Telemedicine Services Research Articles

The use of medical health applications by primary care physicians in Israel: a cross-sectional study

BackgroundThe use of medical health applications (mHealth apps) by patients, caregivers, and physicians is widespread. mHealth apps are often employed by physicians to quickly access professional knowledge, guide treatment, easily retrieve medical records, and monitor and manage patients. This study sought to characterize the use of mHealth apps among primary care physicians (PCPs) in Israel. The reasons for using apps and barriers to their use were also investigated.MethodsFrom all MHS’ PCPs, we randomly selected 700 PCPs and invited them to complete a questionnaire regarding the use of mHealth apps and attitudes toward them.ResultsFrom August 2020 to December 2020, 191 physicians completed the questionnaire (response rate 27.3%). 68.0% of PCPs reported using mHealth apps. Telemedicine service apps were the most frequently used. Medical calculators (used for clinical scoring) and differential diagnosis apps were the least frequently used. The most common reason for mHealth app use was accessibility, followed by time saved and a sense of information reliability. Among infrequent users of apps, the most common barriers reported were unfamiliarity with relevant apps and preference for using a computer. Concerns regarding information reliability were rarely reported by PCPs. Physician gender and seniority were not related to mHealth app use. Physician age was related to the use of mHealth apps.ConclusionsmHealth apps are widely used by PCPs in this study, regardless of physician gender or seniority. Information from mHealth apps is considered reliable by PCPs. The main barrier to app use is unfamiliarity with relevant apps and preference for computer use.

On the effectiveness of regulatory restrictions in conducting telemedicine consultations

The article examines the introduction of an experimental legal regime in the field of telemedicine in the Russian Federation. The authors investigate the general and experimental legal regulation in the field of telemedicine services. It is noted that the main prohibition leading to the emergence of the services in the field of medicine is a ban on clarifying and directly making a diagnosis within the framework of a remote consultation without prior face-to-face appointment with the attending physician. When establishing an experimental legal regime, this prohibition was relaxed, since it is possible to seek remote consultation from another doctor working in the same medical organization and having at least 7 years of experience in the specialty. It is stated that the information services that appeared to circumvent this prohibition are actually medical. In the course of the research, general scientific methods of cognition of the surrounding reality and legal matter, as well as special legal methods, including formal legal ones, were used to achieve these goals. It is noted that when establishing, within the framework of an experimental legal regime, the possibility of prescribing treatment or correcting it by another doctor working in the same medical organization as the attending physician who conducted the preliminary face-to-face appointment of the patient, medical organizations with an extensive network of branches receive advantages for development. In such a situation, it is possible to form two levels of medical care: within the framework of the first, primary face-to-face reception is carried out by the primary link of medical workers, within the framework of the second, specialized doctors conduct remote consultation to the patient (legal representative). The establishment of a ban on diagnosis and restrictions on the prescription of treatment remotely has led to the spread of shady online counseling services. Due to the motives and goals of the patient when accessing such a service, it is essentially medical.

Digital Innovations in Pneumonia Care: A Mini Review

Introduction: Pneumonia is a severe respiratory disease threatening public health and requires timely and accurate diagnosis and early intervention for effective treatment. The emergence of telemedicine during COVID-19 has offered new solutions to solve health problem. This review examines recent studies focusing on effectiveness of telemedicine intervention in pneumonia care. Methods: We systematically searched five databases to retrieve original research that addressed telemedicine's use in pneumonia diagnosis, treatment, monitoring, or patient assistance. Two independent reviewers performed screening to confirm alignment with inclusion criteria. The findings were synthesised narratively. Results: A total of five studies were included in the review. The interventions across studies were telephonic follow-ups, Smartphone-based algorithm for diagnosing pneumonia, telemedicine set-up at patients' homes and Interactive videoconferencing. The findings suggest that telephone consultation is effective for patients with low-risk respiratory infections and may be more effective in early diagnosis of pneumonia patients. Conclusion: The planning for work in telemedicine, whether in regulations or private practice, is necessary to ensure the quality, safety, and consistency of telemedicine practices. The use and availability of telemedicine services, especially in rural areas and on mobile phones, must be expanded to reduce problems in the region.

