Journal Of Telemedicine And Telecare[JOURNAL]
Sun
200 papers
2024 JTT statistics and acknowledgements.
Smith AC
J Telemed Telecare · 2026 Apr · PMID 40491127 · Publisher ↗
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Telerehabilitation for peripheral facial palsy: A scoping review.
Grillo D, Ossola G, Cecconi M … +8 more , Vania S, Geraci I, Calò G, Federico S, Zitti M, Cieślik B, Zangarini S, Kiper P
J Telemed Telecare · 2026 May · PMID 40485309 · Full text
Background and ObjectivesDriven by the rising demand for telerehabilitation (TR) services and digital transformations in the healthcare management of people with facial palsy (FP), studies on TR programs in this specific...
Background and ObjectivesDriven by the rising demand for telerehabilitation (TR) services and digital transformations in the healthcare management of people with facial palsy (FP), studies on TR programs in this specific population are steadily increasing. Our scoping review aimed to provide an overview of the current state of knowledge on TR for people with FP by addressing three subquestions regarding the types of studies conducted, the technologies used, and the potential existing technologies that could be adapted for TR in this context.Study Design and MethodsWe followed the Joanna Briggs Institute methodology for scoping reviews. Between January and February 2024, two authors performed a literature search on Medline, Cochrane, PEDro, and Scopus databases, while two additional authors conducted a gray literature search using the "Grey Matters" tool, repositories, and Google.ResultsA total of 10,804 reports were initially considered in this scoping review. After the screening process, we included and analyzed 39 results. We found 18 studies with 11 different study designs or types related to TR in FP, 14 technologies projected or already used for TR purposes with a variety of delivery methods or rehabilitative treatments, and 18 additional digital instruments suitable for different TR stages.ConclusionsOur findings indicate a growing interest in and development of TR instruments, aligning with the broader expansion of telemedicine services across healthcare. We have identified a diverse range of delivery methods, rehabilitative treatments, and digital tools utilized in TR for FP. Additionally, our comprehensive overview provides healthcare providers with practical insights to improve their approach to managing patients with FP in TR contexts.
Development and validation of novel scales to measure trust and confidence in using telephone and video consultation scales in people with chronic kidney disease.
de Camargo Catapan S, Haydon HM, Santiago PH … +10 more , Hickman IJ, Webb L, Isbel N, Johnson DW, Mayr HL, Canfell OJ, Scuffham P, Burton NW, Smith AC, Kelly JT
J Telemed Telecare · 2026 Apr · PMID 40462680 · Publisher ↗
AimPatients' trust and confidence in telehealth are core components of its adoption, effectiveness and sustained use. This study aimed to develop and validate scales to measure trust and confidence in using telephone and...
AimPatients' trust and confidence in telehealth are core components of its adoption, effectiveness and sustained use. This study aimed to develop and validate scales to measure trust and confidence in using telephone and video consultations in people with chronic kidney disease (CKD).MethodsAfter developing potential items, two-phases were conducted to investigate construct validity. Phase 1 examined face and content validity via: think-aloud patients focus group ( = 5), specialists email feedback ( = 3) and telehealth investigators group discussion ( = 4). Phase 2 used factor analytical methods to evaluate structural validity and internal consistency reliability after surveying a sample of people with CKD at an Australian metropolitan hospital. Four exploratory factor analyses (EFA) with oblique rotation Promax were conducted. Parallel analysis was used for factor retention and items with factor loadings ≥0.60 on the primary factor and without substantive cross-loadings were maintained. Cronbach's alpha () measured the internal consistency reliability.ResultsPhase 1 resulted in 17 items to measure trust in telephone consultations, 17 items to measure trust in video consultations, 8 items to measure confidence in using telephone consultations and 8 items to measure confidence in using video consultations (total 50 items). Phase 2: EFA results ( = 156) for the trust scales were both unidimensional: (1) 12-item trust in telephone consultations ( = 0.92); (2) 12-item trust in video consultations ( = 0.93). EFA resulted in two factors for each of the confidence scales: (3) Confidence in using telephone consultations ( = 0.82), comprising 4-item 'competence & capability' factor ( = 0.84) and 3-item 'social & technical support' factor ( = 0.82); (4) Confidence in using video consultations ( = 0.84) comprising 4-item experience 'competence & capability' factor ( = 0.84) and 3-item 'social & technical support' factor ( = 0.82). Internal consistency reliability of all scales and subscales were adequate ( > 0.80).ConclusionOur study demonstrated excellent psychometric properties of the TCTVC scales, which can be reliably used across broader cohorts.
The effectiveness and cost-effectiveness of a virtual Hospital in the Home service for COVID-19 infection: A cohort study and modelled decision analysis.
