Telemedicine Research Articles

Patient satisfaction with synchronous telehealth care after strabismus surgery.

To measure patient satisfaction with synchronous telehealth care, we administered the Telemedicine Satisfaction Questionnaire (TSQ) to assess the quality of care provided, its similarity to face-to-face meetings, and patients' perception of the interaction. The Portuguese version of the TSQ was administered during 2022 to patients who received postoperative synchronous telehealth care after strabismus surgery in Curitiba, Brazil, from 2020 to 2022. The interval between the questionnaire application and teleconsultation ranged from 2 to 22 months after the telehealth encounter. All patients received synchronous telehealth care from the same surgeon (LMH) between postoperative days 7 and 10 and attended an in-person consultation on postoperative day 30 6 months after surgery, and yearly thereafter. We analyzed the data for 53 patients, of whom 26 (49%) were male and 28 (53%) were <18 years of age. Synchronous telehealth care was considered an excellent experience, with an overall average TSQ rating of 4.3 on a scale of 1-5. The mean score for quality of care provided was 4.1; for similarity of care to face-to-face meetings, 4.5; and for patients' perception of the interaction, 4.5. Ratings of the synchronous telehealth care were strongly associated with the 30-day postoperative evaluation, and patient perceptions of the quality of care in the telehealth encounter were positive.

Young Black and White adults prefer in-person to telehealth for primary care visits and group health promotion programs.

Telehealth utilization has increased since the coronavirus disease 2019 pandemic, reducing barriers to healthcare and, potentially, reducing participation in group health-promotion interventions. However, preferences for telehealth versus in-person formats have not been established. To examine preferences for telehealth and in-person format for primary care and group health-promotion interventions among Black and White women and men aged 20-39. We hypothesized that respondents would report a higher preference for telehealth than in-person appointments. This cross-sectional survey study recruited participants to answer questions about access to technology and preferences for telehealth and in-person formats of primary care and group health promotion. Respondents (n = 404) included similar proportions of White women (24.3%, 26.4 ± 4.3 years), Black women (25.0%, 29.0 ± 6.1 years), White men (25.9%, 32.8 ± 4.5 years), and Black men (24.8%, 30.6 ± 5.2 years). About 98.5% reported having a smartphone, and 80.4% had access to a computer with a camera. Preference ratings were higher for in-person visits, compared to telehealth visits, for both primary care (M = 3.86 ± 1.13 vs. M = 2.87 ± 1.18) and group health promotion (M = 3.72 ± 1.12 vs. M = 3.04 ± 1.20) F's(1,400) > 59.0, P's < .001. Most young adults have access to technology, supporting the feasibility of telehealth interventions. However, telehealth preference ratings were lower than in-person appointments. Preferences for delivery formats should be considered when designing behavioral interventions to promote health and prevent disease.

Telehealth Research Strategies in a Post COVID-19 Era: A Roadmap for the Coming Decade.

An Agency for Healthcare Research and Quality-funded Think Tank, held at Michigan State University, brought together a wide range of subject matter experts in telemedicine, telehealth, digital health, digital access, and health care. The authors of this article represented a group focused on the research needs, constructs, and strategies in the post-COVID era. While telemedicine and telehealth grew exponentially during the pandemic, the challenges that have been with us for decades, while ameliorated to some extent, remain. To showcase the State of Michigan as a model, the authors reviewed challenges and opportunities related to telehealth and telemedicine usage and categorized them into seven areas of highest priority. Based on a review of the literature and consultation in the fields of telehealth, telemedicine, and digital access, we identified seven key categories where research would be most effective going forward. These categories include research into the impact of telehealth on clinical services, telehealth's use in administrative activities, education and training for health care providers and patients, telehealth policy implications at state and federal levels, the impact of future technology and innovation on telehealth services, patient characteristics and their experiences, and the ethical aspects of telehealth in the future. We have formulated this overview of our findings to act as a roadmap for future telehealth research. We recommend that ongoing studies should explore each of the seven categories identified above. The search for solutions to overcome the challenges within these topics must not be constrained to research that has been conducted recently; many of these challenges have faced telehealth researchers for decades, and numerous solutions have been proposed over the years. Some of these proposals should be explored once again in light of technological and societal advances. The findings from these studies should be shared in ways and through venues that can make them accessible outside the spheres of academic research, but also by practitioners, policymakers, and patients. Third, research into telehealth in all its incarnations must be prioritized, and leadership is needed to ensure these areas of study are continued to be spotlighted after the noise of the COVID-19 pandemic grows quiet.

