Journal Of Telemedicine And Telecare[JOURNAL]
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200 papers
Comparative performance of spoke centers versus telemedicine service in the emergency activation of ST elevation myocardial infarction network: Insights from the "detective" registry.
Pepe M, Tritto R, D'Agostino C … +14 more , Napoli G, Rodio D, Naccarati ML, Bruno AI, Natola AM, Giordano S, Caldarola P, Pestrichella V, Cirillo P, Giordano A, Zoccai GB, De Giosa M, Iliceto S, Ciccone MM
J Telemed Telecare · 2025 Dec · PMID 41370063 · Publisher ↗
IntroductionTelemedicine has implemented the regional networks between 24/7 catheterization laboratories of "Hub" hospitals and the Territorial Emergency Medical Service (TEMS) to reduce time to diagnosis and treatment o...
IntroductionTelemedicine has implemented the regional networks between 24/7 catheterization laboratories of "Hub" hospitals and the Territorial Emergency Medical Service (TEMS) to reduce time to diagnosis and treatment of ST segment elevation myocardial infarction (STEMI). Telemedicine has been conversely hypothesized to carry an excess of false-positive diagnoses; however, comparisons with a traditional diagnostic process at non-percutaneous coronary intervention capable ("Spoke") hospitals are lackingMethodsThis multicenter case-control study retrospectively included 1001 consecutive patients with an initial diagnosis of STEMI or very high risk (VHR) non-ST elevation acute coronary syndrome who were referred from January 2018 to December 2021 to the Apulian STEMI network after an "in-presence" clinical evaluation at a Spoke center or a remote telemedicine-supported assessment. The comparative performance of both approaches has been evaluated by comparing the running diagnosis with the discharge diagnosis.ResultsTEMS and Spoke groups included 470 and 531 patients, respectively. False-positive diagnoses occurred in 21.3% and 35.8% of the TEMS and Spoke patients, respectively (p < 0.001). Spoke group showed a higher number of discharge diagnoses of non-ST elevation myocardial infarction without VHR features (p < 0.001), myocardial infarction with no obstruction of coronary arteries (p = 0.033), and myocarditis (p = 0.007). Overall, the main predictors of false-positive diagnoses were the referral from Spoke center, chronic kidney disease, and ongoing oral anticoagulation.ConclusionsTelemedicine showed lower false-positive rate compared with an on-site clinical cardiological assessment. This apparently paradoxical result questions the hypothesis of overdiagnosis as the main limitation of telemedicine which conversely reduces time-to-diagnosis and healthcare costs.
Tele-triage for pediatric foreign body aspiration: A case report from rural India and its implications.
Singh S, Gupta R, Nadig PL … +3 more , Kaur P, Agarwal A, Saikia B
J Telemed Telecare · 2025 Dec · PMID 41364510 · Publisher ↗
BackgroundForeign body aspiration (FBA) is a potentially fatal pediatric emergency, particularly in children under three years of age. Diagnostic delays are common in rural and resource-limited settings due to limited ac...
BackgroundForeign body aspiration (FBA) is a potentially fatal pediatric emergency, particularly in children under three years of age. Diagnostic delays are common in rural and resource-limited settings due to limited access to specialists, leading to increased morbidity. Telemedicine can play a critical role in early recognition and timely referral.Case PresentationWe report a 1.5-year-old boy from rural Haryana who developed a cough following almond ingestion. A teleconsultation was initiated via the platform. On remote assessment, reduced air entry and wheeze on the left side raised suspicion of an airway foreign body. Chest X-ray revealed left lung hyperinflation with mediastinal shift. The child was urgently referred to a tertiary centre, where rigid bronchoscopy confirmed and successfully removed an almond from the left main bronchus. He recovered fully, with subsequent follow-up conducted via teleconsultation.DiscussionThis case highlights the value of telemedicine in early triage of pediatric FBA, especially in rural areas where bronchoscopy facilities are not immediately available. Prompt remote assessment facilitated timely diagnosis, urgent referral, and safe intervention, thereby preventing complications.ConclusionTele-triage through national platforms like is a viable and effective strategy to bridge critical gaps in pediatric emergency care and improve outcomes in rural and resource-limited settings.
Improved appropriateness of electronic consultations in primary care with ongoing liver disease education.
Pérez Hernández FJ, González Méndez Y, González CA … +8 more , Ortega Sánchez JA, Morales Arráez DE, de la Barreda Heuser R, Alonso Abreu I, Ramos López L, Alarcón Fernández O, Carrillo Palau M, Hernández-Guerra M
J Telemed Telecare · 2025 Dec · PMID 41359013 · Publisher ↗
IntroductionThis study evaluates the short-term impact of two educational strategies on the appropriateness of electronic consultations (e-consults) submitted by primary care physicians (PCPs) to hepatologists for chroni...
