Hallal R, Abdul Aal S, Wahab M
… +3 more, Sakan MA, Hadla R, Zahed K
Telemed J E Health
· 2025 Dec · PMID 40982360
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Continuous improvement of health care is bound to the technological advancements affecting the quality of patient care, especially Health Information Management. The objective of our work was to assess the usability and...Continuous improvement of health care is bound to the technological advancements affecting the quality of patient care, especially Health Information Management. The objective of our work was to assess the usability and end-user perception of Health Information Systems (HISs) which is pivotal to improve overall efficiency in medical centers. To understand the intricacies of assessing the usability of such systems at Hospitals, we conducted a rapid review guided by PRISMA, utilizing Medline and CINHAL databases, which resulted in 10,960 articles. Initially, these articles were screened by title and abstract, followed by full text screening with two groups of two reviewers each, which led to the inclusion of 98 articles in the final thematic analysis. The rapid review resulted in ten major themes which offered a comprehensive framework for assessing the HIS user experience from the perspective of hospital end-users. These themes include: operational impact & usefulness, usability & interface, reliability & connectivity, impact on patient care, interruptions, hardware, user proficiency & training, service desk & information technology support, collaboration & communication, and security. The main findings suggest that the various HIS services are effective tools that enhance clinical workflows and subsequently patient care. However, some usability issues, such as complex system designs, interruptive alerts and system crashes should be addressed to improve health care staff's health care user experience. Future research should examine customized HIS designs to decrease workflow interruption, minimize workload, and improve staff productivity, which would ultimately optimize the user experience.
AlZabin A, Almajed E, Alqntash N
… +4 more, Khaytan S, Alkhodier AA, Alhijab K, AlMujil AS
Telemed J E Health
· 2025 Dec · PMID 40982352
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Telehealth has emerged as a transformative tool in modern health care, enhancing access and efficiency. However, in Saudi Arabia, patient-level insights into its adoption, particularly within family medicine, remain limi...Telehealth has emerged as a transformative tool in modern health care, enhancing access and efficiency. However, in Saudi Arabia, patient-level insights into its adoption, particularly within family medicine, remain limited. Understanding public knowledge, attitudes, and perceived barriers is essential for informed policy and practice. This study aimed to assess patients' knowledge, perceptions, satisfaction, and perceived barriers toward telehealth services in family medicine settings across Saudi Arabia. A cross-sectional study was conducted using a structured, self-administered online questionnaire distributed via social media and in-clinic recruitment. The sample included 775 adult participants with at least one telehealth encounter. Data were analyzed using descriptive statistics, Pearson correlations, and multivariable logistic regression to identify factors influencing telehealth knowledge and satisfaction. Participants showed moderate knowledge and favorable perceptions toward telehealth, with 58% having used such services. Telehealth was perceived to reduce unnecessary visits (65.3%) and costs (63.6%). Satisfaction was reported by 53.2% of participants and correlated strongly with knowledge and positive perceptions. Diagnostic reliability (46%), patient resistance (43%), and technological limitations (38%) were the most cited barriers. Higher knowledge was significantly associated with female gender, younger age, Saudi nationality, central region residence, and social media use ( < 0.05). Patients demonstrated overall positive attitudes toward telehealth, but concerns about diagnostic accuracy and technological access remain. Tailored educational initiatives and technological improvements are necessary to address these barriers, promote equitable telehealth adoption, and enhance patient satisfaction in family medicine services.
Telemed J E Health
· 2025 Dec · PMID 40977326
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Field hospitals (FHs) are vital in responding to natural disasters, pandemics, and conflicts. Yet, challenges such as delayed deployment, limited resources, and a narrow focus on trauma care often hinder their impact. Th...Field hospitals (FHs) are vital in responding to natural disasters, pandemics, and conflicts. Yet, challenges such as delayed deployment, limited resources, and a narrow focus on trauma care often hinder their impact. This study examines how integrating telemedicine can enhance FH operations and adapt health care delivery to evolving disaster contexts. Drawing on a structured literature review and expert input, two conceptual models are proposed to map health care needs over time and the role of telemedicine. In sudden-onset disasters, telemedicine aids early trauma care, addresses rising non-trauma needs during recovery, and supports continuity of care post-deployment. In slow-onset crises, such as prolonged conflicts or epidemics, telemedicine plays an even more central role in maintaining routine and elective services as systems weaken. The findings underscore telemedicine's ability to extend clinical reach, reduce reliance on physical infrastructure, and offer scalable support in emergencies. It bridges critical care gaps beyond the operational timeline of FHs. Although challenges in trust and implementation persist, strategic use of telemedicine can greatly improve the flexibility and effectiveness of disaster medical response. This study advocates a paradigm shift in FH planning, positioning telemedicine as a core component of both disaster medicine response and long-term recovery.
