Journal Of Telemedicine And Telecare[JOURNAL]
Sun
200 papers
Adapting telehealth to address health equity: Perspectives of primary care providers across the United States.
Azar R, Chan R, Sarkisian M … +6 more , Burns RD, Marcin JP, Gotthardt C, De Guzman KR, Rosenthal JL, Haynes SC
J Telemed Telecare · 2025 Aug · PMID 38515372 · Full text
BackgroundTelehealth has the potential to increase access to care for medically underserved patients. This qualitative study aimed to identify telecare practices used during the COVID-19 pandemic to meet the needs of pat...
BackgroundTelehealth has the potential to increase access to care for medically underserved patients. This qualitative study aimed to identify telecare practices used during the COVID-19 pandemic to meet the needs of patients experiencing homelessness, patients with disabilities, and patients with language preference other than English (LOE).MethodsWe conducted a secondary qualitative data analysis of 47 clinician interviews at Federally Qualified Health Centers (FQHCs) around the country. Using thematic analysis, transcripts were coded by line-by-line by five qualitative researchers. A multidisciplinary team of telehealth experts, researchers and primary care clinicians reviewed memos and excerpts to generate major themes.ResultsWe identified six main areas demonstrating how community providers developed strategies or practices to improve access to care for vulnerable patients: reaching patients experiencing homelessness, serving deaf and hard of hearing patients, improving access for patients with disabilities, serving patients with LOE, improving access for mental and behavioral health services, and educating patients about telehealth. During the pandemic, FQHCs developed innovative solutions to provide access to care for the unhoused, including using telehealth in shelters, vans, and distributing devices like mobile phones and tablets. Telehealth reduced transportation burdens for patients with disabilities and reduced no-show rates for mental health services by adapting group therapy via telehealth features (like break-out rooms) and increasing provider capacity.ConclusionOur study identified strategies adopted by FQHCs to serve underserved populations during the COVID-19 pandemic. Our findings highlight the need for enduring strategies to improve health equity through telehealth..
Digitally enabled asynchronous remote medical management of anxiety and depression: A cohort study.
Perlman A, Pickman Y, Dreyfuss M … +6 more , Manes I, Bak P, Souroujon D, Paz E, Ebbert JO, Zeltzer D
J Telemed Telecare · 2025 Jul · PMID 38484299 · Publisher ↗
ObjectiveTo evaluate the clinical outcomes of a remote mental health program for managing anxiety and depression, primarily using asynchronous digital communication.MethodsThis retrospective cohort study examined U.S. ad...
ObjectiveTo evaluate the clinical outcomes of a remote mental health program for managing anxiety and depression, primarily using asynchronous digital communication.MethodsThis retrospective cohort study examined U.S. adults seeking remote care for anxiety and depression from January 2021 to May 2022. The program involves clinician-led assessment, patient education, medication management, and ongoing monitoring, primarily via text. Anxiety and depression were measured using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scores. Outcomes examined were changes in scores, 50% score improvement rate, and remission rate (score <5) at 1, 3, and 6 months.ResultsDuring the period evaluated, 11,844 program participants met the inclusion criteria. Most were female (n = 8328, 70.3%); their age ranged from 18-82 years (median 31 years). At baseline, median PHQ-9 and GAD-7 scores were 13 (IQR 9-17); 67% and 69% met score criteria for depression and anxiety, respectively. Most participants (80%) were prescribed a selective serotonin reuptake inhibitor (SSRI). By one month, average PHQ-9 and GAD-7 scores decreased significantly by 9.2 and 9.1 points (both < .01). At 1-month follow-up, the 50% score improvement rate was 66% for PHQ-9 and 69% GAD-7 ( < .01). Scores continued to decrease with follow-up. At 3 months, over half achieved remission (percent [95% CI]: 52% [51-54] for anxiety, 53% [52-55] for depression). Similar improvement was observed at 6 months and in sensitivity analyses accounting for loss to follow-up.ConclusionsUse of a remote mental health program with digital tools was associated with significant clinical improvement in anxiety and depression. Challenges remain in maintaining patient engagement and ensuring appropriate care quality monitoring in digital mental health programs. Additional research comparing remote digital care to traditional in-person models is warranted. Studies should examine long-term outcomes, optimal care protocols, and the challenges to integrating these programs into existing healthcare systems and ensuring equitable access.
Effects of telerehabilitation on cardiac remodeling and hemodynamics parameters in hypertensive older adults: A randomized controlled trial.
Rodrigues-da-Silva AJ, Suassuna JA, Monteiro EDS … +3 more , Borges de Lima IA, Santos ADC, Brasileiro-Santos MDS
J Telemed Telecare · 2025 Aug · PMID 38483844 · Publisher ↗
ObjectiveThis study aimed to assess the effects of telerehabilitation with multimodal exercise on cardiac remodeling and blood pressure in hypertensive older adults.MethodsThirty-two hypertensive older adults (66.7 ± 5.3...
