Journal Of Telemedicine And Telecare[JOURNAL]
Sun
200 papers
Impact of telehealth care on clinical outcomes in heart failure patients.
Chen YJ, Liao PH, Hung CL … +2 more , Chang WH, Shih SC
J Telemed Telecare · 2026 Feb · PMID 40080881 · Publisher ↗
IntroductionHeart failure (HF) is associated with high incidence and mortality rates, limited physical activity, decreased quality of life, and increased healthcare expenses. Implementing a Telehealth Care (TC) HF progra...
IntroductionHeart failure (HF) is associated with high incidence and mortality rates, limited physical activity, decreased quality of life, and increased healthcare expenses. Implementing a Telehealth Care (TC) HF program might address these challenges while improving patient outcomes.MethodWe conducted a retrospective observational study using electronic medical record data. The study recruited 916 participants screened with ICD-10 code I50 from 2016 to 2020. After data screening, 210 participants were divided into a remote care group and a control group using propensity score matching. Patients in the remote care group received TC visits for HF management via Bluetooth-enabled equipment, while those in the control group received typical care.ResultsAmong the 587 participants, those who received TC experienced reduced rates of all-cause mortality and readmission within one year, as well as lower rates of cardiovascular disease and HF-related readmission. However, there was no significant difference in cardiovascular disease mortality compared to the control group within one year. Kaplan-Meier time-event curves showed that there were significant differences in survival analysis.DiscussionTC significantly reduced all-cause mortality and rehospitalization rates in HF patients, highlighting its role in enhancing patient outcomes through remote monitoring. Although cardiovascular-specific mortality within one year did not exhibit significant differences, the TC group had fewer HF-related readmissions. This suggests improved disease management and self-care in this group. The findings demonstrate the potential of TC as a valuable tool in standard HF care, particularly for patients with comorbidities, such as diabetes and coronary heart disease.
Corrigendum: "Will we see data repositories for telehealth activity in the near future? Journal of Telemedicine and Telecare".
J Telemed Telecare · 2026 Jan · PMID 40007308 · Publisher ↗
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Characteristics and longitudinal clinical outcomes of people with type 2 diabetes in regional areas accessing a tertiary telehealth service: A retrospective cohort study.
Tornvall I, Bennetts D, Balasooriya NN … +3 more , Comans T, Russell AW, Menon A
J Telemed Telecare · 2026 Jan · PMID 39936370 · Publisher ↗
BackgroundThe prevalence of type 2 diabetes is rising in Australia, particularly in regional areas where access to specialist care is limited. To address this, Queensland Health (Queensland, Australia) established a tele...
BackgroundThe prevalence of type 2 diabetes is rising in Australia, particularly in regional areas where access to specialist care is limited. To address this, Queensland Health (Queensland, Australia) established a telehealth network, including the Diabetes Telehealth Service (DTS) at the Princess Alexandra Hospital (PAH). The service facilitates video consultations between city-based endocrinologists and regional health centres, with local clinicians providing in-person support. While telehealth interventions have been evaluated in short-term studies, there is a need for longitudinal data to assess their long-term effectiveness in routine diabetes care. This study aims to describe the clinical characteristics and outcomes of patients with type 2 diabetes accessing care from the PAH DTS.MethodsThis retrospective cohort study used data from the PAH DTS to follow adults with type 2 diabetes over 24 months. Data was collected as part of routine care and analysed to assess changes in glycated haemoglobin (HbA1c) levels and cardiovascular risk factors. Statistical analyses included descriptive analysis, t-tests, Chi-squared tests, and fixed effects regression models.ResultsThe study included 374 patients with type 2 diabetes, with a mean age of 57.9 years and a mean duration of diabetes at enrolment of 11.6 years. Baseline HbA1c levels were available for 86% of the patients, with a median HbA1c of 8.4%. The median number of appointments in the 24-month period was 2, and the average time between a person's first and last visit was 72 weeks. The average change in HbA1c between these visits was -0.8%. Statistically significant changes were also seen in cholesterol levels, weight, body mass index, and diastolic blood pressure. A linear regression analysis revealed that the greatest decrease in HbA1c levels occurred within the first 3 months since the initial clinic visit. HbA1c levels continued to decrease over the 24-month follow-up period, but the rate of decrease slowed after the first 3 months.ConclusionThis study provides valuable insights into the telehealth model of care for tertiary diabetes in regional, rural, and remote settings. It demonstrates the effectiveness of this model in improving glycaemic control, particularly in the initial months, while also highlighting areas for improvement.