Building the Evidence on Mental Telehealth Care and Health Outcomes

Building the Evidence on Mental Telehealth Care and Health Outcomes

Telehealth for HIV care and management among people living with HIV in Australia: results from an online survey.

Background The aims of this study were to evaluate the experiences of telehealth for routine HIV care and identify preferred models of HIV routine care for the future. Methods Anonymous, online questionnaire among people living with HIV aged 18years or older. This survey was advertised via posters with a QR code in six sexual health clinics and one community organisation as well as on social media from November 2021 to December 2022. Results Of 89 participants, the majority were males (80/89, 89.9%), between 36 and 55years old (49/89, 55.1%), spoke English at home (74/89, 84.1%), had been living with HIV for >5years (68/89, 76.4%) and reported having a telehealth consultation since the COVID-19 pandemic began (69/89, 77.5%). The top three liked aspects of telehealth were: the convenience of not leaving home or work (50/69, 72.5%); less travel time (48/69, 69.6%); and avoiding contact with other people (30/69, 43.5%). The top three dislikes of telehealth were: they could not be screened for sexually transmitted infections (STIs) or have a physical examination at the same time (29/69, 42.0%); it was an impersonal experience (20/69, 29.0%); and it was more difficult to discuss health concerns (18/69, 26.1%). Among all participants, the preference for future consultations was to have a mix between in-person and telehealth (40/89, 44.9%); however, nearly one-quarter prefer in-person consultations only (20/89, 22.5%). Conclusions Use of telehealth during COVID-19 has been evaluated positively among people living with HIV that participated in this survey. Participants support the use of telehealth for routine care in conjunction with in-person consultations.

The Efficacy of Telehealth Versus In-Person Management Delivery in Adult Patients with Obesity.

The effectiveness of telehealth in managing obesity in Saudi patients is still under investigation. This study compared the effectiveness of telehealth and in-person obesity management programs for adults. This clinical trial involved 62 adults, 29 receiving in-person intervention at the clinic and 33 receiving telehealth via videoconference calls. Anthropometric measurements, biochemical parameters, and dietary and lifestyle habits were assessed at baseline and after 12 weeks. Patients have been educated about goal-setting, healthy eating behaviors, personalized meal plans, and increasing physical activity levels. It showed that 45% and 49% of the in-person and telehealth groups lost more than 5% of their initial body weight. Weight, % body fat, and waist circumference were significantly reduced in the in-person and telehealth groups (p < 0.001). No significant differences between the groups were found in the parameters mentioned above. Within-group analysis showed that light physical activity levels improved in both groups significantly (p < 0.001), and the moderate physical activity level improved significantly among the telehealth group (p < 0.039). No significant differences were observed between the groups regarding physical activity level, blood pressure measurement, and biochemical markers, except for the RBC blood level (p = 0.026). The telehealth group had significantly higher attendance rates for counseling sessions (97% vs. 75% for the in-person group, p < 0.01). Participants' dropout rates were higher for the in-person group 21%, compared to the telehealth group 13%. Telehealth participants' satisfaction regarding the benefits of the obesity management program in losing weight was higher at 87% compared to the in-person group at 76%. In conclusion, applying a telehealth obesity management program can support patients struggling with obesity who may have limited access to traditional healthcare services, while ensuring that telehealth care replicates the quality of in-person care.

Effectiveness of telerehabilitation versus face-to-face pulmonary rehabilitation on physical function and quality of life in people with post COVID-19 condition: a systematic review and network meta-analysis.

