Telemedicine Usage Research Articles

Use of eHealth and remote patient monitoring: a tool to support home dialysis patients, with an emphasis on peritoneal dialysis

ABSTRACT Implementing eHealth requires technological advancement, universal broadband and internet access, and devices to conduct telemedicine and remote patient monitoring in end-stage kidney disease patients receiving home dialysis. Although eHealth was beginning to make inroads in this patient population, the COVID-19 pandemic spurred telemedicine usage when many regulations were waived during the Public Health Emergency to limit the spread of infection by endorsing social distancing. At the same time, two-way communication automatic peritoneal dialysis cyclers were introduced to advance remote patient monitoring. Despite the numerous advantages and potential benefits afforded by both procedures, challenges and untapped resources remain to be addressed. Continuing research to assess the use of eHealth and technological innovation can make eHealth a powerful tool in home dialysis. We review the past, present and future of eHealth and remote patient monitoring in supporting home dialysis.

Effect of telemedicine use on medical spending and health care utilization among patients with gastrointestinal cancer

BackgroundWe sought to assess the impact of telemedicine on healthcare utilization and medical expenditures among patients with a diagnosis of gastrointestinal (GI) cancer. MethodsPatients with newly diagnosed GI cancer from 2013 to 2020 were identified from the IBM MarketScan database (IBM Watson Health) . Healthcare utilization, total medical outpatient insurance payments within 1 year post-diagnosis, and out-of-pocket (OOP) expenses among telemedicine users and non-users were assessed after propensity score matching (PSM). ResultsAmong the 32,677 patients with GI cancer (esophageal, n = 1862, 5.7%; gastric, n = 2009, 6.1%; liver, n = 2929, 9.0%; bile duct, n = 597, 1.8%; pancreas, n = 3083, 9.4%; colorectal, n = 22,197, 67.9%), a total of 3063 (9.7%) utilized telemedicine. After PSM (telemedicine users, n = 3064; non-users, n = 3064), telemedicine users demonstrated a higher frequency of clinic visits (median: 5.0 days, IQR 4.0–7.0 vs non-users: 2.0 days, IQR 2.0–3.0, P < .001) and fewer potential days missed from daily activities (median: 7.5 days, IQR 4.5–12.5 vs non-users: 8.5 days, IQR 5.5–13.5, P < .001). Total medical spending per month and utilization of emergency room (ER) visits for telemedicine users were higher vs non-users (median: $10,658, IQR $5112–$18,528 vs non-users: $10,103, IQR $4628–$16,750; 46.8% vs 42.6%, both P < .01), whereas monthly OOP costs were comparable (median: $273, IQR $137–$449 for telemedicine users vs non-users: $268, IQR $142–$434, P = .625). ConclusionTelemedicine utilization was associated with increased outpatient clinic visits yet reduced potential days missed from daily activities among patients with GI cancer. Telemedicine users tended to have more ER visits and total medical spending per month, although monthly OOP costs were comparable with non-users.

Patient satisfaction with cancer care delivery through telemedicine at a comprehensive cancer center across three years during and after the COVID-19 pandemic.

