Use Of Telehealth Research Articles

Characteristics of Veterans Experiencing Homelessness using Telehealth for Primary Care Before and After COVID-19 Pandemic Onset

BackgroundThe COVID-19 pandemic expanded telehealth use across healthcare systems, including the Veterans Health Administration (VA). Little is known about how large-scale telehealth rollout affected access to primary care for patients experiencing homelessness.ObjectiveTo examine the extent to which homeless-experienced veterans used telehealth services in primary care and to characterize users before and after the onset of the COVID-19 pandemic.DesignRetrospective cohort study, 3/16/2019–3/15/2022.Participants394,731 veterans with homelessness diagnoses nationally using 4,068,109 primary care visits.Main MeasuresThe outcomes were use of 1 + telehealth visits (video, phone, secure messaging) for primary care during each year. Through multivariable regression models, we examined associations between telehealth use, patient characteristics (e.g., age, sex, race-ethnicity, comorbidity), and VA homeless services use (e.g., homeless-tailored primary care (HPACT), permanent supportive housing).Key ResultsCompared to pre-pandemic, telehealth in primary care among homeless-experienced veterans increased substantially 2 years post-pandemic (video: 1.37% versus 20.56%, phone: 60.74% versus 76.58%). Secure messaging was low over time (1.57–2.63%). In adjusted models, video users were more likely to be young (65 + years: OR = 0.43, CI: 0.42–0.44), women (OR = 1.74, CI: 1.70–1.78), Black (OR = 1.14, CI: 1.12–1.16), Hispanic (OR = 1.34, CI: 1.30–1.38), and with more comorbidities (2 + on the Charlson Comorbidity Index; OR = 1.16, CI: 1.14–1.19), compared to video non-users. HPACT patients were less likely to use video (OR = 0.68, CI: 0.66–0.71) than other primary care patients. This was not observed among users of other VA homeless services.ConclusionsDespite decreased access to health information technology and low pre-pandemic telehealth use, veterans experiencing homelessness still sustained high use of telehealth in primary care post-pandemic. Women and racial-ethnic minorities had higher video uptake proportionately, suggesting that telehealth may address access disparities among these homeless-experienced patient groups. Identifying and targeting organizational characteristics (e.g., HPACT users) that predict telehealth use for improvement may be key to increasing adoption among VA primary care patients experiencing homelessness.

Evidence-based telehealth interventions for posttraumatic stress disorder, depression, and anxiety: A systematic review and meta-analysis.

The goal of this systematic review was to examine the efficacy of behavioral health care treatments for posttraumatic stress disorder (PTSD), depression, and anxiety delivered via telehealth. We searched a combination of keywords related to telehealth, relevant mental health disorders, and evidence-based psychotherapies in three databases (PubMed, PsycInfo, and Embase) from database inception to April 2022. We included randomized controlled trials published in English wherein at least one arm received an evidence-based psychotherapy via telehealth. To be included, studies also had to enroll an adult population with symptoms or diagnosis of PTSD, depressive disorder, or anxiety disorder. Moderate quality of evidence was consistent with only small differences, if any, in efficacy between video teleconferencing (VTC) and in-person delivery for patients with PTSD (d = 0.06, 95% CI -0.17, 0.28). However, for those with depression, in-person delivery was associated with better outcomes compared to VTC (d = 0.28, 95% CI 0.03, 0.54; low quality of evidence). We also found that evidence-based treatments delivered over telephone were more efficacious for depression compared to treatment as usual (d = -0.47, 95% CI -0.66, -0.28; very low quality of evidence). Very low quality of evidence supported the use of telehealth versus waitlist for anxiety (d = -0.48, 95% CI -0.89, -0.09). A synthesis across 29 studies indicates that the efficacy of telehealth for delivery of evidence-based behavioral health interventions varies by target diagnosis and telehealth modality. More research is needed on the efficacy of telehealth treatments for depression and anxiety.

