Telemedicine Journal And E-health[JOURNAL]
Sun
200 papers
Application of Telemedicine for Mission Support-Importance of a Cost-Benefit Analysis.
Scheid PL, Padi D, Schvach H … +1 more , Scheid SE
Telemed J E Health · 2026 Jul · PMID 41951549 · Publisher ↗
BACKGROUND: Digital health is more relevant now than ever before, and interventions have a clear potential to improve the quality of care while reducing health care costs. Telemedicine has emerged as a transformative app...
BACKGROUND: Digital health is more relevant now than ever before, and interventions have a clear potential to improve the quality of care while reducing health care costs. Telemedicine has emerged as a transformative approach to health care delivery, particularly accelerated by the COVID-19 pandemic. In mission environments, telemedicine increasingly supports the management of acute injuries, chronic conditions, predeployment screening, and follow-up assessments, often using low-bandwidth store-and-forward modalities. METHOD: By reviewing existing literature and considering several different (heterogeneous) programs for "telemedicine for mission support," the key performance indicators are explored to evaluate telemedicine in missions, following its implementation. Both acute and chronic care use cases, as well as operational, clinical, and technical determinants of feasibility, were considered. RESULTS: This article presents the clinical, operational, and economic benefits of "telemedicine in missions" and the metrics for a comprehensive cost-effectiveness analysis or cost-benefit analysis, considering its economic and clinical impacts. CONCLUSIONS: Telemedicine in missions shows considerable differences from other telemedicine applications depending on the actors and the resulting circumstances. Considering the heterogeneity of the metrics provided, even within the field of "telemedicine in missions," the analyses have to be conducted in accordance with the encountered conditions. Nevertheless, a set of metrics can be applied to nearly all use cases across the different applications and actors. A mission-adaptable minimum data set is proposed to support standardized evaluation across diverse operational contexts.
Analyzing Vital Sign Variability in Remote Monitoring as a Predictor of 31-Day Heart Failure Readmission: A Retrospective Cohort Study.
Arif A, Kumar A, Elsener M … +2 more , Egan K, Jafri FN
Telemed J E Health · 2026 Jul · PMID 41943975 · Publisher ↗
INTRODUCTION: Heart failure (HF) is a major cause of morbidity and early hospital readmission in the United States. Remote patient monitoring (RPM) is increasingly used to support postdischarge care, but evidence remains...
INTRODUCTION: Heart failure (HF) is a major cause of morbidity and early hospital readmission in the United States. Remote patient monitoring (RPM) is increasingly used to support postdischarge care, but evidence remains mixed, and the prognostic value of day-to-day vital sign variability is unclear. This study evaluated whether physiologic variability and patient engagement during RPM were associated with 31-day HF readmission. METHODS: A retrospective cohort study included 213 patients with HF enrolled in a postdischarge RPM program from June 2022 to April 2024. Patients recorded daily weight, blood pressure, and heart rate for up to 31 days after discharge. Vital sign variability metrics were generated by flagging days with threshold-crossing measurements and summarizing these fluctuations over the RPM monitoring period. Adjusted logistic regression models evaluated associations with 31-day HF readmission. RESULTS: Pulse variability was significantly associated with 31-day readmission (OR 9.91, 95% CI 1.63-59.81, = 0.011), while variability in weight and blood pressure showed no significant associations. Total vital sign variability also predicted readmission (OR 6.93, 95% CI 1.71-28.16, = 0.007). Escalation outreach rate was strongly associated with readmission (OR 15.46, 95% CI 3.19-95.69, = 0.001). Maximum brain natriuretic peptide values were higher among readmitted patients ( = 0.019). CONCLUSION: Variability in physiologic measures captured through remote monitoring, particularly pulse variability and overall fluctuation burden, may serve as clinically meaningful indicators of early decompensation. These findings highlight the potential value of dynamic RPM patterns in postdischarge risk assessment.
Telehealth Use and Mammogram Utilization: Does This Relationship Differ Based on Perceived Barrier to Telehealth Use?
Sanjeevi N, Pflugeisen CM, Monsivais P … +3 more , Robison J, Zhong K, Amram O
Telemed J E Health · 2026 Jul · PMID 41937605 · Publisher ↗
BACKGROUND: The objective of the study was to understand barriers to telehealth use among women and to examine mammography uptake in relation to these barriers. For this purpose, we implemented a survey to explore barrie...