ObjectiveThis study aimed to assess the effects of telerehabilitation with multimodal exercise on cardiac remodeling and blood pressure in hypertensive older adults.MethodsThirty-two hypertensive older adults (66.7 ± 5.33 years; 29.5 ± 4.22 Kg/m; 24 female) were randomized into either a telerehabilitation or a control group. Echocardiographic parameters and blood pressure were assessed before and after the 16-week intervention. The exercise program was supervised, individualized, and offered 3×/week via videoconference.ResultsBlood pressure significantly decreased after telerehabilitation when compared to the control group, presenting a large effect size. The moderate effect size in relative and posterior wall thickness ( = 0.63; = 0.61), shortening fraction ( = 0.54), and ejection fraction ( = 0.68).ConclusionAs a preliminary study, telerehabilitation is favorable to promote a moderate clinical improvement of some cardiac morphofunctional parameters and reduce blood pressure in hypertensive older adults.
Increasing primary care capacity and referral efficiency: A case study of a telehealth centre eConsult service in Brazil.
Catapan SC, Bruckmann G, Nilson LG … +4 more , Caffery LJ, Kelly JT, Calvo MCM, Boing AF
J Telemed Telecare · 2025 Aug · PMID 38446874 · Publisher ↗
IntroductioneConsults are asynchronous digital communications for primary care professionals to seek timely specialist advice. Potential benefits include increased primary healthcare capacity and referral efficiency. San...
IntroductioneConsults are asynchronous digital communications for primary care professionals to seek timely specialist advice. Potential benefits include increased primary healthcare capacity and referral efficiency. Santa Catarina Telehealth Centre in Brazil has offered eConsults for an increasing number of specialties since 2008. This study described the characteristics of this service, including referral efficiency, sustainability, and satisfaction.MethodsRetrospective longitudinal analysis of eConsults activity data from 2015 to 2022 with three domains of the Model for Assessment of Telemedicine Applications used to structure the analysis.Results: The total number of eConsults performed in 2015 was 4764, reaching 41,178 in 2022. While 30.3% of eConsults were synchronous in 2015, only asynchronous communication remained from 2021. : eConsults requested to refer patients to specialist care resulting in primary care management remaining above 30% of the total for all specialties from 2019 to 2022, with hematology having the highest percentage (>52%). : Established workflows with local specialists responding to eConsults (cardiology, endocrinology, hematology and orthopaedics) kept a constant or increasing number of eConsults and maintained the proportion of primary care management from 2019 to 2022, once recovered from COVID-19 and funding restrictions-related reductions. Over 90% of primary care professionals are either satisfied or very satisfied with the eConsult service.ConclusionOver 8 years, 223,734 consultations were conducted, with high satisfaction, demonstrating the substantial potential for increased primary care-sensitive conditions management. Hiring local specialists, fostering integrated care, and enabling sustainable workflows are key to eConsults' success.
Efficacy of telerehabilitation in patients with nonspecific neck pain: A meta-analysis.
Zou H, Lu Z, Zhao P … +2 more , Wang J, Wang R
J Telemed Telecare · 2025 Jul · PMID 38425292 · Publisher ↗
IntroductionAt a rate of more than 30% annually, neck pain is a very prevalent musculoskeletal ailment that is second only to low back pain as the most common cause of disability. Most occurrences of neck pain are nonspe...
IntroductionAt a rate of more than 30% annually, neck pain is a very prevalent musculoskeletal ailment that is second only to low back pain as the most common cause of disability. Most occurrences of neck pain are nonspecific. Telerehabilitation is regarded as a potentially effective healthcare approach in this setting. This review aims to evaluate how a telerehabilitation-based intervention affected individuals with nonspecific neck pain (NNP) in terms of pain and disability.MethodsPubMed, Web of Science, Scopus, Embase, MEDLINE, Cochrane library, ClinicalTrials.gov, CNKI, and WanFang were consulted from inception to September 2023, with the inclusion of randomized controlled trials only. The experimental data were meta-analyzed using RevMan 5.3.ResultsThe meta-analysis contained eight studies; there was no significant difference in pain improvement in patients with NNP by telerehabilitation compared to conventional care (SMD = -0.10, 95% CI: -0.48 to 0.28), but there was a significant effect on disability improvement (SMD = -0.41, 95% CI: -0.78 to -0.03). Telerehabilitation demonstrated more significant improvements in pain (SMD = -1.16, 95% CI: -1.99 to -0.32) and disability (MD = -3.78, 95% CI: -5.29 to -2.27) compared to minimal or no intervention.DiscussionThis study emphasizes the potential benefits of employing telerehabilitation in patients with NNP, especially in reducing pain intensity and improving disability. But additional study is required to fully grasp the potential of telerehabilitation in this field.
Managing pediatric-onset multiple sclerosis in an austere setting: A case report.