Vo LK, Allen MJ, McPhail SM … +4 more , Wallis S, McGowan K, Atkinson K, Carter HE
J Telemed Telecare · 2026 May · PMID 40457942 · Full text
IntroductionThis paper estimates the effectiveness and cost-effectiveness of a Hospital in the Home (HITH) service using virtual care technology to provide home-based care for COVID-19 patients with moderate symptoms in...
IntroductionThis paper estimates the effectiveness and cost-effectiveness of a Hospital in the Home (HITH) service using virtual care technology to provide home-based care for COVID-19 patients with moderate symptoms in Queensland, Australia.MethodsA cohort study was conducted to analyse data of all patients admitted to the virtual COVID-19 HITH service between December 2021 and November 2022. A decision tree model was developed to compare of the cost-effectiveness of this service with a hypothetical usual care cohort admitted to a conventional physical ward from the perspective of the Australian health system. Comparator cohort data were sourced from published literature. Base-case analysis employed a 3-month time horizon with an additional lifetime scenario analysis. Quality-adjusted life-years (QALYs) were used as the measure of effectiveness. Sensitivity analyses were performed to assess the robustness of the model.ResultsThe virtual COVID-19 HITH service saved 15,273 bed days. The cost-effectiveness analysis indicated the virtual COVID-19 HITH model was dominant, resulting in an additional 0.015 QALYs and a cost saving of $201 per patient compared to usual care. The incremental cost-effectiveness ratio was most sensitive to the cost of operating the virtual HITH. When all uncertainties were considered, there was 74% likelihood that the virtual HITH model of care was cost-effective, assuming a willingness to pay of $28,033/QALY.DiscussionHITH services incorporating virtual care modalities replicating the systems, staffing, and daily routines of a hospital ward are likely to be an effective and cost-effective intervention to expand inpatient care capacity.
The physical and psychological effectiveness of mHealth-based physiotherapy for patients with chronic non-specific low back pain: A systematic review and meta-analysis.
Shi W, Chen L, Zhang Y … +9 more , Yuan W, Li Q, Chen Z, Zhang H, Feng Q, Gan Y, Zhang H, Liu D, Lin Y
J Telemed Telecare · 2026 May · PMID 40432621 · Full text
BackgroundTo determine (a) the effect of mHealth-based physiotherapy for patients with chronic non-specific low back pain (CNLBP) on fear, anxiety, depression, and self-efficacy; (b) which is the most effective on improv...
BackgroundTo determine (a) the effect of mHealth-based physiotherapy for patients with chronic non-specific low back pain (CNLBP) on fear, anxiety, depression, and self-efficacy; (b) which is the most effective on improving individuals' pain intensity and physical disability through the comparison of the efficacy of mHealth-based physiotherapy with outpatient-based physiotherapy, home-based physiotherapy with simple supervision or unsupervision, and waiting-list group.MethodsThe systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in PubMed, MEDLINE (via Ovid), Scopus, Embase, the Physiotherapy Evidence Database (PEDro), Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) until September 20, 2024. Two independent reviewers (LQ and CZW) extracted information about origin, characteristics of study participants, eligibility criteria, characteristics of interventions, outcome measures and main results.ResultsA total of 37 RCTs involving 5832 participants were included. The risk of bias was generally low in the included studies. The results indicated that mHealth-based physiotherapy for individuals' CNLBP was more effective in reducing pain intensity (standardized mean difference [SMD] -0.32, 95% CI -0.48 to -0.17; < 0.001), improving physical disability (SMD -0.30, 95% CI -0.42 to -0.18; < 0.001), and decreasing fear-avoidance (SMD -0.28, 95% CI -0.47 to -0.09; = 0.004). However, the mHealth-based physiotherapy was less effective on decreasing anxiety (SMD 0.29, 95% CI 0.06-0.52; = 0.01) and remained unclear in decreasing depression (SMD 0.13, 95% CI -0.05 to 0.31; = 0.16) and improving self-efficacy (SMD 0.14, 95% CI -0.06 to 0.34; = 0.18). In subgroup analyses of pain intensity and physical disability, mHealth-based physiotherapy for individual with CNLBP was more effective than outpatient-based physiotherapy, home-based physiotherapy with simple supervision or unsupervision and waiting-list groups.ConclusionOur meta-analysis suggested that mHealth-based physiotherapy holds significant potential for reducing pain intensity and fear-avoidance, and improving physical disability in individuals with CNLBP compared to traditional physiotherapy model. However, its effect was less on reducing anxiety and depression, and improving self-efficacy.
Telephone versus video consultations: A systematic review of consumer and provider preferences.
Snoswell CL, Haydon HM, Catapan SC … +6 more , Kelly JT, Thomas EE, Neil LJ, Taylor ML, Smith AC, Caffery LJ
J Telemed Telecare · 2026 May · PMID 40432456 · Publisher ↗
IntroductionAs telehealth services are increasingly utilised and mature, it is important to continue to assess the preferences of both consumers and providers to ensure that these services are being used in the most acce...