BACKGROUND: The objective of the study was to understand barriers to telehealth use among women and to examine mammography uptake in relation to these barriers. For this purpose, we implemented a survey to explore barriers to telehealth and use of cancer-preventative services. METHODS: Recruitment was based on electronic health record data from MultiCare Health System. Recruitment and enrollment of patients was initiated in 2024 and ended in March 2025, when the target sample size of 1,000 was reached. Women, aged between 50 and 75 years, were surveyed. Women with a personal history of breast cancer were excluded from the analyses. Among those included, 614 women had received virtual care in the previous 5 years, and 265 women had not received virtual care. Women who had 5 or more mammograms in the last 10 years were classified as 'optimal mammogram utilizers'. Those reporting 0-4 mammograms were identified as 'mammogram under-utilizers'. Logistic regression analyses examined the association of telehealth use with mammogram utilization. RESULTS: Compared to women who received virtual health care visits, women whose providers did not offer virtual care had significantly lower odds of optimal mammogram utilization. Lack of receipt of virtual care due to other reasons (i.e., technology issues and lack of preference/need) was not significantly associated with mammogram utilization. CONCLUSIONS: Study findings suggest that greater provider acceptance and use of telehealth for delivery of health care services could be associated with better mammogram utilization. Understanding barriers to provider acceptance of telehealth could inform efforts to expand telehealth.
Consumer Preferences for Telephone and Video Consultations: A Multinominal Regression Analysis Using National Survey Data.
Neil LJ, Mendis R, Kelly JT … +3 more , Haydon HM, Smith AC, Snoswell CL
Telemed J E Health · 2026 Jun · PMID 41896026 · Publisher ↗
ObjectivesTo examine the explanatory variables for consumers' selection of either telephone consultation or video consultation for specific health conditions, using multinomial regression analysis conducted on a national...
ObjectivesTo examine the explanatory variables for consumers' selection of either telephone consultation or video consultation for specific health conditions, using multinomial regression analysis conducted on a national survey dataset.MethodsA cross-sectional survey was conducted involving a sample of Australian adults who had used a telehealth service in 2021. An online sampling service by Qualtrics® enabled the recruitment of consumers that represented the Australian population in terms of gender, age, location (state or territory), and place of residence (urban or remote). Data collected included demographics, recent telehealth experience, and preferences for telephone or video consultation for different scenarios including varying time lengths and reasons for seeking a general practitioner.ResultsA total of 1,069 consumers completed the survey. In-person consultations at a clinic were the top preference in all clinical scenarios presented, except when needing a prescription or to receive test results. In these cases, telephone consultation was preferred. General videoconferencing experience in day-to-day life increased the likelihood of consumers choosing video consultations over in-person clinic visits for their general practitioner appointments. In addition, consumers' preferences for telephone consultations appear to be increased by internet connection issues and needing support to access technology.ConclusionsThis paper revealed that there are a variety of reasons influencing consumer preferences for health care modalities. It also demonstrated that increased exposure to videoconferencing increased consumer preferences for video consultations, particularly when seeking advice for chronic conditions, and decreased their likelihood of choosing telephone over in-person appointments, and that consumers avoid video consultations when they are experiencing technological issues or when they need support. The results of this survey give valuable insights into consumer preferences for telehealth and factors that may influence telehealth uptake within our health system.
Implementation and Evaluation of Virtual Care in Canadian Health Care Systems: A Scoping Review.
Yang B, Leader J, Bowes B … +9 more , Aiyer H, Dunn H, Adams SJ, O'Connell ME, McIntyre L, Dani H, Johnson R, Mendez I, Lovo S
Telemed J E Health · 2026 Jul · PMID 41882974 · Publisher ↗
OBJECTIVE: This scoping review examined available evidence in implementation and evaluation of virtual care in Canada. Virtual care saw recent uptake due to the COVID-19 pandemic; however, to ensure quality of care, rigo...
OBJECTIVE: This scoping review examined available evidence in implementation and evaluation of virtual care in Canada. Virtual care saw recent uptake due to the COVID-19 pandemic; however, to ensure quality of care, rigorous implementation and evaluation frameworks are needed. METHODS: Peer-reviewed and gray literature were searched to determine extent, range, and nature of evidence surrounding implementation and evaluation of virtual care based on the guidelines of the Joanna Briggs Institute. Although virtual care can encompass synchronous and asynchronous modalities, this review focused on synchronous virtual care, defined as real-time interactions between patients and providers via videoconferencing or telephone. Search included MEDLINE, EMBASE, Psych Info, and CINAHL databases and national and provincial health system, professional organization, and regulatory websites. Inclusion criteria included videoconferencing or telephone and English and French Canadian sources. Citations were screened by two researchers at title, abstract, and full-text levels. RESULTS: Two hundred and eight (208) manuscripts were included for analysis. High numbers of studies on patient satisfaction, process outcomes, and barriers were identified, with underrepresentation of health and systems outcomes and impact evaluations. There were very few studies examining hybrid care, planetary health, and use of virtual care with equity-deserving groups. DISCUSSION: This scoping review identified areas of importance for future research, including the use of virtual care in rural and remote regions, inpatient, long-term, and emergency settings, hybrid care, economic and planetary health impacts, and artificial intelligence. As well, enhancing standardization of implementation and evaluation guidelines will optimize quality of care and best practice.