1632 Background: Telemedicine, once sparingly utilized, surged during the COVID-19 pandemic to enhance care accessibility and safety concerns. Despite initial satisfaction, its usage remains highly variable across institutions. We sought to explore patient satisfaction at a comprehensive cancer center, associations with demographic characteristics, and change over time. Methods: A survey was sent to all first-time telemedicine users at Memorial Sloan Kettering Cancer Center from September 2021 to October 2023. Adult patients who had their initial telemedicine visit, regardless of specialty, received the questionnaire. It comprised 10 general questions about the telemedicine experience and 11 questions regarding clinical trial education and informed consent. To analyze the unstructured free text responses, we employed BERTopic, a topic modeling algorithm that leverages transformer-based embeddings to facilitate the creation of easily interpretable topics within a collection of text documents. Through topic modeling with BERT embeddings, we captured subtle nuances and semantic relationships in language to identify topics more effectively. Results: A total of 15,111 patients completed 15,251 questionnaires; 140 patients completing two surveys. Patient demographics are summarized in Table 1; the median age at encounter was 66 years and 98% of patients preferred English. Satisfaction levels were high, with 92% expressing willingness for future telemedicine visits and 90% recommending it to other patients. Notably, 21% found telemedicine superior to in-person visits, while 53% considered them equal. Further, satisfaction remained consistent across six-month intervals from 2021-2023. In 1606 (11%) surveys, patients noted discussing clinical trials; 17% preferred in-person discussions for the informed consent process while most either preferred telemedicine or had no preference. Topic modeling revealed 18 topics within the unstructured dataset; key topics included comments on video &amp; audio quality, connectivity and technology issues, convenience for patients who live outside of the city and those with physical limitations, and long wait time to see a doctor. Conclusions: Our analysis confirms high patient satisfaction with telemedicine, including discussions on clinical trial enrollment, that has remained consistent in the years following the COVID-19 pandemic. Given variability in use, it is important to identify how to better deliver telemedicine to those patients who prefer it.[Table: see text]

Kualitas Layanan Memediasi Pengaruh Kepercayaan Terhadap Kepuasan Pasien pada Aplikasi Telemedicine

Background: The Covid-19 pandemic has led to a significant surge in the utilization of telemedicine applications. The measurement of the effectiveness and success of implementing telemedicine applications is demonstrated through patient satisfaction in their usage. Patient satisfaction is influenced by trust and service quality. Research on trust, service quality, and patient satisfaction in telemedicine is currently limited. Objective: This study aims to explore the relationship between trust and patient satisfaction mediated by service quality. Method: The research involves users of telemedicine applications who completed questionnaires. Data were analyzed using SmartPLS software. Results: The study included 128 respondents, with the majority of telemedicine users aged 18 to 25 years. Based on questionnaire results, most respondents agreed with questions regarding trust, service quality, and satisfaction in telemedicine usage. Model analysis revealed a significant relationship between trust, service quality, and patient satisfaction (P-value &lt; 0.05; T-statistic &gt; 1.96). Additionally, service quality played a mediating role in the influence of trust on patient satisfaction (P-value &lt; 0.05; T-statistic &gt; 1.96). Conclusion: Trust significantly influences service quality and patient satisfaction. Service quality also significantly affects patient satisfaction. Moreover, service quality acts as a mediator in the impact of trust on patient satisfaction

Barriers to intention to adopt telemedicine: The interplay between exposure, trust, and convenience

Telemedicine is an emerging option to improve patients’ medical outcomes and overcome health disparities. The technology is a cost-effective alternative to in-person medical treatments and can supplement medical care to alleviate stress on the medical infrastructure in the upcoming decade. This study uses survey methods to investigate the patient population’s intention to use telemedicine and assess the influence of different variables on telemedicine usage choices. Findings show that loss of income, trust in physicians, and time lost reduce intention to use telemedicine. The results carry implications for the healthcare industry, lawmakers, social workers, community activists, and family caregivers who bear the burden of helping loved ones with everyday tasks.