Tele-allergy improves access to allergy care within the Veterans Health Administration.
Temiño VM, Medina Y
J Telemed Telecare · 2026 Jan · PMID 39930874 · Full text
The shortage of Allergy & Immunology providers in the United States restricts access to specialty care. Telemedicine has the potential to expand access beyond physical locations, however, little is known regarding patien...
The shortage of Allergy & Immunology providers in the United States restricts access to specialty care. Telemedicine has the potential to expand access beyond physical locations, however, little is known regarding patient preferences for tele-allergy or the ability to successfully manage atopic conditions virtually. This retrospective analysis of a tele-allergy program at the Veterans Health Administration demonstrates that tele-allergy can provide efficient allergy care for veterans, including rural patients, although some reliance on local ancillary services was necessary. A hybrid model of virtual and in-person care is likely needed in Allergy & Immunology to overcome geographical barriers and optimize resource allocation.
Limb-saving emergent procedural sedation and joint reduction via telehealth.
Powell B, Gibbs C
J Telemed Telecare · 2026 Jan · PMID 39887184 · Publisher ↗
In this case report, we describe the performance of procedural sedation and emergent joint reduction via remote telehealth leadership for a patient with an acutely limb-threatening injury. The patient was a 33-year-old m...
In this case report, we describe the performance of procedural sedation and emergent joint reduction via remote telehealth leadership for a patient with an acutely limb-threatening injury. The patient was a 33-year-old man who presented to a small rural hospital with a fracture dislocation of his ankle complicated by severe pain refractory to opiate analgesia and neurovascular compromise, including absent peripheral pulses and sensory changes. Due to aviation and resource limitation factors, immediate retrieval was not possible. While it was clear he needed urgent treatment, local staff expressed that they did not possess the training or requisite experience to undertake a procedural sedation and joint reduction. Following extensive discussions between the telehealth specialist and the local team, the telehealth doctor assumed clinical governance for the case, serving as team leader and coaching the local team through a ketamine procedural sedation and emergent joint reduction. Ultimately, these procedures were successful, with immediate improvement in limb neurovascular status. This case, along with prior work, demonstrates that High-Acuity Low-Occurrence (HALO) procedures can be facilitated by telehealth. Key learning points from the case include the choice of anaesthetic agent given limited local experience, delegating a separate telehealth clinician to monitor patient vital signs to cognitively offload local staff, and the importance of detailed pre-procedure discussions prior to completing HALO tasks.
Effect of telemental health adoption on mental health services utilization in federally qualified health centers.
Gadag K, Arora K, Zahnd WE
J Telemed Telecare · 2026 Jan · PMID 39849951 · Publisher ↗
IntroductionMental health issues disproportionately affect rural and low-income populations, where access to prevention and treatment is limited. Implementing telemental health services (TMHS) in Federally Qualified Heal...
IntroductionMental health issues disproportionately affect rural and low-income populations, where access to prevention and treatment is limited. Implementing telemental health services (TMHS) in Federally Qualified Health Centers (FQHCs) could improve accessibility to mental healthcare. This study assessed the effect of TMHS on mental health services utilization in FQHCs, comparing centers with and without TMHS and examined differences in TMHS effect between FQHCs that adopted TMHS before and during the pandemic.MethodsThe study utilized FQHC-level data from Uniform Data Systems annual performance reports ( = 9540 FQHC-year) and county-level demographic, health status, and provider characteristic data from 2016 to 2022. A two-way fixed effects model was applied to examine the effect of TMHS on mental health visit rates, supplemented by the Sun and Abraham difference-in-differences estimator. The analysis included both pre-COVID and during-COVID TMHS adopters.ResultsFQHCs offering TMHS showed 1.04 times increase in overall mental health visit rates compared to those without TMHS. Centers serving higher proportions of Medicaid-insured (1.07 times) and low-income (below 200% FPL; 1.05 times) populations showed even higher visit rates. During-COVID TMHS adopters showed a significant increase (1.05 times), particularly in urban areas, whereas rural adopters did not see significant changes.ConclusionFQHCs offering TMHS showed increased mental health visit rates, especially among low-income and Medicaid-insured populations. FQHCs that adopted TMHS during the pandemic experienced a marked rise in mental health visits, but rural-urban disparities persist, highlighting the ongoing challenges in expanding access to mental healthcare in rural settings.
