Telemedicine Journal And E-health[JOURNAL]
Sun
200 papers
Telehealth Buprenorphine Initiation for Opioid Use Disorder Among American Indian and Alaska Native Veterans, April 2017-March 2023.
Haskins C, Amspoker AB, Walder A … +4 more , Hogan J, Ecker A, Lindsay J, Shore J
Telemed J E Health · 2025 Nov · PMID 40637596 · Publisher ↗
To determine whether buprenorphine initiation among American Indian and Alaska Native (AI/AN) Veterans increased with expanded telehealth-prescribing abilities during the COVID-19 pandemic. This cohort study used the Ve...
To determine whether buprenorphine initiation among American Indian and Alaska Native (AI/AN) Veterans increased with expanded telehealth-prescribing abilities during the COVID-19 pandemic. This cohort study used the Veterans Health Administration medical record system, including 1,761 AI/AN Veterans with a new opioid use disorder (OUD) diagnosis. Exclusion criteria included buprenorphine receipt in the 3 months before diagnosis and methadone use. Primary exposures included time of diagnosis (3 years before vs. during COVID-19 pandemic, April 1, 2020-March 31, 2023), rurality, and telehealth-only versus in-person encounters. Covariates included age, gender, marital status, Deyo-Charlson Comorbidity Index, and psychiatric comorbidities. The primary outcome was buprenorphine initiation, defined by prescription at/after OUD diagnosis. Of 1,761 AI/AN Veterans with OUD, the mean age was 53.8, 58.5% urban residing, and 37.5% married. Depressive (62.8%) and alcohol use disorders (38.9%) were common. The pre-COVID-19 cohort had more in-person opioid encounters (59.8% vs. 35.7%). Buprenorphine was more frequently prescribed in the pre-COVID-19 cohort (18.5% vs. 12.9%). In the adjusted main-effects model, neither time nor rurality was associated with initiation, but in-person encounters were (odds ratio [OR] = 6.09; 95% confidence interval [CI]: 4.24-8.76). Rurality × time effect modification revealed rural Veterans were more likely to initiate buprenorphine than urban Veterans during the pandemic (OR = 1.81, 95% CI: 1.10-2.99). Unadjusted buprenorphine initiation rates decreased during COVID-19 but were ultimately unexplained by time, with only in-person encounters associated with initiation, compared with telehealth alone. Urban Veterans saw a decline, while rural rates remained stable, likely due to less reliance on in-person care. AI/AN Veteran OUD disparities necessitate telehealth optimization and provider education.
Trends in Remote Patient Monitoring Before and After the COVID-19 Public Health Emergency Declaration in the United States: A Comparison Between Rural/Urban and Racial/Ethnic Group.
Mahashabde R, Pandit AA, Acharya M … +4 more , Ali MM, Bogulski CA, Eswaran H, Hayes CJ
Telemed J E Health · 2025 Nov · PMID 40601563 · Publisher ↗
This study assesses the trend in remote patient monitoring (RPM) utilization among Medicare beneficiaries in the United States with differing rural/urban and racial/ethnic statuses. Using Medicare fee-for-service claims...
This study assesses the trend in remote patient monitoring (RPM) utilization among Medicare beneficiaries in the United States with differing rural/urban and racial/ethnic statuses. Using Medicare fee-for-service claims from January 2018 to December 2020, monthly rates of beneficiaries utilizing RPM per 100,000 beneficiaries enrolled in both Medicare Parts A and B were calculated. Comparative interrupted time series models delineated differences in level and trend of RPM utilization between beneficiaries with differing rural/urban status, race/ethnicity, and race/ethnicity as stratified by rural/urban status using March 2020, the start of COVID-19 public health emergency (PHE) in the United States, as interruption time. RPM utilization increased from 2 to 240 RPM claims per 100,000 Medicare beneficiaries from January 2018 to December 2020. Urban beneficiaries experienced a 24.20 RPM user-level change per month at the start of PHE. Trend difference for urban versus rural beneficiaries increased by 7.85 RPM users per month before and after the start of PHE ( < 0.0001). The trend difference for non-Hispanic Black versus White beneficiaries significantly increased by 12.43 RPM users per 100,000 beneficiaries per month after declaration of PHE ( < 0.0001). Similarly, the trend difference for beneficiaries of Hispanic and of other races significantly increased by 7.48 and 16.93 RPM users per 100,000 beneficiaries per month, respectively, after the declaration of the PHE ( < 0.0001 for both). Trends for racial/ethnic minorities stratified by rural/urban status were similar to the overall trends by racial/ethnic group. Inequities in RPM utilization exist and were exacerbated by the COVID-19 pandemic. Targeted interventions are needed to increase RPM utilization broadly, particularly among rural residents.