Factors Associated with Patient Portal Use in a Nationally Representative Sample: Demographics and Savviness with Technology Influence Use of Portals.
Fischer SH, Roth E, Khodyakov D … +2 more , Lee Y, Predmore Z
Telemed J E Health · 2026 Jul · PMID 41879658 · Publisher ↗
BACKGROUND: Patient portals have become widespread since the passage of the American 21 Century Cures Act. However, little is known about how people are using these portals, especially for accessing telemedicine. METHODS...
BACKGROUND: Patient portals have become widespread since the passage of the American 21 Century Cures Act. However, little is known about how people are using these portals, especially for accessing telemedicine. METHODS: We investigated patterns patient portal usage among a nationally representative sample of United States adults, focusing on the demographic factors influencing access and engagement. Using the RAND American Life Panel, we surveyed 1,672 people to assess their experiences with various portal functions, including viewing test results, messaging providers, and scheduling appointments. RESULTS: Our findings reveal that about three-quarters of respondents had used portals to view test results and to access health records, about half have used to message a provider, schedule an appointment, or pay a bill. However, we found significant differences in portal usage with women, non-Hispanic white people, people with college degrees, and those with higher self-reported technological proficiency all more likely to use portals. CONCLUSIONS: These results highlight the need for targeted interventions to enhance accessibility and usability of patient portals, ensuring access to health care resources for all individuals, particularly those from underrepresented populations.
Exploring Telehealth Utilization Among Seniors in Community Wellness Centers in DC During the Pandemic.
Kwinze Smith B, Awuonda MK, Ofoegbu A … +6 more , Ettienne EB, Wingate L, Crowther Brown C, Bonnaire K, Eloy W, Mbami I
Telemed J E Health · 2026 Jul · PMID 41879219 · Publisher ↗
BACKGROUND: Telehealth utilization (TU) increased during the pandemic. Currently, there is limited literature on telehealth use among older adults. This study aims to examine the prevalence and predictive factors of tele...
BACKGROUND: Telehealth utilization (TU) increased during the pandemic. Currently, there is limited literature on telehealth use among older adults. This study aims to examine the prevalence and predictive factors of telehealth use among seniors from wellness centers in Washington, DC and to explore barriers associated with TU during the pandemic. METHODS: A cross-sectional study was done among members of senior wellness centers in DC who were ≥60 years old. Descriptive statistical analysis was conducted for all study variables. Logistic regression analyses were conducted to assess predictive factors of TU during the COVID-19 pandemic. Bivariable associations between telehealth barriers and study factors were also evaluated. All statistical analysis was conducted using SPSS version 28 at an alpha level of 0.05. RESULTS: A total of 105 seniors were included in the study. Of them, 72.4% were female, 57.7% had public health insurance, 88.6% were African American, and 48.6% reported they have remote visits using any type of device. Multivariable analysis showed that gender ( = 0.010), computer access ( < 0.001), communal housing ( = 0.039), and computer self-efficacy (CSE) ( = 0.047) were significant predictors of TU. Fear of fraud, navigation, and computer access were barriers identified as factors associated with gender, age, and having a remote connection, respectively. CONCLUSIONS: Findings showed that only 48.6% of seniors in DC used telehealth during the pandemic, with gender, computer access, communal housing, and CSE playing a significant role. More studies are needed to confirm our study findings. Targeted policies are needed to sustain telehealth use after the pandemic.
Relationships and Collaborations: A Foundation to Build On.
Doarn CR
Telemed J E Health · 2026 Apr · PMID 41844397 · Publisher ↗
Abstract loading — click title to view on PubMed.
Tele-Dance Interventions for Health Outcomes: A Scoping Review.
Shim M, Park SG, Smith D … +2 more , Uhler E, Lacson C
Telemed J E Health · 2026 Jun · PMID 41830552 · Publisher ↗
INTRODUCTION: The rapid expansion of telehealth, particularly during the COVID-19 pandemic, accelerated the development of technology-mediated movement interventions to support physical and psychological health. Among th...