IntroductionThis study evaluates the short-term impact of two educational strategies on the appropriateness of electronic consultations (e-consults) submitted by primary care physicians (PCPs) to hepatologists for chronic liver disease (CLD) management. We compared a synchronous education program delivered in-person and online by hepatologists with an asynchronous approach based on e-consult feedback.MethodsWe conducted a 24-month prospective observational cohort study, analyzing e-consults related to the most prevalent CLD submitted by 326 PCPs to 10 hospital-based specialists in the Department of Gastroenterology and Hepatology. E-consults were categorized into three consecutive 8-month periods based on PCPs' training exposure: Group I (no training), Group II (synchronous continuing medical education) and Group III (asynchronous education via e-consult feedback).ResultsA total of 9934 consecutive e-consults were analyzed, which 663 pertained to CLD cases, submitted by 205 (63%) of 326 eligible PCPs, involving 629 patients (median age: 55 years; 61.8% male). Overall, 68% of e-consults were deemed appropriate, with 58.2% resulting in a specialist care appointment. Appropriateness significantly improved following both synchronous and asynchronous training compared to the pre-training period (75.2% vs. 69.1% vs. 60.1%; < 0.05). E-consults submitted by trained PCPs were significantly more likely to be appropriate (OR = 2.001; 95% CI: 1.360-2.946; < 0.001).ConclusionBoth synchronous and asynchronous training significantly improved e-consult appropriateness and reduced unnecessary referrals. Asynchronous education via e-consult feedback emerged as a practical and effective alternative. These findings underscore the importance of educational programs in optimizing e-consult utilization, warranting further research on long-term impacts.
Video triage by emergency medical service secondary triage clinicians in Victoria, Australia.
Nehme E, Flaus C, Clarke S … +5 more , Magnuson N, Zimmermann D, Cameron P, Nehme Z, Smith K
J Telemed Telecare · 2026 Jul · PMID 41091966 · Publisher ↗
BackgroundUse of video triage in emergency medical dispatch centres is novel. We describe the impact of a video triage trial on call outcomes, triage accuracy and recontact with the emergency medical service in Victoria,...
BackgroundUse of video triage in emergency medical dispatch centres is novel. We describe the impact of a video triage trial on call outcomes, triage accuracy and recontact with the emergency medical service in Victoria, Australia.MethodsA retrospective observational study of consecutive low to medium-acuity emergency ambulance calls undergoing secondary triage between 27/11/2023 and 17/03/2024. Propensity matching was performed to match video triage patients with traditional telephone triage patients.ResultsVideo triage patients were younger than telephone triage patients (49.1 vs. 59.2 years), and more frequently called in-hours (49.5% vs. 39.0%) for injuries or wounds (24.8% vs. 9.1%). Propensity matching yielded 1036 matched pairs. In the matched population, video triage was associated with reduced odds of emergency ambulance dispatch (odds ratio [OR] = 0.621 [95% confidence interval [CI] 0.521,0.741]) and increased odds of referral to alternate health services (OR = 1.287 [95%CI 1.032,1.605]). The odds of recontact within 24 hours among patients referred to alternate services were halved after video triage (OR = 0.514 [95%CI 0.320,0.826]). The technology was associated with increased alignment between dispatch priority and patient acuity (OR = 1.356 [95%CI 1.019,1.804]), and a reduction in over-triage (OR = 0.695 [95%CI 0.520,0.929]). Although, the overall secondary triage duration was longer when video triage was used (22 vs. 15 minutes, < 0.001), there was no difference in time to ambulance dispatch for time-critical patients.ConclusionVideo triage by secondary triage clinicians was associated with fewer emergency ambulance dispatches, more referrals to alternate services, fewer recontacts and improved triage accuracy. Expansion of the technology to primary triage warrants exploration.
Telehealth physical examinations show comparable accuracy and results to clinical exams for MRI confirmed shoulder pathologies.
Glover MA, Bradley KE, Casey PM … +7 more , Cook C, Reinke EK, Vinson EN, Mather RC, Riboh J, Lassiter T, Wittstein JR
J Telemed Telecare · 2026 Jul · PMID 40997236 · Publisher ↗
IntroductionThe purpose of this study is to measure the comparative diagnostic accuracy of telehealth diagnostic examinations for pathologies of the shoulder against an in-person examination. The telehealth examinations...
IntroductionThe purpose of this study is to measure the comparative diagnostic accuracy of telehealth diagnostic examinations for pathologies of the shoulder against an in-person examination. The telehealth examinations were hypothesized to be non-inferior to in-person examinations for accuracy and to demonstrate fair to moderate agreement. This is an expanded study of a data set included in a prior publication.MethodsPatients underwent in-person standardized clinical examination (SCE) and standardized telehealth examination (STE) during the same visit by two different providers in randomized order. Tests were analyzed for sensitivity, specificity, agreement, and diagnostic accuracy using a nonarthrographic shoulder MRI as a reference standard, and divided into tests for rotator cuff tears (RCTs), glenohumeral arthritis (GHA), and acromioclavicular (AC) joint arthropathy. A pooled diagnostic accuracy was created for SCE and STE and directly compared using a Mann-Whitney test.ResultsSixty-two patients, average age of 57.9 years (±11.2), with 60 patients obtaining an MRI, were included in this study. There were no significant differences in the pooled diagnostic accuracy of identifying RCT, GHA, or AC arthropathy between SCE and STE ( = .495, .469, .333, respectively). The highest agreement between SCE and STE was observed for the shoulder shrug test, night pain, and internal rotation limitation for identifying RCT.DiscussionSTE demonstrated non-inferior pooled diagnostic accuracy in comparison to SCE for full-thickness RCT, GHA, and AC joint arthropathy. Secondarily, there was moderate to substantial agreement for selective tests, with a considerable portion ranging from fair to substantial agreement.