Improving Autism Detection Through Telemedicine in China: A Comparative Analysis of Multitool-Combined Screening Protocols.
Wang W, Liu Z, Wu D … +10 more , Qiu X, Li Y, Chen L, Zhang J, Wang S, Tian Y, Zhang Y, Zhu D, Song J, Chen J
Telemed J E Health · 2025 Nov · PMID 40600833 · Publisher ↗
Autism spectrum disorder (ASD) prevalence is rising globally, yet traditional face-to-face screening faces challenges, especially during COVID-19. Telemedicine offers a viable alternative for remote ASD detection. Teleme...
Autism spectrum disorder (ASD) prevalence is rising globally, yet traditional face-to-face screening faces challenges, especially during COVID-19. Telemedicine offers a viable alternative for remote ASD detection. Telemedicine offers a promising alternative for remote ASD screening. This study aimed to enhance ASD screening efficiency through telemedicine by integrating multiple early screening tools and comparing their combined efficacy in China. A cross-sectional, observational, multicenter study was conducted in three districts of Shanghai, utilizing a telemedicine system, the Early Childhood Development Screening, which includes the Warning Signs Checklist for Screening Psychological, Behavioral, and Developmental Problems of Children (WSC), the Early Behavioral Markers of Autism-Five No's behavior, and section A of the Modified Checklist for Autism in Toddlers-23 (CHAT-23-A). Children aged 18 to 36 months were screened, and the Childhood Autism Rating Scale was used as a diagnostic tool. The study evaluated the sensitivity, specificity, and screening performance of these tools individually and in combination. A total of 1,102 valid cases were screened with an effective rate of 83.30%. The WSC and the Five No's demonstrated high sensitivity (90.9%), while the CHAT-23-A showed higher specificity (88.6%) but lower sensitivity (63.6%). In parallel testing, the combination of WSC and Five No's maintained high sensitivity but reduced specificity. Serial testing improved specificity to 97.6% with the triple test but at the cost of lower sensitivity. The area under the receiver operating characteristic curve and the Youden index were highest for the WSC and Five No's combination in serial testing. The study presents a novel ASD screening combination protocol with good sensitivity and specificity, validated through a telemedicine system. This protocol is expected to enhance the accuracy and efficiency of early ASD screening, improving long-term prognoses for children and contributing to their healthy development.
Intensive Remote Onboarding to Improve Digital Health Access Among Safety-Net Patients During a Pandemic: An Implementation Study.
Choudhury AS, Cemballi AG, Tuot DS … +5 more , Su G, DeFries T, Sadasivaiah S, Ratanawongsa N, Lyles CR
Telemed J E Health · 2025 Jul · PMID 40587823 · Publisher ↗
The COVID-19 pandemic exacerbated disparities in digital health access critical to care delivery. San Francisco Health Network aimed to enroll safety-net patients onto a patient portal with a remote onboarding workflow....
The COVID-19 pandemic exacerbated disparities in digital health access critical to care delivery. San Francisco Health Network aimed to enroll safety-net patients onto a patient portal with a remote onboarding workflow. We used a standardized workflow to assess interest in enrollment and provide technical support. Calls from December 2020 to February 2021 were to English-speaking adults with enrollment codes. Outreach expanded March-June 2021 to Spanish speakers and patients without codes after an updated workflow enabled video identity verification and provision of new codes. Of 274 eligible patients, 49% (78/160) of those called were reached. While 62% (48/78) were interested, 20% ultimately enrolled. Barriers included lack of smart devices, internet, and familiarity with videoconferencing. Safety-net patients have high interest in portals but experienced obstacles to enrollment, despite intensive remote support. Health systems must recognize portals as central to patient care and devote additional resources to inclusive onboarding.
Geospatial Analysis of Telemedicine Physicians in the United States.