Pierce Pucci JU, Soloria HM, Eye PG
J Telemed Telecare · 2025 Jul · PMID 38425268 · Publisher ↗
Pediatric-onset multiple sclerosis (POMS) is the most common demyelinating disease in children. Patients suffer from physical disability, cognitive impairment, and psychosocial challenges. Management requires a multidisc...
Pediatric-onset multiple sclerosis (POMS) is the most common demyelinating disease in children. Patients suffer from physical disability, cognitive impairment, and psychosocial challenges. Management requires a multidisciplinary care team. Here we present a case of an 11-year-old boy with POMS who relocated to Guam prior to initiation of a disease-modifying treatment and who experienced a flare without immediate access to an MRI or a child neurologist. Care required the combined efforts of ophthalmology, pediatrics, and emergency medicine in Guam, real-time remote guidance by child neurology, and asynchronous collaboration with cardiology and child neurology. As a result, the immediate flare was accurately diagnosed and treated with steroids, the patient was started on Fingolimod, and an emergency management plan for future flares was constructed. This case illustrates the nuances of both the acute and chronic management of multiple sclerosis in a resource-limited setting and how a combination of synchronous and asynchronous telemedicine was able to achieve a satisfactory treatment plan.
Implementation of Sweden's first digi-physical hospital-at-home care model for high-acuity patients.
Kastengren M, Frisk L, Winterfeldt L … +2 more , Wahlström G, Dalén M
J Telemed Telecare · 2025 Jul · PMID 38425246 · Publisher ↗
AimTo evaluate Sweden's first implementation of a 24/7 high-acuity virtual in-patient ward through a digi-physical in-patient care (DPIPC) program, a hospital-at-home care model combining a virtual hospital-based medical...
AimTo evaluate Sweden's first implementation of a 24/7 high-acuity virtual in-patient ward through a digi-physical in-patient care (DPIPC) program, a hospital-at-home care model combining a virtual hospital-based medical command centre and in-person ambulating medical services functioning as an extension of the Department of Medicine at a secondary-level hospital in Stockholm.MethodsA single-centre descriptive study where adult patients with acute medical illness requiring inpatient-level care were assessed for voluntary treatment in the DPIPC program as a substitute for traditional in-patient care. The primary outcome was patient satisfaction with care. Secondary outcomes included health care use, safety, and quality during the care episode.ResultsFrom October 2022 to June 2023 a total of 200 patients were treated within the DPIPC program. The program covered 63 unique medical conditions, with infectious disease (44%) and pulmonary disease (17%) being the most common. The median length of stay (LOS) in the DPIPC program was 3 days (IQR 3) with a median LOS of 2 days (IQR 3) in the physical hospital prior to inclusion. There were no incidents of patient mortality or hospital-related complications during the DPIPC period. A total of 11 (5.5%) patients were escalated to the traditional hospital, 4 (36.4%) of which required ambulance. The median DPIPC patient satisfaction was 10 (IQR 0) and Net Promotor Score was 88.ConclusionsImplementing a 24/7 high-acuity virtual in-patient ward is feasible and safe for selected patients with acute medical illnesses. Patient satisfaction and care quality within the program is high.
Telephone versus video consultations: A systematic review of comparative effectiveness studies and guidance for choosing the most appropriate modality.
Caffery LJ, Catapan SC, Taylor ML … +4 more , Kelly JT, Haydon HM, Smith AC, Snoswell CL
J Telemed Telecare · 2025 Aug · PMID 38419502 · Publisher ↗
ObjectiveThis systematic review compared clinical, service and cost effectiveness of telephone consultations (TC) to video consultations (VC).MethodsWe searched Embase, CINAHL and MEDLINE for empirical studies that compa...
ObjectiveThis systematic review compared clinical, service and cost effectiveness of telephone consultations (TC) to video consultations (VC).MethodsWe searched Embase, CINAHL and MEDLINE for empirical studies that compared TC to VC using clinical, service or economic outcome measures. Clinician or patient preference and satisfaction studies were excluded. Findings were synthesised descriptively.ResultsA total of 79 articles were included. The most effective modality was found to be VC in 40 studies (50%) and TC in 3 (4%). VC and TC were found to be equivalent in 28 of the included articles (35%). VC were superior or equivalent to TC for all clinical outcomes. When compared to TC, VC were likely to have better patient engagement and retention, to improve transfer decisions, and reduce downstream sub-acute care utilisation. The impact of telehealth modality on consultation time, completion rates, failure-to-attend rates and acute care utilisation was mixed. VC were consistently found to be more cost effective despite having a higher incremental cost than TC.ConclusionsOur systematic review demonstrates equal or better, but not inferior clinical and cost outcomes for consultations delivered by VC when compared to TC. VC appear to be more clinically effective when visual information is required, when verbal communication with the patient is impaired and when patient engagement and retention is linked to clinical outcomes. We have provided conditions where VC should be used in preference to TC. These can be used by clinicians to guide the choice of telehealth modality. Cost effectiveness is also important to consider when choosing modality.