Telehealth-directed emergency tube thoracostomy.
Aston B, Powell B
J Telemed Telecare · 2026 Jul · PMID 40920350 · Publisher ↗
In this case, we describe the remote telehealth leadership of emergent tube thoracostomy in a patient with a critical respiratory status. The patient had presented to a small rural health care facility with breathlessnes...
In this case, we describe the remote telehealth leadership of emergent tube thoracostomy in a patient with a critical respiratory status. The patient had presented to a small rural health care facility with breathlessness and hypoxia despite supplemental oxygen. A subsequent chest x-ray revealed a large pneumothorax requiring emergent treatment to prevent respiratory demise. Due to their location, the arrival of a critical care team would be delayed, and the local staff had very limited prior experience with chest procedures. Through remote telehealth leadership, the local team was guided through initial attempts at the Seldinger tube thoracostomy technique, before progressing to an open approach following failure of the initial attempt. Ultimately, the patient was stabilised and remained admitted locally, avoiding aeromedical retrieval. Key learnings included the need to develop a shared mental model of the procedure, responding to local equipment limitations, the leadership response to initial technique failure, and maintenance of situational awareness. This furthers evidence provided in prior case reports that high acuity low occurrence critical care procedures can be facilitated via remote telehealth support.
Disparities in patient experience with video and audio-only virtual care.
Loevinsohn G, Cui Y, Schwamm LH … +1 more , Zachrison KS
J Telemed Telecare · 2026 Jul · PMID 40920347 · Full text
IntroductionThe rapid expansion of virtual ambulatory care has included both video and audio-only modalities. The impact of visit modality on patient experience is poorly understood, particularly in the interplay with so...
IntroductionThe rapid expansion of virtual ambulatory care has included both video and audio-only modalities. The impact of visit modality on patient experience is poorly understood, particularly in the interplay with social health determinants and technical aspects of virtual care. We sought to characterize differences in the patient-reported experience of virtual care between video and audio-only modalities, and to understand drivers of these differences.MethodsWe analyzed one year of ambulatory virtual visits with linked patient experience data from a US health system. Using nested logistic models, with a patient's likelihood to recommend the provider as the primary outcome, adjusting for patient- and physician-level covariates, we explored differences in experience by visit modality (video vs audio-only), including across demographic groups. We further assessed the impact of modality on patients' experience with technical aspects of virtual care.ResultsAmong 90,670 virtual encounters with patient experience data, 16% were audio-only. Compared with video-based encounters, audio-only visits were associated with lower likelihood to recommend overall (OR 0.75; 95%CI 0.70-0.80) and worse experience with many technical aspects. Black patients were more likely to have audio-only encounters and worse overall patient experience. This disparity persisted after adjusting for visit modality and was partly mediated by differences in perceived respectful provider communication and associated interpersonal aspects of care.DiscussionAudio-only virtual care remains central to ensuring access to care, but poses challenges for patient experience. Interventions and investments targeted at improving technical facets and provider communication are needed, particularly for ensuring equitable experience across racial groups.
Assessing validity and costs of virtual diagnostics for sleep disorders: A feasibility study.
Beier CP, Ølholm AM, Morais GNBDR … +2 more , Waarkjær Olsen AC, Kidholm K
J Telemed Telecare · 2026 Jul · PMID 40920338 · Publisher ↗
IntroductionThe use of digital solutions including patient-reported outcomes is limited to follow-up of patients with established diagnoses but is rarely used as first step of the diagnostic process substituting a person...
IntroductionThe use of digital solutions including patient-reported outcomes is limited to follow-up of patients with established diagnoses but is rarely used as first step of the diagnostic process substituting a personal contact with a health professional. We report on the diagnostic validity and cost per patient implications based on a feasibility study of a new virtual diagnostic service (VDS) for common neurological sleep disorders that, as a first step, involves the collection and automated analysis of self-reported digital patient data.MethodsThe VDS was established at the Odense University Hospital, Denmark. Assessment of diagnostic validity of the underlying algorithm was conducted independently and blinded. Estimation of effects on cost per patient was based on administrative hospital cost data comparing similar periods before and after the introduction of VDS and estimates for travel and time consumption to assess the patients' economic benefits.ResultsA questionnaire-based algorithm was developed leveraging the diagnostic criteria of the American Academy of Sleep Medicine; comprehensibility was secured and improved by initial patient involvement. Parallel use of both the questionnaire and assessment by a senior sleep specialist of the first 20 patients revealed no discernible safety concerns and resulted in additional linguistic adaptions. The final questionnaire was completed by 123 of 157 patients (78.3%) identified as suitable for VDS. The questionnaire-based algorithm resulted in correct use of additional diagnostic procedures in 84 out of 95 patients with final diagnosis at data closure (88.4%, Cohen's kappa: 0.84). The algorithm proposed a specific diagnosis in 55 patients that was correct in 49.1% of cases (Cohen's kappa: 0.39). The economic analysis revealed a 46.7% reduction of the time from referral to diagnosis of the patient (226.5 days to 120.7 days). The average number of contacts with health professionals decreased from 2.15 to 1.26, the average direct costs per patients were reduced by 39.6% from 1811 Danish Kroner (DKK) to 1093 DKK. We estimated a 40.6% reduction of the total costs per patients from 3904 DKK to 2320 DKK including time consumption and travel costs.DiscussionThis first feasibility study indicates that use of digital diagnostic solutions as first step of the diagnostic process of neurological sleep disorders combined with an essentially complete virtual work flow has high accuracy and may be associated with reduced time for diagnostics and cost reductions for health providers and patients.