Innovative telehospitalist model optimizes medical triage in collaboration with community emergency departments: A cross-sectional study.
Koch AT, Keuseman RL, Parikh R … +8 more , Legler SR, Ayanian S, Boyapati RB, Fischer KM, Lawson DK, Dugani SB, Burton MC, Pagali SR
J Telemed Telecare · 2026 Jan · PMID 39846202 · Full text
IntroductionOptimal hospital bed utilization requires innovative patient care models. We studied a novel hospitalist model utilizing telemedicine to facilitate collaboration with affiliated emergency departments (EDs) an...
IntroductionOptimal hospital bed utilization requires innovative patient care models. We studied a novel hospitalist model utilizing telemedicine to facilitate collaboration with affiliated emergency departments (EDs) and support medical triage and care of ED patients with high likelihood of hospital admission.MethodsTelehospitalists based at a tertiary care facility collaborated with four community EDs in the same healthcare network between January 1, 2022, and April 30, 2023. Telehospitalists supported ED clinicians in medical care decisions and facilitated patient disposition. Emergency department length of stay (LOS) and disposition were evaluated, as were hospital LOS, 30-day readmission, and in-hospital mortality. For patients discharged from the ED, 7-day ED readmission and subsequent hospitalization were evaluated.ResultsTelehospitalists discussed 550 "admit-likely" patients with ED clinicians: 105 patients (19.1%) discharged from the ED and avoided admission; 322 patients (58.5%) were admitted to local or nearby community hospitals; 123 patients (22.4%) transferred to the tertiary care facility. Emergency department LOS differed significantly among disposition groups, including patients discharged home (10.2 h), admitted to local hospitals (12.6 h), and transferred to tertiary care hospitalist services (14.9 h; < 0.001). Hospital LOS and in-hospital mortality were not significantly different among disposition groups. Patients admitted locally had lower 30-day readmission compared to those transferred to tertiary care facility (odds ratio = 0.59 [0.36, 0.99], = 0.048).DiscussionTelehospitalists as triage clinicians is an innovative approach to support local ED clinicians and patients. Telehospitalists optimized hospital bed utilization and healthcare system resources by facilitating safe discharges to home and expediting tertiary care transfers when necessary.
A time series analysis of Medicare-reimbursed telepsychiatry consultations across Australian states and territories before and after telehealth item expansion: Enabling policy can improve access to care.
Woon LS, A Maguire P, Reay RE … +3 more , Smith D, Bastiampillai T, Looi JC
J Telemed Telecare · 2026 Jan · PMID 39828938 · Publisher ↗
ObjectiveWe aimed to examine the associations of telepsychiatry consultations with the Medicare Benefits Schedule (MBS) telehealth policy changes (pandemic-related expansion and subsequent consolidation).MethodsWe perfor...
ObjectiveWe aimed to examine the associations of telepsychiatry consultations with the Medicare Benefits Schedule (MBS) telehealth policy changes (pandemic-related expansion and subsequent consolidation).MethodsWe performed a time series analysis of MBS telepsychiatry usage (January 2016-December 2023) using state/territory-level Medicare panel data. Linear regression analyses with panel-corrected standard error and autocorrelation were performed for telepsychiatry consultations (overall and age and sex subgroups). Telehealth policies, rural psychiatrist availability (rural psychiatrists per 100,000 population) and their interaction were the independent variables. The models were adjusted for pandemic lockdown severity (Stringency Index) and population size.ResultsTelehealth expansion and consolidation were associated with substantial increases in telepsychiatry consultations, with larger increases in the consolidation phase. Given the telehealth policy changes, lower per capita rural psychiatrists were associated with more telepsychiatry consultations. Males and older people (>65 years) showed greater relative consultation increases. Policy change-related telepsychiatry increases varied amongst states and territories.DiscussionThere was sustained telepsychiatry usage when it became more readily available, beyond the direct impact of acute pandemic lockdowns. Telehealth-enabling policies may contribute to fulfilling unmet mental health needs and improving access to psychiatric care amongst Australians. Further in-depth research in this area is needed.
Trauma-focused evidence-based psychotherapy for post-traumatic stress disorder delivered via video telehealth in the Veterans Health Administration.