IntroductionAs telehealth services are increasingly utilised and mature, it is important to continue to assess the preferences of both consumers and providers to ensure that these services are being used in the most acceptable and effective manner. This review aims to analyse both consumer and provider preferences for telephone and video consultations.MethodsA systematic search of MEDLINE, CINAHL and Embase databases was conducted in April 2023 to identify studies that investigated consumer or provider preferences for either telephone or video consultations. Data were extracted and synthesised narratively with the main reported findings from each article categorised in regard to modality preference (i.e. preference for either telephone or video; no preference between modality, equivalency, or mixed preference statements).ResultsA total of 78 articles were included in the analysis. Studies were published between 2003 and 2023, with the majority (86%) published after 2020. While most studies used quantitative survey methods (69.2%), five used qualitative (6.4%) and 19 used a mixed methods approach (24.4%). The majority of included studies (54% of consumer studies and 76% of provider studies) reported video as the preferred telehealth modality over telephone.DiscussionAlthough video is mostly preferred over telephone, a number of consumer studies reported equivalent preference for telephone and video consultations and highlighted the benefits of each modality for different purposes.
Telemedicine and digital health for chronic conditions in pediatrics: A systematic review.
Exner B, Frielitz-Wagner IV, Frielitz FS
J Telemed Telecare · 2026 Apr · PMID 40329670 · Publisher ↗
BackgroundThe prevalence of chronic diseases in children and adolescents has significantly increased. The COVID-19 pandemic accelerated telemedicine adoption, leading to improved healthcare access and outcomes. Despite i...
BackgroundThe prevalence of chronic diseases in children and adolescents has significantly increased. The COVID-19 pandemic accelerated telemedicine adoption, leading to improved healthcare access and outcomes. Despite its benefits, telemedicine is still not fully integrated into standard care. Previous reviews have been limited in scope. This systematic review aims to provide a comprehensive overview of recent trials on web or app-based telemedicine for chronically ill children and adolescents, identifying interventions and outcomes for future healthcare strategies.MethodsA comprehensive search was conducted on PubMed on November 21, 2023, and updated on January 9, 2025. Results were filtered to include prospective intervention studies involving children and adolescents with chronic conditions and limited to publications from 2017 onwards. A total of 8699 results were retrieved, and 1506 titles were screened for eligibility, resulting in 116 studies included in the review.ResultsThese studies covered 45 different conditions, with the highest numbers for diabetes, asthma, and obesity. Telemedicine interventions varied, including gamification, video meetings, integrated devices, psychological components, symptom tracking, and educational content. Most studies reported high feasibility and patient satisfaction. Clinical outcomes improved in some cases, and none were worse than standard care. The heterogeneity limited direct comparisons and meta-analysis, and small sample sizes in many studies affected the generalizability and statistical significance of the findings.ConclusionsOur study highlights the potential of telemedicine in managing chronic illnesses among children, emphasizing the need for standardized methodologies, larger sample sizes, and continued investment in infrastructure and equitable policies to fully realize its benefits in improving accessibility, convenience, cost savings, and overall health outcomes.
Effect of telerehabilitation on post-COVID-19 individuals with long-term dyspnea: A randomized controlled study.
Demir C, Aksoy CC, Gokmen GY … +1 more , Durmaz D
J Telemed Telecare · 2026 Apr · PMID 40325938 · Publisher ↗
ObjectiveThis study aimed to determine the effectiveness of telerehabilitation in managing ongoing dyspnea and associated issues following coronavirus disease 2019 (COVID-19), and observe changes over time.DesignThe stud...
ObjectiveThis study aimed to determine the effectiveness of telerehabilitation in managing ongoing dyspnea and associated issues following coronavirus disease 2019 (COVID-19), and observe changes over time.DesignThe study included 36 participants who previously had COVID-19 but continued to experience dyspnea (mean age, 42.44 ± 15.51 years). The participants were randomly allocated into three groups: telerehabilitation (TRG), home exercise (HEG), and control (CG). Dyspnea level, exercise capacity, muscle oxygenation, respiratory function, and fatigue were evaluated at baseline, at 6th, and at 12th weeks. Telerehabilitation was performed supervised and synchronously via video-calls.ResultsAt the 6-week assessment, TRG showed significant improvements in dyspnea, fatigue (p < 0.001), exercise capacity (p = 0.001), and respiratory muscle strength (p < 0.001). By the 12th week, these gains were maintained, with no further changes from week 6. In HEG, dyspnea and fatigue improved at weeks 6 and 12 (p < 0.001), with no additional changes between these time points. In CG, only dyspnea improved at both assessments (p < 0.001); other parameters remained unchanged. TRG achieved greater benefits compared to CG in reducing dyspnea and fatigue at week 6 (p = 0.001 and p = 0.003, respectively), but no group differences were found at week 12 (p > 0.05). No changes in muscle oxygenation were observed in any groups or evaluation points (p > 0.05).ConclusionsTelerehabilitation effectively improved and sustained dyspnea, fatigue, respiratory muscle strength, and exercise capacity in patients with post-COVID, while home-based exercises only reduced dyspnea and fatigue. Supervised and structured telerehabilitation may be a viable approach to managing post-COVID-19 symptoms.