Technological development in telemedicine: bibliometric analysis, research gaps, and literature trends

The aim of this article was to analyze the literature on technological development in telemedicine through bibliometrics, by identifying the state of the art, research gaps, and trends in the literature. The analysis covers a total of 67 articles related to the field of study, published between 2010-2020 in the Springer Link, Science Direct, Wiley Online Library, Web of Science, and Scopus databases. The data was processed using the software StArt, Excel, IBM SPSS Statistics, and Iramuteq. The results presented bibliometric analysis of the articles, classified into the areas of Management (52.2%), IT (25.4%), and Medicine (22.4%), along with a Table of 34 suggestions for future research. Literature trends encompassed six study clusters (health, study, service, technology, patient, and telemedicine), which further subdivided into nine research themes (digital platform, telemedicine service management, telemedicine service operation, end-user perception, business opportunities, healthcare professional perception, covid-19, regulation, and robotics). An observed outcome was a significant increase in the number of publications in the area due to covid-19.

Web Integrated Continuous Positive Airway Pressure System

Keywords: Continuous Positive Airway Pressure(CPAP) 1, Sleep Apnea 2, Neonatal 3, Respiratory Distress Syndrome (RDS) 4, Premature baby 5, Transpiration medical device 6, Internet of Things 7 CPAP, a non-invasive ventilation method crucial in neonatal care, has significant implications for the survival of very low birth weight preterm infants. However, its widespread adoption is hindered by cost constraints and the need for additional features like Apnea Hypopnea Index (AHI) monitoring. This study seeks to overcome these challenges by developing an affordable CPAP device for Neonatal Intensive Care Units (NICUs). By incorporating sensors for data collection and a microcontroller-based control system, this device aims to optimize CPAP function while minimizing energy consumption. Furthermore, the collected data will be securely stored on a cloud platform, potentially benefiting both neonatal care and sleep apnea management. Recognizing the vital role of sleep in human health, this innovation underscores the importance of restorative rest for physical and mental well-being. Highlights: · Web-integrated CPAP devices often come with remote monitoring capabilities. This allows healthcare providers to remotely monitor patients' CPAP usage data, including compliance and efficacy metrics, without requiring in-person visits. This feature facilitates better patient management and allows for timely intervention if issues arise. · These devices typically track and record various parameters such as usage hours, mask leaks, apnea-hypopnea index (AHI), and pressure settings. The data can be accessed by both patients and healthcare providers, providing insights into treatment progress and effectiveness over time. · Many web-integrated CPAP devices offer cloud connectivity, allowing users to sync their data to secure online platforms. This feature enables seamless access to CPAP usage data from multiple devices, such as smartphones, tablets, or computers, enhancing convenience and flexibility for users. · Some modern CPAP machines offer wireless connectivity options, such as Bluetooth or Wi-Fi, enabling users to connect their devices to compatible accessories or smartphone apps. This connectivity allows for features like remote control of device settings, automatic software updates, and integration with health tracking apps for a more comprehensive health management experience. · The integration of web-based CPAP platforms with telemedicine services allows for virtual consultations between patients and healthcare providers. This feature enhances access to care, particularly for patients in remote or underserved areas, and enables real-time adjustments to CPAP settings based on patient feedback and data analysis.