Pain Care Disparities and the Use of Virtual Care Among Racial-Ethnic Minority Groups During COVID-19

Background and ObjectiveCOVID-19 led to an unprecedented reliance on virtual modalities to maintain care continuity for patients living with chronic pain. We examined whether there were disparities in virtual specialty pain care for racial-ethnic minority groups during COVID-19.Design and ParticipantsThis was a retrospective national cohort study with two comparison groups: primary care patients with chronic pain seen immediately prior to COVID-19 (3/1/19–2/29/20) (N = 1,649,053) and a cohort of patients seen in the year prior (3/1/18–2/28–19; n = 1,536,954).Main MeasuresWe assessed use of telehealth (telephone or video) specialty pain care, in-person care specialty pain care, and any specialty pain care for both groups at 6 months following cohort inclusion. We used quasi-Poisson regressions to test associations between patient race and ethnicity and receipt of care.Key ResultsPrior to COVID-19, there were Black-White (RR = 0.64, 95% CI [0.62, 0.67]) and Asian-White (RR = 0.63, 95% CI [0.54, 0.75]) disparities in telehealth use, and these lessened during COVID-19 (Black-White: RR = 0.75, 95% CI [0.73, 0.77], Asian-White: RR = 0.81, 95% CI [0.74, 0.89]) but did not disappear. Individuals identifying as American Indian/Alaska Native used telehealth less than White individuals during early COVID-19 (RR = 0.98, 95% CI [0.85, 1.13] to RR = 0.87, 95% CI [0.79, 0.96]). Hispanic/Latinx individuals were less likely than non-Hispanic/Latinx individuals to use telehealth prior to COVID-19 but more likely during early COVID-19 (RR = 0.70, 95% CI [0.66, 0.75] to RR = 1.06, 95% CI [1.02, 1.09]). Disparities in virtual pain care occurred over the backdrop of overall decreased specialty pain care during the early phase of the pandemic (raw decrease of n = 17,481 specialty care encounters overall from pre-COVID to COVID-era), including increased disparities in any VA specialty pain care for Black (RR = 0.81, 95% CI [0.80, 0.83] to RR = 0.79, 95% CI [0.77, 0.80]) and Asian (RR = 0.91, 95% CI [0.86, 0.97] to RR = 0.88, 95% CI [0.82, 0.94]) individuals.ConclusionsDisparities in virtual specialty pain care were smaller during the early phases of the COVID-19 pandemic than prior to the pandemic but did not disappear entirely, despite the rapid growth in telehealth. Targeted efforts to increase access to specialty pain care need to be concentrated among racial-ethnic minority groups.

Effect of Remote and Virtual Technology on Home Dialysis.

In the United States, regulatory changes dictate telehealth activities. Telehealth was available to patients on home dialysis as early as 2019, allowing patients to opt for telehealth with home as the originating site and without geographic restriction. In 2020, coronavirus disease 2019 was an unexpected accelerant for telehealth use in the United States. Within nephrology, remote patient monitoring has most often been applied to the care of patients on home dialysis modalities. The effect that remote and virtual technologies have on home dialysis patients, telehealth and health care disparities, and health care providers' workflow changes are discussed here. Moreover, the future use of remote and virtual technologies to include artificial intelligence and artificial neural network model to optimize and personalize treatments will be highlighted. Despite these advances in technology challenges continue to exist, leaving room for future innovation to improve patient health outcome and equity. Prospective studies are needed to further understand the effect of using virtual technologies and remote monitoring on home dialysis outcomes, cost, and patient engagement.