Tele-assessment of trunk control in children with cerebral palsy: Intra- and inter-rater reliability, and validity of the trunk control measurement scale.
Üneş S, Tunçdemir M, Özal C … +3 more , Delioğlu K, Seyhan Bıyık K, Kerem Günel M
J Telemed Telecare · 2026 Apr · PMID 40302488 · Publisher ↗
IntroductionThe aim of the study was to evaluate the intra- and inter-rater reliability, and validity of the Trunk Control Measurement Scale (TCMS) for tele-assessment in children with cerebral palsy (CP).MethodA cross-s...
IntroductionThe aim of the study was to evaluate the intra- and inter-rater reliability, and validity of the Trunk Control Measurement Scale (TCMS) for tele-assessment in children with cerebral palsy (CP).MethodA cross-sectional study was conducted with 36 children aged 4-18 years, diagnosed with hemiplegic CP. Participants underwent four TCMS assessments: in-person assessment, tele-assessment via videoconferencing, and two video-based tele-assessments scored by same rater and by a second rater. Reliability was analyzed using intraclass correlation coefficients (ICC). Discriminant validity was assessed by comparing TCMS tele-assessment scores between children with Gross Motor Function Classification System (GMFCS) levels I and II, while criterion validity was evaluated by examining the correlation between face-to-face and tele-assessment TCMS scores.ResultsExcellent reliability was observed between face-to-face and tele-assessment (ICC: 0.91; 95%CI: 0.83-0.95). TCMS tele-assessment also demonstrated excellent intra-rater reliability (ICC: 0.90, 95%CI: 0.80-0.94) and high inter-rater reliability (ICC: 0.82, 95%CI: 0.66-0.90). Criterion validity was confirmed by strong correlations between face-to-face and tele-assessment scores ( = 0.925, and = 0.892, < 0.001 for rater-1 and rater-2, respectively). The TCMS successfully discriminated children by functional levels, demonstrating discriminative validity ( = 0.002). Bland-Altman analysis revealed minimal systematic error, with internal consistency remaining high across all assessments (>0.88).DiscussionTCMS is a valid and reliable tool for teleassessing trunk control in children with hemiplegic CP. These results may pave the way for developing child-specific, targeted telerehabilitation programs, bringing telerehabilitation closer to its primary aim of ensuring equal opportunities.This study was registered as a clinical trial (NCT06707831). https://clinicaltrials.gov/study/NCT06707831.
Translatability of physical examination to teleconsultation in primary care settings.
Tong KS, Waheed M, Jackson TM … +2 more , Sota T, Lau AY
J Telemed Telecare · 2026 Apr · PMID 40270126 · Publisher ↗
BackgroundTelehealth has been widely accepted and investigated however little is known about virtual physical examination (VPE) in primary care settings. In order to understand and improve patient and clinician experienc...
BackgroundTelehealth has been widely accepted and investigated however little is known about virtual physical examination (VPE) in primary care settings. In order to understand and improve patient and clinician experience during VPE, we need to analyse the physical examination during in-person general practitioner (GP) consultations.ObjectiveWe aim to analyse the characteristics of physical examination (PE) during in-person GP consultations including topics of consultations, types of physical examinations, equipment used and body area examined. We then evaluate how translatable these PE are over telehealth.MethodsEligible consultations were extracted from a dataset archive named HaRI, which contains 281 in-person GP consultations in de-identified transcript and video format. Eligible consultations were processed with data extracted. Finally, an evidence-based scoring system was used on each PE, determining its likelihood of being translated to telehealth.ResultsWe analysed 169 in-person GP consultations, in which 79% (133 out of 169) required physical examination (PE). A total of 307 physical examinations, 224 counts of equipment and 331 counts of body parts were observed. Out of 52 physical examination components we have observed, 79% were translatable but only 8% of these were deemed easily translatable over telehealth. 21% of the physical examinations were considered 'untranslatable over telehealth'.ConclusionOver half (54%) of the physical examinations were at least moderately translatable, especially for vital signs, musculoskeletal, neurological and cardiovascular exams. However, more research is warranted to increase the accuracy, reliability and translatability of virtual physical examinations and when VPE is not feasible, safety netting should be applied.
Development and validation of the telemedicine facilitators scale: A novel measure of telemedicine facilitators and use.
Watson JD, Silverman AL, Xia B … +4 more , Pillai R, Balkrishnan R, Pierce BS, Perrin PB
J Telemed Telecare · 2026 Apr · PMID 40270123 · Publisher ↗
The COVID-19 pandemic resulted in a dramatic increase in the use of telemedicine, with heightened rates of use persisting postpandemic. This change in use created a need for a valid and reliable scale to assess telemedic...