Crowley RJ, Lally JS, Kline DM … +1 more , Bunting AM
Telemed J E Health · 2025 Nov · PMID 40567152 · Full text
Telemedicine can increase care access and may be particularly helpful for rural patients. We sought to conduct a geospatial analysis of telemedicine physicians in the United States with attention to urban-rural and speci...
Telemedicine can increase care access and may be particularly helpful for rural patients. We sought to conduct a geospatial analysis of telemedicine physicians in the United States with attention to urban-rural and specialty-level differences. We used the Doctors and Clinicians national downloadable file. We assessed urban-rural differences in telemedicine physician density, categorized by Rural-Urban Continuum Codes. We analyzed telemedicine physician distribution using spatial clustering and choropleth graphs. Our cohort comprised 660,537 physicians, of whom 136,462 (20.7%) offered telemedicine services. Physicians offering telemedicine services were less likely to practice in rural environments (-value < 0.001) than nontelemedicine physicians. There were clusters of low telemedicine physician density in the South. Telemedicine physicians were less likely to practice in rural areas, which may exacerbate health care disparities. Targeted interventions to increase telemedicine accessibility in rural and underserved areas should be pursued.
Assessment of Equitable Use of Virtual Care in Pediatric Specialized Care.
Deliva RD, Tsang K, Manafzadehtabriz P … +3 more , Graham A, Comrie R, Palmert MR
Telemed J E Health · 2025 Nov · PMID 40567117 · Publisher ↗
: Telemedicine and broadly, virtual care are established modes of health care delivery but may present unintended barriers to access. We assessed postpandemic ambulatory care provision to determine whether marginalized a...
: Telemedicine and broadly, virtual care are established modes of health care delivery but may present unintended barriers to access. We assessed postpandemic ambulatory care provision to determine whether marginalized areas were underrepresented among virtual visits. : We retrospectively analyzed 396,624 ambulatory visits (January 2022 through December 2023), using patient demographics and the Ontario Marginalization Index to compare virtual (78% electronic health record-integrated video) and in-person visits across the domains of residential instability, material deprivation, dependency, and ethnic concentration. Logistic regression was used to compare virtual to in-person visits, adjusting for age, sex, and geographic location. : We found higher virtual care utilization for children in remote areas (41% [OR: 1.72 {1.66-1.78}]) and progressively higher virtual care utilization across age groups. Virtual care use for children aged 1-12 was 27% (OR: 1.57 [1.53-1.62]); for adolescents aged 12-16 was 33% (OR: 2.02 [1.96-2.09]); and for those over 16 years was 38% (OR: 2.56 [2.49-2.64]), compared to infants (19%). Indices of residential instability, dependency, and material deprivation had minimal impact on access to virtual care; however, areas with high ethnic concentrations had significantly fewer virtual visits compared to the least ethnically concentrated areas (26.1% vs. 35.0%; adjusted OR: 0.65 [0.63-0.67]). Each quintile increase in marginalization within the ethnic concentration index was associated with an 11% decrease in the odds of a virtual visit. : Virtual care use was higher for those at greater distance but lower in ethnically concentrated areas. Further investigation of strategies targeting language barriers, technological literacy, and cultural beliefs is warranted.
Decreased Health Care Utilization in Complex Care Pediatrics After 1 Year with a Remote Examination Device.
Sibilia AJ, Callahan SR, Pulda K … +4 more , Schiferl LM, Odum JD, Pfarr MA, Tegtmeyer K
Telemed J E Health · 2025 Nov · PMID 40559456 · Publisher ↗
Children with medical complexity are a growing population of pediatric patients with high health care utilization. Telemedicine could provide timely and reliable access to care that mitigates the associated burden of tra...
Children with medical complexity are a growing population of pediatric patients with high health care utilization. Telemedicine could provide timely and reliable access to care that mitigates the associated burden of transportation and cost of expensive emergency room visits or hospitalizations. This study evaluated the health care utilization of patients in a complex care center (CCC) after a year with a remote examination telehealth device. A single-center, nonrandomized retrospective observational study was performed. The health care utilization of 273 patients with the device (cases) was evaluated 1 year after device acquisition and compared with health care utilization 2 years and 1 year prior to device acquisition. The health care utilization of 204 patients without the device (controls) was compared with cases over the same time period. Demographic differences between cases and controls were also evaluated. Cases had significantly less health care utilization compared with controls in the year after device acquisition and compared with the time prior to device acquisition ( < 0.001). Cases were more likely to reside in communities with high socioeconomic status, were more likely to be white, and more likely to speak English than nonusers. A telemedicine remote examination device was shown to be associated with decreased health care utilization in patients in a CCC. However, significant socioeconomic and demographic differences existed between the groups, which may have contributed to these findings.