Post COVID-19 condition (PCC) is characterized by the persistence of symptoms associated with COVID-19 infection for more than 12 weeks, with worsening quality of life and physical function deconditioning being among the most commonly reported persistent symptoms. Pulmonary rehabilitation has emerged as a safe and viable option for these patients. Administered either face-to-face (FTF) or telemedicine (TL), it has been shown to improve symptoms associated with PCC. However, little is known about which approach is best for this population. Therefore, we conducted a systematic review and network meta-analysis on the efficacy of FTF versus TL compared to usual care in improving physical function and quality of life (physical and mental) in patients with PCC. A systematic search of PubMed, Cochrane Library, and Web of Science was performed from 2020 to January 5th, 2024. Two independent reviewers performed study selection, data extraction, and risk of bias assessment; this selection included only randomized controlled trials. A network meta-analysis was performed to compare the effects of FTF and TL with usual care. Multivariate and univariate analysis were performed to evaluate the best intervention. Data were extracted from 10 studies, five of which were treated with FTF and five of which were TL, involving 765 adults with PCC, ranging in age from 22 to 66 years. Interventions consisted of isolated or combined exercises (aerobic, resistance, breathing) and lasted between three and ten weeks in most of the included studies. Multivariate analysis found that FTF produced significant differences compared to TL or usual care with moderate quality of evidence. Univariate analysis found that significant differences were only found for physical function and mental domain of quality of life for TL vs. usual care, with moderate quality of evidence. This study supports the use of FTF as a therapy to improve physical function and quality of life in patients with PCC. However, in the absence of differences between FTF and TL in the univariate model for any of the outcomes studied, the choice of the form of pulmonary rehabilitation administration should be individualized. Future studies should compare FTF with TL directly to clarify which is the best approach.

Telemedicine for long-term continuous positive airway pressure therapy: A six-month follow-up study in Japan using propensity score matching

BackgroundDuring the coronavirus disease (COVID-19) pandemic, Japan's health insurance system allowed continuous positive airway pressure (CPAP) telephone consultations to extend clinic visit intervals. This study aimed to determine whether 6-month CPAP adherence in the telemedicine (TM) group was inferior to that in the standard care group. MethodsPatients receiving long-term CPAP therapy for at least 6 months for obstructive sleep apnea (OSA) from two clinics in Japan were recruited between May and July 2020. The TM group consisted of patients who had not visited the clinic in person for 6 months, with physicians providing telephone consultations every 1–2 months. The standard care group included patients who visited the clinic monthly for physician consultation. In both groups, physicians reviewed CPAP usage data via telemonitoring. Patients were classified into three groups according to change in adherence: ≤ −5%, > −5 to <5%, and ≥5%. The primary outcome was the number of patients with worsened CPAP adherence (≤−5%). ResultsOf the 479 patients in the TM group and 146 in the standard care group, 120 were matched using propensity score 1:1 nearest neighbor matching and selected from both groups. Adherence worsened in 41 (34.2%) and 32 (26.7 %) patients in the TM and standard care groups, respectively. The TM group was not inferior to the standard care group in terms of the proportion of patients with worsened CPAP adherence (χ2 = 1.81, df = 1, P = 0.178). ConclusionsThis study found no significant difference in the 6-month CPAP adherence between the TM and standard care groups.

INteractive survivorship program to improve health care REsources [INSPIRE]: A study protocol testing a digital intervention with stepped care telehealth to improve outcomes for adolescent and young adult survivors

INteractive survivorship program to improve health care REsources [INSPIRE]: A study protocol testing a digital intervention with stepped care telehealth to improve outcomes for adolescent and young adult survivors

Development and Implementation of a Value-Based Care Telehealth Emergency Medicine Program: Triage and Care Alignment in an Integrated Health System

Background: Acute unscheduled episodic care is an area of potential cost savings, given the high frequency and cost of unnecessary emergency department (ED) utilization. Methods: We developed a provider-assisted patient navigation program using a telehealth platform designed to decrease ED utilization and reduce costs while providing exceptional patient satisfaction. Results: Urgent care (UC) visits were analyzed from July 1, 2022, to June 30, 2023. The “ED comparison” group (n = 68,320) consisted of patients discharged to home after receiving care in the ED. The “avoided ED visits” group included patients (n = 7,430) who received care in a lower-acuity setting and did not require emergency services within 48 hours. The calculated overall medical expense savings comparing the costs between the ED vs. lower-acuity settings revealed that 50% (n = 450) of consultations were managed as outpatients, avoiding ED visits. Evaluation of distribution by source revealed that 67% of ConnectCare consults resulted in admission, 48% for UC, while 36% of patients were service center consults. Conversely, 31% of consultations resulted in recommendations to go to the ED, and 16% of these were assisted transfers where the Telehealth Emergency Medicine (TeleEM) clinician communicated with the receiving ED. Among the 280 patients directed to the ED, 243 were sent because of immediate clinical acuity, 28 were because of logistical or scheduling issues, three for non-qualifying insurance for outpatient workup, and six were redirected to the ED following diagnostic results. Our analysis suggests an estimated average avoided medical expense of $1,701 per case to insurers and patients if an ED visit was avoided. Conclusion: Implementing a TeleEM program to assist with triage and resource alignment, as well as identification and outpatient management of patients while avoiding an ED visit, is feasible within an integrated health system. Our TeleEM program may be a model for other integrated health systems.