INTRODUCTION: The rapid expansion of telehealth, particularly during the COVID-19 pandemic, accelerated the development of technology-mediated movement interventions to support physical and psychological health. Among these, tele-dance interventions (TDI) emerged as accessible and scalable models of care; however, a comprehensive synthesis of the evidence supporting these interventions remains limited. This scoping review maps existing literature on the feasibility, acceptability, and health-related outcomes of TDI across diverse populations. METHODS: Guided by Arksey and O'Malley's framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines, we conducted a systematic search of 6 electronic databases and identified 26 eligible studies employing quantitative, qualitative, or mixed-methods designs. Methodological quality was appraised using the Mixed Methods Appraisal Tool. All interventions were delivered synchronously via videoconferencing platforms and were primarily adapted from established in-person dance programs, typically incorporating warm-up activities, structured or improvisational movement, and cool-down phases. RESULTS: Across studies, TDI were consistently feasible and well accepted among older adults, individuals with neurological conditions, and people living with chronic illness. Psychosocial benefits, including enhanced social connection, improved mood, and reduced loneliness, were commonly reported. Physical outcomes such as improvements in balance, gait, and strength were also observed, suggesting potential functional benefits relevant to rehabilitation and health promotion. CONCLUSION: TDI offer important advantages, including increased accessibility, flexible delivery formats, and scalability beyond in-person care. However, limitations include methodological heterogeneity, small sample sizes, underrepresentation of diverse populations, and limited long-term follow-up. Overall, TDI represent a promising telehealth modality, warranting future research emphasizing methodological rigor, inclusive design, hybrid delivery models, and implementation-focused evaluations.
Socioeconomic Evaluation of Pediatric Teledermatology in a Tertiary Hospital.
Palazon Cabanes JC, Juan Carpena G, Palazon Cabanes B … +3 more , Berbegal De Gracia L, Martínez-Miravete MT, Betlloch-Mas I
Telemed J E Health · 2026 Jul · PMID 41830550 · Publisher ↗
INTRODUCTION: Comprehensive evaluation of teledermatology systems includes socioeconomic assessment. In 2021, we implemented an intervention to improve the use of teledermatology in the health care area of . This study a...
INTRODUCTION: Comprehensive evaluation of teledermatology systems includes socioeconomic assessment. In 2021, we implemented an intervention to improve the use of teledermatology in the health care area of . This study aimed to evaluate the socioeconomic impact of our intervention by comparing the costs and waiting times associated with teledermatology compared with conventional in-person care. MATERIAL AND METHODS: We designed a cost-effectiveness study from a health care system perspective using 2021 data. The monetary variables included the costs of the materials, application software, and training associated with teledermatology, as well as the costs of the consultations in both modalities. Our clinical outcome variable was waiting time until evaluation by a pediatric dermatologist. Using these data, we calculated an incremental cost-effectiveness ratio, then performed a sensitivity analysis. We also calculated the break-event point between the two modalities, based on the percentage of remote resolution of teleconsultations. RESULTS: There were 357 teleconsultations in 2021, and we estimated 3,108 conventional referrals. The average per-patient cost of teledermatology was EUR 22.97 more than conventional care, with a cost-effectiveness ratio of EUR 0.21/day saved, which increased to EUR 0.35/day saved in the sensitivity analysis. To balance the costs of the two modalities, 84% of teleconsultations would need to be resolved remotely. CONCLUSIONS: Teledermatology is more expensive than conventional in-person care but is a cost-effective option from a health care system perspective.
Mental Health and Substance Use Treatment Telehealth Shifts During COVID-19 by Race, Ethnicity, and Population Density.
Benitez AD, Gong CH, Stewart M … +1 more , Acevedo A
Telemed J E Health · 2026 Jun · PMID 41822945 · Publisher ↗
OBJECTIVE: Telehealth can increase health care utilization for substance use disorder (SUD) and mental health (MH) services, particularly for underserved populations. We examined shifts to telehealth for SUD and MH servi...
OBJECTIVE: Telehealth can increase health care utilization for substance use disorder (SUD) and mental health (MH) services, particularly for underserved populations. We examined shifts to telehealth for SUD and MH services during the COVID-19 public health emergency and whether they occurred similarly by race, ethnicity, and population density. METHODS: We used data from the 2021 to 2022 National Survey on Drug Use and Health, focusing on adults with an SUD and/or MH condition in the past year. Estimated prevalence of SUD and MH appointments shifting from in-person to telehealth and used adjusted logistic regression models to examine differences by race, ethnicity, and population density. Sample sizes ranged from 2,440 to 9,695 (∼11-42 million weighted), depending on condition and outcome. RESULTS: Approximately 26% of adults with an SUD reported their SUD appointments shifted to telehealth, whereas 66% of adults with an MH condition reported their MH appointments shifted to telehealth. Black (59%) and Latinx (61%) adults with an MH condition were significantly less likely to report appointment shifts to telehealth than White adults (69%, < 0.01 for both). Individuals in less populated areas were significantly less likely to report their SUD and MH appointments shifted to telehealth, compared with those in highly populated areas. CONCLUSION: Shifts to telehealth were less common for SUD than MH appointments. Rates differed by race and ethnicity. Telehealth was underutilized by those in less populated areas. Research to identify barriers for telehealth services and strategies to ensure telehealth equity in the present day are needed.
