Telehealth Equipment Research Articles

Rural Cancer Survivors' Perceptions of a Nurse-Led Telehealth Intervention to Manage Cancer-Related Distress.

To understand rural survivors' experiences of participating in a nurse-led telehealth visit designed to address cancer-related distress. 25 rural-dwelling, post-treatment adult survivors of head and neck cancer recruited from a cancer center clinic affiliated with an academic health system serving a rural catchment area in the southeastern United States. A descriptive multimethod approach using semistructured qualitative interviews and the Telemedicine Satisfaction and Usefulness Questionnaire. Three primary themes emerged from the qualitative interviews, related to trust, access to information, and technology barriers. Quantitative findings indicated high satisfaction with the nurse-patient relationship through telehealth and lower satisfaction with using telehealth equipment to connect to a visit. Despite facing technology barriers, rural cancer survivors prioritize speaking with an oncology certified nurse through telehealth. Although they may be willing to be open and vulnerable with an oncology nurse about their distress, rural survivors are less likely to accept a referral to another provider of psychosocial care. Nurses can incorporate warm handoffs to increase psychosocial referral uptake for rural survivors.

Patient perceptions of trauma-focused telemental health services using the Telehealth Satisfaction Questionnaire (TSQ).

Telehealth services can address many barriers to traditional office-based mental health services. Few studies have assessed youth and caregiver perceptions of and satisfaction with trauma-focused interventions delivered via telemental health. The present study reports data collected using the Telehealth Satisfaction Questionnaire (TSQ), which was developed to measure child and caregiver satisfaction with services, comfort with the telehealth equipment, and barriers to traditional office-based services. Thirteen clinicians delivered home- and school-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) via videoconferencing on tablets and computers to 60 child patients (71.7% Latinx, 18.3% Black, and 10.0% non-Hispanic White). Patients and caregivers completed the TSQ at treatment discharge via telephone, videoconferencing, or in-person interviews. There was a high level of satisfaction among patients and caregivers receiving TF-CBT via telemental health. Furthermore, most youth and caregivers felt comfortable using the telehealth equipment from the outset of therapy, and all participants who were not initially comfortable using the equipment reported feeling more comfortable over time. The most common barriers to traditional office-based services were caregiver work schedule (57.7%), distance to mental health clinic (55.8%), and lack of transportation (44.2%). Patients and caregivers expressed a preference for telemental health services if given the option between receiving therapy via videoconferencing versus going to an office-based clinic. Findings indicated telemental health treatment addressed barriers that would have otherwise prevented families from accessing office-based services. The TSQ can be used to help clinics and providers assess patient and caregiver satisfaction with telehealth services in various settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Designing digital health applications for climate change mitigation and adaptation.

Designing digital health applications for climate change mitigation and adaptation.

How We Can Reap the Full Benefit of Teleconsultations: Economic Evaluation Combined With a Performance Evaluation Through a Discrete-Event Simulation.