The Clinical Resource Hub Telehealth Program and Use of Primary Care, Emergency, and Inpatient Care During the COVID-19 Pandemic

BackgroundThe COVID-19 pandemic disrupted delivery of health care services worldwide. We examined the impact of the pandemic on clinics participating in the Veterans Affairs (VA) Clinical Resource Hub (CRH) program, rolled out nationally in October 2019, to improve access to care at under-resourced VA clinics or “spoke” sites through telehealth services delivered by regional “hub” sites.ObjectiveTo assess whether the CRH program was associated with increased access to primary care, we compared use of primary, emergency, and inpatient care at sites that adopted CRH for primary care (CRH-PC) with sites that did not adopt CRH-PC, pre-post pandemic onset.DesignDifference-in-difference and event study analyses, adjusting for site characteristics.Study CohortA total of 1050 sites (254 CRH-PC sites; 796 comparison sites), fiscal years (FY) 2019–2021.InterventionCRH Program for Primary Care.Main MeasuresQuarterly number of VA visits per site for primary care (across all and by modality, in-person, video, and phone), emergency care, and inpatient care.ResultsIn adjusted analyses, CRH-PC sites, compared with non-CRH-PC sites, had on average 221 additional primary care visits (a volume increase of 3.4% compared to pre-pandemic). By modality, CRH-PC sites had 643 fewer in-person visits post-pandemic (− 14.4%) but 723 and 128 more phone and video visits (+ 39.9% and + 159.5%), respectively. CRH-PC sites, compared with non-CRH-PC sites, had fewer VA ED visits (− 4.2%) and hospital stays (− 5.1%) in VA medical centers. Examining visits per patient, we found that CRH-PC sites had 48 additional telephone primary care visits per 1000 primary care patients (an increase of 9.8%), compared to non-program sites.ConclusionsVA’s pre-pandemic rollout of a new primary care telehealth program intended to improve access facilitated primary care visits during the pandemic, a period fraught with care disruptions, and limited in-person health care delivery, indicating the potential for the program to offer health system resilience.

Telehealth use in 2022 among US adults by sexual orientation.

To address a lack of research documenting telehealth use and experiences among sexual minority individuals during the COVID-19 pandemic and inform health care policies beyond the pandemic. Secondary analysis of the 2022 Health Information National Trends Survey (HINTS), a cross-sectional survey representative of US adults. We estimated multivariable probit regressions to understand how sexual orientation was associated with reporting telehealth use, modality (video only, telephone only, both), and experiences, including the reason for, subject of most recent, and quality of the telehealth visit. We adjusted estimates based on respondents' self-reported demographics and health status. Analyses were weighted to represent the US adult population and used full information maximum likelihood to account for missing data. Among all HINTS respondents, having a telehealth visit within the past year was more common among sexual minority respondents than heterosexual respondents. Among telehealth users, sexual minority respondents were more likely than heterosexual respondents to say that they used telehealth because it was convenient and minimized their exposure to illnesses and that the subject of the most recent telehealth visit was mental health. They were less likely to say the subject was minor/acute care. Modality use and quality were comparable between sexual minority respondents and heterosexualrespondents. The findings show greater demand for telehealth, especially for mental health care, among sexual minority adults. Knowledge of factors driving patterns in health care utilization within minoritized communities and the implications for both telehealth access and quality are necessary to create policies that have a broad positiveimpact.

Telehealth Intervention for Self-management Among Patient with Hypertension: A Scoping Review

Background: Self-management among hypertensive patients is important to reduce morbidity and mortality. The use of telehealth can be applied to optimized self-management among hypertensive patients. Purpose: This study aimed to describe the application of telehealth in self-management of hypertensive patients. Methods: This review uses three electronic databased namely PubMed, EbscoHost and Scopus. The article included in the review is the use of telehealth in management in hypertensive psien. Review papers are excluded from the review. 9 articles are included in this review. Result: The form of application of telehealth in the management of hypertensive patients is health education related to hypertension, blood pressure monitoring, motivational support related to self-management, reminders in the form of taking medication, doctor visits, and diet, recording blood pressure results regularly in the form of charts / diagrams, and online consultations. Implication: The forms of telehealth implementation in this review are education, monitoring the blood pressure of hypertensive patients, motivation, reminders, diagram of blood pressure monitoring, and e-consultation. Although in the application of telehealth, there are some challenges, the application of telehealth provides advantages and benefits in chronic patient management Keywords: Hypertension; self-management; telehealth