Patient Satisfaction with Telemedicine

The COVID-19 pandemic emphasized the significance of telemedicine for delivering healthcare services. However, the rapid development of a framework for telemedicine implementation necessitates the investigation of the existing acceptance and satisfaction of Filipino respondents and physicians. This study assessed the satisfaction of patients with telemedicine in Tuguegarao City in terms of system, information and healthcare service quality. Employing a descriptive quantitative design was used and 230 respondents were included and selected through snowball sampling. A structured questionnaire based on Yip et al., (2003), Bakken et al., (2006), Lin, Z. (2017), and Parmanto et al., (2016) was also used. Gathered data were analyzed using mean, frequency, and percentage while test of significant difference was also conducted using independent sample T-test and One-way ANOVA. Results indicate slight satisfaction among telemedicine users in Tuguegarao City across quality dimensions: system, information, and health service. Moreover, significant differences in the level of satisfaction exist in the respondent’s age, educational attainment, average monthly income, occupation, type of residences, and number of health services availed. It was revealed that respondents who are 18 to 24 years old and are commonly senior high school and college graduates had the lower level of satisfaction with the overall quality of telemedicine. While respondents with lower monthly income, in rural areas and who availed more than two services appeared to have better satisfaction with telemedicine services. In conclusion, the results of the study showed that the respondents are slightly satisfied with the telemedicine services within Tuguegarao City.

Patient Experience Correlates with Willingness to Retain Service Utilization in Post-Pandemic Times Among Telemedicine Users in Indonesia.

Background: COVID-19 pandemic increases the use of telemedicine worldwide. Sustaining its use during post-pandemic times is important to overcome health care disparities, especially in countries with an inadequate number or uneven distribution of health care workers. This study aims to analyze factors associated with the willingness to retain telemedicine utilization after the COVID-19 pandemic. Methods: An online survey was administered during the COVID-19 pandemic. Demographic characteristics and patient experience were used as predictors. Chi-square was used to examine the relationship between the outcome variable and the predictors. Finally, binary logistics regression was conducted to determine factors associated with willingness to retain telemedicine utilization after the COVID-19 pandemic. Results: A total of 784 responses were included in the analysis. The result showed a high rate of willingness to retain telemedicine utilization (81%). Factors associated with outcome variable were satisfaction (adjusted odds ratio [aOR] 7.893; 95% confidence interval [CI]: 3.600-17.308; p < 0.001), telemedicine efficacy (aOR 1.747; 95% CI: 1.144-2.667; p = 0.010), ease of use (aOR 6.570; 95% CI: 3.029-14.250; p < 0.001), time efficiency (aOR 1.666; 95% CI: 1.092-2.540; p = 0.018), and cost efficiency (aOR 1.852; 95% CI: 1.005-3.411; p = 0.048). In contrast, patients who first used telemedicine during the COVID-19 pandemic were less likely to retain telemedicine utilization (aOR 0.437; 95% CI: 0.281-0.679; p < 0.001). Conclusions: The high willingness to retain utilization is a good indication of the sustainability of telemedicine services during post-COVID-19 pandemic. The stakeholders should focus on factors revealed in this study to increase the service uptake.

Telemedicine Beyond Borders: A Mixed-Methods Approach to Understanding Cross-National Usage Intention.

Introduction: Drawing on the Unified Theory of Acceptance and Use of Technology 2 and the Diffusion of Innovation Theory, this article investigates the adoption of telemedicine services from a patient perspective in Germany, Spain, and the United States using a mixed-methods approach. Digital health technologies have the potential to improve access to care and to alleviate the burden on traditional health care systems and are becoming more integrated into everyday medicine. Therefore, understanding the factors that impact patients' intentions to use telemedicine is crucial to ensure successful development. Methods: Based on 1,200 surveys collected in Germany, Spain, and the United States, structural equation modeling (IBM SPSS Amos 24) is employed to test the hypotheses. The article also explores how age and gender moderate the proposed relationships. Results: Seven out of the 10 hypotheses (performance expectancy, hedonic motivation, habit, relative advantage, and perceived security) are found to be positive, direct, and statistically significant. Furthermore, findings suggest stronger effects for telemedicine usage intention for younger female users than their male counterparts. Discussion: With digital health technologies becoming more prevalent, the outcomes of this study can endorse the development of effective strategies to promote the adoption of telemedicine, ultimately improving access to care and contributing to the advancement of and modern health care.