Facilitators and barriers to using telemedicine for gender-affirming care in gender-diverse youth: A qualitative study.
Inwards-Breland DJ, Yeh D, Marinkovic M … +4 more , Richardson TR, Marino-Kibbee B, Bayley A, Rhee KE
J Telemed Telecare · 2025 Jul · PMID 38400512 · Full text
IntroductionAccess to gender-affirming care (GAC) is limited for gender-diverse (GD) youth, with the potential for further limitations given the current political climate. GAC has been shown to improve the mental health...
IntroductionAccess to gender-affirming care (GAC) is limited for gender-diverse (GD) youth, with the potential for further limitations given the current political climate. GAC has been shown to improve the mental health of GD youth and telemedicine (TM) could increase access to GAC. With limited data on the acceptability and feasibility of TM for GAC among GD youth, we sought to further explore their perspectives on the use of TM in their care.MethodsWe used a semi-structured interview guide, with prompts developed to explore participants' knowledge of TM, identify factors that influenced use, and advantages or disadvantages of use.ResultsThirty GD participants aged 13-21 years old participated in TM. While TM was not the preferred option for medical visits, it was recognized as a practical option for providing GAC. Various actual and perceived disadvantages noted by youth included, technical issues interrupting the visit, not receiving care equivalent to that of an in-person visit, having to see themselves on the screen, family members interrupting visits, and meeting new staff while connecting to a TM visit. The advantages, however, were an increased autonomy and convenience of TM, especially when used for specific aspects of GAC.DiscussionThe use of TM in GAC could be optimized by limiting camera use, eliminating/reducing staff involvement, being sensitive to privacy issues, and alternating TM with in-person visits. Clinicians should be cognizant of patient preferences and concerns and be flexible with visit types.
Evaluation of the satisfaction and experiences of oncology patients and doctors using teleconsultation during the COVID-19 pandemic.
Kastrisiou M, Karimi M, Christou EA … +9 more , Bizot A, Ropers MA, De-Jesus A, Mokdad-Adi M, To THV, Viansone A, Delaloge S, Besse B, Kfoury M
J Telemed Telecare · 2025 Jul · PMID 38327172 · Publisher ↗
IntroductionDuring the coronavirus disease 2019 (COVID-19) pandemic, the Gustave Roussy Cancer Center introduced teleconsultation via telephone, as an alternative to face-to-face consultation to reduce patient hospital v...
IntroductionDuring the coronavirus disease 2019 (COVID-19) pandemic, the Gustave Roussy Cancer Center introduced teleconsultation via telephone, as an alternative to face-to-face consultation to reduce patient hospital visits. This study was designed to assess patient and doctor satisfaction with this modality of care in oncology patient care during the period of the pandemic and beyond.MethodsWe designed two questionnaires based on validated scores to assess satisfaction from teleconsultation in patients (EORTC OUT-PATSAT 35 and Telemedicine Satisfaction Questionnaire [TSQ] scores) and doctors (Telehealth Usability Questionnaire [TUQ]), and anxiety levels in both groups (anxiety section of the Hospital Anxiety and Depression Scale [HADS], HADS-A). These were electronically sent to patients and doctors with experience of at least one remote consultation during the first wave of the COVID-19 pandemic.Results239 patients and 32 doctors were eligible for the analyses. In the patient group, the mean satisfaction scores were 79.5 (SD 18.1) and 74.92 (SD 15.3) for EORTC OUT-PATSAT 35 and TSQ, respectively. In the doctor group, the mean satisfaction scores were 67.1 (SD 12.7) and 64.9 (SD 13.9) for TUQ and TUQ for Skype for Business, respectively. 65.7% of patients and 81.2% of doctors had no/low anxiety. Univariable analyses in patients showed correlation of the EORTC OUT-PATSAT 35 and TSQ scores with anxiety and gender, with lower mean scores in women compared to men. Multivariable analysis showed correlation of the EORTC OUT-PATSAT 35 and TSQ scores to anxiety in both patients and doctors.ConclusionsTeleconsultation via telephone is an acceptable modality of care for oncology patients, with high satisfaction from its implementation during the pandemic reported by patients and doctors. This was consistent across responder groups with different characteristics. An individualized approach to patients should be implemented for the safe and effective use of teleconsultation in oncology beyond the pandemic.
Smartphone applications for remote patient monitoring reduces clinic utilization after full-endoscopic spine surgery.
Leyendecker J, Prasse T, Bieler E … +5 more , Yap N, Eysel P, Bredow J, Hofstetter CP, Members of the Endoscopic Spine Research Group (ESRG)
J Telemed Telecare · 2025 Jul · PMID 38321874 · Publisher ↗
IntroductionThe rising number of outpatient spine surgeries creates challenges in postoperative management and care. Telemedicine offers a unique opportunity to reduce in-person clinic visits and improve resource allocat...