The COVID-19 pandemic resulted in a dramatic increase in the use of telemedicine, with heightened rates of use persisting postpandemic. This change in use created a need for a valid and reliable scale to assess telemedicine use and facilitators impacting its uptake. The current study developed and validated the Telemedicine Facilitators Scale (TFS), a novel measure for assessing facilitators of telemedicine uptake. A sample of 228 physicians completed 13 items for the TFS along with an index of telemedicine use for convergent validity. We conducted two confirmatory factor analysis (CFA) models testing a four-factor structure (Positive Attitudes, Facilitating Infrastructure, Organizational Support, and External Policies) and a bifactor model in which all items loaded onto to a single telemedicine facilitators factor and the previous four factors. Both the four-factor CFA and bifactor models demonstrated acceptable fit for χ/degrees of freedom, comparative fit index, and incremental fit index. The correlations among subscales showed that each subscale, while related, measured independent constructs. Both the general telemedicine facilitators factor and all four subfactors were positively correlated with telemedicine use, evidencing good convergent validity. Results suggest that the TFS may be used as a four-factor scale, a unidimensional scale, or a scale composed of both an overarching construct and four subconstructs. The TFS represents a useful tool for researchers, clinicians, and healthcare administrators who wish to study, use, or facilitate the use and evolution of telemedicine.
Distinguishing stroke from mimics in telemedicine: How well does the TM-Score perform in a Brazilian telestroke network?
de Carvalho VS, da Silva LF, de Sousa CAM
J Telemed Telecare · 2026 Apr · PMID 40262089 · Publisher ↗
BackgroundStroke is a leading cause of mortality and disability worldwide. In Brazil, ischemic strokes account for 85% of cases, but many hospitals lack resources for acute stroke care. Telestroke programs connect unders...
BackgroundStroke is a leading cause of mortality and disability worldwide. In Brazil, ischemic strokes account for 85% of cases, but many hospitals lack resources for acute stroke care. Telestroke programs connect underserved hospitals to specialized centers, improving access to treatment. However, stroke mimics (SMs) pose a diagnostic challenge, potentially delaying appropriate management. The Telestroke Mimic Score (TM-Score) is a clinical tool designed to differentiate ischemic cerebrovascular disease (ICVD) from SM, but it has not been validated in South America. The objective of this study is to assess the validity of the TM-Score in distinguishing ICVD from SM in a Brazilian cohort.MethodsWe conducted a retrospective study using data from the Neurological Telemedicine Database of Hospital Pró-Cardíaco, Rio de Janeiro. Patients evaluated for suspected stroke via telemedicine (January 2019-December 2022) were classified as ICVD or SM by a telestroke neurologist. The TM-Score's performance was analyzed using receiver-operating characteristic (ROC) curves, sensitivity, specificity, and predictive values.ResultsAmong 777 patients (ICVD: 561, SM: 216), the mean TM-Score was significantly higher in ICVD (20.72 ± 6.86 vs 14.36 ± 5.73, < 0.001). A score ≥25 had high specificity (96%) and PPV (95%) for ICVD, while <10 had an NPV of 0.71. The AUC was 0.755 (95% CI: 0.718-0.791).ConclusionThe TM-Score is a valuable tool for differentiating ICVD from SM in Brazil, supporting more accurate decision-making, particularly in telemedicine settings without stroke specialists.
Telestroke consultant use in acute stroke care: Evidence for best practices from the IMPROVE stroke care program.
Kolls BJ, Iversen E, Monk L … +3 more , Shah S, Graffagnino C, Ehrlich ME
J Telemed Telecare · 2026 Feb · PMID 40255180 · Publisher ↗
BackgroundEvolving stroke care demands careful screening of stroke patients to ensure the right care is administered to the right patients in a timely manner. Telestroke has been increasingly utilized to improve access t...
BackgroundEvolving stroke care demands careful screening of stroke patients to ensure the right care is administered to the right patients in a timely manner. Telestroke has been increasingly utilized to improve access to stroke specialists to make these assessments. Here we explore the care processes at these telestroke site to determine if an optimal care process can be determined.MethodsThis is a post-hoc analysis of data collected as part a larger quality improvement program, the IMPROVE stroke care program. We rank ordered and normalized the DTN times from encounters that used telestroke services to range between 0 and 1. We used linear mixed models to assess the acute stroke care process steps most associated with improvement in thrombolytic administration times.ResultsThe dataset consisted of 21,456 acute stroke code assessments, of which 8356 (80.6%) were conducted via telestroke (TS) services. Of these TS events, 7088 (84.8%) were conducted at sites that used TS for >85% of all events. Compared to private vehicle, EMS arrival is associated with 4% improvement in DTN ranks, though when paired with prehospital notification, DTN ranks significantly improve by 25%. Key process steps associated with shorter DTN times included calling a code stroke quickly upon arrival and notifying the telestroke consultant prior to obtaining the initial CT scan.DiscussionWorking with local EMS to provide prehospital notification along with rapid code stroke activation and consultant notification prior to CT were identified as best practices for providing timely acute stroke care using telestroke providers.