Usefulness of combined telemedicine for self‐injection of calcitonin gene‐related peptide pathway targeting monoclonal antibodies

AbstractObjectiveWe examined whether the combined use of telemedicine and self‐injection could improve patient satisfaction.BackgroundFor patients with migraine, the use of calcitonin gene‐related peptide ‐pathway targeting monoclonal antibodies is associated with concerns, such as the burden of doctor visits and anxiety around self‐injection.MethodsAt four institutions, patients with migraines who used self‐injectable calcitonin gene‐related peptide ‐pathway targeting monoclonal antibodies attempted telemedicine, and web‐based questionnaires and interviews were conducted thereafter.ResultsOf the 26 participants, 58% felt that telemedicine helped with self‐injections and 65% wanted to continue using the combination. The average time required per doctor visit was reduced from 158 to 31 min, and the median from 86 to 18 min. The benefits included reduced burden (46%), ease of schedule adjustment (35%), and lower anxiety levels (19%).ConclusionAlthough there are issues with telemedicine usage, including the burden on healthcare professionals or lower reimbursement points, the combination of self‐injection of calcitonin gene‐related peptide ‐pathway targeting monoclonal antibodies and telemedicine is effective in improving the experience of patients have migraines.

Assessing Telemedicine Competency Among Doctors in a Tertiary Care Hospital: A Questionnaire-Based Cross-Sectional Study.

Background The use of telemedicine in contemporary healthcare has become essential, providing a novel method of delivering care, particularly in rural and underdeveloped areas. This study assesses the telemedicine awareness, knowledge, attitude, skills, and challenges among physicians working in tertiary care hospitals. Methods A cross-sectional study was carried out with 100 doctors from diverse specialties at a tertiary care institution. The questionnaire evaluated five domains: telemedicine awareness and knowledge, telemedicine attitude, telemedicine technology skills, telemedicine utilization patterns, and perceived barriers and educational needs. Results The study indicated that 95% of participants were aware of telemedicine. However, knowledge gaps remained, particularly in legal and ethical concerns (50%) and international rules (40%). Eighty percent of respondents had a favorable opinion of telemedicine, and 85% thought it might improve patient care in rural regions. The proficiency level of telemedicine users was variable: 60% of them had previous experience, and 70% of them rated their proficiency as intermediate or better. According to utilization patterns, 50% of telemedicine users used it at least once a week, primarily for remote monitoring (30%) and video consultations (60%). The study found that 90% of respondents had a high demand for training and educational opportunities. The absence of infrastructure (65%), worries about data security (55%), and patient acceptability (30%) were the main obstacles found. It also highlighted how important it is to have defined policies and collaborate across disciplines. Conclusion The study identifies a good attitude toward telemedicine among doctors as well as a need for improved training and infrastructure. It is essential to tackle these requirements and obstacles in order to successfully incorporate telemedicine into healthcare systems.

Komunikasi Kesehatan Mental untuk Menciptakan Kepuasan Pengguna Telemedicine

Communication through mobile apps is still looking for a better form, how to be carried out effectively, and how to be well received by the audience. One of the mobile apps widely used by the public today is telemedicine, which offers the integration of various health services. In health communications, the message sent by the doctor is proven to affect patient satisfaction. However, no studies on user satisfaction with telemedicine regarding mental health have been found. One telemedicine service in Indonesia is Halodoc, which provides psychological consultation and mental health articles. This study seeks to prove whether the quality of psychological consultation messages and mental health articles affects Halodoc user satisfaction. Concepts used are health communication, communication psychology, interpersonal communication, message quality, and customer satisfaction. With the quantitative method, this research sampling technique was purposive sampling. Questionnaires were distributed through Google Docs to 100 male and female respondents over 17 years old who had psychological consultations and read mental health articles through Halodoc in the last six months. With all the significant values being 0,000, this study finds out the effect of message in psychological consultation (0,461), mental health articles (0,469), and both together (0,560) on telemedicine user satisfaction.