Holder N, Batten A, Shiner B … +1 more , Maguen S
J Telemed Telecare · 2026 Jan · PMID 39784162 · Publisher ↗
IntroductionTrauma-focused evidence-based psychotherapy (EBP) is the recommended treatment for post-traumatic stress disorder (PTSD). During and after the COVID-19 pandemic, veterans began to initiate general mental heal...
IntroductionTrauma-focused evidence-based psychotherapy (EBP) is the recommended treatment for post-traumatic stress disorder (PTSD). During and after the COVID-19 pandemic, veterans began to initiate general mental health services delivered via video telehealth at high rates. Our goal in the current project was to describe the percentage as well as the demographic, military, and clinical characteristics of veterans receiving PTSD EBPs via video telehealth versus in-person.MethodsUsing data from the VA electronic health record, we identified a national cohort of all-era veterans who received individual PTSD EBP between April 2022 and April 2023 (= 24,447). We used multivariable hierarchical Bayesian logistic regression to model the probability of receiving at least 50% of their EBP care via video telehealth.ResultsIn our sample, 74.4% of veterans who received PTSD EBP used video telehealth for at least one EBP session and 66.8% of veterans received at least half of their EBP sessions by video telehealth. Female veterans, younger veterans, and veterans with fewer mental health comorbidities were more likely to have received their PTSD EBP via video telehealth. Additional strong interaction effects for Black female veterans, Hispanic female veterans, female officer veterans, and Black officer veterans.DiscussionVideo telehealth delivery of PTSD EBPs was more common than in-person delivery of PTSD EBPs. Consistent with underlying trends in telehealth services, female veterans, and particularly female, racial/ethnic minority veterans were more likely to receive PTSD EBP via video telehealth. Future research designed to contextualize the observed differences in video telehealth delivery of PTSD EBPs should consider the role of social determinants of health.
Effects of physical therapy via telerehabilitation on cardiopulmonary, physical and psychological function in patients with coronavirus disease 2019: A randomised controlled trial.
Suthanawarakul B, Promma N, Iampinyo P … +3 more , Saraboon C, Wattanaprateep J, Waongenngarm P
J Telemed Telecare · 2026 Jan · PMID 39716851 · Publisher ↗
ObjectivesTo compare the effects of physical therapy via telerehabilitation on the improvement in cardiopulmonary function, physical factors and psychological factors in patients with coronavirus disease 2019 (COVID-19)....
ObjectivesTo compare the effects of physical therapy via telerehabilitation on the improvement in cardiopulmonary function, physical factors and psychological factors in patients with coronavirus disease 2019 (COVID-19).MethodsThirty-two patients with COVID-19 were randomly assigned to intervention and control groups. Both groups received online guidance and a leaflet on cardiopulmonary rehabilitation. Additionally, participants in the intervention group received physical therapy training via video call, which included pulmonary training and various exercises. Cardiopulmonary exercise testing, quality of life, functional capacity, cognitive function, lower body strength and endurance and psychological aspects (anxiety, depression and insomnia) were assessed.ResultsThe physical therapy programme delivered via telerehabilitation significantly improved cardiopulmonary function in patients with COVID-19 at the 3-month follow-up compared with the control group. Additionally, the physical therapy programme had beneficial effects on functional capacity, depression symptoms and quality of life.ConclusionA physical therapy programme via telerehabilitation can be delivered to patients with COVID-19 in their own homes to improve cardiopulmonary function after 3 months of follow-up.
Measuring factors associated with telehealth use by people who use mental health services: A psychometric analysis of a theoretical domains framework questionnaire.
Wilson J, Heinsch M, Buykx P … +9 more , Ticker C, Gupta R, Clancy R, Brosnan C, Wilson R, Rutherford J, Sampson D, Paolucci F, Kay-Lambkin F
J Telemed Telecare · 2025 Dec · PMID 39711094 · Publisher ↗
IntroductionTelehealth has the potential to improve access to mental health care, especially for people living in rural and remote regions. Yet, telehealth accessibility remains a challenge in Australia, and there is a s...