Shared Decision Making in Telehealth Versus In-Person Pediatric Primary Care.
Lipstein EA, Lee S, Anderson C … +8 more , Beck AF, Brinkman WB, Britto MT, Hyland-Brown R, Liu C, Tegtmeyer K, Zhang N, Ray KN
Telemed J E Health · 2025 Nov · PMID 40559455 · Publisher ↗
: Expansion of telehealth in pediatrics has occurred without evaluation of how communication, such as shared decision making (SDM), is impacted. : We recorded telehealth and in-person pediatric primary care visits and th...
: Expansion of telehealth in pediatrics has occurred without evaluation of how communication, such as shared decision making (SDM), is impacted. : We recorded telehealth and in-person pediatric primary care visits and then scored them using an adaptation of the Informed Decisions Measure (IDM). We compared the total score for telehealth versus in-person through mixed effect models with random intercept for clinicians. : We observed 88 visits (46 telehealth and 42 in-person). The mean parent IDM score for telehealth was 5.43 ± 3.34 and for in-person was 5.19 ± 3.39. For adolescent patients, the mean IDM score for telehealth was 4.00 ± 3.26 and for in-person was 5.43 ± 3.8. There was no statistical difference between in-person visits and telehealth visits for parents or adolescents. : The lack of difference in SDM between telehealth and in-person pediatric care provides an opportunity to develop training approaches that would work for either modality.
A Systematic Review of the Concepts of Efficacy, Effectiveness, and Efficiency as Applied and Measured for Virtual Health Care Delivery in Correctional Facilities.
Nyongesa C, Majeed T, Remond M … +4 more , Lewandowski A, Dolja-Gore X, Haysom L, Sullivan E
Telemed J E Health · 2025 Oct · PMID 40559367 · Publisher ↗
The use of virtual care interventions in correctional facilities has increased in recent years owing to the impacts of the COVID-19 pandemic. However, the literature shows variability in the application and measurement o...
The use of virtual care interventions in correctional facilities has increased in recent years owing to the impacts of the COVID-19 pandemic. However, the literature shows variability in the application and measurement of efficacy, effectiveness, and efficiency of virtual care interventions. This systematic review addresses this gap in evidence and provides an overview and appraisal of the methods and measures used to evaluate these aspects of virtual care interventions in correctional facilities, using a modified conceptual framework by the World Health Organization (WHO). We conducted a systematic review using a narrative synthesis approach. Comprehensive searches were performed in PubMed, Scopus, and Web of Science for peer-reviewed studies published in English between 2014 and 2024. The Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument was used to assess the methodological quality of included studies. Twenty-one studies were included, and most were conducted in the United States and focused on synchronous modality for adult males. None of the studies explicitly defined the efficacy, effectiveness, and efficiency of virtual care interventions. The concept of effectiveness was the most frequently explored, and aligned best with WHO's conceptual framework, whereas efficiency was the least explored. The most common evaluation measures were clinical effectiveness, user satisfaction, and interexaminer agreement. This review highlights the need for adopting a unified framework for evaluating virtual care in correctional facilities that can standardize evaluation metrics and improve resource allocation, ultimately enhancing patient outcomes by ensuring that virtual care interventions are efficacious, effective, and efficient.
Economic Impact of an Employer-Sponsored Integrated Digital Intervention Targeting Substance Use Disorders: Return on Investment Analysis.
Glasner S, Ang A, Michero D
Telemed J E Health · 2025 Oct · PMID 40538345 · Full text
In light of the limited accessibility of evidence-based treatments for substance use disorders (SUD), coupled with the excess health care costs associated with untreated SUD, digital health has the potential to be transf...