Healthcare utilization in a cohort receiving chronic disease specialty care by video telemedicine compared to propensity-matched adults not using telemedicine.
Ferucci ED, Arnold RI, Holck P
J Telemed Telecare · 2026 Apr · PMID 40233020 · Full text
IntroductionTelemedicine use has undergone rapid transformation in recent years. We designed this study to evaluate factors associated with telemedicine use and modality and the association with telemedicine use and heal...
IntroductionTelemedicine use has undergone rapid transformation in recent years. We designed this study to evaluate factors associated with telemedicine use and modality and the association with telemedicine use and healthcare utilization in a post-pandemic period.MethodsThis observational study included four regions of the Alaska Tribal Health System. We used electronic health record data to evaluate a cohort of adults who had chronic disease specialty care visits, with or without telemedicine, between July 1, 2021 to December 31, 2021 for factors associated with telemedicine use and modality. We then evaluated the association between telemedicine use and healthcare utilization in 2022. We used propensity score matching to improve covariate balance between adults who had used telemedicine or not, and then estimated the effect of telemedicine on outcomes (inpatient hospitalizations, outpatient visits, and emergency department visits) using multivariable models.ResultsAdults who used telemedicine were slightly older, had more chronic conditions and clinic visits, and resided in different regions compared to those who did not, with differences also observed between telemedicine modalities. The incident rate ratio for inpatient visits (1.16, p = 0.28), outpatient visits (1.15, p = 0.13), and emergency department visits (1.12, p = 0.36) were higher but not statistically significant for adults using telemedicine when compared to individuals not using telemedicine.DiscussionWe found a non-significant association of higher rates of inpatient, outpatient, and emergency department visits in people who used telemedicine compared to propensity-matched "controls." These findings should be considered in context of potential benefits of telemedicine and patient preference.
Co-design of the Intelligent HOme-based Palliative care for End-of-life system: A development and feasibility study.
Zhang S, Xu L, Li Z … +5 more , Wei L, Yang B, Yue P, Tang Q, Zhang X
J Telemed Telecare · 2026 Feb · PMID 40151959 · Publisher ↗
ObjectiveThis study aimed to develop the Intelligent HOme-based Palliative care for End-of-life (I-HOPE) system, a WeChat mini-program designed to provide home-based palliative care (HBPC), including education, interacti...
ObjectiveThis study aimed to develop the Intelligent HOme-based Palliative care for End-of-life (I-HOPE) system, a WeChat mini-program designed to provide home-based palliative care (HBPC), including education, interaction, and social resource access for users.MethodsA mixed-method approach was employed to ensure a comprehensive exploration of user needs, system design, and evaluation. This approach integrated qualitative and quantitative methods, rapid prototyping, expert consultations, and co-design methodologies informed by social ecological theory. Four key stakeholder groups i.e. patients, caregivers, healthcare professionals, and the general public were included. Initially, field research and surveys were conducted to assess the palliative care needs of patients and caregivers. Based on these findings, the mini-program was developed in collaboration with a technical team specializing in healthcare technology. Usability, user experiences, and suggestions for improvement were then collected. This study was conducted in three tertiary hospitals and two community health service centers in Beijing, China.ResultsThe I-HOPE system achieved a System Usability Scale score of 71.89 ± 13.85. User feedback on version 1.0 led to improvements in interface design, features, information presentation, usability, and privacy protection.ConclusionThe development of the I-HOPE system represents an advancement in enhancing the accessibility and quality of HBPC. Future research should focus on identifying areas for further development and assessing its impact on palliative care outcomes.
Clinical decision support systems for heart failure management optimization: A systematic review and meta-analysis of randomized controlled trials.
Khan U, Amin AM, Khlidj Y … +6 more , Majeed Z, Ayyad M, Al-Shammari AS, Imran M, Ali J, Abuelazm M
J Telemed Telecare · 2026 Feb · PMID 40151108 · Publisher ↗
BackgroundHeart failure (HF) patients are frequently rehospitalized shortly after discharge. Telemonitoring and clinical decision support systems (CDSS) health alert follow-up may reduce the mortality and hospitalization...