Workforce Development and Training Needs for Behavioral Health Telehealth Use in the Post COVID-19 Era

Temporary regulatory changes early in the COVID-19 pandemic facilitated telehealth use, but with an increased return to in-person care in some settings, understanding provider attitudes about the practice and benefits of telehealth may help to inform policy and practice. This mixed methods study seeks to identify areas of training needed for effective telehealth provision in this new era. An online survey was distributed by five Mental Health Technology Transfer Center (MHTTC) regional service centers, which provide workforce capacity-building training and technical assistance, and the MHTTC Network Coordinating Office’s national listserv. Three hundred and sixty-five respondents from 43 states and Puerto Rico participated. The majority of respondents were clinical providers (69.3%). Eighty-five percent of respondents indicated they provided at least one telehealth service. Most indicated telehealth has improved their organizations’ ability to meet patient needs and increased access for underserved populations but suggested significant needs for continued training on telehealth use. These needs were consistent across organization locations and provider types. Qualitative analysis of free response questions identified key areas for ongoing training, including administrative topics (e.g., billing, documentation); integration of telehealth with existing systems; telehealth use with specific populations, especially children; and methods to increase access to technology for less-connected populations. Despite many providers receiving exposure to telehealth use during COVID-19, training in telehealth administration is still needed and may better serve those in certain roles and areas. While ongoing training may effectively address many needs identified, other significant concerns facing behavioral health providers may not be easily addressed via training (e.g., increasing technology access) and may require other approaches to facilitate the continued use of telehealth.

Lesbian, Gay, Bisexual, and Other Sexual Minority Adults in the United States and Their Unmet Medical Needs and Telehealth Use Due to the COVID-19 Pandemic in 2020

Sexual minority adults—including lesbian, gay, bisexual, queer/questioning, and other sexual minorities (LGBQ+)—face demonstrated barriers to employment, health insurance, and healthcare access. We sought to assess the association between sexual orientation, unmet medical needs, and telehealth use due to the COVID-19 pandemic using the National Health Interview Survey (2020). Using multivariable analyses, we assessed the likelihood of having unmet medical needs and telehealth use in LGBQ+ adults and heterosexual adults, adjusting for socioeconomic, demographic, and clinical factors. We found that LGBQ+ individuals had a significantly higher likelihood of having any unmet medical needs or unmet non–COVID-related medical needs due to the pandemic compared with heterosexual individuals. The LGBQ+ individuals were more likely to use telehealth than their heterosexual counterparts—for both general and pandemic-related reasons. Our findings indicate that disastrous events such as the COVID-19 pandemic likely exacerbate existing healthcare access disparities faced by LGBQ+ individuals. This warrants further research to explore the interventional potential of telehealth for reducing healthcare access disparities, especially for those living in geographic regions lacking culturally competent providers.

Telehealth use in maternity care during a pandemic: A lot of bad, some good and possibility