Impact on healthcare costs of adding telemedicine to a multidisciplinary disease management program for heart failure: a sub-analysis of the iCOR trial

Abstract Background Impact of telemedicine on heart failure outcomes has shown conflicting results. Little is known about the effect of these programs on mid-term healthcare costs. Purpose To evaluate the cost-efficacy of a comprehensive telemonitoring program within the vulnerable post-discharge period after an acute heart failure admission. Methods The insuficiència cardiaca Optimizació Remota (iCOR) trial was a single-centre, randomized, open-label study designed to evaluate the efficacy of the addition of telemonitoring and teleintervention to a specialized multidisciplinary nurse-led heart failure (HF) program. Adult patients with a recent hospital admission for acute HF and an acceptable social support and cognitive ability were recruited. This sub-analysis evaluates the effect of telemedicine on mid-term healthcare costs, including clinical events, drugs and devices, technology purchase and maintenance, outpatient care, days of hospitalization, procedures and complementary tests. t-test via bootstrap estimation is used to compare differences between the telemedicine (TM) and the usual care (UC) groups. Results 81 patients were assigned to the TM group and 97 patients to the UC group. Mean age was 74 years, more than 50% had HF with preserved ejection fraction and 25% were frail. Baseline characteristics were well-balanced between groups. Among the TM subgroup, adherence was very high (&amp;lt; 1% of missed biometric daily transmissions). During 6 months of follow-up, mean total healthcare cost per patient was 7949 euros (€) in the UC cohort and 4383 € in the TM cohort (relative risk reduction [RRR] of 45%; between-group differences 3546 €, 95% confidence interval 627-6464 €, bootstrap achieved significance level 0.022). This result was consistent across several subgroups (age, sex, frailty, left ventricular ejection fraction, educational level) and mainly driven by a 63% RRR in costs of hospitalization (which accounted for two-thirds of the total costs) in the TM cohort. 20 patients required HF admissions in the TM group, compared to 51 patients in the TM group (p &amp;lt; 0.001). This was associated with a 59% RRR in the need for diagnostic procedures. Total number of days of hospitalization per patient decreased from 12.2 in the UC group to 4.2 days in the TM group (p = 0.003), impelled by a reduction in HF and cardiovascular days of hospital stay. On the contrary, ambulatory care costs increase two-fold in the TM group compared to UC group. Nevertheless, these costs only accounted for a 19% of the total costs. Cost of devices needed to implement TM supposed 698 € per patient. Use of TM was associated with a 355 € increase in the cost of ambulatory neurohormonal treatment for HF. Conclusions TM implementation during the vulnerable phase after an acute HF admission was associated to a 45% RR reduction in mean total healthcare cost per patient. This result was driven by an almost two-thirds decrease in costs of hospitalization.UC and TM total healthcare costs

Patient-, Provider-, and Facility-Level Contributors to the Use of Cardiology Telehealth Care in the Veterans Health Administration: Retrospective Cohort Study.

Telehealth (care delivered by phone or video) comprises a substantial proportion of cardiology care delivered in the Veterans Health Administration (VHA). Little is known about how factors specific to patients, clinicians, and facilities contribute to variation in cardiology telehealth use. The aim of this study is to estimate the relative extent to which patient-, clinician-, and facility-level factors affect cardiology telehealth use in VHA. This was a retrospective, nation-wide cohort study of veterans' use of VHA cardiology telehealth care during the first 2 years of the COVID-19 pandemic (March 11, 2020, to March 10, 2022). We constructed multilevel, multivariable, logistic regression models of patient-level cardiology telehealth use (telephone or video-based care). Models included random effects for the patient, the patient's main cardiology provider, and the patient's primary facility (ie, VHA medical center) for specialty care and fixed effects for patient sociodemographic and clinical characteristics. Our analytic cohort comprised 223,809 veterans with 989,271 encounters among 2235 unique clinicians. The veterans' average age was 70.2 years, and 3.4% (n=7616) were women. Of the 989,271 encounters, 4.2% (n=41,480) were video based and 34.3% (n=338,834) were phone based. Adjusted odds of telehealth use were slightly higher for women versus men (adjusted odds ratio [AOR] 1.08, 95% CI 1.05-1.10), individuals identifying as Hispanic or Latino versus not Hispanic or Latino (AOR 1.46, 95% CI 1.43-1.49), and those with medium and long drive times versus short drive time (AOR 1.11, 95% CI 1.10-1.12 and AOR 1.09, 95% CI 1.07-1.10, respectively). Further, 40.5% of the variation in a veteran's likelihood of using cardiology telehealth care was found at the patient level, 30.8% at the clinician level, and 7% at the facility level. The largest share of the attributable variability in VHA cardiology telehealth use in this cohort was explained by the patient, followed closely by the clinician. Little variability was attributed to the primary facility through which the veteran received their cardiology care. These results suggest that policy solutions intended to improve equity of cardiology telehealth care use in VHA may be most impactful when directed at patients and clinicians.