BackgroundIn recent years, the rapid development of information and communications technology enabled by innovations in videoconferencing solutions and the emergence of connected medical devices has contributed to expanding the scope of application and expediting the development of telemedicine.ObjectiveThis study evaluates the use of teleconsultations (TCs) for specialist consultations at hospitals in terms of costs, resource consumption, and patient travel time. The key feature of our evaluation framework is the combination of an economic evaluation through a cost analysis and a performance evaluation through a discrete-event simulation (DES) approach.MethodsThree data sets were used to obtain detailed information on the characteristics of patients, characteristics of patients’ residential locations, and usage of telehealth stations. A total of 532 patients who received at least one TC and 18,559 patients who received solely physical consultations (CSs) were included in the initial sample. The TC patients were recruited during a 7-month period (ie, 2020 data) versus 19 months for the CS patients (ie, 2019 and 2020 data). A propensity score matching procedure was applied in the economic evaluation. To identify the best scenarios for reaping the full benefits of TCs, various scenarios depicting different population types and deployment strategies were explored in the DES model. Associated break-even levels were calculated.ResultsThe results of the cost evaluation reveal a higher cost for the TC group, mainly induced by higher volumes of (tele)consultations per patient and the substantial initial investment required for TC equipment. On average, the total cost per patient over 298 days of follow-up was €356.37 (US $392) per TC patient and €305.18 (US $336) per CS patient. However, the incremental cost of TCs was not statistically significant: €356.37 – €305.18 = €51.19 or US $392 – US $336 = US $56 (95% CI –35.99 to 114.25; P=.18). Sensitivity analysis suggested heterogeneous economic profitability levels within subpopulations and based on the intensity of use of TC solutions. In fact, the DES model results show that TCs could be a cost-saving strategy in some cases, depending on population characteristics, the amortization speed of telehealth equipment, and the locations of telehealth stations.ConclusionsThe use of TCs has the potential to lead to a major organizational change in the health care system in the near future. Nevertheless, TC performance is strongly related to the context and deployment strategy involved.

The pandemic silver lining: preparing osteopathic learners to address healthcare needs using telehealth.

During the COVID-19 pandemic, many clinicians quickly adapted their way of practicing patient care by offering telehealth and virtual office visits while simultaneously having to minimize direct patient care. The shift in direct clinical learning opportunities provided to third- and fourth-year medical students required a shift in the educational curriculum to develop learner skills around the appropriate use of telehealth in patient care. The aim of this project was to provide exposure to students so they could learn the telemedicine equipment and best practices, and how to identify infectious diseases to improve access to care and meet the needs of the patient. In July and August of 2020, the Indiana Area Health Education Centers Program partnered with Marian University College of Osteopathic Medicine (MUCOM) to support a 1day telehealth simulation (online curriculum, group lecture, and two standardized patient encounters) into their clerkship curriculum. We utilized a retrospective pretest-posttest to assess changes in learner knowledge around telehealth after the program. At the conclusion of the telehealth training program, students were asked to complete a retrospective pretest-posttest assessing their level of preparedness to utilize telehealth equipment, their preparedness to demonstrate "telehealth best practices" in a manner consistent with protecting patient (and data) privacy, their confidence to utilize telehealth for identification of infectious diseases, and their confidence to utilize telehealth to identify proper treatment plans. A total of 96 learners completed the program in 2020. Posttest results demonstrate a statistically significant (p<0.05) improvement for learners' self-reported level of preparedness to utilize telehealth equipment, their preparedness to demonstrate "telehealth best practices" in a manner consistent with protecting patient (and data) privacy, their confidence to utilize telehealth for identification of infectious diseases, and their confidence to utilize telehealth to identify proper treatment plans. Our telehealth curriculum involving a video, interactive learning session, and two standardized patient experiences provided osteopathic medical learners with realistic simulated case scenarios to work through in effort to improve their knowledge and self-efficacy around the utilization of telehealth in practice.

Telehealth Availability and Usage Among Medicare Beneficiaries During the COVID-19 Pandemic, October and November 2020.