IntroductionThe rising number of outpatient spine surgeries creates challenges in postoperative management and care. Telemedicine offers a unique opportunity to reduce in-person clinic visits and improve resource allocation. We aimed to investigate the impact of a validated smartphone application on clinic utilization following full-endoscopic spine surgery (FESS).MethodsWe evaluated patients undergoing FESS from 2020 to 2022 and a pre-COVID control group (CG) from 2018 to 2019. Subsequently, we divided the patients into three groups: one using the application (intervention group, IG), and two CGs (2020-2022, CG and 2018-2019, historical control group (HG)). We analyzed the post-surgical hospitalization rate, all follow-ups, and virtually transmitted patient-reported outcomes.ResultsA total of 115 patients were included in the IG. The CG consisted of 137 and the HG of 202 patients (CG and HG in the following). Group homogeneity was satisfactory regarding patient age (= 0.9), sex (= 0.88), and body mass index (= 0.99). IG patients were treated as outpatients significantly more often [14.78% vs. 29.2% vs. 37.62% (< 0.001)]. Additionally, IG patients showed significantly higher follow-up compliance [74.78% vs. 40.14% vs. 37.13% (< 0.001)] 3-month post-surgery and fewer in-patient follow-up visits [(0.5 ± 0.85 vs. 1.32 ± 0.8 vs. 1.33 ± 0.7 (< 0.001)].ConclusionOur results underline the feasibility, efficacy, and safety of remote patient monitoring following FESS. Furthermore, they highlight the opportunity to implement a virtual wound checkup, and to substantially improve postoperative follow-up compliance via telemedicine.
The association between rurality, dual Medicare/Medicaid eligibility and chronic conditions with telehealth utilization: An analysis of 2019-2020 national Medicare claims.
Bogulski CA, Pro G, Acharya M … +4 more , Ali MM, Brown CC, Hayes CJ, Eswaran H
J Telemed Telecare · 2025 Jul · PMID 38314738 · Full text
IntroductionTelehealth services have the potential to increase healthcare access among underserved populations, such as rural residents and racial/ethnic minority groups. The COVID-19 public health emergency led to unpre...
IntroductionTelehealth services have the potential to increase healthcare access among underserved populations, such as rural residents and racial/ethnic minority groups. The COVID-19 public health emergency led to unprecedented growth in telehealth utilization, but evidence suggests the growth has not been equitable across all patient populations. This study aimed to explore whether telehealth utilization and expansion changed equitably from 2019 to 2020 among sub-groups of Medicare beneficiaries.MethodsWe conducted an analysis of telehealth utilization among a 20% random sample of 2019-2020 Medicare beneficiaries on a national level. We fit multivariable logistic regression models and calculated average marginal effects (AME) to assess the association between demographic and clinical characteristics on telehealth utilization.ResultsWe found telehealth utilization was less likely among non-Hispanic Black/African-American (2019: adjusted odds ratio [aOR] = 0.77, AME = -0.15; 2020: aOR = 0.85, AME = -3.50) and Hispanic (2019: aOR = 0.79, AME = -0.13; 2020: aOR = 0.87, AME = -2.89) beneficiaries, relative to non-Hispanic White beneficiaries in both 2019 and 2020, with larger disparities in 2020. Rural beneficiaries were more likely to utilize telehealth than urban beneficiaries in 2019 (aOR = 2.62, AME = 0.84), but less likely in 2020 (aOR = 0.57, AME = -14.47). In both years, dually eligible Medicare/Medicaid beneficiaries were more likely than non-dually eligible beneficiaries to utilize telehealth (2019: aOR = 4.75, AME = 0.84; 2020: aOR = 1.34, AME = 2.25). However, the effects of dual eligibility and rurality changed in both models as the number of chronic conditions increased.DiscussionWe found evidence of increasing disparities in telehealth utilization among several Medicare beneficiary sub-groups in 2020 relative to 2019, including individuals of minority race/ethnicity, rural residents, and dually eligible beneficiaries, with disparities increasing among individuals with more chronic conditions. Although telehealth has the potential to address health inequities, our findings suggest that many of the patients in greatest need of healthcare are least likely to utilize telehealth services.
A hospital-based asynchronous ENT telehealth service for children with otitis media: Cost-minimisation and improved access.
Altamimi AA, Brennan-Jones CG, Robinson M … +10 more , Kuthubutheen J, Herbert H, Tran TT, Veselinović T, Edmunds M, Oremulé B, Alenezi EM, Richmond PC, Choi RS, Li I
J Telemed Telecare · 2025 Jul · PMID 38295365 · Publisher ↗
AimThe purpose of this study is to explore the effectiveness of a hospital-based asynchronous ear, nose, and throat (ENT) telehealth service (the Ear Portal) in reducing cost and improving access for children with otitis...