Jaske E, Wheat CL, McCann R
… +3 more, Nelson K, Wahlberg L, Felker B
Telemed J E Health
· 2025 Dec · PMID 40931792
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The Veterans Health Administration (VHA) Clinical Resource Hubs (CRHs) provide telemental health (TMH) services to improve access for Veterans, but use varies greatly across clinics. A retrospective FY23 analysis examin...The Veterans Health Administration (VHA) Clinical Resource Hubs (CRHs) provide telemental health (TMH) services to improve access for Veterans, but use varies greatly across clinics. A retrospective FY23 analysis examined all VHA outpatient mental health encounters. Clinics were categorized by CRH-MH use and level of CRH-MH penetration. Descriptive statistics, LASSO regression, and fixed-effects models identified key patient and clinic predictors. Of 920 clinics, 218 used CRH-MH services. Clinics using CRH-MH services were larger, more likely to be VA medical centers, and had higher community care referrals. High-penetration sites were smaller, rural clinics with longer travel distances and lower community care use. Large sites appear to use CRH-MH alongside existing resources to manage complex needs, while smaller rural sites rely heavily on CRH-MH to fill service gaps. Targeted strategies can strengthen CRH-MH integration, expand Veteran mental health access, and guide similar MH implementations in other health systems.
Barshay M, Zang C, Bolden T
… +7 more, Rosenfeld L, Marko K, Sudimack A, Sebastian A, Loganathan A, Ma Y, Meltzer AC
Telemed J E Health
· 2025 Dec · PMID 40865115
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Mobile technology may enhance traditional prenatal care by supporting screening and patient compliance. Although prior studies report high satisfaction with mobile prenatal technologies, the impact of integrating remote...Mobile technology may enhance traditional prenatal care by supporting screening and patient compliance. Although prior studies report high satisfaction with mobile prenatal technologies, the impact of integrating remote patient monitoring (RPM) into routine workflows on clinical outcomes remains uncertain. This retrospective study assessed whether higher engagement with RPM via the Babyscripts™ digital health platform was associated with increased detection of preeclampsia (PEC). In this university-based obstetric practice, pregnant patients received the Babyscripts™ platform in addition to standard care. The platform enabled tracking of gestational weight gain and blood pressure and delivered scheduled education on symptoms and screening tests. Patients were included if they initiated RPM use before the end of the first trimester; those without available pregnancy outcomes were excluded. Chart reviews were performed using structured data forms by trained abstractors. RPM engagement was defined as the percentage of weeks with at least one remote blood pressure measurement. Outcomes included PEC and a composite of maternal complications. Multivariate logistic regression identified predictors of engagement. A total of 823 patients were included: 28% identified as Black, 32% were Medicaid/Medicare recipients, 43% were over age 35, and 5% had a history of hypertension. Thirty-seven patients developed PEC or pregnancy-induced hypertension. Living in a distressed community and having at least one prior full-term pregnancy were associated with reduced engagement, with decreases of 7.9% (95% confidence interval [CI]: 1.2-14.6%) and 12.2% (95% CI: 5.2-19.1%), respectively. There was a nonsignificant trend toward increased detection of PEC with higher RPM engagement (odds ratio: 1.014, 95% CI: 0.999-1.846). Higher maternal age and first-time pregnancy were associated with increased RPM engagement, while living in a distressed community was linked to lower engagement. There was a nonsignificant positive association between RPM engagement and detection of PEC. Future studies should explore whether engagement with digital health platforms in prenatal care can modify risk factors for pregnancy complications.