Effect of State Medicaid Reimbursement Policies on Telehealth Visits in Community-Based Health Centers.
Larson AE, Escarce JJ, Ettner SL … +1 more , Leung LB
Telemed J E Health · 2026 Jun · PMID 41817962 · Publisher ↗
PURPOSE: Over the past several years, states began formally enacting telehealth policies to avail audio-only services for those unable to receive care in-person or over video. Such policies may be especially important in...
PURPOSE: Over the past several years, states began formally enacting telehealth policies to avail audio-only services for those unable to receive care in-person or over video. Such policies may be especially important in community-based health centers (CHCs) where, when telehealth is provided, it is primarily via audio-only. This retrospective study examined whether codified policies for Medicaid reimbursement and payment parity of audio-only telehealth were associated with greater use of telehealth. METHODS: Electronic health records for Medicaid-insured adults 18-64 years with visits to primary care ( = 700,051) and to behavioral health care ( = 95,136) in 433 primary care and 279 behavioral health care CHCs from April 1, 2021, to March 31, 2023, were analyzed. We collected policies using standardized legal mapping methods to identify audio-only telehealth policies having: (1) no reimbursement for telehealth, (2) reimbursement for telehealth, but no payment parity, or (3) reimbursement for telehealth, at parity. RESULTS: One-third of primary care visits were telehealth, most of which were audio-only. Two-thirds of behavioral health care visits were telehealth, half of which were audio-only. Primary care visits in states with audio-only telehealth reimbursement policies not at parity were 4.8 percentage points more likely, and behavioral health care visits in states with reimbursement at parity were 3.2 percentage points more likely to use telehealth. CONCLUSIONS: While audio-only telehealth reimbursement only modestly impacted overall telehealth utilization, Medicaid policies remain one of the few mutable factors important for primary care and behavioral health care access among safety-net populations.
Individuals' Perceptions of the Efficacy, Quality, and Safety of Care Accessed via a Telemedicine Platform: A Retrospective Analysis of Survey Data.
Yu JS, Bohl M, Governale L … +3 more , Mochida S, Beasley K, Carroll P
Telemed J E Health · 2026 May · PMID 41797533 · Publisher ↗
INTRODUCTION: The use of telemedicine, including direct-to-consumer telemedicine, has increased significantly, yet there are concerns about the quality and safety of care accessed via this model. The current study retros...
INTRODUCTION: The use of telemedicine, including direct-to-consumer telemedicine, has increased significantly, yet there are concerns about the quality and safety of care accessed via this model. The current study retrospectively analyzed survey data from individuals about their perceptions of the efficacy, safety, and quality of care they accessed through a telemedicine platform. METHODS: An online survey, originally intended for the purposes of quality improvement, was sent to individuals who had accessed treatment via a national telemedicine platform. The survey, made available between June 30, 2025 and July 3, 2025, consisted of 22 questions that queried individuals about their experience with the platform. Data were de-identified and retrospectively analyzed, with descriptive statistics used to report on the number and percentage of participants who indicated agreement with survey items. RESULTS: The survey was completed by 2,399 participants. Overall, participants (>80%) reported a positive experience pertaining to the quality and safety of care accessed via the platform. The majority (>90%) of participants reported a positive experience with the online clinical intake and with providers on the platform. Participants consistently (>90%) rated their overall experience with the platform as equal to or better than prior in-person health care experiences. There was variability with regard to participants' awareness of specific safety practices implemented by the platform. DISCUSSIONS: Our findings indicate that the majority of individuals who engaged with the telemedicine platform had positive perceptions of the efficacy, quality, and safety of the care they received and viewed the experience as rivaling care they had previously received in an in-person setting.
Deployment of Low-Latency Satellite Technology for Telemedicine: A Backhaul Solution for Improving Rural Health Care Connectivity in Developing Countries.
Padi D, Nyapom K, Scheid PL
Telemed J E Health · 2026 Apr · PMID 41797528 · Publisher ↗
BACKGROUND: In developing countries, satellite-based technology can aid critical telemedicine applications and other digital health services in critically underserved areas. Affordable, high-speed broadband services can...