AimThe purpose of this study is to explore the effectiveness of a hospital-based asynchronous ear, nose, and throat (ENT) telehealth service (the Ear Portal) in reducing cost and improving access for children with otitis media.MethodsParticipants were recruited to the Ear Portal from a tertiary hospital ENT waiting list. Ear and hearing assessments were conducted during appointments by the Ear Portal research assistant, and data was stored for an asynchronous review by the Ear Portal multidisciplinary team. A cost-minimisation analysis was conducted for the Ear Portal and the standard care pathways. Waiting times to provide care for both pathways were calculated for children with semi-urgent (i.e. Category 2) and non-urgent (i.e. Category 3) referrals.ResultsThe running cost for the Ear Portal was $67.70 for initial appointments and $37.34 for follow-up appointments. Conversely, the running cost for the standard care pathway was $154.65 for initial appointments and $86.10 for follow-up appointments. A total of 223 appointments were required to offset the initial Ear Portal investment of $19,384.00. The median waiting time for the Ear Portal from initial contact to care plan delivery was <30 days, whereas the median waiting times for children in the standard care pathway were 291 days (interquartile range (IQR) = 117) for Category 2 and 371 days (IQR = 311) for Category 3 referrals.ConclusionUnder the current circumstances, the Ear Portal service can reduce costs for the health care system by reducing marginal costs per patient in addition to providing ENT specialist care within the clinically recommended timeframes.
Is it safe to use telephone for anaesthesia consultation in high-risk patients before non-invasive surgery? A pilot study in ophthalmology.
Guerrier G, Ohayon J, Rothschild PR … +1 more , Baillard C
J Telemed Telecare · 2025 Jul · PMID 38280210 · Publisher ↗
BackgroundAlthough telemedicine with video support for preoperative evaluation has been found effective, there is limited research on anaesthesia consultation by phone without video support, particularly among high-risk...
BackgroundAlthough telemedicine with video support for preoperative evaluation has been found effective, there is limited research on anaesthesia consultation by phone without video support, particularly among high-risk patients. To evaluate the effectiveness, safety and potential benefits of performing pre-anaesthesia evaluation by phone before eye surgery in patients having non-invasive surgery, we performed an observational study in a French teaching hospital.MethodAll elective patients having elective ophthalmic surgery were included to have a consultation by phone instead of an in-person consultation, regardless of the type of anaesthesia or ASA score. The incidence of day-of-surgery cancellations, patient satisfaction and time/distance saved through phone consultations were assessed.ResultsFrom February to October 2022, data of 3480 patients were analyzed, including 370 (11%) high-risk patients (ASA 3-4). Anaesthesia-related day-of-surgery cancellation rate was 0.5% ( = 20) due to non-compliance with pre-operative instructions. No cancellation was due to inadequate pre-operative evaluation. No difference in cancellation rate was observed between low-risk patients and high-risk patients. Telephone consultations saved patients a mean of 126 min and 86 km. A younger age, an active status and living far from the hospital were associated with phone consultation preference.ConclusionPhone anaesthesia consultation seems to be effective and safe before ophthalmic surgery, regardless of patient's perioperative risk. In addition, phone consultation provides significant time and distance savings. Our results must be confirmed through a multicentric randomised study comparing phone and traditional consultation in ophthalmology as well as in other non-invasive surgical procedures in a high-risk patients population.
Assisted teleconsultation in an outpatient pharmacy: Results of a pilot study in Geneva, Switzerland.
Braillard O, Mazouri Karker S, Djarmouni R … +3 more , Lafaix R, Guessous I, Schneider MP
J Telemed Telecare · 2025 Jul · PMID 38263622 · Publisher ↗
IntroductionAssisted teleconsultation (ATC) is the act of telemedicine involving on one side a patient in the presence of a healthcare professional, and an expert on the other side. ATC in outpatient pharmacies may be an...
IntroductionAssisted teleconsultation (ATC) is the act of telemedicine involving on one side a patient in the presence of a healthcare professional, and an expert on the other side. ATC in outpatient pharmacies may be an alternative to the emergency room for patients with a semi-urgent medical problem. This project aimed at pilot testing the ATC in an outpatient pharmacy to assess its feasibility and to collect initial real-world data.MethodsAfter initial evaluation and triage by the pharmacist, ATC was proposed to patients consulting at one outpatient pharmacy for semi-urgent medical problems. Prospective data on patients, consultation reasons, teleconsultation duration, patient's orientation and pharmacist' satisfaction were prospectively collected.ResultsBetween December 2020 and June 2021, 39 consultations took place, 12 with video and 27 with telephone. Patients' median age was 37 years (IQR 26-50), 59% were women. Near half of the consultations (19) happened during the weekend. Mean ATC duration was 22 min (IC95% 18.6-26.1). Twenty-nine (74%) consultations ended with a prescription, 8 (21%) with medical recommendations and 2 (5%) with an emergency care referral. Without teleconsultation, 34 (87%) patients would have consulted a physician for their problem, and 24 (62%) would have been to the emergency room (self-reported). Fourteen (36%) consultations involved ENT, ophthalmologic and dermatologic complaints.ConclusionA young population with semi-urgent medical problems can be managed in the pharmacy using ATC with a primary care physician. Financial, technical and training aspects should be developed and optimized in the future.