In light of the limited accessibility of evidence-based treatments for substance use disorders (SUD), coupled with the excess health care costs associated with untreated SUD, digital health has the potential to be transformative in addressing substance use and related chronic co-occurring conditions. This research aimed to evaluate the economic impact of Pelago (PEL), an integrated digital intervention combining psychosocial and pharmacological treatment targeting alcohol, tobacco, and opioid use disorders in a commercially insured adult population (N = 7,586). The model provided telehealth services using a smartphone application, from which clinician-facilitated videoconferencing and asynchronous messaging were delivered, along with digital, evidence-based therapy content and pharmacotherapy. Using a longitudinal model, a return on investment (ROI) analysis was undertaken to evaluate the impact of PEL on all-cause medical plan utilization costs 12 months before and after treatment initiation, relative to a matched control group. In the 12 months following PEL registration, the intent-to-treat cohort who received the digital intervention evidenced an average all-cause medical plan utilization cost savings of $6,758 or 33% less per participant (4.5 ROI; p = 0.001). Among 1,172 participants who received PEL, a total savings of $7,920,376, relative to total program costs of $1,747,452 yielded a 4.5:1 ROI. Evidence-based treatment for SUD delivered via telehealth is associated with a significant positive ROI. Employers and payers willing to offer access to digital SUD care can mitigate morbidity and mortality while concurrently reducing medical costs and service utilization.
Knowledge, Attitudes, and Practices of Teleconsultation in France Among General Population and Physicians: A National Survey.
Ohannessian R, Lamarche D, Brugnaux S … +5 more , Ghazarian S, Cheniour J, Martin Gousset P, Piermé JP, Salomon J
Telemed J E Health · 2025 Oct · PMID 40512586 · Publisher ↗
The utilization of teleconsultation (TC) via synchronous video calls has surged globally and in France since the onset of the COVID-19 pandemic in 2020. The objective was to describe the knowledge, attitudes, and practic...
The utilization of teleconsultation (TC) via synchronous video calls has surged globally and in France since the onset of the COVID-19 pandemic in 2020. The objective was to describe the knowledge, attitudes, and practices regarding TC among the general population and physicians in France. We conducted two national voluntary anonymous online surveys for the general population and for physicians. The sample size, calculated for a 95% confidence level and a 5% margin of error, was determined to be 2,001 participants for the general population and was estimated with the quota method to ensure representativeness. The survey for physicians was sent from April 27 to June 2, 2023. Among the population, 32% were TC users primarily conducted for themselves (83%) or their children (28%), as a replacement for a physical consultation (75%) and not with their treating physician (56%), while considering the physician location as not relevant (68%). The satisfaction among TC users was 88%. They experienced quicker access to care (54%) and similar or better experience (74%), and 84% agreed that TC improved access to care. If TC had not been available, 28% would have gone to the emergency department (ED). The main reasons cited for consulting remotely were to obtain a medical opinion related to new symptoms (38%) and to acquire a medical certificate or sick leave (35%). Among non-TC users, 53% were considering using it. Among physicians, 83.6% used TC for 1-4 years (68%), with 32% practicing for at least 3 years. Thirty-two percent of the French population practiced TCs in France in 2023 with a very high satisfaction rate of 88%. Almost one-third of patients would visit the ED if they could not do a TC.
Staying in Your Lane-Perhaps Change Lanes!
Doarn CR
Telemed J E Health · 2025 Jul · PMID 40512049 · Publisher ↗
Abstract loading — click title to view on PubMed.
Early Assessment on the Impact of Virtual Backgrounds on Patient Perceptions in Telemedicine.
Holtz B, Ma M
Telemed J E Health · 2025 Oct · PMID 40501336 · Publisher ↗
Telemedicine is widely used, yet nonverbal cues such as virtual backgrounds remain understudied despite their potential influence on patient perceptions of provider credibility. This study used a randomized experimental...
Telemedicine is widely used, yet nonverbal cues such as virtual backgrounds remain understudied despite their potential influence on patient perceptions of provider credibility. This study used a randomized experimental design to examine the impact of three telemedicine background conditions, clinical, home office, and plain white, on patient ratings of provider expertness, competence, and ethicality. Participants (N = 136) were recruited from a large Midwestern university and completed a postvideo survey. Analysis of variance results showed significant effects of background type on all three credibility measures. Providers in the white background condition were consistently rated lower in expertness, competence, and ethicality compared with the clinical and home office backgrounds. Findings suggest virtual backgrounds convey meaningful professional cues. Clinical and home office settings enhanced perceptions of provider credibility, while plain backgrounds diminished them. Background choice in telemedicine influences patient trust, underscoring the need for visual professionalism guidelines in virtual care settings.