IJCM_235A: Extent and pattern of telemedicine usage and perceptions about telemedicine among health care practitioners across the state of Karnataka, A cross sectional study

Background: Telemedicine is a developing technology in the Indian healthcare sector. The success of any new technology depends on factors such as knowledge, perception, and willingness of users and professionals to engage it. Hence this study will be conducted to assess the perceptions and usage of telemedicine by healthcare professionals in Karnataka state of India. Objectives: a. To ascertain the extent of telemedicine usage by healthcare professionals in different parts of the state of Karnataka. b. To determine the different models of telemedicine used by healthcare professionals. c. To compare the utilization pattern of telemedicine across various demographic, academic, career and healthcare setting-related parameters of healthcare providers. Methodology: Methods: This study will be conducted using a cross-sectional survey design. The survey will be conducted among healthcare professionals in Karnataka, including doctors, nurses, and other healthcare professionals. Results: In the present study overall usage f telemedicine was 30%. The utilization pattern of telemedicine various widely across various demographic, academic, career and healthcare setting-related parameters of healthcare providers. Different models of telemedicine were used by healthcare professionals in different parts of Karnataka. The utilization pattern of telemedicine is more in urban areas of state. Covid 19 pandemic has a great effect on usage of telemedicine by healthcare professionals. Conclusion: In the present study overall usage f telemedicine was 30%. The utilization pattern of telemedicine various widely across various demographic, academic, career and healthcare setting-related parameters of healthcare providers. Different models of telemedicine were used by healthcare professionals in different parts of Karnataka.

Telemedicine Utilization in Tertiary, Specialized, and Secondary Hospitals in Thailand.

COVID-19 has accelerated the adoption of telemedicine for counseling, follow-up examination, and treatment purposes. The official guidelines in Thailand were launched to regulate or frame the protocols for health care professions and teams in different organizations. To explore the trend of telemedicine utilization in selected hospitals in Thailand and to understand the characteristics of patients who used telemedicine from 2020 to 2023. This retrospective secondary data analysis was conducted in four hospitals in Thailand: two tertiary care (T1 and T2) hospitals, one secondary care (SN) hospital, and one specialized (SP) hospital. Data were routinely collected when services were provided and were categorized into telemedicine outpatient department (OPD) visits or onsite OPD visits. The data included demographic information (age, sex), date and year of service, location (province and health region), and primary diagnosis (using International Statistical Classification of Diseases and Related Health Problems 10th Revision codes). Descriptive analysis was conducted using R and STATA software. All four hospitals reported an increase in telemedicine use from 2020 to 2023. The majority of telemedicine users were female (>65%) at all hospitals except for the SP hospital (44%). Participants aged 25-59 years reported greater utilization of telemedicine than did the other age-groups. The within-hospital comparison between OPD visits before and after telemedicine was significant (p < 0.001). The situation during the COVID-19 pandemic and the transition to the post-COVID-19 era impacted telemedicine utilization, which could support national monitoring and evaluation policies. However, further studies are needed to explore other aspects, including changes in telemedicine utilization over time for longer timeframes, effectiveness of telemedicine, and consumer satisfaction.

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.

Trends in telemedicine visits among pediatric asthma patients during COVID-19

BackgroundEnvironmental and social factors, including lack of access to asthma care contribute to persistent inequities in asthma outcomes among children from historically marginalized racial and ethnic groups. Telemedicine, which expanded rapidly during the COVID-19 pandemic, may be an approach to augment access to pediatric asthma care. ObjectivesTo describe characteristics of pediatric (0-17 years) telemedicine users with asthma and characterize use trends throughout the COVID-19 pandemic. MethodsWe conducted a retrospective analysis using electronic health record data of pediatric patients with asthma seen at University of California, Los Angeles Medical Center between March 2019 to March 2022 describing (a) telemedicine user characteristics, (b) trends of asthma-related telemedicine use, and (c) associations between user characteristics and having a telemedicine visit. ResultsAmong 6,777 patients with asthma, the percentage of asthma-related telemedicine visits peaked early in the pandemic, comprising 74.3% of visits, before decreasing to 13.6% in 2022. Compared to White patients, Black patients had lower odds of an asthma telemedicine visit (0.49, 95% CI: 0.26, 0.94). Those with public insurance (1.7, 95% CI: 1.19, 2.43), severe persistent asthma (3.03, 95% CI: 1.70, 5.42), or comorbidities (1.59, 95% CI: 1.08, 2.33) had higher odds. Time to first emergency department visit and hospitalization comparing those with at least one telemedicine visit to those with none, were similar. ConclusionsMore pediatric asthma patients are using telemedicine since the COVID-19 pandemic, particularly those with medical complexity and comorbidities, and outcomes appear similar. However, Black patients at our institution have lower odds of using telemedicine.