Virtual agents among participants with methamphetamine use disorders: Acceptability and usability study.
Li S, Wang Y, Chen L … +8 more , Chen T, Du J, Su H, Jiang H, Wu Q, Zhang L, Bao J, Zhao M
J Telemed Telecare · 2025 Jun · PMID 38260973 · Publisher ↗
IntroductionWhile the potential future role of virtual agents (VAs) in treating addiction is promising, participants' attitudes toward the use of VAs in psychotherapy remain insufficiently investigated. This lack of inve...
IntroductionWhile the potential future role of virtual agents (VAs) in treating addiction is promising, participants' attitudes toward the use of VAs in psychotherapy remain insufficiently investigated. This lack of investigation could pose barriers to the adoption of VA-led psychotherapy for people with substance use disorders (SUD). This research aims to explore the acceptability and usability of VAs for people with methamphetamine use disorder.MethodsFollowing a single session of psychotherapy led by VAs through the Echo-app, a group of 49 individuals actively seeking treatment for current DSM-V substance dependence (with a mean age of 39.06 ± 8.02) completed self-administered questionnaires and participated in focus group interviews. These questionnaires aimed to investigate participants' preference regarding the type of psychotherapy and their willingness to engage in VA-led psychotherapy, taking into account their diverse psychological needs.ResultsQuantitative data were subjected to analysis through both descriptive and inferential statistical methods. Interestingly, participants exhibited a significantly higher acceptability for traditional face-to-face psychotherapy compared to email-based psychotherapy (= 0.042), but there was no statistically significant difference between their acceptance of traditional psychotherapy and VA-led psychotherapy (= 0.059). The questionnaire outcomes indicated participants' willingness to engage in VA-led psychotherapy for purposes such as relapse prevention intervention, addressing emotional issues, managing somatic experiences, and facilitating social and family functional recovery. Furthermore, the participants' attitudes toward VA-led psychotherapy were predicted by factors including the need for anxiety-focused psychotherapy (= 0.027; OR [95%CI] = 0.14[0.03,0.80]), the presence of chronic somatic diseases ( = 0.017; OR [95%CI] = 13.58[1.59,116.03]), and marital status ( = 0.031; OR [95%CI] = 5.02[1.16,21.79]).DiscussionThrough the interviews, the study uncovered the factors that either supported or hindered participants' experiences with VA-led psychotherapy, while also gathering suggestions for future improvements. This research highlights the willingness and practicality of individuals with SUD in embracing VA-led psychotherapy. The findings are anticipated to contribute to the refinement of VA-led tools to better align with the preferences and needs of the users.
Referral of patients from rural primary care clinics to telemedicine vendors for opioid use disorder treatment: A mixed-methods study.
Lin C, Zhu Y, Mooney LJ … +5 more , Ober A, Clingan SE, Baldwin LM, Calhoun S, Hser YI
J Telemed Telecare · 2025 Jul · PMID 38258323 · Full text
IntroductionRural primary care clinics can expand their medication treatment for opioid use disorder (MOUD) capacity by coordinating care with external telemedicine (TM) vendors specializing in addiction medicine. This s...
IntroductionRural primary care clinics can expand their medication treatment for opioid use disorder (MOUD) capacity by coordinating care with external telemedicine (TM) vendors specializing in addiction medicine. This study used mixed methods to identify factors that influence patient referrals from rural primary care clinics to TM vendors for MOUD.MethodsBetween July/August 2020 and January/February 2021, 582 patients with OUD were identified across six primary care sites; that included 68 referred to an external TM vendor to receive MOUD. Mixed effects logistic regression identified individual and site-level factors associated with being referred to the TM vendor. Clinic providers and staff participated in in-depth interviews and focus groups to discuss their considerations for referring patients to the TM vendor.ResultsPatient referrals were positively associated with local household broadband coverage (OR = 2.55, p < 0.001) and negatively associated with local population density (OR = 0.01, p = 0.003) and the number of buprenorphine prescribers in the county (OR = 0.85, p < 0.001). Clinic personnel expressed appreciation for psychiatric expertise and the flexibility to access MOUD brought by the TM vendor. Perceived concerns about TM referral included a lack of trust with external providers, uncertainty about TM service quality, workflow delays, and patients' technological and insurance challenges.ConclusionThis study revealed several clinic-level factors that may potentially influence patient referral to TM vendor services for MOUD. To facilitate the referral process and utilization of TM vendors, efforts should be made to foster open communication and trust between clinic providers and TM vendors, streamline workflows, and improve Internet access for patients.
Evidence-based telehealth interventions for post-traumatic stress disorder, depression, and anxiety: A systematic review and meta-analysis.