Kim YK, Han SH, Sanghavi K
… +1 more, Bangerter LR
Telemed J E Health
· 2025 Dec · PMID 40844501
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The extension of Medicare telehealth waivers, following the COVID-19 public health emergency, presents an unprecedented opportunity to examine the longitudinal relationship between telehealth usage and cognitive function...The extension of Medicare telehealth waivers, following the COVID-19 public health emergency, presents an unprecedented opportunity to examine the longitudinal relationship between telehealth usage and cognitive functioning in later life. We analyzed transitions in telehealth use and investigated whether associations between telehealth use and cognitive functioning vary across different levels of cognitive performance. Using a longitudinal cohort design with data from the National Health and Aging Trends Study (2021-2023), we examined patterns of telehealth access and use among Medicare beneficiaries aged 70+ ( = 3,116). Cognitive functioning was assessed using a comprehensive battery measuring memory, orientation, and executive function. We categorized telehealth access/use into four categories: (1) no access to internet-enabled devices, (2) basic use (email/texting only), (3) broader internet use without telehealth, and (4) telehealth use. Using unconditional quantile regression with fixed effects, we examined associations between telehealth access/use and cognitive functioning across the cognitive performance distribution. While 64% of telehealth users maintained their usage over consecutive years, 44% of those without device access remained without access. Compared to basic internet use, lack of access to internet-enabled devices was associated with cognitive decline (b = -0.64, < 0.05), whereas telehealth use was associated with better cognitive functioning (b = 0.57, < 0.01). The association between telehealth use and cognitive functioning was only significant at the lower end of the cognitive distribution (10th percentile: b = 1.43, < 0.01), with no significant associations observed at higher levels. The stable nature of digital access and usage over time-with most older adults either maintaining their initial level or showing limited upward mobility in digital engagement-underscores the importance of early intervention to promote internet access and skills. Telehealth use was linked to cognitive benefits only at the lower end of the distribution, suggesting the importance of targeted interventions to promote telehealth access among the older population at risk of cognitive impairment.
Telemed J E Health
· 2025 Dec · PMID 40839011
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The COVID-19 pandemic accelerated the global adoption of telemedicine; however, the triadic model of assisted remote care, where nursing assistants or caregivers facilitate patient interaction with remote physicians, rem...The COVID-19 pandemic accelerated the global adoption of telemedicine; however, the triadic model of assisted remote care, where nursing assistants or caregivers facilitate patient interaction with remote physicians, remains underutilized. This narrative review examines the challenges and opportunities associated with assisted telemedicine globally, with a particular focus on the Israeli health care system. Emphasis is placed on health care providers' attitudes, as well as the competencies and training required for effective care delivery within this model. The review of PubMed, Scopus, and Google Scholar publications was conducted from 2015 to 2025. Evidence suggests that assisted telemedicine contributes to improved patient outcomes, including reduced hospitalizations and mortality among those with chronic conditions. In Israel, despite a robust digital infrastructure, the health care system faces professional shortages, particularly in nursing and secondary care. While current remote services are mostly phone-based, studies indicate that the triadic model of assisted care can enhance diagnostic accuracy, streamline physician workflows, and improve continuity of care. The triadic model of assisted telemedicine holds considerable potential for equitable, efficient, and high-quality care. Its success relies on the establishment of clear protocols, robust technological platforms, ethical safeguards, and comprehensive training initiatives for all participants involved.
Larson AE, Der-Martirosian C, Boston D
… +1 more, Gold R
Telemed J E Health
· 2025 Dec · PMID 40828006
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Medically complex community-based health center (CHC) patients face barriers accessing specialty care. Electronic consultations (eConsults) could mitigate these barriers by improving CHC providers' access to specialist k...Medically complex community-based health center (CHC) patients face barriers accessing specialty care. Electronic consultations (eConsults) could mitigate these barriers by improving CHC providers' access to specialist knowledge. We described patient, provider, and clinic characteristics of eConsult utilization in CHCs. Analyzed electronic health record data from adult patients from April 1, 2021, to March 31, 2024. Among 1,690,788 patients and 13,769 providers from 437 CHC sites (18 states), there were 20,066 eConsults (17,066 patients; 1,390 providers), with wide variation in the characteristics of patients for whom providers requested eConsults. Ten percent of providers ever requested an eConsult, with the highest rates among nurse practitioners and physicians; 73% of providers who requested an eConsult did so <10 times. eConsult documentation rates were highest in urban CHCs. We found substantial variation in eConsult use in CHCs. Opportunities to support specialty care access for CHC patients should be further explored.