IntroductionTelehealth has the potential to improve access to mental health care, especially for people living in rural and remote regions. Yet, telehealth accessibility remains a challenge in Australia, and there is a scarcity of appropriate, psychometrically sound tools for evaluating telehealth use by mental health service users. The aim of this study was to adapt and validate a scale for measuring factors associated with mental healthcare telehealth use.MethodsA 39-item scale was adapted from the Theoretical Domains Framework questionnaire (TDFQ); a 14-domain framework for measuring implementation of evidence-based practice in health research and service delivery. Since use of the TDFQ in the service user and telehealth space is novel, we adapted and piloted the TDFQ using a rigorous and iterative consultation process and analysis. The study sample included 208 people who use mental health services (52% male). Preliminary analysis identified 32-items for inclusion in the exploratory factor analysis. Internal reliability and construct validity were also analysed.ResultsThe resulting 21-item telehealth adaption of the TDFQ includes four factors, each with good internal reliability: satisfaction and habit (6 items), knowledge and training (5 items), benefit and value (6 items), and emotionality (4 items). Both the total scale and individual factors were positively associated with telehealth use.DiscussionThe telehealth adaption of the TDFQ is a psychometrically sound tool for assessing factors associated with the use of telehealth by people who use mental health services.
The effect of telehealth on clinical outcomes in patients with hypertension and diabetes: A meta-analysis of 106,261 patients.
Kelly FA, Moraes FCA, Lôbo AOM … +6 more , Sano VKT, Souza MEC, Almeida AM, Kreuz M, Laurinavicius AG, Consolim-Colombo FM
J Telemed Telecare · 2025 Dec · PMID 39691061 · Publisher ↗
IntroductionTelemedicine, propelled by recent technological advancements, has transformed healthcare delivery, notably benefiting patients with chronic non-communicable diseases (NCDs) such as systemic arterial hypertens...
IntroductionTelemedicine, propelled by recent technological advancements, has transformed healthcare delivery, notably benefiting patients with chronic non-communicable diseases (NCDs) such as systemic arterial hypertension and diabetes mellitus. This meta-analysis of randomized clinical trials aimed to assess the efficacy of telehealth-based interventions on disease control rates and clinical parameters among NCD patients, including systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) levels.MethodsWe conducted searches in PubMed, Scopus, Web of Science, and the Cochrane Database for interventional studies that compared tele-monitoring with usual care in patients with hypertension and type 2 diabetes mellitus. Odds ratios with 95% confidence intervals (CIs) were computed.ResultsOur meta-analysis included 75 studies, encompassing a total of 106,261 patients, with 50,074 (47.12%) receiving usual care and 56,187 (52.88%) receiving tele-monitoring care. The telemedicine group was associated with a statistically significant reduction in SBP (mean difference (MD) -4.927 mmHg; 95% CI -6.193 to -3.660; < 0.001; ² = 90%), DBP (MD -2.019 mmHg; 95% CI -2.679 to -1.359; < 0.001; ² = 54%), FBG (MD -0.405 mmol/L; 95% CI -0.597 to -0.213; < 0.001; ² = 32%), and HbA1c (MD -0.418%; 95% CI -0.525 to -0.312; < 0.001; ² = 76%).ConclusionsOur meta-analysis shows that telehealth technologies notably enhance blood pressure and blood glucose control. This supports integrating telemedicine into clinical protocols as a valuable complementary tool for managing hypertension and diabetes mellitus comprehensively.
Assessment of cardiovascular diagnoses associated with telemedicine during and after the COVID-19 pandemic.
Shan R, Patel N, Chen JY … +1 more , Cho D
J Telemed Telecare · 2025 Dec · PMID 39676455 · Publisher ↗
BackgroundThe COVID-19 pandemic led to widespread adoption of telemedicine, which has persisted in healthcare delivery.ObjectiveWe aimed to characterize telemedicine use in ambulatory cardiology clinics over two years fo...
BackgroundThe COVID-19 pandemic led to widespread adoption of telemedicine, which has persisted in healthcare delivery.ObjectiveWe aimed to characterize telemedicine use in ambulatory cardiology clinics over two years following the onset of the COVID-19 pandemic.MethodsRetrospective cross-sectional study from 16 March 2020 to 27 June 2022 in a single-center ambulatory cardiology clinic and telemedicine visits. Mixed effects logistic regression was used to model the association of diagnosis class (based on International Classification of Disease 10th Revision codes) with whether an encounter was scheduled as telemedicine, adjusting for age, sex, race, ethnicity, date, and zip code. This was performed for telemedicine and in-office encounters across 15 University of California Los Angeles (UCLA) Health System ambulatory cardiology clinics.ResultsThe analysis included 76,127 patients (49.60% women, age 61.5 ± 17.30 years, 57.27% white, 12.25% Hispanic, 81.79% with zip code in a UCLA Health service area) over 255,674 encounters. Each patient had a median of two encounters (range 1-81). Of all encounters, 29,154 (11.40%) were scheduled as telemedicine. Telemedicine was more likely used in the management of chronic conditions, especially metabolic disorders (adjusted OR [aOR] 2.36, 95% CI 2.19-2.54) and cardiomyopathies (aOR 2.16, 95% CI 1.99-2.34), than for evaluation of undifferentiated signs/symptoms. Telemedicine was less likely used for general exam/screening (aOR 0.49, 95% CI 0.44-0.56) and heart transplant (aOR 0.51, 95% CI 0.40-0.64).ConclusionAmong the outpatient encounters in this study, the most established use case for telemedicine in cardiology was for care of chronic cardiovascular conditions among nontransplant patients, suggesting that future telemedicine expansion should be targeted toward the most appropriate clinical scenarios.