BackgroundTo reduce transmission risk during the COVID-19 pandemic, ‘telehealth’ (health care delivered via telephone/video-conferencing) was implemented into Australian maternity services. Whilst some reports on telehealth implementation ensued, there was scant evidence on women and midwives’ perspectives regarding telehealth use. MethodsA qualitative study was conducted in Australia during 2020–2021 using two data sources from the Birth in the Time of COVID-19 (BITTOC) study: i) interviews and ii) surveys (open-text responses). Content analysis was utilised to analyse the data and explore telehealth from the perspective of midwives and women accessing maternity care services. In-depth interviews were conducted with 20 women and 16 midwives. Survey responses were provided from 687 midwives and 2525 women who were pregnant or gave birth in 2021, generating 212 and 812 comments respectively. FindingsTelehealth delivery was variable nationally and undertaken primarily by telephone/videoconferencing. Perceived benefits included: reduced COVID-19 transmission risk, increased flexibility, convenience and cost efficiency. However, women described inadequate assessment, and negative impacts on communication and rapport development. Midwives had similar concerns and also reported technological challenges. ConclusionDuring the COVID-19 pandemic, telehealth offered flexibility, convenience and cost efficiency whilst reducing COVID-19 transmission, yet benefits came at a cost. Telehealth may particularly suit women in rural and remote areas, however, it also has the potential to further reduce equitable, and appropriate care delivery for those at greatest risk of poor outcomes. Telehealth may play an adjunct role in post-pandemic maternity services, but is not a suitable replacement to traditional face-to-face maternity care.

Bridging the Telehealth Divide: Racial and Ethnic Disparities in Medicare Telehealth Usage Highlights the Need for Equity-Focused Approaches.

Background: The COVID-19 pandemic led to a dramatic increase in Medicare reimbursed telehealth utilization in the United States, but significant racial disparities persist. Methods: This research analyzed trends and disparities in Medicare reimbursed telehealth usage and claims from 2020 through 2022 using data from the Centers for Medicare & Medicaid Services. Results: Medicare telehealth user claims were 10.1 million in 2020, 52.7 million in 2021, and 85.3 million in 2023. The adjusted odds of telehealth use were significantly lower in 2021 (adjusted odds ratios [aORs]: 0.746; 95% confidence intervals [CI]: 0.683-0.815) and 2022 (aOR: 0.529; 95% CI: 0.484-0.578) compared with 2020. Large racial differences were observed in 2020-2022, with lower telehealth usage among African Americans (aOR: 0.068; 95% CI: 0.054-0.087), Hispanics (aOR: 0.036; 95% CI: 0.027-0.047), American Indians/Alaska Natives (aOR: 0.012; 95% CI: 0.009-0.017), and Asian Pacific Americans (aOR: 0.001; 95% CI: 0.001-0.002) versus Non-Hispanic Whites. Rural residents, older adults, and beneficiaries with disabilities also had reduced telehealth utilization. However, women were more likely to use telehealth versus men (aOR: 1.689; 95% CI: 1.363-2.094). Conclusion: Despite telehealth expansion during the pandemic, significant disparities remain, highlighting the need for targeted efforts to increase access and reduce barriers among underserved populations. Addressing disparities is critical to ensuring equitable access to health care through telehealth.

Telehealth use during the early COVID-19 public health emergency and subsequent health care costs and utilization.

Telehealth utilization increased during the COVID-19 pandemic, yet few studies have documented associations of telehealth use with subsequent medical costs and health care utilization. We examined associations of telehealth use during the early COVID-19 public health emergency (March-June 2020) with subsequent total medical costs and health care utilization among people with heart disease (HD). We created a longitudinal cohort of individuals with HD using MarketScan Commercial Claims data (2018-2022). We used difference-in-differences methodology adjusting for patients' characteristics, comorbidities, COVID-19 infection status, and number of in-person visits. We found that using telehealth during the stay-at-home order period was associated with a reduction in total medical costs (by -$1814 per person), number of emergency department visits (by -88.6 per 1000 persons), and number of inpatient admissions (by -32.4 per 1000 persons). Telehealth use increased per-person per-year pharmacy prescription claims (by 0.514) and average number of days' drug supply (by 0.773 days). These associated benefits of telehealth use can inform decision makers, insurance companies, and health care professionals, especially in the context of disrupted health care access.

Digital Health Literacy and Social Determinants of Health Affecting Telehealth Use by Athletic Trainers.