Jones CD, Peng C, Jones RD
… +7 more, Smith D, Leal K, Leal M, Meyers S, Bogulski CA, Porter A, Eswaran H
Telemed J E Health
· 2025 Nov · PMID 40789652
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The American Academy of Pediatrics recommends that infants be exclusively breastfed for a minimum of 6 months; however in Arkansas, only 23.8% of mothers are exclusively breastfeeding at 6 months, despite an 81.2% breast...The American Academy of Pediatrics recommends that infants be exclusively breastfed for a minimum of 6 months; however in Arkansas, only 23.8% of mothers are exclusively breastfeeding at 6 months, despite an 81.2% breastfeeding initiation rate. Easy access to professional lactation consultants through telehealth can reduce barriers to prolonged breastfeeding through continuity of education, troubleshooting for problems, and positive emotional support. The objective of this study is to evaluate the feasibility, acceptability, and impact of virtual lactation visits with a lactation consultant on sustaining breastfeeding at 2 months postnatal. A total of 100 pregnant women were recruited, with 39 lost to follow-up. Participants received lactation support via telehealth with appointments at approximately 2 days, 7 days, 1 month, and 2 months post-discharge. Quantitative analysis included descriptive statistics and paired t-tests or Wilcoxon signed-rank tests to evaluate pre- and post-survey changes in breastfeeding knowledge. Sixty-one participants completed both pre- and post-surveys. Infant feeding intention scores were high, with an average score of 13.08 ± 3.09 out of 16. The Vermont Breastfeeding Attrition Prediction Scale scores were high, which had an average score of 21.93 ± 5.67 out of 38, with scores >20 indicating a high likelihood to sustain breastfeeding. Breastfeeding knowledge was significantly increased (p < 0.0001) after the telelactation intervention, with an average pre-survey score of 70.26 ± 5.40 and post-survey average score of 74.77 ± 4.31. Findings of this study underscore the effectiveness of telelactation in enhancing breastfeeding education and support, emphasizing its potential as a critical resource for sustaining breastfeeding practices.
Telemed J E Health
· 2025 Dec · PMID 40788778
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To compare in-person pre-anesthesia evaluation (PAE) to virtual evaluation at home using a remote stethoscope. One hundred and six (N =106) presurgical hysterectomy and prostatectomy patients were approached to be enrol...To compare in-person pre-anesthesia evaluation (PAE) to virtual evaluation at home using a remote stethoscope. One hundred and six (N =106) presurgical hysterectomy and prostatectomy patients were approached to be enrolled in the study: 53 from each surgical group. Those who agreed were then randomized using random allocation codes to in-person versus telemedicine with Eko Duo stethoscope versus PAE. In 39/49 patients, the Eko allowed remote auscultation of heart sounds and electrocardiogram tracing. Airway exam concordance was 62% for in-person and 65% for virtual patients compared with the day of surgery (DOS) exam ( = 0.796). The mean clinic visit time was 89.5 ± 104.5 versus 110.4 ± 24.1 min for telemedicine and in-person cohorts ( < 0.001). Telemedicine patients saved mean roundtrip driving distance and time of 124.58 ± 81.40 miles and 124.58 ± 74.72 min, respectively, with $103.67 ± 78.80 in cost savings ($0.82/mile) and 43.22 ± 33.45 kilograms fewer carbon dioxide emissions per patient. Telemedicine PAE saves time, distance, and costs, and does not seem to be associated with increased DOS cancellations. Virtual visits were shorter and scheduled sooner. The remote stethoscope showed high concordance to in-person exam. Patients were highly satisfied, indicating they would undergoanother telemedicine visit with digital stethoscope.
