests could be helpful for CD monitoring with telemedicine assistance. The extended knowledge gathered from the COVID-19 pandemic is expected to complement pre-COVID-19 data supporting the usefulness of telemedicine even after the emergent pandemic, encouraging its wider adoption in standard clinical practice. The monitoring and follow-up of CD patients and other GFD-dependent conditions can greatly benefit from telemedicine.

Mental health management in healthcare organizations: Challenges and strategies - a review

This research delves into the nuanced realm of mental health management within healthcare organizations, addressing challenges and unveiling transformative strategies. The study underscores the critical importance of integrating mental health into broader healthcare policies by examining the multifaceted role of training, education, technology, and interdisciplinary collaboration. Successful training initiatives empower healthcare professionals, reduce stigma, and enhance collaboration, contributing to a mental health-literate workforce. Technology, including telehealth and innovative solutions, acts as a catalyst, overcoming barriers and ushering in a new era of accessibility. Interdisciplinary collaboration fosters holistic care, while the future direction involves comprehensive research, policy integration, and technological innovation. In conclusion, a proactive and inclusive approach is crucial for shaping a healthcare ecosystem where mental health thrives and is central to holistic patient care. Keywords: Mental Health Management, Healthcare Organizations, Training and Education, Policy Integration.

Unveiling the Surge: A Comprehensive Analysis of the Stimulating Impact of the Covid-19 Pandemic on Telemedicine and Its Academic Landscape.

The Covid-19 pandemic spurred an unprecedented shift towards digitalization, prompting a surge in telehealth practices. This paper explores the impact of the pandemic on telemedicine through a comprehensive analysis of scientific publications. Utilizing a bibliometric approach, the study examines trends in telemedicine research before and after the onset of Covid-19. The systematic search in PubMed yielded 8,454 pre-Covid-19 publications (2016-2019) and 16,633 post-Covid-19 publications (2020-2023). A total of 21,989 distinct keywords were extracted. Co-occurrence maps reveal evolving thematic clusters, with "mhealth" and "ehealth" dominating pre-Covid-19, while "Covid-19" emerges as a top keyword post-pandemic. The Top-10 keywords shift post-Covid-19, reflecting dynamic research priorities. The bibliometric approach illuminates a heightened exploration of telehealth solutions post-pandemic, emphasizing the enduring impact of the crisis on academic discourse. Changes in key terms and shifts in key term ranking indicate dynamic research priorities and a broader consideration of multidimensional healthcare challenges. Acknowledging study limitations, the analysis offers a high-level perspective, focusing on authors' keywords. Despite challenges, the study provides a systematic overview, revealing the emergence of new telemedicine application domains and the need for further in-depth analyses. Future research directions may explore the ecological impact of telemedicine applications and other intriguing aspects, contributing to a comprehensive understanding of telemedicine's scholarly trajectory.

Adoption and Use of Telemedicine and Digital Health Services Among Older Adults in Light of the COVID-19 Pandemic: Repeated Cross-Sectional Analysis.

As the population ages and the prevalence of long-term diseases rises, the use of telecare is becoming increasingly frequent to aid older people. This study aims to explore the use and adoption of 3 types of telehealth services among the older population in Israel before, during, and after the COVID-19 pandemic. We explored the use characteristics of older adults (aged ≥65 years) belonging to Clalit Health Services in several aspects in the use of 3 types of telehealth services: the use of digital services for administrative tasks; the use of synchronous working-hours telehealth visits with the patient's personal physician during clinic business hours; and the use of after-hours consultations during evenings, nights, and weekends when the clinics are closed. The data were collected and analyzed throughout 3 distinct periods in Israel: before the COVID-19 pandemic, during the onset of the COVID-19 pandemic, and following the COVID-19 peak. Data of 618,850 patients who met the inclusion criteria were extracted. Telehealth services used for administrative purposes were the most popular. The most intriguing finding was that the older population significantly increased their use of all types of telehealth services during the COVID-19 pandemic, and in most types, this use decreased after the COVID-19 peak, but to a level that was higher than the baseline level before the COVID-19 pandemic. Before the COVID-19 pandemic, 23.1% (142,936/618,850) of the study population used working-hours telehealth visits, and 2.2% (13,837/618,850) used after-hours consultations at least once. The percentage of use for these services increased during the COVID-19 pandemic to 59.2% (366,566/618,850) and 5% (30,777/618,850) and then decreased during the third period to 39.5% (244,572/618,850) and 2.4% (14,584/618,850), respectively (P<.001). Multiple patient variables have been found to be associated with the use of the different telehealth services in each period. Despite the limitations and obstacles, the older population uses telehealth services and can increase their use when they are needed. These people can learn how to use digital health services effectively, and they should be given the opportunity to do so by creating suitable and straightforward telehealth solutions tailored to this population and enhancing their usability.

Developing Systems of Emergency and Inpatient Neurologic Care in Resource-Limited Settings.