BACKGROUND: In developing countries, satellite-based technology can aid critical telemedicine applications and other digital health services in critically underserved areas. Affordable, high-speed broadband services can and should be accessible to all citizens. Remote locations are necessary to support various critical services, including education and training, telehealth applications, remote patient monitoring, and warning systems, particularly during disasters. Currently, however, these services are limited to urban centers, leaving rural areas without access to specialized health care services. This digital divide significantly impacts health care delivery, with only 48% of rural populations having internet access compared with 83% in urban areas. METHODS: The goal of this study was to assess the suitability of Geostationary Earth Orbit (GEO), Medium Earth Orbit (MEO), and Low Earth Orbit (LEO) satellites for telemedicine and health care backhaul connectivity. To achieve this, the study conducted a comparative analysis of the systems, highlighting their respective advantages and limitations in terms of latency, coverage, and deployment costs. A systematic literature review and the assessment of real-world case studies and worldwide datasets complemented this analysis. Case studies from Starlink deployments in North America and Sub-Saharan Africa and Amazon's Project Kuiper were evaluated. RESULTS: LEO satellites demonstrated significantly lower latency (20-50 ms) compared with MEO (100-300 ms) and GEO (600 ms) systems. Cost analysis revealed LEO services ($110-$500 per month) were substantially more affordable than MEO ($250-$1,000 per month) and GEO ($500-$2,000 per month) alternatives. Starlink deployments achieved download speeds of 50-250 Mbps with sub-50 ms latency, enabling real-time telemedicine consultations that met clinical standards. Rural telemedicine consultations increased by over 300% in areas with LEO satellite coverage. CONCLUSIONS: Our findings suggest that the LEO Starlink satellite technology would provide the most cost-effective backhaul broadband connectivity for real-time telemedicine services, given its low latency needs (20-50 ms), which enable high-quality video calls and remote diagnostics. We recommend using an LEO-based satellite network as the best approach to extend internet services to underserved remote communities due to its low latency and cost-effectiveness in aiding health care delivery in developing countries.
A Multidimensional Cross-Sectional Impact Assessment of Teleconsultation Services at Emirates Health Services, United Arab Emirates.
Ibrahim M, AlHammadi A, AlHamadi A … +5 more , Pilankuveedu S, Naqvi SA, Vinodson B, Preman N, Khan Y
Telemed J E Health · 2026 Apr · PMID 41797526 · Publisher ↗
BACKGROUND: Teleconsultation services have emerged as vital components of digitally enabled, sustainable health care delivery. Emirates Health Services (EHS) launched its e-visits program to enhance outpatient care acces...
BACKGROUND: Teleconsultation services have emerged as vital components of digitally enabled, sustainable health care delivery. Emirates Health Services (EHS) launched its e-visits program to enhance outpatient care accessibility, operational efficiency, and environmental stewardship. The objective of this research was to conduct a comprehensive evaluation of the E-visits program over 2023-2024, assessing its financial, environmental, and societal value. METHODS: A retrospective cross-sectional study was conducted using electronic health record data across all qualifying EHS facilities. Multidimensional analyses evaluated direct consultation cost reductions, physician time savings, carbon emission mitigation, and broader societal benefits. Uniquely, the study incorporated an opportunity cost framework that estimated the economic value of time saved by employed patients-a dimension often overlooked in telehealth evaluations. Subgroup analyses ensured demographic and geographic representation. RESULTS: E-visits accounted for a substantial proportion of consultations, particularly among women (65.9%) and working-age patients. Physician time savings averaged more than 4 min per consultation, equating to more than 14 full-time employees' time saved on average. The program averted approximately 5,920.8 metric tons of CO emissions. Uniquely, this study estimated over United Arab Emirates Dirham (AED) 50 million in combined annual savings, including not only organizational efficiencies but also patient-level and community-wide economic gains-such as reduced travel and fuel costs and opportunity cost savings from recovered work hours. The calculated net present value over 2 years exceeded AED 65 million. CONCLUSION: This study presents a novel and comprehensive model for evaluating telehealth impact, uniquely quantifying opportunity costs for employed patients alongside community and organizational benefits. The findings demonstrate how E-visits can drive transformational change across multiple domains of value, reinforcing the case for sustainable, digital-first care models.
Poststroke Telehealth Utilization Patterns Across Gender, Geography, Insurance, and Age in Arkansas.