While increasing telehealth use throughout sports medicine has improved patients' access to health care, some communities may not have the same opportunities to connect with a provider. Barriers to telehealth implementation can be influenced by internal (eg,provider's digital health literacy and resources) and external (eg,community's social determinants of health or "SDOH") factors. This study aimed to assess the impact of internal and external factors on telehealth use by athletic trainers (ATs). Cross-sectional survey. In total, 767 ATs participated in the study. Participants (age = 39 [13]y) completed a survey containing the electronic health literacy scale and digital health literacy instrument, reported professional use of telehealth as a provider (yes/no), provided resources at their clinical site, and provided the zip code for the community they served. After data collection, the researchers extracted SDOH information using the zip code data from 2 US databases, including population density, median household income, poverty index, education level, and technology access. Chi-square or independent samples t tests were conducted to compare telehealth use by each SDOH factor. In total, 62.3% (n = 478/767) of ATs reported using telehealth, and 81.6% of ATs (n = 626) had a dedicated facility to offer health care services. We identified a significant difference in digital health literacy scores between users and nonusers of telehealth (P = .013). We did not identify any significant differences between telehealth users by community type (P = .957), population density (P = .053), income (P = .462), poverty index (P = .073), and computer (P = .211) or broadband internet access (P = .295). Our data suggest that internal factors such as digital health literacy and clinical site resources may have contributed to an AT's previous telehealth use in clinical practice. However, the SDOH data extracted from the community zip code where the AT provided clinical services were similar for those with and without previous telehealth use.

Exploration of the barriers and facilitators influencing use of telehealth for orthotic/prosthetic services in the United States of America: An orthotist/prosthetists perspective.

Innovative models of healthcare, such as telehealth, are required to meet the growing demand for orthotic/prosthetic (O&P) services. While O&P users report being very satisfied with telehealth, many clinical facilities have reverted to in-person modes of care as COVID-19 restrictions have eased. As such, there is a disconnect between benefits of telehealth to O&P users, and the clinical services being delivered in-person. The aim of this study was to explore the orthotist/prosthetist's perspective of the barriers and facilitators influencing use of telehealth in the United States of America (USA). O&P practitioners were recruited from across the USA. In-depth, semi-structured interviews were used to document practitioner demographics, the services being provided using telehealth, and practitioners' perspective of the barriers and facilitators influencing use of telehealth. Data describing participant demographics and services were summarised. Interviews were transcribed verbatim and analysed using thematic analysis. 30 practitioners from across the USA participated. Telehealth was used to deliver a range of O&P services including: initial evaluations, routine follow-ups, and delivery of a device in rare circumstances. Barriers to using telehealth included: poor phone/internet connection and lack of access to technology. Facilitators to using telehealth included: a patient-focussed attitude, and recognition of the benefit of telehealth. Telehealth is being used across the entire spectrum of O&P care. Once the significant barriers were resolved, like access to reliable internet/phone reception, telehealth was feasible. An outstanding telehealth experience was facilitated by practitioners who focused on the benefits that telehealth can provide (not the limitations), as well as giving O&P users agency over the choice to use telehealth. There are opportunities to improve access to safe and effective O&P telehealth services by adopting a right-touch approach to practitioner regulation, and advocating for reimbursement that supports better systems and procedures within clinical facilities.

Characterizing telehealth use in the US: analysis of the 2022 Health Information National Trends Survey.

Use of telehealth has been on the rise since the start of the COVID-19 pandemic. Although there has been much investigation of telehealth use in the context of replacing in-person visits, there has been limited study of patients' motivations for using telehealth. The objectives of this study were to (1) evaluate patient characteristics associated with telehealth use and (2) evaluate patients' motivations for using telehealth. We conducted a cross-sectional secondary data analysis of the 2022 nationally representative Health Information National Trends Survey. We conducted logistic regression models estimating the relationship between demographic and health characteristics and (1) use of telehealth services in the previous 12 months and (2) each of 5 motivations for using telehealth among telehealth users. The most common reason for using telehealth was recommendation or requirement by a clinician (73.6%). Respondents with depression were more likely to use telehealth than those without depression (OR, 2.73; P < .001) and were more likely to be motivated by convenience (OR, 1.80; P < .01), and Hispanic respondents were more likely to use telehealth to avoid exposure to infection (OR, 1.58; P < .05). Identifying patients' motivations may help decision makers better understand the perceived value of telehealth among patients and may help policy makers and administrators create opportunities for increased patient choice around visit modality to maximize health care access, value, and quality. Consideration of patient motivations for telehealth use may support practitioners in making tailored and person-centered decisions when recommending telehealth vs in-person visits.