During the COVID-19 pandemic, demand for telehealth services increased to reduce disease exposure for patients and providers and to meet preexisting demand for physician services in health resource shortage areas. To estimate self-reported telehealth availability, equipment for accessing telehealth, and telehealth usage among Medicare beneficiaries during the COVID-19 pandemic. We used data from the 2020 Medicare Current Beneficiary Survey (MCBS) COVID-19 Fall Supplement Public Use File to estimate the weighted percentages of beneficiaries who had (a) access to telehealth before or during COVID-19; (b) equipment for accessing telehealth; and (c) telehealth visits during COVID-19. We used logistic regression to examine sociodemographic factors associated with telehealth usage. Beneficiaries who participated in the MCBS COVID-19 Fall Supplements. During October and November 2020, telehealth appointments offered by providers were available to 63.8% (95% confidence interval [CI], 61.8-65.9) of Medicare beneficiaries who had accessed medical care by telephone or video. Among those, only 18.0% (95% CI, 16.1-19.9) had been offered telehealth before the pandemic. The majority of beneficiaries (92.2%; 95% CI, 91.2-93.1) had 1 or more types of equipment available for accessing telehealth, but only 44.9% (95% CI, 43.0-46.9) had had a telehealth visit since July 1, 2020. Older adults, minorities, those with a lower income, and non-English speakers had less availability of telehealth equipment. Patient characteristics were significantly (P < .05) associated with telehealth use, including age, sex, race/ethnicity, and equipment availability. Telehealth availability for Medicare beneficiaries increased substantially during the COVID-19 pandemic. Even with the improvement in telehealth offerings and use hastened by the pandemic, gaps in access and use still exist. Effectiveness and implementation research can find ways to close gaps in telehealth services between vulnerable and underrepresented populations and counterparts.

Veterans Hospital Administration Telehealth Utilization for Recreation and Creative Arts Therapies: A Brief Report.

Background: A brief query was fielded to Veterans Health Administration (VHA) facilities across the United States to provide an initial assessment of recreation therapy (RT) and creative arts therapy (CAT) telehealth utilization. Methods:To develop an understanding of barriers and identify potential solutions for better delivery of services, a cross-sectional survey was deployed to points of contact at 136 VHA facilities. The survey included questions across five areas: staff, infrastructure, barriers to use, training, and interventions being deployed. Descriptive statistics were calculated, and a thematic analysis of qualitative responses was conducted.Results:The most frequent themes from aggregated responses indicated a need for hands-on training, reliable telehealth equipment, and accessible training and tools for Veteran patients who want to use telehealth services.Conclusion:Telehealth delivery of RT/CAT has increased services to Veteran patient populations; however, equipment and training are needed to expand consistent delivery to enhance patient reach across a national health care system.

Nurse Practitioner Student Perceptions of a Pilot Simulated Gerontologic Telehealth Visit.

Recently published nurse practitioner (NP) education organization recommendations and telehealth equipment acquisition necessitated integration of telehealth simulation into NP curricula at a large, public university. The COVID-19 pandemic and associated rapid uptake of telehealth accelerated the need for evidence-supported research in tele-health simulation in NP education. A formative gerontologic simulation scenario using telehealth robot technology was developed by synthesizing best practice guidelines for simulation and telehealth delivery. The simulated telehealth visit used standardized patients and embedded participants. Primary care NP students' perceptions of simulation effectiveness, situational realism, and telehealth robot usability were evaluated using three quantitative tools. Thirty-three primary care Doctor of Nursing Practice students participated in this gerontologic telehealth simulation. Students found the simulation to be effective and realistic, and found the telehealth robot technology to be usable. NP students positively evaluated this telehealth simulation experience. Additional research is needed on evidence-based teaching strategies to guide faculty in teaching and evaluating telehealth content. [J Nurs Educ. 2021;60(7):408-413.].

76644 Cognitive and Behavioral Outcomes in Adolescents with Sickle Cell Disease Before and After a Telehealth Cognitive Remediation Program to Prepare for Transition of Care