Analysis of User Satisfaction of Telemedicine Services During COVID-19 Self-Isolation among FPH Students at the University of Indonesia

Telemedicine has become a new paradigm in the world of health since its popular use to assist the Ministry of Health in monitoring self-isolating patients during the COVID-19 pandemic. This study aims to analyze service quality variables related to user satisfaction with telemedicine services during COVID-19 self-isolation among students in FPH UI. This research is quantitative research with a cross-sectional approach. The results show that the platform most widely used for telemedicine services during the COVID-19 pandemic was platform H by 25 people. The average satisfaction of telemedicine users during self-isolation tends to be high, namely 3.8 with the lowest value being 2.3 (SD=0.534). Service quality and user satisfaction are all positively correlated with weak to strong correlation levels, namely responsiveness (r=0.306), service reliability (r=0.598), information quality (r=0.490), empathy (r=0.509), ease of service (r=0.633), perceived usefulness (r=0.486). The quality improvement factor is based on high satisfaction in easier appointment registration, savings in out-of-pocket costs for travel and queuing time at health services. However, holistic health and regulatory services are needed to address user data security threats.

Rural-Urban Disparities in Telemedicine Use Among U.S. Adults with Cancer.

Introduction: The COVID-19 pandemic has resulted in significant changes in health care delivery worldwide, including the widespread adoption of telemedicine. This study examines the prevalence of telemedicine use among cancer survivors in the United States based on rurality and investigates its association with telemedicine use. Methods: The 2021 National Health Interview Survey was used to analyze telemedicine use among cancer survivors during the pandemic. Telemedicine use was the primary outcome, and rurality was the main exposure. Descriptive statistics and multiple logistic regression models were used to examine the association. Results: Out of 27,500 eligible cancer survivors, 51.6% reported using telemedicine in 2021. Telemedicine usage varied across rural areas, with 41.4% of rural cancer survivors using telemedicine compared with 57.5% of cancer survivors in large metropolitan areas (p < 0.001). Rural cancer survivors had significantly lower odds of using telemedicine during the pandemic compared with large metropolitan cancer survivors. Cancer survivors residing in rural areas were 0.56 times less likely (odds ratio [OR] = 0.56; 95% confidence interval [CI] = 0.41-0.75), and those residing in medium and small metropolitan areas were 0.69 times less likely (OR = 0.69; 95% CI = 0.56-0.86) to report telemedicine use compared with cancer survivors in large metropolitan areas. Conclusions: Substantial disparities in telemedicine use were observed between rural and urban areas among cancer survivors. Rural cancer survivors were less likely to utilize telemedicine during the COVID-19 pandemic. Ensuring equitable access to telemedicine requires continued reimbursement for telemedicine services, along with additional efforts to improve access to and utilization of health care for rural cancer survivors.

Direct-to-consumer telemedicine in primary care settings: A scoping review of contemporary empirical literature.