Non-invasive telemonitoring programs for patients with chronic heart failure: A systematic review and meta-analysis of randomized controlled trials.
Parente HA, Hornemann SB, Faria IM … +3 more , Salgado DR, Correia MG, Azevedo FS
J Telemed Telecare · 2025 Dec · PMID 39676453 · Publisher ↗
AimsTo assess whether telemonitoring improves outcomes in patients with chronic heart failure.Methods and resultsA literature search was conducted on studies of randomized controlled trials involving non-invasive telemon...
AimsTo assess whether telemonitoring improves outcomes in patients with chronic heart failure.Methods and resultsA literature search was conducted on studies of randomized controlled trials involving non-invasive telemonitoring and heart failure using Medline, Embase, and Cochrane Library. The primary outcomes were all-cause mortality, all-cause hospitalization, and hospitalization for heart failure. Secondary outcomes were length of stay, health-related quality of life as assessed by validated questionnaires, healthcare costs and cost-effectiveness, and self-care behaviors. We performed a meta-analysis using a random effects model for the primary outcomes. The effect measure was odds ratio with corresponding 95% confidence interval, and heterogeneity among studies was assessed using the Higgins I value. We screened 212 references, and 34 randomized controlled trials were included in this review. A total of 16179 participants with heart failure were included. Non-invasive telemonitoring reduced all-cause mortality by 18% (OR 0.82, 95% CI 0.71 to 0.95; participants = 15,211; studies = 28; I= 34%; GRADE: moderate-quality evidence) and heart failure hospitalization by 20% (OR 0.80, 95% CI 0.69 to 0.94; participants = 7491; studies = 18; I= 31%; GRADE: moderate-quality evidence). Non-invasive telemonitoring didn't demonstrate significant benefit on all-cause hospitalization (OR 0.93, 95% CI 0.82 to 1.05; participants = 11,565; studies = 25; I= 49%).ConclusionTelemonitoring programs in patients with heart failure were associated with a reduction in all-cause mortality and heart failure hospitalization without harmful events.
Telehealth use and receipt of recommended services within one-year postpartum.
Kishkovich TP, James KE, Orona KC … +3 more , Bernstein SN, Cohen JL, Clapp MA
J Telemed Telecare · 2025 Dec · PMID 39648689 · Publisher ↗
IntroductionIn obstetrics, telehealth is widely used in the provision of prenatal and postpartum care. The objective was to compare the utilization of commonly recommended services after delivery among individuals receiv...
IntroductionIn obstetrics, telehealth is widely used in the provision of prenatal and postpartum care. The objective was to compare the utilization of commonly recommended services after delivery among individuals receiving telehealth versus in-person postpartum care.Study DesignWe performed a retrospective cohort study of individuals receiving postpartum care at a single institution between 1 July 2020 and 30 June 2023. The primary exposure was the exclusive use of telehealth versus an in-person visit for postpartum care. Two primary outcomes were assessed between 0 and 365 days after the delivery: 1) long-acting reversible contraceptive (LARC) method use and 2) pap smear screening. Secondary outcomes occurring between 0 and 365 days after delivery included: clinic-based weight assessment, clinic-based blood pressure assessment, any prescription contraception use, primary care visit, and pregnancy within 1 year.ResultsAmong the 9953 individuals, 9058 (91.0%) had a postpartum visit. 1811 (19.9%) utilized telehealth exclusively, which peaked during the COVID-19 pandemic. Exclusive telehealth users were less likely to have a pap smear (21.6 vs. 40.1%, < 0.001) or use LARCs (8.6 vs. 19.4%, < 0.001) than those receiving in-person care. In the adjusted analysis, the odds ratio for receiving a pap smear was 0.38 (95% confidence interval [CI] 0.32-0.47) and for using a LARC was 0.38 (95% CI 0.31-0.47) when comparing telehealth to in-person care. Reduced odds of all secondary outcomes were seen in the exclusive telehealth use compared to the in-person cohort, with the exception of subsequent pregnancy within 1 year, which was not significantly different.DiscussionAcknowledging that telehealth now has become an important means for patients to access medical care, these findings should prompt clinicians to consider when an in-person postpartum visit should be offered or recommended over telehealth, especially when a patient may not have a preference or reported barriers to accessing an in-person visit.