Walker B, Owsley K, Bravo R … +3 more , Alsulimani A, Shi L, Longo M
Telemed J E Health · 2026 Apr · PMID 41797525 · Publisher ↗
BACKGROUND: Stroke is a major cause of death and disability. Prior strokes increase the risk of subsequent strokes, and follow-up care is important yet underutilized for recurrence prevention. METHODS: We used data from...
BACKGROUND: Stroke is a major cause of death and disability. Prior strokes increase the risk of subsequent strokes, and follow-up care is important yet underutilized for recurrence prevention. METHODS: We used data from the Arkansas All-Payer Claims Database (2017-2022) on patients with a prior stroke diagnosis. We plotted trends in telehealth use, stratified by gender, rurality, insurance (private vs. Medicaid), and age (18-44 vs. 45-64), and used chi-square tests to assess differences. We then used regression analysis to assess whether telehealth impacted overall office visit utilization through the COVID-19 pandemic era. RESULTS: Telehealth surged during the first year of the COVID-19 pandemic before settling at levels higher than baseline. Telehealth utilization patterns varied by gender, insurance, and age. Telehealth generally offset pandemic-associated loss of in-person care across all groups for the first two years of the pandemic. One exception was its use by insurance type, in which total care decreased among Medicaid beneficiaries but increased among the commercially insured. CONCLUSION: Our findings highlight four patterns: (1) telehealth utilization among poststroke patients increased sharply but then steadily declined, settling at higher-than-prepandemic levels; (2) telehealth generally staved off in-person care losses; (3) patterns and levels of telehealth use varied by demographic group; and (4) heterogeneities in use by insurance highlight both the potential benefits of telehealth in increased care utilization but also caution against its ability to completely mitigate a decrease among vulnerable populations. Overall, telehealth may serve as an effective tool to increase follow-up visits and support recurrent stroke prevention.
Administrative and Logistical Considerations Essential for Success of Virtual Mental Health Clinics for Rural Native Veterans.
Day SC, Hoggan G, Lindsay J … +1 more , Shore J
Telemed J E Health · 2026 Apr · PMID 41797524 · Publisher ↗
INTRODUCTION: Native Americans enlist in the military at the highest per capita rate among racial or ethnic groups. Approximately 49% of Native Veterans live in rural areas, facing multiple barriers to health care and a...
INTRODUCTION: Native Americans enlist in the military at the highest per capita rate among racial or ethnic groups. Approximately 49% of Native Veterans live in rural areas, facing multiple barriers to health care and a high prevalence of mental health concerns. Video telehealth can improve access to care, and Veterans Health Administration has developed a culturally centered telehealth model for native Veterans. Personalized Implementation of Virtual Treatments for Rural Native Veterans (RNVs), an approach emphasizing cultural safety, helped expand the impact of existing telehealth clinics. METHODS: Recent efforts included a systematic program review and mixed-methods evaluation to identify logistical and administrative considerations for implementation and outreach. RESULTS: Key lessons emphasize protected clinical time for specific regions, building sustained community partnerships, collaborating with leadership, and streamlining messaging to improve patient engagement. CONCLUSIONS: These practices expand care access and quality for RNVs, with potential application to other populations.
Uneven Access: How Rurality and State Policies Shaped Telehealth Provision to Medicaid Enrollees, 2020-2021.
Bodas M, Park YH, Luo Q … +1 more , Vichare A
Telemed J E Health · 2026 Apr · PMID 41797521 · Publisher ↗
OBJECTIVE: This study assesses how providers delivered telehealth services to pregnant Medicaid enrollees, using multistate Medicaid claims data. It also examines how provider rurality and state-level telehealth policies...
OBJECTIVE: This study assesses how providers delivered telehealth services to pregnant Medicaid enrollees, using multistate Medicaid claims data. It also examines how provider rurality and state-level telehealth policies influenced provision. METHODS: We analyzed claims data on telehealth provision from the Transformed Medicaid Statistical Information System Technical Analytic File from January 2020 to April 2021. Monthly telehealth provision was estimated for family physicians, obstetricians and gynecologists, nurse practitioners, and physician associates, and variations therein were examined by rurality and state policy. RESULTS: Telehealth provision peaked in April 2020, when 19.5% of providers delivered at least one telehealth service. At the peak in April 2020, rural providers were less likely to provide telehealth than urban providers (15.2% vs. 20.6%), and states with telehealth-supportive policies saw higher provision of telehealth by providers (20.9%) than those without (14.3%). Throughout the study period, rural providers from all specialties in nonsupportive policy states showed the lowest telehealth provision. CONCLUSIONS: Provider location rurality and state policy environments significantly influenced telehealth provision. Sustained policy support is essential to ensure equitable access to perinatal care.