Modeling telemedicine consumer behavior amid COVID-19 pandemic

PurposeThis study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in visiting brick-and-mortar clinics or hospitals during the pandemic, Telemedicine had emerged as a potent alternative for seeking redressal to health issues. Based on theory and focus interviews with the telemedicine users, the researchers proposed a model to understand the intent and actual usage of telemedicine in India.Design/methodology/approachThe cross-sectional study undertaken used a questionnaire designed on a seven-point Likert scale and administered to respondents with the objective of identifying the determinants of intent and actual usage of telemedicine services. Simple random sampling was used to collect primary data. The data was cleaned and finally a sample of 405 responses complete in all respects was considered for analysis. The questionnaire comprised of 34 items and following the recommendation of Hair et al. (2016), which says the minimum sample size in structural equation modeling should be ten times the number of indicator variables, a sample size of 405 was deemed adequate.FindingsThe research paper finds that performance expectancy, attitude, credibility and self-efficacy positively impact the intention of consumers to use telemedicine services. As the effort expectancy or risk perception toward telemedicine increases the intent and actual usage of telemedicine decreases. The intention to use telemedicine emerged as a strong predictor of the actual usage of telemedicine. Intent to use telemedicine was explained 81.4% by its predictors of performance expectancy, effort expectancy, attitude, risk, credibility and self-efficacy, and actual usage was explained 79.9% by its predictors. This study also reports that telemedicine was found to be popular among chronic as well as episodic patients though the preference was skewed in favor of the episodic patients. One of the advantages of telemedicine is its availability round the clock, and the study found that 8 a. m. to 12 noon time slot as the most preferred slot for seeking telemedicine services.Practical implicationsChang (2004) opined that telemedicine can fulfill the needs of all stakeholders: citizens, health-care consumers, medical doctors and health-care professionals, policymakers, and so on. Considering the promise telemedicine holds, this realm must be studied and leveraged to the full potential. The study found that patients were using telemedicine even for their day-to-day aliments. This indicates a growing popularity of telemedicine and as such an opportunity for telemedicine companies to leverage it. In India, pharmaceutical companies cannot give commercial advertisements for medicines, and the same can only be sold through a registered medical practitioner’s prescription. As such there is total dependency on the medical practitioner for the sale of medicines. Telemedicine companies offer services of home delivering medicines clubbed with medical consultation thus giving them forward integration in their business models. Using telemedicine the patients had control over the timings of the services offered, and as such the waiting time to get a consultation and subsequent treatment was reduced considerably. Best medical advice from across the globe is available to the patient at less cost. Medical practitioners also stand to benefit as they can treat a variety of cases, collaborate among the medical fraternity and give consultation safely in case of fatal contagious diseases.Originality/valueThis study points to a definite growing popularity of telemedicine services not only in episodic patients but also chronic patients. Telemedicine with its unique advantages holds the promise to grow exponentially in the future and is a compelling health-care segment to focus on for delivering health-care solution to the geographically distant consumers.

Remote mobile health monitoring frameworks and mobile applications: Taxonomy, open challenges, motivation, and recommendations

Advancements in mobile technology have propelled the rapid progress of remote health monitoring, particularly in the domain of mobile health (mHealth). This progress is underscored by sophisticated smart health monitoring applications designed for mobile devices. mHealth monitoring, a standout area within remote health monitoring, excels in providing continuous health monitoring for patients and enabling remote observation by physicians. These applications cater to ambulatory patients with chronic diseases, offering essential features such as Telemedicine services, doctor availabilitys, and emergency ambulance services. Despite the development of various frameworks for mHealth monitoring, existing review papers often fall short in addressing critical parameters and issues related to Telemedicine. Many reviews provide a broad overview but lack the depth needed to dissect intricate aspects like implementation challenges in Telemedicine, nuances in decision-making applications, and the dynamics of mobility for both patients and healthcare providers. Patient rescue protocols, especially in diverse locations, are also underexplored. To fill this gap, our research delves into these dimensions, providing a nuanced understanding of challenges and opportunities in mobile health monitoring, particularly within the Telemedicine context. Leveraging a comprehensive literature review, we meticulously selected over 100 research articles from reputable databases like ScienceDirect, IEEE Xplore, and Springer. We have assessed and ranked the significance of each article. The study aims to address open issues in telemedicine, contributing valuable insights to enhance remote health monitoring.

Access to Otolaryngologic Telemedicine Care Across the COVID-19 Pandemic at an Urban Tertiary Hospital System.