ABSTRACT IMPACT: This study is providing a telehealth intervention for the first time in patients with sickle cell disease with the goal of improving cognitive functioning and preparing adolescents for successful transition of care to adult healthcare providers. OBJECTIVES/GOALS: There is a high prevalence of cognitive impairment in adolescents with sickle cell disease (SCD). The purpose of this study is to test the efficacy of an individualized cognitive remediation program designed to promote not just cognitive function, but also adaptive and self-management skills necessary for successful transition to independence. METHODS/STUDY POPULATION: 12 participants with SCD (5 males, ages 10-16) participated in an individualized program, Cognitive-Remediation of Executive and Adaptive Deficits in Youth [C-READY], consisting of three main components: individual goal-based therapy, parent training sessions, and home skill practice. C-READY sessions occur one-on-one with a trained therapist for 8 sessions conducted over 4 weeks. Weekly parent training sessions are also conducted as part of the C-READY program. All of these sessions occurred via telehealth video-calling between the therapist and the adolescent/parent. Participants were evaluated before and after the C-READY program using neuropsychological assessment measures and transition readiness questionnaires. Parents also completed ratings on telehealth delivery, content, and timing. RESULTS/ANTICIPATED RESULTS: Repeated measures ANOVA indicated significant improvement in transition readiness behaviors as rated by parents, including improved independence in medication management (p = 0.029) and in talking with their healthcare providers (p = 0.019). Significant improvement was also demonstrated on a neuropsychological measure related to executive function skills, specifically inhibition and switching (p = 0.012). Results from telehealth surveys (rated on a 5-point Likert scale) indicated overall satisfaction with services (4.2/5), including visual (4/5) and voice quality (4.3/5) of telehealth equipment. Ratings also indicated feeling that their privacy was respected (4/5) and that their interactions with their therapist were appropriate and sensitive (4.5/5). DISCUSSION/SIGNIFICANCE OF FINDINGS: These results provide support for interventions that focus on cognitive skills to improve behaviors necessary for successful transition of care in youth with SCD. Results are also promising for delivery via telehealth in order to address barriers related to access to care. Future results will continue to be reported, as this study is currently ongoing.

Feasibility of Advanced Practice Nurse - Led Telehealth Service in Patients with Myeloproliferative Neoplasm in the Community: A Singapore Single-Centre Report

Introduction Telehealth is fast becoming a promising alternative service for face-to-face consultation in healthcare to improve access to healthcare in a cost effective manner. An academic medical centre (AMC) piloted a tele-consultation program for patients with myeloproliferative neoplasm (MPN), a disease with an abnormal mutation in the bone marrow leading to overproduction of any combination of white cells, red cells and platelets. The program aimed to demonstrate the feasibility and safety of the use of telehealth in managing patients with MPN. Methods For this program only patients with Essential Thrombocytosis (ET) and Polycythemia Vera (PV) who met the criteria were recruited and enrolled into the program. Workflows, logistics and education materials were developed and briefed to stakeholders prior to the commencement of the program. The program utilised the Advanced Practice Nurses' (APNs) expertise in the haematology unit to support the service. APNs were provided addition training on both clinical practice knowledge and the appropriate use of the telehealth equipment. Data was collected between January and July 2020. Prospective outcome indicators measured were i) correct treatment prescribed according to guidelines; ii) number of emergency visits due to events related to MPN and its complications, iii) deterioration in cardiovascular health (namely hypertension, diabetes mellitus and hyperlipidermia) iv) number of patient visits right-sited to the community and v) barriers and facilitators for the uptake of the program. Results A total of 21 patients with 44 tele-consults over 7 months was captured. Average age of the patients were 70.1 years. Thirteen patients were diagnosed with ET and 8 patients have PV. Only 1 patient was on a combination of hydroxyurea and anagrelide, the rest of the patients were on hydroxyurea. A total of 14 dosage adjustments were made based on patients' complete blood count, and all of patients' blood countsremained stable during the following review. Two venesections were prescribed for patients with PV. None of the patients required ED visit or admission due to events related to MPN and its complications. One patient was referred back to physician earlier due to non-compliance to telehealth review. All patients had their blood pressure reviewed within 1 year. Sixteen patients had fasting glucose/HbA1c within 2 years, and 14 patients had fasting lipid within 2 years. None of the patients required cardiovascular medication titration, thus there is no deterioration in their cardiovascular health since recruitment. For 9 of the telehealth review, patients did their blood tests concurrently with other medical appointments they had at an earlier date, hence saving a separate trip to hospital for blood test. We were also able to consolidate blood tests and reduce repetition for these 9 patients. Only 8 telehealth blood tests were done in the community, largely due to the closure of satellite blood test service during COVID pandemic. There were only 6 home medicine deliveries, largely because many of the patients had collected adequate medications lasting half a year to a year during physical consult with physicians. The MPN telehealth service has right sited a total of 67 hospital visits to the community. We determined the barriers and facilitators to the program are due to patient, physician and workflow factors. Some of our older patients do not own a mobile device, or prefer traditional, physical consultations with physicians. Some physicians are unfamiliar with telehealth referral workflow. Potential facilitators include older, immobile patients with multiple comorbiditieswanting to cut down hospital visits, as well as patients whose work schedule did not permit frequent hospital visits. Conclusions Our results show that utilising APN-led telehealth service is a feasible and safe method to deliver care to patients with myeloproliferative neoplasm in the community. Right-siting of patient care could reduce patient visits to hospitals especially during COVID pandemic. Ongoing challenges include increasing the number of blood test facilities in the community to facilitate blood taking in the community. Other proposed intangible benefits would include improving patients' psychosocial well-being by transiting them to a new normalcy with minimal hospital visits to a haematology centre. There is potential cost- saving as well that will be explored. Disclosures Chng: Janssen: Honoraria, Research Funding; Celgene: Honoraria, Research Funding; Novartis: Honoraria; Abbvie: Honoraria; Amgen: Honoraria, Research Funding.