Integrating IoT and Machine Learning for Advanced Breast Cancer Detection: A Secure Framework for Enhanced Diagnostic Accuracy

Background: Breast cancer continues to be a major global health issue, with outmoded analytic methods often limited in their capacity for early detection. The emergence of telehealth care emphasizes the need for advanced, advanced diagnostic explanations. Objective: This study explores the possibility of integrating advanced technologies, such as thermal imaging cameras, with sophisticated ML algorithms, particularly CNNs, to enhance breast cancer discovery beyond the capabilities of conventional risk models. Method: We propose a pioneering predictive healthcare system that harnesses the IoT and EHRs for real-time, automated breast cancer detection. This system is designed to operate in various healthcare environments, including hospitals, nursing homes, and schools. Beyond early breast cancer detection, it seeks to identify other health issues using the shared rule of DL and IoT techniques. To maintain data integrity and protect patient confidentiality, the system implements strong security protocols, including encrypted data transmission, secure access controls, and adherence to healthcare data protection regulations. Results: The study explores the methodologies and technological frameworks necessary for developing this comprehensive cancer detection system. Emphasis is placed on secure data management practices and the implementation of security protocols to safeguard sensitive health information. Main Findings: This research assesses whether the proposed system can effectively address global challenges related to breast cancer detection and contribute to enhanced patient outcomes. The integration of advanced security features aims to defend patient data and certify the system's reliability and trustworthiness in diverse healthcare settings. Conclusion: This investigate evaluates capabilities of new health care system that combines smart technologies with ML methods to identify breast cancer and possibly other health problems at an early stage. Future investigate should focus on assessing the system’s practical feasibility and effectiveness in real-world scenarios, as well as its ability to uphold stringent security standards. This emphasizes its efficiency when operating on a lightweight and portable processor. Our experimental results indicate that our system achieves a 96.32% accuracy on the BreakHis database and can operate on a Raspberry Pi device with minimal resources.

Cost-Effectiveness Analysis of Telehealth and In-Person Primary Care Visits for People Living with Alzheimer’s Disease-Related Disorders in the State of Nevada

To people living with Alzheimer’s Disease-Related Disorders (ADRD), timely and coordinated communication is essential between their informal caregivers and healthcare providers. In provider shortage areas, for example, the state of Nevada, telehealth can be an effective primary care delivery alternative to in-person visits. To evaluate the cost-effectiveness of telehealth visits for people living with ADRD in the state of Nevada, a decision-analytic Markov model was developed from healthcare system perspectives with a 10-year horizon/1-year cycle. To estimate the effects of demographic and geographic parameters on the Markov model, race parameters were divided into non-Hispanic White individuals vs. others and location parameters were divided into urban vs. rural. A 12-item short-version Zarit Burden Interview (ZBI-12) was applied to measure the informal caregiver burdens of non-institutionalized people living with ADRD. The values of mortality rate and healthcare utilization were obtained from healthcare systems’ publicly available payor administrative data and Nevada State Inpatient/Emergency Department datasets. Among urban-residing non-Hispanic White individuals, the Incremental Cost-Effectiveness Ratio (ICER) per modified ZBI-12 indicated a cost saving of USD 9.44 with telehealth visits; among urban-residing racial minorities, the ICER per modified ZBI-12 indicated a cost saving of USD 29.26 with in-person visits; and among rural residents, the ICER per modified ZBI-12 indicated a cost-saving of USD 320.93 with telehealth visits. Distributional differences in the cost-saving effects of telehealth primary care were noted in line with racial and geographic parameters. Workforce and caregiver training is necessary for reducing distributional differences, especially among urban-residing racial monitories living with ADRD in the provider shortage area of the state of Nevada.