Objective: To describe associations between patients' demographic characteristics and access to telemedicine services in an urban tertiary academic medical system across the COVID-19 pandemic, and to identify potential barriers to access. Methods: This was a retrospective cohort study conducted at a single-center tertiary academic medical center. The study included adult patients undergoing outpatient otolaryngologic care in person or via telemedicine during 8 week timeframes: before the pandemic, at the onset of the pandemic, and during later parts of the pandemic. Patients were characterized by age, sex, race, insurance type, primary language, portal activation status, income estimate, and visit type. Where appropriate, chi-squared tests, Wilcoxon signed-rank tests, and logistic regression were used to compare demographic factors between the cohorts. Results: A total of 14,240 unique patients [median age, 58 years (range, 18-107 years); 56.5% were female] resulting in a total of 29,457 visits (94.8% in-person and 5.2% telemedicine) were analyzed. Patients seen in person were older than those using telemedicine. Telemedicine visits included a higher proportion of patients with private insurance, and fewer patients with government or no insurance compared to in-person visits. Race, income, and English as primary language were not found to have a significant effect on telemedicine use. Conclusion: In an urban tertiary medical center, we found significant differences in sociodemographic characteristics between patients who accessed otolaryngologic care in person versus via telemedicine through different phases of the COVID pandemic, reflecting possible barriers to care associated with telemedicine. Further studies are needed to develop interventions to improve access.

Knowledge and stress level in pregnant women: A cross-sectional study during the COVID-19 pandemic

Introduction: Pregnant women are vulnerable to COVID-19 due to weakened immunity, leading to heightened stress amidst uncertainties about its impact. Research indicates increased levels of depression, stress, and anxiety in pregnant women since the pandemic declaration. This study explores the link between COVID-19 knowledge and stress levels among pregnant women.Methods: Data collection involved the administration of a questionnaire addressing COVID-19 knowledge and stress levels. A total of 255 respondents voluntarily participated in the study. Quantitative methods were utilized, employing a descriptive correlation design within a cross-sectional approach. The accidental sampling technique was used to select participants.Results: Univariate analysis results obtained 78.4% have a good knowledge, and 40.4% experienced moderate stress levels. Bivariate analysis using the Spearman rank indicated a relationship between knowledge and stress levels (P-value <0.001, r 0.732).Conclusions: The study proposes that hospitals implement an educational approach using online seminars, audiovisual materials, and free telemedicine services to facilitate training and counseling on stress management and adaptive coping strategies. Keywords: knowledge; pregnant women; stress level

U.S. Tax Credits to Promote Practical Proactive Preventative Care for Parkinson's Disease.

Persons with Parkinson's disease (PD) and society at large can profit from a strategic investment into a forward leaning, practical, preventative, and proactive multidisciplinary care policy. The American healthcare system is not easily bent to accommodate this type of care, and thus a tax benefit is an attractive option. An individual federal income tax benefit of $6200 each year for every person residing in the US with a diagnosis of PD, could among other offerings provide monthly access to a licensed clinical social worker and access to mental health services. The implementation of more coordinated care has the potential reduce the burden of depression, anxiety, and demoralization. Personal training would also be covered and directed by physical and occupational therapists. The combination of home-based and telemedicine services would have the added benefit of improving access. The tax benefit would also provide access to a dietician. This type of care strategy could be designed to proactively identify early signs of aspiration and urinary tract infections to 'head off' significant morbidity. A $6200/year individual tax benefit for those diagnosed with PD will thus translate into more fall prevention, more care in the home setting, less hospitalizations, less depression, less anxiety, less demoralization, better diets, and less persons placed in nursing facilities. Additionally, this tax benefit will provide the potential for billions of dollars in savings to the healthcare system. A tax benefit for PD is a practical preventative and proactive strategy which can serve to advantage both this generation and the next.

The Impact of Telemedicine and Remote Patient Monitoring on Healthcare Delivery: A Comprehensive Evaluation.