This study comprehensively reviews the contemporary empirical literature on direct-to-consumer (DTC) telemedicine services within primary care. MEDLINE, Embase and SCOPUS were strategically searched and screened. Data on the modality of consultations, population of focus, condition of focus andtreatment of focus were extracted, narratively synthesised and tabulated. Forty-four articles were included in this review. Most used quantitative methods, with predominantly cross-sectional or retrospective cohort designs. DTC telemedicine user characteristics and perspectives were most researched, followed by quality and safety. Most services used video or text messaging. Articles typically examined a specific health condition (eg acute respiratory infections) and its treatment, and several focused on a specific population (eg men). In light of the poor evidence base and lack of rigorous studies, there is a critical need for more robust research on DTC telemedicine within primary care. Quality assessment tool development and health economics analyses are necessary to support the integratation of DTC telemedicine services with traditional primary care systems and improve primary healthcare quality and efficiency.

Assessment of Telemedicine Usage Among Saudis During the COVID-19 Pandemic.

Telemedicine was the first line of defense during the COVID-19 pandemic. As a result, Saudi Arabia believes it is essential to emphasize telemedicine services to combat the virus as part of its early precautionary actions. To measure the prevalence of telemedicine usage and determine the facilitators and barriers affecting telemedicine usage. A cross-sectional study was conducted among Saudis from October 2020 to April 2021. Participants received an online questionnaire through multiple social media platforms. The prevalence of telemedicine usage was 45.2%. The most significant facilitator that affected the participants' usage was avoiding the infection of COVID-19, at 87.3%. In-person consultation preference was the biggest barrier preventing Saudis from using telemedicine services (62.5%). Not enough people are aware of telemedicine services, so it is recommended to multiply advertisements for the services provided to reach many users. To enhance Saudi Arabia's awareness of the risks of COVID-19, further studies are needed to assess telemedicine usage during COVID-19, since the majority of studies were conducted in advance.

Healthcare Utilization Differences Among Primary Care Patients Using Telemedicine in the Veterans Health Administration: a Retrospective Cohort Study

BackgroundThe COVID-19 pandemic encouraged telemedicine expansion. Research regarding follow-up healthcare utilization and primary care (PC) telemedicine is lacking.ObjectiveTo evaluate whether healthcare utilization differed across PC populations using telemedicine.DesignRetrospective observational cohort study using administrative data from veterans with minimally one PC visit before the COVID-19 pandemic (March 1, 2019–February 28, 2020) and after in-person restrictions were lifted (October 1, 2020–September 30, 2021).ParticipantsAll veterans receiving VHA PC services during study period.Main MeasuresVeterans’ exposure to telemedicine was categorized as (1) in-person only, (2) telephone telemedicine (≥ 1 telephone visit with or without in-person visits), or (3) video telemedicine (≥ 1 video visit with or without telephone and/or in-person visits). Healthcare utilization 7 days after index PC visit were compared. Generalized estimating equations estimated odds ratios for telephone or video telemedicine versus in-person only use adjusted for patient characteristics (e.g., age, gender, race, residential rurality, ethnicity), area deprivation index, comorbidity risk, and intermediate PC visits within the follow-up window.Key ResultsOver the 2-year study, 3.4 million veterans had 12.9 million PC visits, where 1.7 million (50.7%), 1.0 million (30.3%), and 649,936 (19.0%) veterans were categorized as in-person only, telephone telemedicine, or video telemedicine. Compared to in-person only users, video telemedicine users experienced higher rates per 1000 patients of emergent care (15.1 vs 11.2; p < 0.001) and inpatient admissions (4.2 vs 3.3; p < 0.001). In adjusted analyses, video versus in-person only users experienced greater odds of emergent care (OR [95% CI]:1.18 [1.16, 1.19]) inpatient (OR [95% CI]: 1.29 [1.25, 1.32]), and ambulatory care sensitive condition admission (OR [95% CI]: 1.30 [1.27, 1.34]).ConclusionsTelemedicine potentially in combination with in-person care was associated with higher follow-up healthcare utilization rates compared to in-person only PC. Factors contributing to utilization differences between groups need further evaluation.