Cost-effectiveness of a telehealth intervention for in-home dementia care support: Findings from the FamTechCare clinical trial.

Determining the cost-effectiveness of technological interventions is a crucial aspect in assuring these interventions can be adopted. The FamTechCare intervention is an innovative telehealth support that links family caregivers of persons living with dementia to tailored feedback from dementia care experts based on caregiver-initiated video recordings of challenging care situations. The FamTechCare intervention has demonstrated significant reductions in caregiver depression and increases in caregiver competence when compared to standard telephone support. The purpose of this article is to report on the cost-effectiveness of the FamTechCare telehealth intervention. Process-based costing and a cost-effectiveness analysis using the incremental cost-effectiveness ratio (ICER) was completed with 68 caregiver and person living dementia with dyads. The cost of the 12-week FamTechCare telehealth intervention was found to be greater ($48.43 per dyad per week) due to the telehealth equipment, recording application, and expert panel time compared with the telephone support intervention ($6.96 per dyad per week). The ICER was $18.51 for caregiver depression and $36.31 for caregiver competence indicating that it cost no more than $36.38 per dyad per week over 12 weeks to achieve significant improvement in depression and competence in the FamTechCare caregivers compared to the telephone support caregivers. The FamTechCare intervention appears to be cost-effective when compared to the telephone support intervention and remains near the willingness-to-pay threshold for caregivers providing in-home dementia care support.

Telehealth for Cancer Care in Veterans: Opportunities and Challenges Revealed by COVID.

The Veterans Health Administration system is one of the largest integrated health care providers in the United States, delivering medical care to > 9 million veterans. Barriers to delivering efficient health care include geographical limitations as well as long wait times. Telehealth has been used as a solution by many different health care services. However, it has not been as widely used in cancer care. In 2018, the US Department of Veterans Affairs (VA) Pittsburgh Healthcare System expanded the use of telehealth to provide antineoplastic therapies to rural patients by creating a clinical video telehealth clinic of the Virtual Cancer Care Network. This allows oncologists located at the tertiary center to virtually deliver care to remote sites. The recent COVID-19 pandemic forced oncologists across the VA system to adopt telehealth to provide continuity of care. On the basis of our review and personal experience, we have outlined opportunities for telehealth to play a role in every step of the cancer care journey from diagnosis to therapy to surveillance to clinical trials for medical, surgical, and radiation oncology. There are many advantages, such as decreased travel time and potential cost savings; however, there continues to be challenges with veterans having access to devices and the Internet as well as understanding how to use telehealth equipment. The lessons learned from this assessment of the VA telehealth system for cancer care can be adopted and integrated into other health systems. In the future, there needs to be evaluation of how telehealth can be further incorporated into oncology, satisfaction of veterans using telehealth services, overcoming telehealth barriers, and defining metrics of success.