Background Telemedicine and remote patient monitoring have emerged as transformative solutions in contemporary healthcare. This study aimed to conduct a comprehensive evaluation of the impact of these technologies on healthcare delivery, focusing on patient outcomes, economic parameters, and overall satisfaction. Methods A prospective observational study was conducted in various healthcare facilities, involving 186 participants with chronic diseases. Inclusion criteria included patients actively using telemedicine services. Data collection methods included surveys, interviews, and review of medical records, focusing on patient demographics, clinical outcomes, and economic parameters. The intervention involved a seamless integration of telemedicine technologies into the existing health system. Results Primary outcomes revealed significant improvements in patient health, including a decrease in disease-specific markers (mean reduction of 12,000 to 11,000, p = 0.002), a substantial reduction in severity of symptoms (mean reduction from 3,500 to 2,500, p < 0.001), and a general improvement in health status (mean increase from 7,200 to 8,500, p < 0.001). The savings in healthcare costs were evident, with direct costs decreasing from 25,000 to 12,000 (p < 0.001) and indirect costs decreasing from <10,000 to <5,000 (p = 0.004). Secondary results demonstrated increased patient satisfaction with communication (increase from 80% to 95%, p < 0.001) and convenience of services (increase from 75% to 90%, p < 0.001). Patient satisfaction also increased significantly (from 80% to 95%, p < 0.001). Accessibility to healthcare services improved, with a reduction in geographic barriers (increase from 65% to 90%, p < 0.001) and a decrease in the frequency of healthcare utilization (decrease from 2.5 to 1.5, p < 0.001). Conclusion The study provides robust evidence of the positive impact of telemedicine and remote patient monitoring on healthcare delivery. Significant improvements in patient outcomes, coupled with substantial cost savings and increased satisfaction levels, underscore the transformative potential of these technologies.

Reduction of NIFTI files storage and compression to facilitate telemedicine services based on quantization hiding of downsampling approach

Magnetic resonance imaging is a medical imaging technique to create comprehensive images of the tissues and organs in the body. This study presents an advanced approach for storing and compressing neuroimaging informatics technology initiative files, a standard format in magnetic resonance imaging. It is designed to enhance telemedicine services by facilitating efficient and high-quality communication between healthcare practitioners and patients. The proposed downsampling approach begins by opening the neuroimaging informatics technology initiative file as volumetric data and then planning it into several slice images. Then, the quantization hiding technique will be applied to each of the two consecutive slice images to generate the stego slice with the same size. This involves the following major steps: normalization, microblock generation, and discrete cosine transformation. Finally, it assembles the resultant stego slice images to produce the final neuroimaging informatics technology initiative file as volumetric data. The upsampling process, designed to be completely blind, reverses the downsampling steps to reconstruct the subsequent image slice accurately. The efficacy of the proposed method was evaluated using a magnetic resonance imaging dataset, focusing on peak signal-to-noise ratio, signal-to-noise ratio, structural similarity index, and Entropy as key performance metrics. The results demonstrate that the proposed approach not only significantly reduces file sizes but also maintains high image quality.

The effects of COVID-19 pandemic on women’s access to maternal health and family planning services in Egypt: an exploratory study in two governorates