Patient Satisfaction with Lung Transplant Telemedicine: Lessons from the COVID-19 Pandemic.
Kim J, Villalonga-Olives E, Doumat G … +18 more , Vesselinov RM, Huapaya JA, Abbas HMN, Kaza V, Bollineni S, Ladikos N, Lawrence A, Mohanka MR, Deleija-Lujano J, Khan A, Crossno J, Torres F, Patel V, Varghese A, Iacono AT, Griffith BP, Terrin ML, Timofte I
Telemed J E Health · 2025 Oct · PMID 40498590 · Full text
Telemedicine has become essential for maintaining post-transplant care while reducing exposure risks during the SARS-CoV-2 pandemic. Lung transplant recipients require frequent monitoring due to chronic immunosuppression...
Telemedicine has become essential for maintaining post-transplant care while reducing exposure risks during the SARS-CoV-2 pandemic. Lung transplant recipients require frequent monitoring due to chronic immunosuppression and comorbidities. This study evaluates patient satisfaction and the feasibility of a lung transplant telemedicine program using a multidimensional, patient-centered survey. We conducted an observational study at the University of Maryland Lung Transplant Center between March and November 2020. A customized telemedicine satisfaction survey, developed with expert and patient input, was distributed via e-mail to lung transplant recipients, with a follow-up 6 months later. Key domains included quality of care, technology usability, cost burden, and overall experience. Of 148 patients surveyed, 106 responded, with 53 completing the follow-up survey. In the initial and follow-up surveys, 94% and 89% rated telemedicine care as "very good" or "excellent." Technology usability was high, with 96% and 94% reporting good understanding. Most patients (90% initially, 84% at follow-up) noted decreased travel costs. However, while patients appreciated these benefits, preference for in-person visits increased from 45% initially to 65% at follow-up. Lung transplant patients reported high satisfaction with telemedicine, benefiting from reduced costs and COVID-19 exposure risk. The survey captured the complexities of post-transplant care while addressing technological barriers. Future research should validate telemedicine satisfaction tools across multiple centers and assess its impact on clinical outcomes in transplant populations.
Telenursing Demands Among Older Adults with Disability in Saudi Arabia.
Aljohani KA
Telemed J E Health · 2025 Oct · PMID 40491417 · Publisher ↗
Telenursing leverages information technology and telecommunications to provide nursing services remotely, which offers distinct advantages to patients, caregivers, and nurses. This study explored the demand for and facto...
Telenursing leverages information technology and telecommunications to provide nursing services remotely, which offers distinct advantages to patients, caregivers, and nurses. This study explored the demand for and factors influencing long-term telenursing care among older adults with disabilities in Saudi Arabia. Participants included individuals aged 60 or older with physical disabilities, or their caregivers with at least three months of caregiving experience. Data were collected using a three-part questionnaire distributed through multiple channels, including nursing facilities. Descriptive statistics, single-factor analysis, and multivariate linear regression were conducted using SPSS v25, with significance set at p < 0.05. A total of 188 responses were analyzed. Among the telenursing services assessed, online appointments had the highest demand (M = 4.18 ± 0.78), followed by visual calls (M = 4.04 ± 0.83) and telenursing consultations (M = 3.88 ± 0.88). Online reminders for important dates were least in demand (M = 3.41 ± 1.12). Demand varied significantly by gender, marital status, number of chronic illnesses, and self-perceived health. Women and widowed individuals showed the highest demand (M = 91.8 ± 16.9; M = 99.4 ± 13.6, respectively). Similarly, participants with poor self-perceived health or multiple chronic conditions reported greater interest in telenursing (M = 106.9 ± 26.4; M = 98.5 ± 16.5, respectively). Strong interest was observed for online appointments, visual calls, and consultations, among older adults with disabilities. Key influencing factors include marital status, chronic illness, health perception, and socioeconomic status. Further research is needed to develop targeted, patient-centered telenursing strategies.
Telehealth Competencies to Ensure Health Care Access, Quality, and Equity for Older Adults: A Scoping Review.
Gentry MT, Beito AH, Hilty DM
Telemed J E Health · 2025 Oct · PMID 40491355 · Publisher ↗
During the COVID-19 pandemic, increased use of telehealth expanded access to health care for older adults. Many clinicians and health systems adjusted workflows and realized that certain competencies are needed to fully...