Early adoption of telehealth/remote patient monitoring and hospital revenue changes during COVID-19.
Rhoades CA, Whitacre BE, Davis AF
J Telemed Telecare · 2025 Dec · PMID 39632751 · Full text
IntroductionThe COVID-19 pandemic dramatically affected the financial performance of hospitals across the U.S. The prompt availability of telehealth options likely impacted both a hospital's healthcare options and opport...
IntroductionThe COVID-19 pandemic dramatically affected the financial performance of hospitals across the U.S. The prompt availability of telehealth options likely impacted both a hospital's healthcare options and opportunities for revenue in the short-term. The aim of this study was to explore the association between early adoption of telehealth and changes in revenue during the early phase of the pandemic, and to compare whether the results differed between rural and urban hospitals.MethodsWe performed first-difference regressions on a cross-sectional dataset of 1,742 U.S. hospitals. Our dependent variables were percent changes in four categories of revenue between 2019 and 2020: inpatient, outpatient, gross, and net. The adoption of telehealth and remote patient monitoring as of 2019 served as the primary independent variables of interest. We controlled for changes in hospital characteristics from 2019 to 2020, including case mix index and number of employees.ResultsOur results suggest that telehealth adoption prior to the COVID-19 pandemic was associated with significant increases in all four revenue categories from 2019 to 2020, ranging from 1.79% (net patient revenue) to 2.92% (outpatient revenue). However, RPM implementation in 2019 was associated with significant declines in gross patient (0.08%) and outpatient revenue (1.50%). The results were largely similar across rural and urban locations.DiscussionAdopting telehealth before the onset of COVID-19 helped hospitals increase revenue during the initial phase of the pandemic. Alternatively, implementation of remote patient monitoring was associated with revenue declines, likely due to limited ability for monetization. Whether these relationships have persisted needs further investigation.
Combined telemedicine-first and direct primary care as a promising model of healthcare delivery.
Schlegel D
J Telemed Telecare · 2025 Dec · PMID 39632732 · Publisher ↗
Telemedicine is comparable in quality to in-person care, adequate for many primary care concerns, acceptable to patients, and can overcome barriers to care. However, patients are reluctant to pay the same for telemedicin...
Telemedicine is comparable in quality to in-person care, adequate for many primary care concerns, acceptable to patients, and can overcome barriers to care. However, patients are reluctant to pay the same for telemedicine as in-person care and uncertainty about future payor reimbursement makes it risky to base a clinical practice primarily on telemedicine. Physical exam-supported information collection and relationship-building are limited in telemedicine, but can be mitigated through remote patient monitoring and ample access to a provider and clinical team. Subscription-based direct primary care models disconnect payment from episodes of care, which can support enhanced communication between the patient and care team and support time for asynchronous tasks such as remote patient monitoring data review. A "telemedicine first, direct primary care" model in which most care is provided through telemedicine and financed via subscription would retain the convenience of telemedicine, mitigate relationship-limiting deficiencies due to the lack of physical contact, and provide a stable revenue stream to support a telemedicine-based approach to care. Paired with specialist access via eConsults and options to refer to in-person care when necessary, this model would support telemedicine as the foundation for practice and connect underserved populations to primary and specialty care.
A comprehensive evaluation tool to assess community capacity and readiness for virtual care implementation.
Deason JP, Adams SJ, Khan A … +2 more , Lovo S, Mendez I
J Telemed Telecare · 2025 Dec · PMID 39563105 · Full text
IntroductionThe rapid evolution and implementation of virtual care technologies for clinical use often exceeds the development of standardized implementation protocols, leading to gaps in the equitable and sustainable ad...