BackgroundHeart failure (HF) patients are frequently rehospitalized shortly after discharge. Telemonitoring and clinical decision support systems (CDSS) health alert follow-up may reduce the mortality and hospitalization in HF patients following discharge.MethodologyWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, Web of Science, Scopus, Embase, and Cochrane Central Register of Controlled Trial until May 2024. Dichotomous data were pooled using risk ratio (RR) and continuous data using mean difference. This systematic review and meta-analysis was registered with PROSPERO ID: CRD42024555577.ResultsWe included eight RCTs with a total of 7661 patients. Patients managed by CDSS were at lower risk of all-cause mortality than those who received usual care [RR: 0.64 with 95% confidence interval [CI] (0.45, 0.92), = 0.01]. However, there was no difference in all-cause hospitalization [RR: 0.99 with 95% CI (0.88, 1.11), = 0.84] between both groups. Additionally, CDSS led to a significant increase in mineralocorticoid antagonist (MRA) prescription compared to usual care [RR: 1.77 with 95% CI (1.48, 2.11), < 0.00001], but there was no difference in addition of all-class guideline-directed medical therapy (GDMT) [RR: 1.23 with 95% CI (1.00, 1.52), = 0.05] between the both groups.ConclusionClinical decision support systems significantly reduced all-cause mortality and increased MRA prescription. Still, there was no difference in all-cause hospitalization and the addition of all-class GDMT. More robust studies with longer follow-ups are therefore required to thoroughly examine the efficacy of CDSS in optimizing HF management.
A randomized controlled trial: Mobile app vs videoconference telerehabilitation for rotator cuff tendinopathy.
Timurtaş E, Selçuk H, Kartal G … +2 more , Demirbüken İ, Polat MG
J Telemed Telecare · 2026 Feb · PMID 40151063 · Publisher ↗
IntroductionThe aim of this study was to compare the effectiveness of two methods of telerehabilitation (TR) delivery: mobile health TR (mHealth-TR) and video conference TR (VC-TR) in improving outcomes for patients with...
IntroductionThe aim of this study was to compare the effectiveness of two methods of telerehabilitation (TR) delivery: mobile health TR (mHealth-TR) and video conference TR (VC-TR) in improving outcomes for patients with RC tendinopathy.MethodsEighty-five participants diagnosed with RC tendinopathy were randomized into synchronous (VC-TR) and asynchronous (mHealth-TR) groups. Both groups received an identical 8-week exercise programme delivered through their assigned platform. The programme included scapular mobilization, range-of-motion, strengthening, and stretching exercises. The primary outcomes were pain level (Visual Analogue Scale [VAS]), disability (Disabilities of the Arm, Shoulder and Hand [DASH] score), quality of life (Short Form-36 Health Survey [SF-36] score), and shoulder mobility (universal goniometer). The assessments were carried out at baseline, after the treatment (week 8) and at a follow-up of 16 weeks.ResultsThe mean participant age was 51.8 years (SD 9.24), with 27% ( = 23) male. No significant between-group differences were observed for pain (VAS) or shoulder mobility ( > .05 for both). However, a significant group-by-time interaction effect was found for disability, measured by the DASH score ((1,83) = 10.56, = .001), and quality of life, measured by the SF-36 overall score (excluding physical role functioning, emotional role functioning, and social function) (Vitality/Energy: (1,83) = 7.34, = .006; Pain: (1,83) = 4.78, = .034; General Health: (1,83) = 4.82, = .032). Post-hoc analysis indicated significant improvements in disability and quality of life scores in the synchronous VC-TR group compared to the asynchronous mHealth-TR group. Specifically, DASH scores in the synchronous group decreased by 9.41 points (95% CI: 3.46 to 15.36, = .002) from baseline to after treatment, and by 9.34 points (95% CI: 3.48 to 15.20, = .002) by the 16th week. For quality of life, the VC-TR group showed significant improvements in the Vitality/Energy, Pain, and General Health domains from baseline to follow-up, with mean differences of 6.41, 11.68, and 10.83, respectively (all < .05).DiscussionThis study suggests that patients with RC tendinopathy may experience greater improvements in pain management, disability, and overall quality of life through synchronous VC-TR compared to asynchronous mHealth-TR.
Heart Health Hub virtual care program for newly diagnosed heart failure patients.
Hettiarachchi RM, McClurg A, Wallis S … +3 more , Neill J, Tomlinson R, Carter HE
J Telemed Telecare · 2026 Jan · PMID 40101251 · Publisher ↗
BackgroundThe Heart Health Hub (HHH) is a virtual model of care for patients with newly diagnosed heart failure. A program pilot commenced in April 2020 and aimed to achieve acceptable titration rates for heart failure m...