Effects of the remote video-based SARAH program in individuals with rheumatoid arthritis: A randomized controlled single-blinded study.
Ceylan A, Baskan E, Inanc I … +7 more , Sarac DC, Ozkan A, Karaca NB, Solmaz D, Gucenmez S, Akar S, Bayraktar D
J Telemed Telecare · 2026 Jul · PMID 40920335 · Publisher ↗
IntroductionTo investigate the effectiveness of the remote video-based Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) exercise program in individuals with rheumatoid arthritis (RA) with wrist i...
IntroductionTo investigate the effectiveness of the remote video-based Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) exercise program in individuals with rheumatoid arthritis (RA) with wrist involvement.MethodsSeventy-three individuals were included in the study. Wrist joint position sense, wrist joint range of motion, wrist pain, wrist morning stiffness, subjective and objective hand function, grip strength, and disease-related health status were assessed at baseline and after 12 weeks. Following the baseline assessment, participants were randomly assigned into two groups as SARAH and Control. All participants maintained their pharmacological therapy. The SARAH group received SARAH exercise videos via a free messaging platform (WhatsApp Messenger) weekly and performed the program daily for 12 weeks. No additional intervention was provided to the control group.ResultsForty-nine individuals (SARAH group = 28, control group = 21) completed all study procedures. Both per-protocol and intention-to-treat (ITT) analyses showed significant improvements in all parameters in the SARAH group ( < 0.05), while no statistically significant changes were detected in the control group ( > 0.05). When the changes were compared between the groups, SARAH group showed greater improvements regarding the changes in wrist joint position sense, wrist flexion, extension (only in ITT analysis) and radial deviation joint range of motion, wrist pain, wrist morning stiffness duration (only in ITT analysis), hand function, grip strength, and disease-related health status compared to the control group ( < 0.05).DiscussionA 12-week remote video-based SARAH exercise program provides additional benefits in individuals with RA who present wrist related problems when added to pharmacological therapy.
Same goal, different perspectives: Stakeholder views on context for connected care technology implementation in an integrated healthcare system.
Robinson SA, Lipschitz JM, Ndiwane N … +8 more , Bixler FR, Etingen B, Zocchi MS, Shimada SL, Palmer JA, Newton TJ, Shah N, Hogan TP
J Telemed Telecare · 2026 Jul · PMID 40910952 · Full text
IntroductionThe Veterans Health Administration (VHA) prioritizes use of connected care technologies to enhance access and outcomes. The context in which connected care is implemented is crucial, yet difficult to measure,...
IntroductionThe Veterans Health Administration (VHA) prioritizes use of connected care technologies to enhance access and outcomes. The context in which connected care is implemented is crucial, yet difficult to measure, due to its subjective and complex nature. This evaluation examined alignment among stakeholder perceptions of context related to connected care implementation across VHA.MethodsA national, cross-sectional survey assessed perceptions of 11 contextual factors relevant to connected care implementation as identified in published reviews within the implementation science literature. Across 142 VHA facilities and 18 regions, surveys were sent to four stakeholder groups: clinical team members, connected care coordinators, facility leadership, and regional leadership. Mean scores for each factor were compared between stakeholder groups using Welch's ANOVA and Bonferroni-corrected post-hoc comparisons.ResultsA total of 5541 respondents (36.1% response rate) participated. Organizational Culture and Climate was rated the most favorable contextual factor (mean = 3.9, SD = 0.7), while Financial Resources was perceived as least favorable (mean = 3.0, SD = 1.0). Significant differences emerged between the perceptions of frontline workers (clinical team members, connected care coordinators) and leadership (facility, regional). Clinical team members rated nearly all contextual factors less favorably than facility leadership. Coordinators similarly rated most factors less favorably than leadership.DiscussionFindings highlight a misalignment between leadership and frontline workers in their perceptions of organizational context for implementing connected care technologies. Leadership viewed key contextual factors (e.g. Organizational Readiness to Change, Leadership Support) more favorably than frontline workers. This misalignment may impact implementation success, suggesting a need for strategies to better align stakeholder perceptions.
The agreement between face-to-face and tele-assessment of ataxia severity scales in multiple sclerosis patients with ataxia.