Groom LL, Schoenthaler AM, Budhrani R
… +2 more, Mann DM, Brody AA
Telemed J E Health
· 2025 Nov · PMID 40735809
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Publisher ↗
This study aimed to explore the effects of demographics and social determinants of health (SDOH) on remote patient monitoring (RPM) utilization and blood pressure (BP) improvement. A secondary data analysis of an RPM pr...This study aimed to explore the effects of demographics and social determinants of health (SDOH) on remote patient monitoring (RPM) utilization and blood pressure (BP) improvement. A secondary data analysis of an RPM program for hypertension in federally qualified health centers (FQHCs). This observational study, guided by the Digital Health Equity-focused Implementation Research framework (DH-EquIR), used linear mixed effect models to investigate the effects of demographics and mean area deprivation index (ADI) on utilization and BP change among patients with three months of home BP monitoring data. Utilization was measured as a count of missed days per week, indicating days without transmitted BP readings. There were 105 participants, averaging 55.4 years old, with 64.8% Black or African American race, and 33.4% of Hispanic/Latino ethnicity. On a scale of 1-10, with 1 indicating the lowest level of deprivation, the mean ADI NY state rank was 3.3. As weeks on RPM progressed, participants experienced significant increases in missed days per week overall. For every point increase in ADI NY state rank, missed days per week increased by 0.24 ( < 0.05). Regardless of ADI, for every increasing week on RPM, the systolic BP value decreased by 0.55 mmHg ( < 0.0001). This DH-EquIR-guided RPM study, among the first in FQHCs, found minimal RPM usage differences by demographics and SDOH. Overall, participants in this sample effectively utilized RPM and showed improvement in BP, including in participants living in areas of high ADI NY state rank and inconsistent RPM utilization.
Telemed J E Health
· 2025 Nov · PMID 40720406
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Publisher ↗
Many children often face gaps in crucial prevention and intervention services. Telehealth has shown promise as a delivery model well suited for mental and behavioral health. The rapid expansion of telehealth services dur...Many children often face gaps in crucial prevention and intervention services. Telehealth has shown promise as a delivery model well suited for mental and behavioral health. The rapid expansion of telehealth services during the COVID-19 pandemic created a timely opportunity to investigate this issue. This study is one of the first to use the 2021 and 2022 National Survey of Children's Health data to examine nationwide patterns in children's behavioral health service use. The analysis focused on weighted prevalence estimates for current diagnosed mental health conditions and telehealth utilization by select demographics. Crude and adjusted prevalence ratios (aPRs) were calculated using Poisson regression with robust standard errors to examine associations between each independent variable and telehealth utilization. There were 50,892 children in this study. Children with common mental/behavioral conditions were more likely to use telehealth, not due to COVID-19, and adjusting for sociodemographic factors and rurality (aPRs: anxiety = 3.12, depression = 3.45, behavioral = 2.83, attention-deficit/hyperactivity disorder [ADHD] = 2.87, multiple = 3.42; < 0.001). This association diminished significantly as a result of COVID-19. Finally, factors that significantly reduced the use of telehealth before COVID-19 include rurality (29%), language (17%), care coordination (54%), and a personal health care provider (7%). Gaps in telehealth use were identified, including rurality, insurance status, medical home, primary care provider, health care navigation support (care coordination), transportation, language, and service availability. The pandemic was not a significant factor influencing telehealth use. Targeted policies are needed to sustain the use of telehealth even after the pandemic. Tailored interventions to optimize the delivery of behavioral health services were also recommended.
Telemed J E Health
· 2025 Nov · PMID 40669868
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Publisher ↗
: Internet-delivered cognitive behavioral therapy (iCBT) has become a promising alternative to face-to-face CBT, yet its long-term effectiveness across psychiatric disorders remains unclear. While numerous studies have e...: Internet-delivered cognitive behavioral therapy (iCBT) has become a promising alternative to face-to-face CBT, yet its long-term effectiveness across psychiatric disorders remains unclear. While numerous studies have examined short-term outcomes, it is essential to understand how iCBT compares with traditional CBT over extended periods and which conditions benefit most. : A systematic search of PubMed, Embase, MEDLINE via EBSCO, PsycINFO via APA, Scopus, and Cochrane Library (CENTRAL) was conducted up to May 21, 2025. Randomized controlled trials (RCTs) comparing the long-term effects of iCBT and face-to-face CBT for depression, anxiety disorders, and eating disorders were included. The random-effects model was used to calculate the standardized mean difference (Hedges' g), and a chi-square test assessed adherence differences. : Eleven RCTs (1,272 participants) met the inclusion criteria. Pooled analysis showed no significant difference in long-term effectiveness between iCBT and face-to-face CBT (Hedges' g = -0.07, 95% CI: -0.36 to 0.21). Depressive disorders responded best to iCBT, while anxiety disorders showed mixed results, and eating disorders had the least favorable outcomes. Adherence was higher in face-to-face CBT (86.68%) than in iCBT (70.06%), with therapist-guided iCBT improving completion rates (79.09%) compared with self-guided formats (48.17%). iCBT is a promising alternative to traditional face-to-face CBT, demonstrating treatment effectiveness even in the long term. However, dropout rates are higher in iCBT, particularly in unguided formats, suggesting that therapist support may be crucial for ensuring participant adherence. Future research should optimize iCBT delivery, tailor it to specific disorders, and develop strategies to improve engagement.