BackgroundThe Heart Health Hub (HHH) is a virtual model of care for patients with newly diagnosed heart failure. A program pilot commenced in April 2020 and aimed to achieve acceptable titration rates for heart failure medications while improving patient access to services. This study aimed to investigate whether the virtual HHH service could deliver feasible, safe and acceptable titration outcomes.MethodsA single-arm observational cohort study design was adopted. Eligible heart failure patients currently receiving care could consent to be enrolled in the pilot virtual HHH program based on pre-defined inclusion and exclusion criteria. Data on patient demographics, clinical characteristics and heart failure medication titration rates were obtained from routine health system databases and patient notes. Patient satisfaction data were collected using a Likert-scale questionnaire. Overall health service use and costs for each patient were obtained from health system databases for a period of 12 months following enrolment in the virtual HHH program.ResultsA total of 89 heart failure patients were included in the evaluation. Of these, 95% reached titration to either guideline-recommended target doses or maximum tolerated doses for both angiotensin-converting enzyme inhibitor/angiotensin receptor blockers/angiotensin and angiotensin receptor-neprilysin inhibitor (ACEI/ARB/ARNI) and beta-blockers combined. The mean number of days to achieve titration ranged from 20.2 days for mineralocorticoid receptor antagonist drugs, between 27.5 to 32.3 days for ACEI/ARB/ARNI drugs and 41.0 days for beta-blockers; 70 (79%) patients completed the satisfaction survey at least once, with more than 98% of survey questions receiving a positive response. The average monthly equipment and consumables cost per patient was $277 in year 2021/22.ConclusionThis study provides evidence that a virtual model of care for newly diagnosed heart failure patients was feasible, safe and acceptable, with high titration rates, relatively rapid times to titration, strong patient satisfaction outcomes and relatively low equipment costs.
Using inpatient addiction consult service via telehealth to improve pharmacotherapy initiation: An observational study.
Deng H, Nikravesh M, Raheemullah A … +1 more , Tate S
J Telemed Telecare · 2026 Jan · PMID 40095504 · Publisher ↗
IntroductionThe COVID-19 pandemic exacerbated existing challenges in treating substance use disorders. This study explores the impact of telehealth on addiction consult services (ACS) medication initiation in hospitalize...
IntroductionThe COVID-19 pandemic exacerbated existing challenges in treating substance use disorders. This study explores the impact of telehealth on addiction consult services (ACS) medication initiation in hospitalized patients with alcohol and opioid use disorders (AUD and OUD).MethodsWe retrospectively analyzed data from adult patients who received their first ACS consultation in-person (pre-pandemic) and telehealth ACS consultation (during the pandemic). We compared medication initiation rates for AUD and OUD before and after ACS consultation.ResultsThe ACS completed 398 in-person consults and 473 telehealth consults. In-person ACS consultation increased the medication initiation rates from 3.41% for AUD in hospitalized patients without an ACS consult, to 45.45% for AUD after an ACS consult. For OUD pharmacotherapy initiation, an ACS consultation increased medication rates from 6.94% to 41.67% for OUD. Telehealth ACS consultation increased medication initiation rates from 5.16% to 66.20% for AUD and from 7.53% to 67.74% for OUD. Buprenorphine and naltrexone were the most commonly initiated medications for OUD and AUD, respectively.DiscussionThe adoption of telehealth by the hospital ACS during the pandemic effectively increased medication initiation rates for AUD and OUD, consistent with pre-pandemic, demonstrating its potential to expand access to addiction services. This approach could address the current shortage of addiction providers and serve underserved populations.
Changes in provider responsibilities and associated outcomes for cirrhotic patients with telehealth: A single-center, retrospective study.
Bloomberg L, Hong P, Hepburn C … +6 more , Kaboff A, Fayad M, Varda B, Joyce C, Cotler S, Rubin J
J Telemed Telecare · 2026 Feb · PMID 40080886 · Publisher ↗
BackgroundStudies show satisfaction with telemedicine, but there is limited data regarding changes in provider practices and clinical outcomes. We sought to evaluate the impact of telehealth on patient-provider communica...
BackgroundStudies show satisfaction with telemedicine, but there is limited data regarding changes in provider practices and clinical outcomes. We sought to evaluate the impact of telehealth on patient-provider communications between visits and clinical outcomes in patients with cirrhosis during the COVID-19 pandemic.MethodsSingle-center retrospective study of cirrhotic patients seen outpatient in 2019 and 2020 was conducted. Clinical characteristics, provider practices, and clinical outcomes were obtained. Provider practices included medication adjustments, labs ordered, and patient communication. Clinical outcomes included ED visits, hospitalizations, and mortality.ResultsTotally, 1395 patients were included with a mean age of 61, 51% female, and 73% Caucasian. The median baseline model for end-stage liver disease (MELD-Na) score was 10. During 2019 there were no telehealth visits. In 2020, 37% of clinic visits were telehealth and 64% of patients had at least one telehealth visit. The rate of medication changes significantly decreased in 2020. There was no significant difference in number of clinic visits, labs ordered, emergency department visits, hospitalizations, or intensive care unit (ICU) stays between 2019 and 2020. In 2020, the rate of telephone contacts and patient messages significantly increased. Compared to 2019, the odds of death were 2.6 times higher in 2020.ConclusionWhen a majority of cirrhotic patients had a telehealth visit, patients had similar rates of emergency department visits, hospitalizations, and ICU stays, but a higher rate of mortality compared to patients with in-person visits. Telehealth was associated with more patient contact between visits, increasing communication demands on providers.
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