Ozvar Senoz GB, Ayvat F, Ayvat E … +1 more , Kilinc M
J Telemed Telecare · 2026 Jun · PMID 40831242 · Publisher ↗
BackgroundTele-assessments are becoming increasingly important to increase access to healthcare services and facilitate patient follow-up. Whether they can provide results with similar accuracy to face-to-face assessment...
BackgroundTele-assessments are becoming increasingly important to increase access to healthcare services and facilitate patient follow-up. Whether they can provide results with similar accuracy to face-to-face assessments remains relevant.ObjectiveThe aim of this study was to compare the face-to-face and tele-assessment scores of the International Cooperative Ataxia Rating Scale (ICARS) and Assessment and Rating of Ataxia (SARA) in ataxic MS patients and to examine their suitability for tele-assessment.MethodsThe participants were assessed both online and face-to-face. Randomization determined which method would be used first to assess the participants. ICARS and SARA were used in the assessments. Face-to-face assessments were conducted as part of routine clinical practice by one researcher, while teleassessments were performed via real-time video by two different researchers. The video was recorded and reassessed one week later. The agreement and correlation between face-to-face and teleassessments were analyzed using intra-class correlation coefficients (ICC), Bland-Altman Plots, and Pearson's/Spearman's correlation coefficients.ResultsThis study included 20 patients with ataxic MS with an EDSS score of 3.6 ± 0.66. The inter-rater reliability of tele-assessments (ICC = 0.97; ICC = 0.97) achieved excellent reliability. Intra-rater reliability of the tele-assessment was excellent (ICC = 0.99; ICC = 0.99). High correlations were observed in ICARS and SARA scores between face-to-face and tele-assessment methods according to assessors ( > .80 for all).ConclusionICARS and SARA are reliable and agreed-upon tests that can be used with tele-assessments, offering similar data to face-to-face methods.
Co-design of a digital health lifestyle intervention for adults with metabolic dysfunction-associated steatotic liver disease.
Sood S, Roberts SK, Scott D … +8 more , Keating SE, Tan SY, George J, Kiss N, Daly RM, Dunstan DW, Tucker RM, George ES
J Telemed Telecare · 2026 Jun · PMID 40831241 · Publisher ↗
IntroductionBehavioural changes targeting diet and physical activity to achieve weight loss are considered the cornerstones of metabolic dysfunction-associated steatotic liver disease (MASLD) management. Digital health i...
IntroductionBehavioural changes targeting diet and physical activity to achieve weight loss are considered the cornerstones of metabolic dysfunction-associated steatotic liver disease (MASLD) management. Digital health interventions effectively address barriers in accessing such lifestyle interventions particularly for persons in remote and regional communities that have high rates of MASLD and limited access to healthcare. This research uses co-design methodology to inform the development of a multimodal, digital lifestyle intervention for individuals with MASLD.MethodsOver 20 months (May 2023-January 2025), an iterative co-design process guided by the Double Diamond framework-was implemented. Twenty-seven adults (≥18 years) from Alfred Health, Australia participated in one-on-one interviews to explore insights and perspectives during the phase. This included people with MASLD ( = 10; 50% female; mean age: 63.6 years), and healthcare professionals ( = 17; 59% female; mean age: 37.1 years) [dietitians ( = 5), exercise professionals ( = 6) and hepatologists/clinicians ( = 6)], representing a range of ethnic backgrounds. Key themes were synthesised using a reflexive thematic analysis employing a data-driven, inductive approach during the phase. The phase led to actionable suggestions, and final feedback was sought from participants in the phase.ResultsInterviews identified barriers and facilitators that influenced participant engagement and adherence to the digital intervention, highlighting the need for an evidence-based, personalised and holistic approach during the and phases. Five key themes emerged: i) content relevance and adaptability, ii) personalisation, iii) social and community, iv) barriers and facilitators, and v) website interface design. The phase focused on refining the intervention based on participant feedback and phase encompassed finalising the digital intervention.ConclusionsThis iterative co-design process identified the needs and preferences of individuals with MASLD for a multimodal, digital lifestyle intervention. This research will guide a holistic, tailored approach with culturally appropriate resources and community engagement, piloted to assess feasibility.
Telehealth use in home health care in the US: A literature review.
Chen X, Li R, Ma C
J Telemed Telecare · 2026 Jun · PMID 40785511 · Publisher ↗
ObjectiveThe rapid shift toward home- and community-based care in the US has intensified the demand for home health care, particularly as the population continues to age. Amid challenges such as workforce shortages and i...
ObjectiveThe rapid shift toward home- and community-based care in the US has intensified the demand for home health care, particularly as the population continues to age. Amid challenges such as workforce shortages and increasing patient needs, telehealth has emerged as a potential strategy to enhance care delivery and patient outcomes in home health settings. This literature review examines empirical studies published between January 2020 and April 2024 to investigate the status of telehealth use within the US in home health care settings.MethodsA systematic search was conducted in PubMed and CINAHL for peer-reviewed studies published in English between January 2020 and April 2024. Quality of reviewed studies was assessed independently by reviewers using quality assessment checklists.ResultsSix quasi-experimental studies were included, examining various telehealth modalities in home health care. Tele-video, tele-calls, and remote monitoring were commonly used for patient education, symptom management, and interdisciplinary collaboration. Telehealth interventions were generally associated with high patient satisfaction, reduced acute care utilization, and improved communication between providers and caregivers. Study quality varied, with limitations in sample size, methodology, and outcome measurement affecting generalizability. Further research is needed to optimize telehealth integration in home health care.ConclusionsThese findings highlight the effectiveness of telehealth in delivering home health care and its potential to address current challenges. These findings also call for policy changes for expanded reimbursement models as well as large-scale pragmatic studies to enhance telehealth integration in home health care to support aging in place.