Impact of Transportation Barriers on Telehealth Use During the COVID-19 Pandemic.

Telehealth use among individuals with and without transportation challenges remains understudied. This study aims to compare telehealth utilization and types of healthcare services between subjects with and without transportation challenges. Using data from the 2021 Medical Expenditure Panel Survey (MEPS), we identified telehealth use for office visits by adults (≥18 years old) in 2021, categorizing the type of healthcare services received, such as checkups and mental health counseling. Weighted logistic regression was employed to identify factors associated with telehealth usage. The total population analyzed was 204 621 985 (unweighted n = 17 674). The average (SD) age of the subjects was 49 (18) years old, and 53% were female. On average, individuals with transportation challenges had 1.40 telehealth visits, while those without such challenges had 0.87 visits (P = .03). Additionally, individuals with transportation challenges had more visits related to behavioral health compared to those without transportation challenges (22% vs 11%, P < .01). Those facing transportation challenges were 40% more likely to use telehealth compared to those without transportation challenges (OR = 1.40, P = .01). The findings suggest that telehealth could serve as a viable solution to overcome transportation barriers and improve access to care. However, it is crucial to assess access to care through telehealth to enhance the health outcomes for individuals facing transportation challenges.

Patient and Provider Experiences and Views on the Use of Telehealth in Genetics Clinics in Response to the COVID-19 Pandemic.

Introduction: The 2019 Coronavirus Disease (COVID-19) pandemic necessitated a mass transition in genetics clinics nationwide from in-person care to virtual care through telehealth. Before the COVID-19 pandemic, there was limited research on the use of telehealth in genetics specialties. Therefore, the COVID-19 pandemic presented a unique opportunity to study this emerging mode of care delivery in the setting of genetics clinics. This study described the scope of telehealth use in genetics clinics nationally and determined how COVID-19 influenced patients' decisions regarding their genetic care. Methods: Two anonymous surveys for patients and providers were developed. The patient survey was offered online to all genetics patients seen through telehealth at a Manhattan-based practice between March and December 2020. The provider survey was distributed through several listservs to genetics providers nationwide. Results: Patients (n = 242) and providers (n = 150) responded. Telehealth was used in all specialty genetics clinics for both initial and follow-up visits. Telehealth was both effective and satisfactory to patients for both visit types and across specialties; however, Asian and Hispanic/Latino patients had significantly lower mean satisfaction scores compared with White patients (p = 0.03 and 0.04, respectively). Patients appreciated telehealth for its convenience and to avoid COVID-19 exposure. Providers across specialties and provider types preferred telehealth for follow-up rather than initial visits. Several clinic initiatives related to telehealth were identified. Discussion: Telehealth was generally well received by both patients and providers, and is expected to become permanent option in genetics clinics. Further studies are needed to identify barriers to accessing telehealth.