Lyons J, K Awuonda M, Sinclair D
… +5 more, Uprety R, Ogini F, Crowther C, Daftary M, Nunlee-Bland G
Telemed J E Health
· 2025 Nov · PMID 40642808
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Publisher ↗
The purpose of this study is to explore the prevalence of and factors associated with telehealth utilization in a medically underserved, ambulatory care diabetes population during COVID-19 pandemic. A retrospective char...The purpose of this study is to explore the prevalence of and factors associated with telehealth utilization in a medically underserved, ambulatory care diabetes population during COVID-19 pandemic. A retrospective chart review was conducted using electronic medical records from January 2020 to January 2021 at an ambulatory care diabetes clinic within an urban teaching hospital. Descriptive statistical analysis was conducted for all study variables. Simple and multiple logistic regression analyses were conducted to assess predictive factors of telehealth utilization during the COVID-19 pandemic. All statistical analysis was conducted using SPSS version 28 at an alpha level of 0.05. A total of 325 patients were included in the study. The mean age of the study population was 58.2 ± 15.9 years, and the majority was female (67.6%) and Black/African American (92.6%). The average number of medications prescribed was 4.9 ± 2.6 medications, and the average A1C was 8.1% ± 2.4%. A high proportion of patients utilized telehealth (88.3%). Findings from the multivariable analysis showed that females were more likely to use telehealth compared to males, adjusting for other factors (OR 2.14 (95% CI: 1.06-4.32). Ward, as a proxy for low income and high medically underserved status, was not a significant predictor of telehealth utilization ( = 0.89). Findings showed that telehealth was widely acceptable at the height of the COVID-19 pandemic even for participants who are low income and have high medically underserved status. Telehealth should continue to be championed as a viable option of care delivery for these vulnerable patients.
Telemed J E Health
· 2025 Nov · PMID 40637602
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Publisher ↗
Telemedicine research in France remains relatively underexplored, with a notable absence of comprehensive literature reviews or bibliometric analyses guiding research prioritization and funding allocation for public heal...Telemedicine research in France remains relatively underexplored, with a notable absence of comprehensive literature reviews or bibliometric analyses guiding research prioritization and funding allocation for public health interests. The objective of this study is to provide a comprehensive overview of telehealth research in France, elucidating its current trends and primary funding sources. A bibliometric analysis was conducted spanning a 20-year period from January 1, 2004, to December 31, 2023, using six open-access databases, including the Ministry of Health of France (public research funding), Health Data Hub (research protocols from France), Clinicaltrials.gov (global repository of research protocols), PubMed (scientific publications), Theses.fr (PhD database in France), and DUMAS (master's and doctorate theses database in France). The French Ministry of Health funded 41 telehealth research projects between 2009 and 2022, amounting to €15 million, which constituted 1.1% of all projects funded during this period. 279 study protocols were identified on ClinicalTrials.gov, peaking in 2021 with 58 protocols (20.8%), representing 5.8% of worldwide protocols. Public hospitals provided most of the funding (66%), with 18% coming from the industry. A total of 1,254 publications related to telehealth were identified in PubMed, representing 2.5% of worldwide telehealth publications. This is the first study in France and Europe to describe the trends in telehealth research over a 20-year period. Telehealth research in France started in the early 2000s, had a linear growth between 2011 and 2021, peaked during the COVID-19 pandemic, and decreased in 2022 and 2023. All types of telehealth interactions were covered, and funding came mostly from public sources. Funding for telehealth research was however limited and should be increased in France.