During the COVID-19 pandemic, increased use of telehealth expanded access to health care for older adults. Many clinicians and health systems adjusted workflows and realized that certain competencies are needed to fully engage older adults in telehealth services. This scoping review evaluates the approaches needed to educate clinicians about providing telehealth services to older adults. We conducted a review of studies published from January 2000 through February 2024 by using the 6-stage scoping review process. Searches of PubMed/MEDLINE and five other databases included the concept areas of competencies, telehealth delivery of mental health services, and older adults. We initially identified 813 articles, of which 89 were eligible for full-text review and 15 met our inclusion criteria. Most studies included training participants about the use of telehealth but without formal curricular interventions or evaluations and lacked details about topics, materials, methods, or outcomes. Telehealth training was general and focused primarily on the use of technology and telepresence, although not specifically for older adults. Three themes were identified from the studies: the role of teams and interprofessional education, the importance of training for clinicians and older patients, and adaptations to improve telehealth delivery for older adults. Individual and institutional competencies are needed to guide educational goals and outcome measures related to telehealth services for older adults. The use of telehealth specifically for older adults may require adaptation to clinical practice and delivery, adjustments to workflow, development of clinician skills, and promotion of interprofessional teamwork.
Lessons Learned from a Vitreoretinal Virtual Service in a Tertiary Referral Center.
Tasnadi B, Gigon A, Al-Hayouti H … +1 more , Saidkasimova S
Telemed J E Health · 2025 Oct · PMID 40470525 · Publisher ↗
We present our experience in telemedicine in a tertiary referral hospital covering the west of Scotland, from November 29, 2021, to June 27, 2022. We piloted vitreoretinal virtual clinics where patients were directly ref...
We present our experience in telemedicine in a tertiary referral hospital covering the west of Scotland, from November 29, 2021, to June 27, 2022. We piloted vitreoretinal virtual clinics where patients were directly referred by community optometrists or by general ophthalmologists. Most patients were referred with an accompanying Optical Coherence Tomography (OCT) scan. A consultant vitreoretinal surgeon reviewed the scans with any accompanying-colored pictures and conducted a telephone consultation with the patients. This study aimed to analyze the efficacy of this virtual service to improve delivery of future care. : This was a retrospective audit study. All patients booked into the virtual telephone clinics for one consultant were identified through the electronic referral pathway and health care records. The total number of patients booked into these virtual clinics was 284, of which 258 attended. Each patient's referral letter and clinic letter were reviewed. Patients were also sent a questionnaire to assess their experience accessing the virtual clinic. : Of the 258 patients who attended the virtual clinic, 55 patients were listed for surgical intervention, 6 were sent for outpatient treatment, 38 were invited for a face-to-face consultation, 10 were offered surgery but declined, and 149 were discharged from the clinic. Our patient questionnaire found that 86% of attendees were satisfied with the accessibility of the appointment and 63% were confident in the quality of care provided. : The combination of patients requiring no further treatment and those declining treatment demonstrated a 62% reduction in the number of face-to-face hospital appointments required. We believe the use of imaging such as OCT and wide-field colored fundus photography proves to be an excellent tool for assessment of patients in combination with a telephone discussion of symptomatology and management plans. This approach can also prove cost-effective for both the health care systems and the patients.
Telemedicine in the Management of Patients with Obstructive Sleep Apnea: Evidence from the Literature and Practical Issues. A Consensus Document from the Task Force for Telemedicine in Respiratory Diseases, Part of the Italian Society of Telemedicine.
Spicuzza L, Attinà A, Bignamini E … +9 more , Cilla M, De Bortoli J, Di Michele L, Foresi A, Malorgio E, Marino L, Rocca A, Toraldo DM, Sanna A
Telemed J E Health · 2025 Oct · PMID 40443361 · Publisher ↗
Obstructive sleep apnea (OSA) is a high prevalent condition associated with relevant cardiovascular morbidity and mortality, determining the consume of a great amount of health care resources. Diagnosis and treatment of...