Análise sob a perspectiva ocupacional do uso da telesaúde na terapia ocupacional em tempos de confinamento

Abstract Introduction The actions adopted with the purpose of avoiding community infections, during the COVID-19 pandemic, meant an occupational interruption since these measures prevented or restricted the participation in significant occupations of people. At the same time, the different health institutions and health professionals had to resort to telehealth to provide continuity of care. Objective To analyze from an occupational perspective the use of telehealth in Occupational Therapy in confinement contexts. Methodology Qualitative. Information is produced through focus groups and individual interviews. 9 students, 10 teachers, 5 users and/or family members and 5 members of the care teams participate in this study. An analysis of the thematic content is carried out through the triangulation of actors to integrate the opinions of all the participants, later in order to deepen the use of telehealth from an occupational perspective, theoretical triangulation is included. Results Telehealth as an occupation materializes the possibility of having socio-emotional support and allows collaboration in search of well-being in times of social isolation. It is also an occupation that allowed recognizing the home as a territory, in which the appropriation of material and relational resources occurs in a collaborative way between the treatment team and the users. Conclusions Telehealth is a collective occupation that allows re-existence in times of occupational interruption and new forms of occupational dislocation.

Motivation and Use of Telehealth Among People with Depression in the United States.

The global mental health crisis, compounded by the challenges of the COVID-19 pandemic, underscores the urgent need for accessible mental health care solutions. Telehealth services have emerged as a promising technology to address barriers to access mental health services. However, population-based studies examining telehealth utilization among individuals with depression are limited. Using data from the National Cancer Institute's Health Information National Trends Survey (HINTS) of 2022 (n = 4502), we investigated telehealth utilization among individuals diagnosed with depression in the United States. We employed multivariable logistic regression analysis to assess the association, adjusting for demographics, health behaviors, health status, trust in the medical system, and access to transportation. We also studied the factors that motivated the use of telehealth among individuals diagnosed with depression. In the multivariable adjusted logistic regression models, individuals diagnosed with depression (AOR 2.59, 95% CI 1.96-3.42) were significantly more likely to use telehealth services relative to individuals with no depression diagnosis. Other factors associated with increased telehealth use included women (AOR 1.36, 95% CI 1.07-1.72), Hispanic ethnicity (AOR 1.78, 95% CI 1.28-2.48), being married or living with a partner (AOR 1.30, 95% CI 1.05-1.62), frequent healthcare visits (AOR 2.31, 95% CI 1.71-3.11), health insurance coverage (AOR 1.86, 95% CI 1.04-3.34), confidence in self-care (AOR 1.38, 95% CI 1.07-1.78), and lack of reliable transportation (AOR 1.57, 95% CI 1.01-2.42). Major motivation factors that influenced telehealth use among individuals with depression primarily included convenience, such as reduced travel times, as well as clinicians' recommendations. Telehealth is a promising option for accessing mental health care, particularly for those with depression. Further research is needed to understand how well telehealth works and how it can be combined with traditional care, ensuring fair costs and keeping information safe.

A Comparative Analysis of Telerehabilitation and Telemedicine Utilization During the COVID-19 Pandemic in Poland: Trends, Patterns, and Implications.

The study aimed to examine the influence of COVID-19 on the adoption of teleservices in Poland, with a focus on contrasting patterns between rehabilitation and ambulatory care settings. We conducted a retrospective analysis of a national dataset to assess trends in telehealth use from 2020 to 2022. The use of teleservices peaked in April 2020 in both sectors. The share of the teleservices in the period of October 2020-December 2022 was much higher in the ambulatory (average 7,8%) than the rehabilitation sector (average 0,16%). Although, the analysis showed a moderate relationship between COVID-19 incidence and telehealth utilization (Spearman's rho from 0.39 and 0.52). Our findings demonstrate no statistically significant difference in Spearman's rho values between ambulatory care and rehabilitation, indicating a similar strength of response to the pandemic waves. Our findings underscore the importance of telehealth services in ensuring healthcare accessibility during times of crisis, emphasizing their role in facilitating continuity of care amidst pandemic-related disruptions. This study contributes to the understanding of telehealth utilization trends during the COVID-19 pandemic, offering insights into the adaptive responses of healthcare systems to unprecedented challenges. Further research is warranted to explore the long-term implications of telehealth use and to inform strategies for optimizing healthcare delivery in post-pandemic contexts.