Cost-Effectiveness Analysis of the Multicenter Scale-Up of the SAFE@Home Telemonitoring Platform for Blood Pressure and Symptoms in Women with Hypertensive Disorders of Pregnancy.
Moes SL, van Lieshout C, Kvamme I … +15 more , Schuit E, In 't Anker E, Dirken J, van Eerden L, Franx A, Gordijn SJ, de Heus R, Koenen S, Lely AT, van der Made F, Santegoets L, Spaanderman M, Ahaus K, Depmann M, Bekker MN
Telemed J E Health · 2026 May · PMID 41797520 · Publisher ↗
INTRODUCTION: Health care systems are increasingly pressured by workforce shortages and increasing chronic conditions. Hypertensive disorders of pregnancy (HDP) require frequent monitoring. Telemonitoring of blood pressu...
INTRODUCTION: Health care systems are increasingly pressured by workforce shortages and increasing chronic conditions. Hypertensive disorders of pregnancy (HDP) require frequent monitoring. Telemonitoring of blood pressure (BP) offers a promising alternative for components of hospital care, potentially improving outcomes and reducing costs. Following cost-saving results from the SAFE@home pilot, this study conducts a cost-effectiveness analysis (CEA) of SAFE@home versus care as usual (CAU) at scale. METHODS: A CEA was conducted within the SAFE@home II multicenter before-after study. Women with high risk of or established HDP received remote BP monitoring as part of hybrid care. The controls received CAU. Antenatal costs were calculated in euros. Cost-effectiveness was measured as the absolute risk reduction (ARR) in adverse outcome and the incremental cost-effectiveness ratio (ICER) as the cost per adverse outcome prevented. RESULTS: Mean antenatal costs per patient were €6,756 (standard deviation [SD] €5,144) in the SAFE@home group and €7,142 (SD €5,149) in the CAU group, corresponding with a cost reduction of €368 (5.4%) using telemonitoring. The ARR was 4.3% and resulted in a negative ICER. Health care consumption per adverse outcome revealed cost savings during pregnancy of €765 per participant with an adverse outcome. Fewer HDP-related admissions (12.0% vs. 15.5%, = 0.039) in the SAFE@home group compared with CAU supported cost-effectiveness. CONCLUSION: This CEA demonstrated that at scale, SAFE@home modestly reduces costs. With lower costs per adverse outcome resulting in a negative ICER, SAFE@home dominates CAU. Future research should explore how telemonitoring can optimize use of resources. In conclusion, addressing adoption barriers is essential to sustainably integrate telemonitoring.
Hospitalizations for Ambulatory Care Sensitive Conditions and Provider-to-Provider Telephone Consultations in Brazil: An Ecological Study from TelessaúdeRS.
Bezerra de Medeiros LE, Rados DV, Roman R … +4 more , de Oliveira EB, Katz N, Gonçalves MR, Giugliani C
Telemed J E Health · 2026 May · PMID 41797518 · Publisher ↗
INTRODUCTION: Provider-to-provider consultations may improve primary health care (PHC), but empirical data are limited. Hospitalizations for ambulatory care sensitive conditions (ACSC) indicate PHC quality. We aim to add...
INTRODUCTION: Provider-to-provider consultations may improve primary health care (PHC), but empirical data are limited. Hospitalizations for ambulatory care sensitive conditions (ACSC) indicate PHC quality. We aim to address the effects of synchronous telephone-based discussions on ACSC hospitalizations. METHODS: We performed an ecological observational temporal series study based on secondary data. All municipalities of Rio Grande do Sul (Brazil's southernmost state) were eligible; lack of data was the sole exclusion criterion. The main factor explored was the annual rate of consultations per 1,000 inhabitants from 2014 to 2019. Other factors considered included municipality typology (urban or nonurban), poverty, hospital bed rate, PHC coverage, and non-ACSC hospitalizations. The primary outcome was the rate of ACSC hospitalizations per 1,000 inhabitants from 2014 to 2019. Both comparisons between and within municipalities were assessed. The association between the exposure variables and the outcome was explored using a hierarchical multivariable model with a generalized estimating equations (GEE) analysis. RESULTS: Out of 497 municipalities, one was excluded due to lack of data. Between 2014 and 2019, there was an increase in the usage of consultations and a reduction in ACSC hospitalizations. In the final model, time, poverty, municipality typology, hospital bed rate, non-ACSC hospitalization, and consultations were all associated with ACSC hospitalization. After adjusting for the possible confoundings, the GEE model prediction showed that a higher number of consultations between- and within-municipalities was associated with a lower rate of ACSC hospitalization. DISCUSSION: The presented data suggest that increased consultation usage is associated with improved PHC performance.
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