Telemedicine and Medical Education in the Age of COVID-19.

The COVID-19 pandemic has offered medical schools an opportunity to incorporate telemedicine training into the curricula in a timely and practical manner. Telemedicine has grown exponentially in the United States, and the shift toward remote care to align with social distancing guidelines is fueling this growth. Training medical students to deliver high-quality, secure, and personalized health care through telemedicine will prepare the next generation of physicians to conscientiously use these technologies and meet a growing need for telehealth services. Telemedicine-specific educational goals can be incorporated into curricula and integrated with existing clinical experiences to provide students with core telemedicine and clinical skills to prepare them for current and future pandemics. Medical educators could explore 5 major telemedicine domains: (1) access to care, (2) cost, (3) cost-effectiveness, (4) patient experience, and (5) clinician experience. Schools could use the following learning vehicles to help medical students explore these domains: (1) asynchronous lectures covering telehealth history; (2) discussions on applications, ethics, safety, etiquette, and patient considerations; (3) faculty-supervised standardized patient telehealth encounters; and (4) hands-on diagnostic or therapeutic procedures using telehealth equipment. Incorporating telemedicine into the medical school curriculum exposes students to the application of telemedicine across specialties as well as its limitations.

Guidance and Best Practices for Nuclear Cardiology Laboratories During the COVID-19 Pandemic: An Information Statement From ASNC and SNMMI.

Guidance and Best Practices for Nuclear Cardiology Laboratories During the COVID-19 Pandemic: An Information Statement From ASNC and SNMMI.

Creating a COVID-19 Action Plan for GME Programs.

Creating a COVID-19 Action Plan for GME Programs.

Using Telehealth as a Tool for Rural Hospitals in the COVID-19 Pandemic Response.

Using Telehealth as a Tool for Rural Hospitals in the COVID-19 Pandemic Response.

Opportunities and Challenges of Telehealth in Remote Communities: Case Study of the Yukon Telehealth System

BackgroundTelehealth has been shown to improve access to health care and to reduce costs to the patient and health care system, especially for patients living in rural settings. However, unique challenges arise when implementing telehealth in remote communities.ObjectiveThe study aimed to explore the current use, challenges, and opportunities of the Yukon Telehealth System. The lessons learned from this study were used to determine important factors to consider when attempting to advance and expand telehealth programs in remote communities.MethodsA mixed methods approach was used to evaluate the Yukon Telehealth System and to determine possible future advances. Quantitative data were obtained through usage logs. Web-based questionnaires were administered to nurses in each of the 14 Yukon community health centers outside of Whitehorse and patients who had used telehealth. Qualitative data included focus groups and semistructured interviews with 36 telehealth stakeholders.ResultsSince 2008, there has been a consistent number of telehealth sessions of about 1000 per year, with clinical care as the main use (69.06% [759/1099] of all sessions in 2015). From the questionnaire (11 community nurses and 10 patients) and the interview data, there was a consensus among the clinicians and patients that the system provided timely access and cost savings from reduced travel. However, they believed that it was underutilized, and the equipment was outdated. The following 4 factors were identified, which should be considered when trying to advance and expand a telehealth program: (1) patient and clinician buy-in: past telehealth experiences (eg, negative clinician experiences with outdated technology) should be considered when advancing the system. Expansion of services in orthopedics, dermatology, and psychiatry were found to be particularly feasible and beneficial in Yukon; (2) workflow: the use and scheduling of telehealth should be streamlined and automated as much as possible to reduce dependencies on the single Yukon telehealth coordinator; (3) access to telehealth technology: clinicians and patients should have easy access to up-to-date telehealth technology. The use of consumer products, such as mobile technology, should be leveraged as appropriate; and (4) infrastructure: the required human resources and technology need to be established when expanding and advancing telehealth.ConclusionsWhile clinicians and patients had generally positive perceptions of the Yukon Telehealth System, there was consensus that it was underutilized. Many opportunities exist to expand the types of telehealth services and the number of telehealth sessions, including the expansion of services in several new specialty areas, updating telehealth equipment to streamline workflows and increase convenience and uptake, and integrating novel technologies. The identified barriers and recommendations from this evaluation can be applied to the development and expansion of telehealth in other remote communities to realize telehealth’s potential for providing efficient, safe, convenient, and cost-effective care delivery.