Kelber MS, Smolenski DJ, Boyd C … +8 more , Shank LM, Bellanti DM, Milligan T, Edwards-Stewart A, Libretto S, Parisi K, Morgan MA, Evatt DP
J Telemed Telecare · 2025 Jul · PMID 38254285 · Publisher ↗
IntroductionThe goal of this systematic review was to examine the efficacy of behavioral health care treatments for post-traumatic stress disorder (PTSD), depression, and anxiety delivered via telehealth.MethodsWe search...
IntroductionThe goal of this systematic review was to examine the efficacy of behavioral health care treatments for post-traumatic stress disorder (PTSD), depression, and anxiety delivered via telehealth.MethodsWe searched a combination of keywords related to telehealth, relevant mental health disorders, and evidence-based psychotherapies in three databases (PubMed, PsycInfo, and Embase) from database inception to April 2022. We included randomized controlled trials published in English wherein at least one arm received an evidence-based psychotherapy via telehealth. To be included, studies also had to enroll an adult population with symptoms or diagnosis of PTSD, depressive disorder, or anxiety disorder.ResultsModerate quality of evidence was consistent with only small differences, if any, in efficacy between video teleconferencing (VTC) and in-person delivery for patients with PTSD (= 0.06, 95% CI -0.17, 0.28). However, for those with depression, in-person delivery was associated with better outcomes compared to VTC (= 0.28, 95% CI 0.03, 0.54; low quality of evidence). We also found that evidence-based treatments delivered over telephone were more efficacious for depression compared to treatment as usual (= -0.47, 95% CI -0.66, -0.28; very low quality of evidence). Very low quality of evidence supported the use of telehealth versus waitlist for anxiety (= -0.48, 95% CI -0.89, -0.09).ConclusionsA synthesis across 29 studies indicates that the efficacy of telehealth for delivery of evidence-based behavioral health interventions varies by target diagnosis and telehealth modality. More research is needed on the efficacy of telehealth treatments for depression and anxiety.
Evaluation of video visit appropriateness for common symptoms seen in primary care: A retrospective cohort study.
Chen D, Gonzales E, Winget M … +4 more , Shaw J, Artandi M, Tsai SA, Nelligan I
J Telemed Telecare · 2025 Jul · PMID 38254267 · Publisher ↗
IntroductionLittle is known about which conditions seen in primary care are appropriate for video visits. This study evaluated video visits compared to office visits for six conditions: abdominal pain, joint pain, back p...
IntroductionLittle is known about which conditions seen in primary care are appropriate for video visits. This study evaluated video visits compared to office visits for six conditions: abdominal pain, joint pain, back pain, headache, chest pain, and dizziness.MethodsSix hundred charts of adult patients from our institution's same-day outpatient clinic were reviewed in this study. Charts for video visits evaluating the aforementioned chief complaints that occurred between August and October 2020 were reviewed and compared with charts for office visits that occurred from August to September 2019. Frequencies of 3-week follow-up visits, Emergency Room visits, imaging, and referrals for office and video visits were measured. Reasons for in-person evaluation for patients seen by video were determined by review of clinician notes.ResultsThree-week in-person follow-up was more frequent for patients presenting with chest pain (52% vs 18%, = 0.0007) and joint pain (24% vs 8%, = 0.05) after video evaluation, relative to an office evaluation. Three-week in-person follow-up was also more frequent for patients presenting with dizziness (38% vs 28%) and low back pain (24% vs 14%); however, this difference was not statistically significant. Patients presenting with headache and abdominal pain did not have a higher rate of follow-up.DiscussionBased on the frequency of in-person follow-up, this study suggests that video visits are generally adequate for evaluating headache and abdominal pain. Patients with dizziness and chest pain have the highest frequency of in-person and Emergency Room follow-up within 3 weeks when first seen by video compared to other conditions evaluated and may be less suitable for an initial video visit. Institutions can consider these findings when scheduling and providing guidance to patients on what type of visit is most appropriate for their symptoms.
Integrating place-based and virtual models of palliative care: A case report.
Toll K, Villis A, Moullin J
J Telemed Telecare · 2025 Jul · PMID 38239051 · Publisher ↗
Palliative care management in rural and remote areas generally relies on local resources including a primary healthcare professional and a local health facility. Either in the absence of a primary healthcare professional...
Palliative care management in rural and remote areas generally relies on local resources including a primary healthcare professional and a local health facility. Either in the absence of a primary healthcare professional, or in more complex cases, a patient is frequently transferred to a larger rural- or metropolitan-based health facility, away from community and local supports. With increasing challenges in locum availability, healthcare professionals are challenged in looking out for their own wellness needs, often having to choose between taking time-off or staying on duty and available to provide ongoing care for their patients. In this case report, we describe an alternative hybrid model of care which integrates place-based and virtual management, utilising digital health technologies. This approach supported a rural healthcare professional to take leave, by transferring the care and management of a palliative care patient to the WA Country Health Inpatient Telehealth Service, allowing the patient to remain in their local community and die in their place of choice. Access to palliative care is of great importance to quality care and its impacts cannot be overstated for the person with a terminal illness and their family, it is also important to take into consideration the role of the health professional and their well-being.
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