BackgroundThe COVID-19 pandemic has been noted to decrease access to maternal health and family planning services globally. However, evidence from the Middle East and North Africa region is very scarce and limited. We qualitatively explored women’s experiences in accessing maternal health and family planning services during the COVID-19 lockdown months in the two Egyptian governorates of Port Said and Souhag.MethodsUsing a case study design, semi-structured phone interviews were conducted with a total of 40 women aged 18–35 years from Port Said and Souhag governorates in Egypt. Interviews explored women’s experiences in accessing maternal health and family planning services during COVID-19 lockdown months, their coping strategies, and impact of challenges and/or coping strategies on participants and their families. The collected data was analyzed manually using qualitative thematic analysis.ResultsMany participants were unable to access maternal health and family planning services during COVID-19 lockdown due to fear of contracting the virus, closure of health facilities, changing service hours, family planning method or drug stock-outs, and/or financial constraints. The above challenges in accessing services along with coping strategies that some women and their families used exposed women to additional health risks, including unintended pregnancies, and posed several social, emotional, and financial burdens to many.ConclusionsThe COVID-19 pandemic and associated lockdown measures undermined women’s access to maternal and family planning services and interfered with their ability to achieve their reproductive goals. The paper concludes with a number of recommendations to ensure access to maternal and family planning services at times of crisis. Those recommendations include: (1) adapting reliable guidelines from humanitarian settings, (2) providing adequate guidance to healthcare providers and the public to tackle fears and misinformation, (3) making self-care products available such as oral contraceptive pills, vaginal rings and self- administered injectables, (4) involving other health professionals in the provision of maternal and family planning services through task-sharing/shifting, (5) expanding the use of telemedicine and/or digital health services especially to those living in remote areas and (6) raising policymakers’ awareness of the centrality of reproductive rights and the importance of protecting them at all times.

Perceived impact of COVID-19 lockdown on access to healthcare services, food affordability and family income among married patients of a resource-limited primary care setting

Objective: To examine the perceived impact of COVID-19 lockdown on access to healthcare services, food affordability, and family income during the first phase of the pandemic among married people of a resource-limited primary care setting in Kano, Nigeria. Methods: This survey involved 432 married respondents systematically selected from attendees of a primary care clinic in Kano, Nigeria, using a structured questionnaire. Results: Over half (53.5%) of respondents or their family members fell ill during the lockdown; 67.1% felt it difficult to access hospital treatment, while 32.9% sick patients resorted to self-medication. Over half (57.2%) could afford food as they used to, 75.0% reported that food items were costly, while 35.9% received government assistance. Only 29.9% had employment, of which 49.6% received a salary, while 29.5% had their salaries reduced. Educational level was significantly associated with ease of accessing healthcare services (χ2 =8.528, P=0.014). Age (χ2=12.209, P&lt;0.001), family type (χ2 =12.943, P&lt;0.001), home location in Kano state (χ2= 15.397, P&lt;0.001) and family headcount (χ2=3.968, P=0.044) were significantly associated with perceived food affordability. Conclusions: This study demonstrated the negative impact of the lockdown on healthcare access, food affordability, and family income among respondents’ families. This suggests the need for more investments in promoting and scaling up telemedicine services as platforms for accessing healthcare, which could be utilized in similar future events. More studies will be needed to ascertain the complete picture of the implementation of social assistance in the study area to enhance planning and distribution of future government social assistance.

Stability of telemedicine legislation: current issues

The main features and problems of the development of legislative regulation of telemedicine in the Russian Federation are considered. The stages of such development are identified and analyzed: the existence of a concept, the existence of detailed regulation, the establishment of the possibility of deregulation within the framework of a legal experiment, the beginning of a legal experiment. The correlations between changes in the telemedicine services market and changes in legislation and regulated public relations are considered. The probable reasons that prompted the legislative bodies to establish detailed regulation of relations in the field of telemedicine have been identified, given that the provision of telemedicine services has never been prohibited (encouraging participants in civil turnover to use this legal institution, public interest in regulated public relations). The aim of the work was to formulate the problems of non-systemic changes in legislation on telemedicine, their determinants and further optimal development vectors. The research methodology is based on historical and teleological methods that allow us to consider the problems of legal regulation of telemedicine, based on the peculiarities of the formation of legislation in this area. The paper analyzes statistical data, regulations and materials of judicial practice; using the comparative legal method, general and various trends with the development of other legislative institutions are identified. It is concluded that regular changes in legislation on telemedicine, undermining its stability and predictability of legal regulation, have their reasons for the lack of conditionality of reforms with the current concept of development of legislation on telemedicine, as well as the redundancy of the adopted regulatory regulation. Taking into account the absence of civil law litigation on the provision of telemedicine services, it is proposed to expand deregulation in this area beyond the legal experiment: extending its provisions to the current legislation as a whole. This need is indirectly confirmed by statistical data on a significant increase in the provision of telemedicine services after their legislative consolidation, with its subsequent decrease and the introduction of a legal experiment on deregulation after that. The study is financially supported by the Russian Science Foundation, project No. 23-78-10175, https://rscf.ru/project/23-78-10175/.