An Interdisciplinary, Multi-Institution Telehealth Course for Third-Year Medical Students.

The American Medical Association has called for telehealth to become a core competency of medical students. Studies indicate that a principal reason physicians do not practice telehealth is lack of training, yet patient interest in and satisfaction with telehealth are high. No comprehensive U.S. undergraduate medical education curriculum teaching telehealth principles has been published. In February 2018, the Uniformed Services University of the Health Sciences (USU) provided an innovative telehealth training experience for third-year medical students. USU led an interinstitutional, interprofessional learner-centered course including six segments: (1) multiple-choice pretest; (2) asynchronous lectures covering telehealth history, applications, ethics, safety, military uses, etiquette, and patient considerations; (3) in-person interactive telehealth instruction including patient selection, current uses, and risk management; (4) faculty-supervised mock patient telehealth encounters; (5) hands-on diagnosis and advanced surgical procedures using telehealth equipment; and (6) multiple-choice posttest. This course was piloted with 149 third-year medical students. Students' improvement in telehealth knowledge was demonstrated through (1) 10.1% average improvement between pre- and posttest scores, (2) completion of competency-based checklists, and (3) postcourse preceptor and student feedback. Faculty feedback indicated that technology use was novel and effective based on student input. Faculty noted that students enjoyed engaging via videoconference. Of participating medical students, 119 (80%) indicated future plans to practice telehealth; several requested to be part of future telehealth courses. Telehealth will be integrated into clinical rotations in collaboration with other institutions. As the telehealth curriculum is taught at other institutions, lessons learned will inform enhancements at USU.

Telehealth Etiquette Training: A Guideline for Preparing Interprofessional Teams for Successful Encounters.

Telehealth technologies have increased in many health care settings. However, much of the training that occurs regarding telehealth is vendor driven. Training that is typically offered focuses on technical aspects of using telehealth equipment, legal issues, and reimbursement. Rarely does industry training involve soft skills or "screen side etiquette" unique to telehealth encounters. The purpose of this article is to present a training program that prepares students with the unique skill set necessary to conduct telehealth visits. A training program was developed to teach health care students (n = 103) proper telehealth etiquette. Preprogram and postprogram data were collected on students' understanding of telehealth etiquette. Results demonstrate significant improvement in knowledge in all areas of telehealth etiquette following the program. Students recognized some improper telehealth etiquette prior to the program but improved significantly following the program.

The impact of telehealth technology on user perception of wellbeing and social functioning, and the implications for service providers

The aim of the project was to evaluate the use of telehealth equipment in the homes of older community-dwelling people, and to review its social and economic impact. A mixed methods approach was adopted, involving interviews, observation and Depression Anxiety Stress Scales. Overall, the greatest benefit was apparent in those participants with a low familiarity with technology and low digital literacy, where changes in behaviours to prevent an exacerbation of their condition was possible. The user interface design reduced concern about using the technology. Changes achieved were through better compliance with medication and associated understanding of the impact on their vital signs and hence daily activities. This represented an improved health literacy and the economic benefits appear to be linked to that. Less benefit was observed by those who had been self-monitoring previously. A greater focus on specific conditions and improved self-management could strengthen the evidence for targeted economic benefits.