Neurologic diseases represent a significant global health challenge, leading to disability and mortality worldwide. Healthcare systems in low- and middle-income countries are disproportionally affected. In these resource-limited settings, numerous barriers hinder the effective delivery of emergency and inpatient neurologic care, including shortages of trained personnel, limited access to diagnostics and essential medications, inadequate facilities, and absence of rehabilitation services. Disparities in the neurology workforce, limited access to neuroimaging, and availability of acute interventions further exacerbate the problem. This article explores strategies to enhance global capacity for inpatient neurologic care, emphasizing the importance of workforce development, context-specific protocols, telehealth solutions, advocacy efforts, and collaborations.

(028) The Emerging Role of Telehealth in Sexual Medicine: A Survey of Patient Attitudes

Abstract Introduction The COVID-19 pandemic brought with it an increase of healthcare interactions on an electronic interface, but a return to in-person interactions has left many questions open regarding the future utility and viability thereof. Urologic care, and particularly sexual health, frequently involves sensitive issues and understanding patients’ attitudes is imperative to determine how to incorporate telemedicine in the future. Objective This study seeks to characterize patients’ overall perspective on telehealth services in a sexual medicine setting to identify patient preferences and satisfaction with the use of telehealth services. Methods An electronic survey was sent through REDCap to patients who had at least one telehealth visit with a provider in our tertiary referral center since the start of the COVID-19 pandemic. The accrued patient cohort was sent a 15-question four-pronged survey assessing the purpose of the visit, the patient-provider relationship and communication, the perceived quality of care, and the patient’s overall satisfaction on a 5-point Likert scale. Descriptive statistical analysis was done using REDCap. Results We surveyed 4071 patients and received 771 (18.9%) responses. Of those who replied, 470 (61%) were seen for hypogonadism, 216 (28%) for erectile dysfunction, 50 (6.5%) for infertility, and 35 (4.5%) for Peyronie’s. A majority of patients (78.4%) ‘moderately’ or ‘strongly’ agreed that they are able to maintain a physician-patient relationship, are comfortable with telehealth use for new and follow-up visits alike and perceive a comparable quality of care when averaged across all questions in these sections. 613 (79.5%) of patients reported being ‘somewhat’ or ‘very’ satisfied with their telehealth visits and 513 (66.6%) patients would prefer a telehealth visit over an in-person in the future. Conclusions The results of this study indicate that patients are generally satisfied with telehealth visits, and it would likely be in the best interest for physicians and their patients to increasingly adopt telehealth solutions. The data further suggests that patients with certain diagnoses are less likely to prefer telehealth than others, though a more rigorous statistical analysis is needed once additional patient responses are received. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast Investor: Sprout.

A Novel Deep Ensemble Method for Selective Classification of Electrocardiograms.

Telehealth paradigms are essential for remotely managing patients with chronic conditions. To assist clinicians in handling the large volumes of data collected through these systems, clinical decision support systems (CDSSs) have been developed. However, the effectiveness of CDSSs depends on the quality of remotely recorded physiological data and the reliability of the algorithms used for processing this data. This study aims to reliably detect atrial fibrillation (AF) from short-term single-lead (STSL) electrocardiogram (ECG) recordings obtained in unsupervised telehealth environments. A novel deep ensemble-based method was developed for detecting AF from STSL ECG recordings. Following this, a postprocessing algorithm was created to assess uncertainty in classified STSL ECGs and to refrain from interpretation when confidence is low. The proposed method was validated through a 5-fold cross-validation on the Cardiology Challenge 2017 (CinC2017) dataset. The deep ensemble method achieved 83.5 ± 1.5% sensitivity, 98.4 ± 0.2% specificity, and an F 1-score of 0.847 ± 0.016in AF detection. Implementing the selective classification algorithm resulted in significant improvements, with sensitivity increasing to 92.8 ± 2.2%, specificity to 99.7 ± 0.0%, and an F 1-score of 0.919 ± 0.016. The proposed method demonstrates the feasibility of accurately detecting AF from STSL ECG recordings. The selective classification approach offers a substantial enhancement to automated ECG interpretation algorithms in telehealth solutions. These findings highlight the potential for improving the utility of telehealth systems by integrating advanced CDSSs capable of managing uncertainty and ensuring higher accuracy, thereby improving patient outcomes in remote healthcare settings.

Drivers and Barriers of National Innovation Ecosystems for Implementing Sustainable Development Goals: A Latvian Case Study

Research examining the drivers and barriers of implementing sustainable development goals (SDGs) in national innovation ecosystems (NIEs) is scarce. This study proposes a framework of drivers and barriers to NIEs for SDGs implementation used in the Latvian context. An exploratory qualitative approach based on the Latvian case study is used to generate in-depth information on the drivers and barriers of NIEs for implementing SDGs. Our results show that at the NIE level, drivers for actors and institutions, such as legislative compliance, eco-innovations, cross-sector cooperation, and talent pools, are hindered by some barriers, such as lack of networking skills, institutional voids, totalitarian power, and academic rigidity. Despite attempts at technological convergence that facilitated distance learning, remote work, and telehealth solutions during the pandemic, the lack of collaborative platforms hinders the development of artifacts. Sustainable innovation is hindered by a lack of resources and openness that also blocks open innovation. Beyond coevolution and co-specialization initiatives, friction between the public and private sectors hinders complementary and substitute relations. Our results provide a systemic and holistic NIE tool to analyze the drivers and barriers of the SDGs.