Obstructive sleep apnea (OSA) is a high prevalent condition associated with relevant cardiovascular morbidity and mortality, determining the consume of a great amount of health care resources. Diagnosis and treatment of OSA are generally performed in OSA Units (OUs). However, although the large expansion of OUs in western countries, these still fail to cope with the increasing number of patients requiring care. Since long time, well before the COVID-19 pandemic, telemedicine (TM) has been explored as a tool to monitor both physiological parameters during sleep and treatment outcomes. Recently, the availability of wireless data transmission technology and new TM solutions has given an impetus to the spread of TM services. Nowadays, these find application throughout the diagnosis, treatment and follow-up of patients with OSA and the management of these patients is recognized as the most promising TM application among chronic disorders. A Task Force of experts in respiratory diseases, within the Italian Society of Telemedicine, has recently produced a document on distance management of OSA. Here, we present a revision of literature discussed by the TF and the document produced focusing on how to integrate TM services into the traditional routine care of patients with OSA.
Provider Perspectives of Providing Clinically Appropriate Care with Telemedicine.
Links AR, Claus L, Hughes HK … +1 more , Manahan MA
Telemed J E Health · 2025 Oct · PMID 40405817 · Publisher ↗
Following the initial resurgence of telemedicine during the COVID-19 pandemic, higher levels of virtual ambulatory care utilization continue. This study aimed to identify factors that contribute to providers' perspective...
Following the initial resurgence of telemedicine during the COVID-19 pandemic, higher levels of virtual ambulatory care utilization continue. This study aimed to identify factors that contribute to providers' perspectives about the utility of telemedicine across various medical and surgical clinical contexts within a single academic health system. A cross-sectional survey including an open-response question about the clinical appropriateness of telemedicine was distributed to Johns Hopkins Medicine clinical sites, including 6 hospitals and 40 ambulatory clinics in Maryland, the Washington, D.C., Capital Region, and Florida. Modified grounded theory was used to code responses about the clinical appropriateness of telemedicine. Responses from providers who perform >50% of both new patient and follow-up care via telemedicine were evaluated. Analysis of 567 comments revealed domains of advantage/disadvantages to telemedicine including clinical factors (e.g., physical exam, interventions, testing), process factors (e.g., logistics, technology), information-sharing (teaching, history-taking), communication (e.g., rapport), patient factors (e.g., patient preference, child attention), clinician factors (e.g., clinician preference, reimbursement), and overall appropriateness. Domains of clinical and process factors were most commonly discussed. This study identifies features of telemedicine that may affect the provision of clinically appropriate care across medical and surgical fields. As health care spending continues to be assessed, traditional delivery models may adapt. Proactive identification of opportunities for additional virtual care implementation may assist systems in nimble responsiveness to changing landscapes.
Assessment of Patients' Postpandemic Perception of Telehealth Utilization: A Scoping Review.
Ogini F, Elesho R, Awuonda M
Telemed J E Health · 2025 Oct · PMID 40387617 · Publisher ↗
Studies have reported telehealth benefits, focusing on telehealth performance during the pandemic. However, there is a need to assess the persistence of patients' satisfaction beyond the pandemic. The objective of this w...
Studies have reported telehealth benefits, focusing on telehealth performance during the pandemic. However, there is a need to assess the persistence of patients' satisfaction beyond the pandemic. The objective of this work was to evaluate patient satisfaction, acceptance, and utilization of telehealth in the postpandemic years, highlighting significant barriers and potential areas for future studies. Published studies were identified from PubMed and Scopus databases from January 2022 to January 2024. Predesigned inclusion/exclusion criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram were applied. Search terms related to "Post-pandemic," "Patient satisfaction," and "Telehealth" were used, and the primary outcomes of interest (patients' perception and satisfaction) were extracted from the articles. A total of 228 articles were obtained from the literature search. After screening, 17 articles were included in the study. Most studies recorded sustained satisfaction and a decrease in utilization early postpandemic. Recurring areas of concern reported by patients were barriers related to patient-physician communication, the ineffectiveness of telehealth due to a lack of physical examination, and the preference for telehealth for less severe conditions. Individuals without prior telehealth experience had the lowest tendency to utilize telehealth. Treatment time, reduced trust in specialist competency, and lack of familiarity with telehealth modality were identified as nonconventional factors influencing telehealth utilization. Telehealth remains an essential form of care delivery in the postpandemic years. This review emphasizes the need for more up-to-date research on patients' telehealth perceptions. The recurring barriers, emerging nonconventional factors, and telehealth optimization for less preferred visit types are areas for future research.
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