Breaking barriers in Parkinson’s care: the multidisciplinary team approach

Parkinson’s disease is a complex neurodegenerative disorder presenting a range of motor and non-motor symptoms that greatly impact both patients and caregivers. The diverse needs arising from these symptoms make a multidisciplinary team (MDT) approach crucial for effective management. This article explores the role and benefits of MDTs in Parkinson’s care, highlighting how collaborative models improve clinical outcomes and quality of life. MDTs integrate neurologists, nurse specialists, therapists, and other professionals to deliver comprehensive, patient-centered care. The inclusion of patients and caregivers fosters shared decision-making, enhancing health outcomes. However, challenges like limited controlled trials, lack of comprehensive guidelines, and under-referral remain. Innovative models, such as telehealth and community-based care, offer promising solutions, especially in underserved regions. The article advocates for further research and standardized guidelines to optimize the MDT approach for Parkinson’s disease.

An investigation of public trust in autonomous humanoid AI robot doctors: a preparation for our future healthcare system

As a preparation for our future healthcare system with artificial intelligence (AI)-based autonomous robots, this study investigated the level of public trust in autonomous humanoid robot (AHR) doctors that would be enabled by AI technology and introduced to the public for the sake of better healthcare accessibility and services in the future. Employing the most frequently adopted scales in measuring patients’ trust in their primary care physicians (PCPs), this study analyzed 413 survey responses collected from the general public in the United States and found trust in AHR nearly matched the level of trust in human doctors, although it was slightly lower. Based on the results of data analysis, this study provided explanations about the benefits of using AHR doctors and some proactive recommendations in terms of how to develop AHR doctors, how to implement them in actual medical practices, more frequent exposure of humanoid robots to the public, and the need of interdisciplinary collaboration to enhance public trust in AHR doctors. This line of study is urgently demanded because the placement of such advanced robot technology in the healthcare system is unavoidable as the public has experienced it more these days. The limitations arising from the non-experimental design, a voluntary response sampling through social media, and few theories on communication with humanoid robots remain tasks for future studies.

Telehealth for rare disease care, research, and education across the globe: A review of the literature by the IRDiRC telehealth task force

The International Rare Diseases Research Consortium (IRDiRC) Telehealth (TH) Task Force explored the use of TH for improving diagnosis, care, research, and education for rare diseases (RDs). The Task Force reviewed related literature published from January 2017 to August 2023, and identified various models and implementation strategies of TH for RD. The Task Force highlighted the reported value and benefits of using TH for RDs, along with the limitations and opportunities. The number of publications sharply increased since 2021, coinciding with the onset of the COVID-19 pandemic, which forced the rapid adoption of TH in many healthcare settings. One of the major benefits of TH for RDs lies in its capacity to surmount geographical barriers, which helps in overcoming the constraints posed by limited numbers and geographical dispersion of specialists. This was evident during the pandemic when TH was used to maintain a level of continued medical care and research when face-to-face visits were severely restricted. TH, through which clinical research can be decentralized, can also facilitate and enhance RD research by decreasing burden, expanding access, and enhancing efficiency. This will be especially beneficial when coupled with the adoption of digital health technologies, such as mobile health (mHealth) and wearable devices for remote monitoring (i.e., surveillance of outpatient data transmitted through devices), along with big data solutions. TH has also been shown to be an effective means for RD education and peer mentoring, enabling local health care providers (HCPs) to care for RD patients, which indirectly ensures that RD patients get the expertise and multidisciplinary care they need. However, limitations and weaknesses associated with using TH for RD care and research were also identified, including the inability to perform physical examinations and build relationships with HCPs. Therefore, TH has been recommended as a complement to, rather than substitute for, face-to-face consultations. There is also a concern that TH may lead to an amplification of health disparities and inequities related to social determinants of health for those with RDs due to lack of access to TH technologies, inadequate digital literacy, and geographical, socio-cultural, and linguistic barriers. Finally, the Task Force also discussed evidence and knowledge gaps that will benefit from future research efforts to help advance and expand the use of TH for RD care, research, and education.