Are universal digital mental health interventions effective for promoting mental health outcomes among children and adolescents? A meta-analysis of effects and moderators.
Takizawa Y, Zhou X, Krishnamoorthy G … +8 more , March S, Slee P, Pill S, Agnew D, O'Dea B, Wang T, Han W, Edirippulige S
J Telemed Telecare · 2026 Jun · PMID 40702942 · Publisher ↗
IntroductionUniversal digital mental health interventions (DMHIs) are emerging as a viable approach to promoting mental health among children and adolescents in general population. However, there is a scarcity of meta-an...
IntroductionUniversal digital mental health interventions (DMHIs) are emerging as a viable approach to promoting mental health among children and adolescents in general population. However, there is a scarcity of meta-analyses that examined their short- and long-term effects or potential moderators in individuals aged 19 or younger.MethodsA systematic search was conducted to identify randomised controlled trials that delivered universal DMHIs for promoting mental health, targeting children and adolescents aged 19 or younger in general population. Meta-analysis was performed to identify studies using Comprehensive Meta-Analysis.ResultsThe meta-analysis of 29 included studies identified significant overall effects ( = 0.16) as well as significant effects for anxiety ( = 0.09), depression ( = 0.06), psychological distress ( = 0.28), externalising problem ( = 0.21), psychological well-being ( = 0.19), interpersonal functioning ( = 0.21) and social-emotional skills ( = 0.19) at post-intervention. The analysis of 7 studies that followed up 6 months or longer revealed a significant overall effect ( = 0.09) as well as significant effects for anxiety ( = 0.11) and depression ( = 0.05) at follow-up. Age and intervention duration moderated the overall effects. Gamification moderated the effect on depression. Attrition rate moderated the effect on social-emotional skills.ConclusionsProviding universal DMHIs with longer durations to younger children may be critical for effectively improving a range of mental health outcomes among children and adolescents. To promote engagement and effectiveness, future studies may explore how gamification and other features for reducing attrition could be effectively incorporated into DMHIs.
Suicide prevention ECHO: Evaluating a tele-education program to increase suicide prevention knowledge and skills in adolescent and adult providers.
Liu A, Otero S, Gower P … +9 more , Allen S, Hamilton M, Rodriguez I, Mittal K, Lee R, Baker NA, Patrick S, Johnson D, Laiteerapong N
J Telemed Telecare · 2026 May · PMID 40686370 · Publisher ↗
IntroductionSuicide is the second leading cause of death in persons aged 10-34 in the US. Despite the availability of evidence-based suicide screening tools and interventions, there is a gap in suicide prevention knowled...
IntroductionSuicide is the second leading cause of death in persons aged 10-34 in the US. Despite the availability of evidence-based suicide screening tools and interventions, there is a gap in suicide prevention knowledge among non-psychiatric healthcare providers. This study examined a novel education program, Project ECHO, focused on suicide prevention. Project ECHO delivers subspecialized medical knowledge via teleconferencing to primary care providers and behavioral health providers.MethodsThe ECHO-Chicago Suicide Prevention program encompassed three series with 10 (behavioral health providers & primary care providers) or 9 (pediatric primary care providers) one-hour sessions in 2023-2024. Each session was comprised of expert-led didactics and participant-led case discussions. Topics included suicide epidemiology, secondary stress, zero suicide model, screening, cultural competency, safety planning, follow-up, and post-acute care transitions. Pre- and post-series surveys were used to evaluate the education program. Free text responses were analyzed using thematic coding.ResultsIn total, 106 participants participated in the program; 79 (75%) completed both the pre- and post-series surveys. Overall mean self-efficacy scores increased from 4.1 to 5.4 ( < 0.0001) in the behavioral health providers/primary care providers series and from 3.3 to 5.2 ( < 0.0001) in the pediatric primary care providers series. Participants reported an improved ability to manage complex cases and an increased quality of care. Qualitative analysis suggested clinicians benefited from learning specific screening tools and soft skills, including patient communication.DiscussionAs an affordable, scalable model, our novel curriculum has the potential to improve suicide prevention knowledge and practices amongst pediatric, adult, behavioral health, and interdisciplinary providers.
Telerehabilitation in the remote care of patients' post-orthopaedic surgery: Benefits and limitations for patients.
Ouendi N, Avril E, Dervaux B … +2 more , Pudlo P, Wallard L
J Telemed Telecare · 2026 May · PMID 40686347 · Publisher ↗
ObjectiveThe aim of this study was to identify the factors that might influence patients' adoption of telerehabilitation post-orthopaedic surgery knee and hip.MethodSemi-structured interviews were conducted with 20 total...