Breaking the Emergency Room Cycle: The Impact of Telemedicine on Emergency Department Utilization.

Background Telemedicine has gained prominence in healthcare, and understanding its impact on diverting non-urgent cases from the emergency room (ER) has become crucial. This study delves into the dynamic relationship between telemedicine utilization and ERvisits, seeking to understand the transformative impact of telehealth on breaking the traditional ER cycle. Method To explore the awareness and utilization of telemedicine services in the broader population of Saudi Arabia, we adopted a cross-sectional design utilizing the convenience sampling method. Data collection was facilitated through a self-administered online survey comprising four sections: demographic variables, ER visits, awareness of non-urgent cases, and suggestions. The collected data were entered into IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States) for descriptive analysis. Results Among the 1140 participants, the majority were females (56.8%), with 43.2% being males. Regarding age distribution, the highest percentage fell within the 18-25 age group (46.8%). Nationality-wise, a substantial proportion identified as Saudi (95.2%). Educational backgrounds varied, with 60.7% holding a bachelor's degree. Notably, 62.6% of the visits were classified as urgent. A significant portion (66.8%) demonstrated awareness of alternative options for non-urgent care, such as outpatient clinics and telemedicine services. Specifically regarding telemedicine, 82.8% of respondents believed that video consultations and prescription refills could effectively address non-urgent conditions. Furthermore, 89.6% of participants agreed that educating patients on self-care and home remedies could help manage symptoms and deter unnecessary ER visits. Conclusions The positive reception of telemedicine, as evidenced by high satisfaction rates among participants, further reinforces its role in reshaping the landscape of healthcare delivery.

Patient Perceptions on Telepsychiatry as an In-Consult Alternative During COVID-19 Pandemic: Peruvian Adaptation of the Telehealth Usability Questionnaire.

Objective: To identify the perceptions of the patients who received alternative care by telepsychiatry at the Cayetano Heredia Hospital (HCH). Methods: This research consisted of two phases: (1) transcultural adaptation of the Telehealth Usability Questionnaire (TUQ) with three experts and (2) application of the questionnaire in 183 patients from psychiatry in HCH. Nonparametric tests were used to determine the association between variables. Results: We applied 20 questions to 60 men and 123 women, with a median age of 45. The ease of using the virtual consultation service, the comfort with its use, and the general satisfaction had a score of 6 out of 7 and are associated with the number of devices that patients have and their degree of education. The usefulness, communication by virtual means, and the solution of technical problems had scores higher than 6, being considered acceptable by the patients. Willingness to have a teleconsultation again was high and was associated with patient satisfaction with the consultation. Conclusions: Most patients were satisfied with telepsychiatry via telemonitoring during the COVID-19 pandemic. The usage of validated tools such as TUQ might be included as part of evaluations of new telemedicine services.

Are We Adequately Measuring Patient Satisfaction with Telemedicine? A Systematic Review with a Meta-Analysis.