Nurse-led telehealth and mobile health care models for type 2 diabetes and hypertension in low-income US populations: A scoping review.

Increasing numbers of underserved people with chronic diseases and decreasing providers in rural areas have contributed to the care shortage in the United States. Nurse-led telehealth/mobile care models have potential benefits for this population. However, there is a substantial gap in the literature regarding this topic. To examine the available literature on nurse-led telehealth/mobile health care models with a particular focus on care model settings, nursing roles, care components, achieved outcomes, and the identification of both facilitative factors and encountered challenges. The ultimate goal is to offer recommendations based on these findings, thereby aiding the development or refinement of evidence-based care models that meet to the unique needs of low-income populations. Literature published from 2010 to 2023 was searched in six electronic databases (Cumulative Index to Nursing and Allied Health Literature, Communication and Mass Media Complete, Medline, APA PsycINFO, Social Sciences Index, and Web of Science databases). Commonalities identified among included studies with significant improvements were the provision of home monitors and education to participants, multiple engagements, and extensive community and/or family involvement. Nurse-led telehealth/mobile health care models for chronic diseases are an emerging approach. Nurse educators must ensure that future nurses are adept in diverse telehealth modes, collaborating across disciplines. Leveraging advanced practice registered nurses and interdisciplinary teams provides holistic care. Our review outlined recent research findings that suggest enhanced patient outcomes through technology, communication, and community support. In addition, we offered suggestions for future research and practice, emphasizing the importance of exploring the requirements of diverse and underserved communities.

Telehealth Education in Athletic Training

Context: Within the broad telehealth education literature, there are numerous case studies and position statements from various associations of model practices. Little is known about how athletic training is addressing telehealth education. Objective: To determine how athletic training education programs teach, assess, and structure telehealth content. Design: Cross-sectional study Setting: Online survey instrument Patients or Other Participants: An institutional athletic training faculty member from 82 athletic training programs in the United States. Data Collection and Analysis: The survey contained the validated Telehealth Evaluative Content in Higher Education (TECHE) instrument, which consisted of descriptive items focused on how education programs teach, assess, and deliver telehealth education content. Data were cleaned and basic descriptive statistics were calculated. Results: Of the program faculty that responded, 49% (n=39) reported that their program includes telehealth content. Specifically, 19 programs (49%) taught about the knowledge, skills, and abilities using multiple presentations across the curriculum (42%, n = 8) ,including techniques such as class discussions (68%, n = 13) and lectures (63%, n = 12). For assessment, 17 programs (44%) included simulations (65%, n = 11) evaluated most commonly by faculty (82%, n = 14). Only 14 (36%) programs created telehealth clinical experiences including practice with simulated patients throughout all the domains of telehealth skills. When programs included telehealth clinical experiences, they mainly focused (28%, n = 16) on orthopedics and (26%, n = 15) on primary care experiences. Discussion: The development of telehealth content should be based on model practices and delivered across multiple curriculum presentations. Assessment should incorporate various perspectives and utilize different methods. Practice opportunities with classmates and simulated patients that require interpersonal communication, data gathering, and patient education should be developed. Conclusion: While a slight majority of programs do not teach telehealth content, those that do teach telehealth utilize various strategies. Most program faculty use simulations conducted by faculty to assess orthopedic and primary care telehealth content.

Experiences of Older Adults with Heart Failure Using Telemedicine During the COVID-19 Pandemic: A Qualitative Study.

Background: Telemedicine (TM) usage increased rapidly during the COVID-19 pandemic. This study is part of a larger mixed-methods study comparing TM and in-person visits of older adults with heart failure (HF) and describes patient's TM experiences during the pandemic. Methods: This study employed qualitative design using survey responses and individual interviews. Study eligibility requirements included >55 years old, HF diagnosis, and TM visit between September 1, 2020 and May 31, 2021, at one of two participating health systems in the southern United States. Results: Twenty-two TM recipients completed qualitative interviews, and 91 of 125 online survey respondents answered open-ended questions. Data were gathered, sorted, and revealed five themes. Discussion: Interview respondents identified benefits, e.g., convenience, inclusion, decreased exposure, and problems, e.g., connectivity issues, inadequate equipment, and medical conditions impacting use. Recommendations included allocating sufficient appointment time, tailoring visits, and increasing written communication. This study was part of a larger clinical trial registered at ClinicalTrials.gov: NCT04304833.