ObjectiveThe aim of this study was to identify the factors that might influence patients' adoption of telerehabilitation post-orthopaedic surgery knee and hip.MethodSemi-structured interviews were conducted with 20 total hip arthroplasty (THA; = 6) and total knee arthroplasty (TKA; = 14) patients. These interviews were guided by an interview framework inspired by the Unified theory of acceptance and use of technology 2 (UTAUT2). The System Usability Scale (SUS) was used to assess patients' perception of usability.ResultsThe interviews highlighted facilitators perceived by the subjects, such as reinforcement and motivation to practice physical activity, personalised follow-up from clinicians (via gamification), complementarity to conventional therapy and cost (urban travel). The results also revealed perceived barriers, including the risk of injury and lack of relationship with the professional. These factors need to be considered in user-centred design. SUS results were not influenced by the subject gender, or age. The results obtained for the SUS indicate an average score of 54.6 ± 19.6, meaning that potential usability is slightly acceptable.ConclusionUser-centred design is essential for adherence. Individualised and gamified programmes could improve patient care by encouraging participation and autonomy. Setting achievable goals and clinician support help maintain engagement, ensuring the long-term benefits of exercise. These key points could increase mass participation and thus improve telerehabilitation care.
Effectiveness of telehealth interventions for family caregivers of older adults with multiple diseases: A systematic review and meta-analysis.
Ortiz-Piña M, Encarnación Martín-Franco M, Molina-García P … +4 more , Prieto-Moreno R, Mora-Traverso M, Russell T, Ariza-Vega P
J Telemed Telecare · 2026 Jun · PMID 40665825 · Publisher ↗
IntroductionTelehealth may offer a valuable resource for family caregivers' physical and psychological well-being; however, understanding its effectiveness is crucial to determining its true potential. Thus, this systema...
IntroductionTelehealth may offer a valuable resource for family caregivers' physical and psychological well-being; however, understanding its effectiveness is crucial to determining its true potential. Thus, this systematic review and meta-analysis aims to examine the effectiveness of telehealth interventions focused on family caregivers' physical and psychological well-being, along with other factors during the care of older adults with various diseases (such as neurocognitive disorders, chronic conditions, and musculoskeletal diseases).MethodsPubMed, Web of Science, Scopus, and Cochrane Library databases were searched. Studies that investigated the effects of telehealth on family caregivers of older adults with any disease and a comparison group receiving any type of intervention were selected. Two independent reviewers carried out the study selection and data extraction. We conducted a meta-analysis using standardized mean differences (SMDs) to pool the continuous outcomes included. Heterogeneity (² and Tau²), publication bias (Egger's test and funnel plots), risk of bias (Joanna Briggs Institute tool), potential mediators (meta-regressions), and robustness (leave-one-out method) were also assessed.ResultsTwenty-six studies were selected (23 randomized controlled trial and 3 quasi-experimental studies), including a total of 2932 family caregivers. Telehealth was more effective than usual care in improving psychological well-being (SMD = 0.21; = 0.006), caregiving competence (SMD, 0.73; = 0.007), and reducing caregiver burden (SMD = -0.26; = 0.01) in a follow-up shorter than 4 months. It was not effective in reducing anxiety or depression (SMD = -0.18 and -0.40; = 0.08 and 0.20, respectively), nor in improving physical fitness (SMD = -0.16; = 0.460). Considering a follow-up period of 4-12 months, the only outcome in favor of telehealth was the improvement in managing patients' problematic behaviors (SMD = -1.27; < 0.0001). It was not effective for psychological well-being, anxiety, depression, or caregiver burden (SMD = 0.15, 0.22, 0.08, and -0.33; = 0.290, 0.260, 0.550, and 0.550, respectively).ConclusionTelehealth may be a valuable option for supporting family caregivers of older adults in improving psychological well-being, caregiving competence, and reducing burden, but the benefits may not last long term.
Effects of telemedicine interventions on cognitive function in post-stroke cognitive impairment: A systematic review and meta-analysis.
Zhong Q, Wu Y, Zhi S … +7 more , Fang S, Li M, Li J, Zhang H, Lang J, Wang R, Sun J
J Telemed Telecare · 2026 Jun · PMID 40660940 · Publisher ↗
BackgroundPost-stroke cognitive impairment is characterized by cognitive dysfunction occurring within 6 months post-stroke. Telemedicine uses communication technologies to deliver healthcare remotely and has shown effica...