Introduction: Telemedicine has gained significant attention as an effective means of providing health care remotely, particularly during the COVID-19 pandemic. Patient satisfaction is a critical aspect of implementing telemedicine, but we have no comprehensive understanding of satisfaction levels and the associated factors. The aim of this systematic review and meta-analysis was to assess patient satisfaction related to telemedicine consultations and to identify key factors influencing satisfaction levels. Results: The search yielded a total of 147 cross-sectional studies, of which 107 met the criteria for inclusion in the meta-analysis. Overall, patient satisfaction with teleconsultations was found to be high, with satisfaction levels ranging from 38 to 100 on a scale of 0 to 100. Only a small percentage (2.72%) of the studies reported satisfaction levels below 75%. Surprisingly, most studies used nonvalidated satisfaction questionnaires, which highlight the need for the development of standardized measurement instruments. Conclusions: This systematic review and meta-analysis provide evidence that patients generally exhibit high levels of satisfaction with telemedicine consultations. The use of nonvalidated satisfaction questionnaires in many studies, however, suggests a need for more standardized assessment tools. Factors such as the time interval between the consultation and the assessment were found to influence satisfaction levels. Understanding these factors can help health care providers improve telemedicine services and patient-provider relationships and optimize health care delivery in the context of telemedicine. Further research is warranted to develop validated satisfaction measurement instruments and explore any additional factors that influence patient satisfaction with telemedicine.

Integrated Virtual Care for Irritable Bowel Syndrome: A Qualitative Study.

Irritable bowel syndrome (IBS) is a condition that affects approximately one in 10 people in the United States (Defrees & Bailey, 2017). Despite the high prevalence of IBS, the medical community struggles to effectively understand, diagnose, and treat this disorder (Ankersen et al., 2021). In recent years, an increasing number of health-tech companies have emerged to offer integrated treatment of IBS via telemedicine. This pilot study explores the patient experience of virtual, multidisciplinary IBS care through a U.S.-based company, Oshi Health. Semistructured interviews were conducted followed by thematic analysis to identify commonalities between patient experience and perspective (Van Manen, 2014). Overarching themes were identified as follows: loss of the grocer, a broken system, and the power of self-trust. Although several limitations exist, including small sample size, the study offers insight into the experience of telemedicine services for IBS and provides a framework for future research.

Challenges of Using Telemedicine in Hospital Specialty Consultations during the COVID-19 Pandemic in Portugal According to a Panel of Experts.

The COVID-19 pandemic has accelerated the adoption of telemedicine as a means of reducing face-to-face contact and protecting professionals and patients. In Portugal, the number of hospital telemedicine consultations has significantly increased. However, the rapid implementation of telemedicine has also led to disparities in access to these services, resulting in inequalities in healthcare delivery. The aim of this study was to identify the main challenges to accessing hospital medical specialty consultations through telemedicine in Portugal during the COVID-19 pandemic. Additionally, this study aimed to establish a consensus on possible solutions for the challenges which were identified. This study used the nominal group technique, which involved a panel of 10 experts. The panel generated a total of 71 ideas, which were then categorized into three groups: A) challenges relating to patients, which impact access to hospital-based medical specialty consultations through telemedicine; B) challenges relating to professionals, institutions and health systems, which impact access to hospital medical specialty consultations through telemedicine; C) recommendations to overcome the challenges faced in adopting telemedicine solutions. Each of the ideas was assessed, scored and ranked based on its relevance considering the study objectives. This study identified several significant challenges that impacted the adoption of telemedicine in Portugal during the COVID-19 pandemic. The challenges that related to patients (A) that were deemed the most relevant were low digital literacy, lack of information about telemedicine processes, low familiarity with technologies and distrust about the quality of services; the challenges that impacted healthcare professionals, institutions, and health systems (B) and were deemed the most relevant were the lack of integration of telemedicine in the patient's journey, low motivation to adopt telemedicine solutions, poor interoperability between systems, and the absence of the necessary technological equipment. The most relevant recommendations (C) included investing in healthcare institutions, developing clear guidelines for the safety and quality of telemedicine practices, and incorporating telemedicine into the curricula of health professions. This study identified several challenges that impacted the adoption and implementation of telemedicine services for hospital care in Portugal during the pandemic period. These challenges were related to digital health literacy, technological and operational conditions, and reluctance in technological adoption. To overcome these challenges, training programs for healthcare professionals and patients may be necessary, along with investment in technological infrastructures, interoperability between systems, effective communication strategies and the strengthening of specific regulations.