IntroductionThe rapid evolution and implementation of virtual care technologies for clinical use often exceeds the development of standardized implementation protocols, leading to gaps in the equitable and sustainable adoption of virtual care services, particularly in rural and remote areas. This paper introduces a comprehensive evaluation tool designed to assess community capacity and readiness for virtual care.MethodsThe development of the tool was informed by experiences from the Virtual Care and Robotics Program at the University of Saskatchewan. It involved a collaborative, multi-stakeholder approach that engaged healthcare leaders, IT experts and community healthcare workers. This iterative process included defining evaluation categories, mapping evaluative domains and refining the tool into a user-friendly checklist manual.ResultsThe tool identifies three key domains for assessing readiness: clinical needs, technology infrastructure and human resources/workflows. It was piloted in the remote community of Fond du Lac, Saskatchewan, where it successfully qualified the community for implementing telerobotic ultrasound services. The tool facilitated local engagement and highlighted the community's specific needs and readiness, enhancing the implementation process.ConclusionThis evaluation tool contributes to bridging the gap between the rapid deployment of virtual care technologies and the need for comprehensive, standardized implementation protocols. It offers a structured, practical approach to assessing and enhancing community readiness for virtual care while promoting successful clinical implementation and equitable access to healthcare.
Virtual discharge counseling: An assessment of scalability of a novel patient educational process across a multi-site urban emergency department.
Leybov V, Ross J, Grabinski Z … +6 more , Smith SW, Wang Y, Wittman IG, Caspers CG, Tse AB, Conroy N
J Telemed Telecare · 2025 Dec · PMID 39558591 · Publisher ↗
BackgroundInadequate counseling at patient discharge from the emergency department can lead to adverse patient outcomes. Virtual discharge counseling can address gaps in discharge counseling and improve patients' underst...
BackgroundInadequate counseling at patient discharge from the emergency department can lead to adverse patient outcomes. Virtual discharge counseling can address gaps in discharge counseling and improve patients' understanding of instructions.MethodsA previously established virtual discharge counseling program was scaled across three emergency departments and expanded to 13 diagnoses. Utilizing a standardized protocol and script, counselors performed virtual discharge counseling via a remote, secure teleconference platform in the patients' preferred language.ResultsVirtual discharge counseling was performed with 166 patients. COVID-19, back pain, and headache were the most frequent diagnoses. The median counseling time was 14 min. Median counseling time for English was 11 min, versus 20 min for other languages ( < 0.001). Counseling times were the longest for COVID-19 and diabetes (18 min for each).ConclusionWe demonstrate the scalability of a virtual discharge counseling program. Our findings can assist in targeting virtual discharge counseling resources for limited English-proficiency patients and specific diagnoses that require longer counseling times.
Patterns of eConsult use: A retrospective analysis of usage comparing two models deployed at an academic medical center.
Grim S, Miller D, Mooneyhan E … +3 more , Kessler R, Fuhlbrigge A, Thomas JF
J Telemed Telecare · 2025 Dec · PMID 39533946 · Publisher ↗
IntroductionElectronic consultations (eConsults) have been implemented by numerous academic medical centers (AMCs) to improve communication and address access to specialty care. As these models proliferate, we must under...
IntroductionElectronic consultations (eConsults) have been implemented by numerous academic medical centers (AMCs) to improve communication and address access to specialty care. As these models proliferate, we must understand their comparative benefit and use in various settings.MethodsThis retrospective, descriptive analysis compares eConsult utilization trends at an AMC that has deployed an internal effort and an external pivot. Relevant metrics are presented using counts and proportions or median and range where appropriate.ResultsThe internal AMC program demonstrated sustained growth from years 1 through 6, while the external pivot demonstrated considerable growth in year 1, followed by a steady decline in subsequent years. Endocrinology generated the highest number of eConsult orders in both programs (AMC 21%, external pivot 16%). Conversion rates to in-person visits were higher in the external pivot (22%) than in the internal AMC program (14%). Median response time across all specialties was faster (17 hours) for the AMC program than the external pivot (23 hours). The median number of eConsults ordered by any single primary care provider was 3 in both programs. The percentage of providers using the eConsult ordering system only once was approximately 30% in both programs. eConsults were primarily ordered by physicians (68%) at the AMC and physician assistants (40%) in the external pivot.DiscussionThe current study highlights similarities and differences between internal and external eConsult programs that can inform future "right-sizing" of care according to patient needs while promoting local care delivery and improving efficiencies at the AMC.
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