BackgroundPost-stroke cognitive impairment is characterized by cognitive dysfunction occurring within 6 months post-stroke. Telemedicine uses communication technologies to deliver healthcare remotely and has shown efficacy in improving cognitive impairment. However, a systematic review specifically evaluating telemedicine's effects on cognitive outcomes in post-stroke cognitive impairment is lacking.ObjectivesThis systematic review aimed to examine the effectiveness of telemedicine interventions for cognitive function in post-stroke cognitive impairment.MethodsA comprehensive search was performed across 10 electronic databases, including PubMed, Web of Science, CINAHL, EMBASE, Cochran library, Scopus, and ProQuest Dissertations and three Chinese-language databases (CNKI, Wan Fang, and Vip) from their respective inception dates to May 2025. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Meta-analysis was performed by the use of Review Manager 5.3 and Stata 15.ResultsThe initial search yielded 10,365 articles, with 19 studies included in the systematic review. The results showed that telemedicine interventions had a significant moderate effect on global cognition (standardized mean difference (SMD = 0.69, = 4.23, < 0.01) and significantly improved visuospatial function (SMD = 0.57, = 2.76, < 0.05) and language (SMD = 0.62, = 2.59, < 0.05). Sub-group analyses showed significant effects for both online tools or computer software and mobile apps, though high heterogeneity was noted. Additionally, telemedicine interventions had a significant effect on activities of daily living (SMD = 0.64, = 5.16, < 0.01).ConclusionConsidering the obstacles and limitations of traditional face-to-face rehabilitation, telemedicine is an effective approach for treating post-stroke cognitive impairment that can significantly improve cognitive function. Future studies should address heterogeneity through rigorous designs, long-term follow-ups, neuroimaging, and biomarker integration to elucidate underlying mechanisms.The protocol was registered on PROSPERO (CRD42024502185).
Telecare enhances the retention of patients with inflammatory bowel disease within a tertiary care inflammatory bowel disease center.
Olson J, Beaulieu D, Bennett A … +6 more , Dalal R, Pabla B, Schwartz DA, Scoville E, McCoy A, Horst S
J Telemed Telecare · 2026 May · PMID 40551537 · Publisher ↗
BackgroundTelecare is increasingly important in managing patients with chronic diseases, including patients with inflammatory bowel disease (IBD). This study evaluates the impact of telecare on patient retention and acce...
BackgroundTelecare is increasingly important in managing patients with chronic diseases, including patients with inflammatory bowel disease (IBD). This study evaluates the impact of telecare on patient retention and access to tertiary care for patients with IBD.MethodsWe analyzed patient data from a tertiary care IBD center, comparing patterns pre-COVID (January 2018 to March 2020) and post-COVID (August 2020 to January 2023) as only post-COVID patients had availability of telecare for return visits. Patients were classified based on their visit types and drive times to the clinic. Statistical analyses were conducted using Pearson Chi Square analysis for categorical variables as well as Mann-Whitney U and Kruskal-Wallis statistical tests with Bonferroni correction for multiple tests.ResultsA total of 7040 patients were included. In the post-COVID period, 62% of return visit patients chose telecare, leading to increased retention rates (nonreturning patients decreased from 14% to 8%). Returning patient retention increased for 2 to 3 hours and more than 3 hours of drive time (+10% and +14%). Telecare return patients had significantly longer drive times (median 56.1 minutes) than nonreturn (median 45.7 minutes, p = 0.007) and in-person return prior to telecare availability (median 38.8, p < 0.001) patients. Patient satisfaction scores were high for both telecare and in-person visits. Telecare patients had lower rates of emergency department visits and hospital admissions.ConclusionTelecare significantly enhances patient retention and access to tertiary IBD care, particularly for patients living at greater distances. The study demonstrates that telecare is an effective strategy for maintaining multidisciplinary IBD care without compromising patient satisfaction or outcomes.
Exploration of a remote swallowing training model after laryngeal cancer surgery: Non-randomized concurrent controlled trial.
Li N, Guo W, Hu Z … +2 more , Huang Z, Huang J
J Telemed Telecare · 2026 Feb · PMID 40491348 · Publisher ↗
BackgroundPatients with supraglottic laryngeal carcinoma need to receive swallowing rehabilitation training. During the COVID-19 pandemic, patients do not have the conditions to visit the hospital for follow up frequentl...
BackgroundPatients with supraglottic laryngeal carcinoma need to receive swallowing rehabilitation training. During the COVID-19 pandemic, patients do not have the conditions to visit the hospital for follow up frequently, so it is imperative to explore a new remote rehabilitation training model based on network conditions.ObjectiveTo explore the effect of remote rehabilitation training mode on improving postoperative swallowing function in patients with supraglottic laryngeal carcinoma.MethodsPatients undergoing remote rehabilitation and video rehabilitation after surgical treatment for supraglottic laryngeal cancer, 16 each, were collected, and swallowing function at the start of transoral feeding was assessed as a baseline to compare swallowing function and the occurrence of complications at different stages of training.ResultsPatients in the remote group began to show significant improvement in subjective swallowing function from the second week (< .001). In terms of objective swallowing function, although the remote group did not show a significant (= .66) advantage initially, it was also significantly better than the control group in the fourth week (＜.001). These effects are even more impressive in patients undergoing open surgery (＜.001). When completed the rehabilitation phase, patients in the remote group had a better nutritional status (= .03), especially postlaser surgery patients (= .02).ConclusionsThe remote rehabilitation training model has an improving effect on patients with supraglottic laryngeal cancer postoperative swallowing disorder, which provides a theoretical basis for the design and improvement of the future remote rehabilitation training model. This study suggests that this training model should be incorporated into the daily postoperative management of patients with laryngeal cancer to improve the efficiency of patients' recovery, provide patients with real-time medical information, and relieve patients' anxiety, thus reducing the need for repeated visits and improving patients' postoperative quality of life.
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