Telemedicine Journal And E-health[JOURNAL]
Sun
200 papers
Patient Preferences for Virtual Versus In-Person Care in Inflammatory Bowel Disease: A Cross-Sectional Study.
Alghamdi A, Alshahrani S, Almuaili H … +11 more , Alhassoun A, Alothri A, Alfawzan H, Alyousef A, Alhammad B, Alazmi B, Karhan H, Alharbi R, Alhuraibi A, Alotaibi T, Bawazir A
Telemed J E Health · 2026 Jul · PMID 42397174 · Publisher ↗
BACKGROUND: Telemedicine adoption in gastroenterology has accelerated rapidly in recent years. Virtual interventions offer disease activity control comparable to standard in-person care. However, factors determining pati...
BACKGROUND: Telemedicine adoption in gastroenterology has accelerated rapidly in recent years. Virtual interventions offer disease activity control comparable to standard in-person care. However, factors determining patient satisfaction and personal perceptions of virtual clinics remain poorly explored. This study identifies the clinical, demographic, and socioeconomic predictors of clinic format preference among patients with inflammatory bowel disease. METHODS: We conducted a cross-sectional observational study at King Fahad Medical City in Riyadh, Saudi Arabia. The study included adult patients diagnosed with Crohn's disease or ulcerative colitis. Authors collected demographic parameters, clinical covariates, and patient experience ratings using a structured questionnaire. A multivariable binary logistic regression model was employed to isolate independent predictors of virtual clinic preference. RESULTS: The cohort comprised 1,005 patients. Overall, 55.6% preferred in-person appointments and 44.4% preferred virtual clinics. Prior telehealth exposure served as the strongest predictor for future virtual care (odds ratio [OR] = 4.10; 95% confidence interval [CI]: 2.90, 5.82). Patients utilizing subcutaneous injections (OR = 2.02) or oral medications (OR = 1.81) demonstrated significantly higher odds of selecting virtual care. Conversely, an ulcerative colitis diagnosis predicted a preference for physical visits (OR = 0.63). Prioritizing ease of access (OR = 1.47) and the use of technology (OR = 2.14) underpinned virtual choices. Strict privacy concerns (OR = 0.57) and inadequate physician communication (OR = 0.05) deterred patients from the remote clinic. CONCLUSION: Prior telehealth experience and the use of home-based therapies drive virtual clinic adoption. Disease phenotype, reliance on intravenous treatments, and privacy concerns may necessitate accessible in-person care. Health care systems must abandon uniform digital strategies and implement tailored, hybrid care models to optimize resource allocation.
A Qualitative Retrospective Chart Review of Remote Communication for Rural Older Cancer Survivors.
Hzerron A, Berger L, Franklin K … +3 more , Pilson B, Dadha P, Lewis MW
Telemed J E Health · 2026 Jul · PMID 42384547 · Publisher ↗
BACKGROUND: Evidence assessing rural older cancer survivors' patient portal use is limited. To this end, we analyzed My Chart messages among this group to reveal key insights into their patient portal use. METHODS: We co...
BACKGROUND: Evidence assessing rural older cancer survivors' patient portal use is limited. To this end, we analyzed My Chart messages among this group to reveal key insights into their patient portal use. METHODS: We conducted a retrospective qualitative chart review of MyChart messages from cancer patients aged at least 65 years and from rural ZIP codes receiving care at an urban hospital from March 1, 2020, to May 25, 2023. RESULTS: The resulting sample consisted of 860 coded messages from 411 patients. The qualitative analysis yielded 1,295 coded occurrences, from which nine themes emerged. The most frequent coded messages were identified as ( = 464) and . The least frequently coded theme was . CONCLUSION: Our analysis of MyChart messages of rural older cancer survivors demonstrates high engagement with MyChart messaging and has implications for the use of tailored patient portal designs for this uniquely vulnerable patient population.
Characterization of Clinical Diagnoses at a Community Telehealth Platform in Uganda.
Otieno F, Mwanga D, Mawanda A … +4 more , Kamulegeya L, Bwanika JM, Kadengye D, Kiragga A
Telemed J E Health · 2026 Jun · PMID 42371738 · Publisher ↗
BACKGROUND: Rocket Health Africa (formerly The Medical Concierge Group) pioneered telehealth in Uganda by integrating technology with personalized care, providing consultations, diagnostics, pharmacy services, laboratory...
BACKGROUND: Rocket Health Africa (formerly The Medical Concierge Group) pioneered telehealth in Uganda by integrating technology with personalized care, providing consultations, diagnostics, pharmacy services, laboratory services, clinics, and vaccination services on a single platform. METHODS: This study examined the diagnostic and demographic profiles captured through Rocket Health's digital health platform from 2019 to 2023, across the prepandemic, pandemic, and postpandemic periods, using descriptive statistics. RESULTS: A total of 2,677 users were recorded on the telehealth platform during the prepandemic period, 47,072 during the pandemic, and 99,904 during the postpandemic period. Male users accounted for the largest proportion of platform users across all three periods. Married individuals constituted the largest proportion by marital status categories, while users aged 25-34 accounted for the highest proportion within the age group distribution. A range of diagnostic categories was documented across the study period. Diseases of the respiratory system, such as acute upper respiratory infection, were the most frequently recorded diagnostic category, followed by symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified, including fever, headache, and cough. Certain infectious and parasitic diseases, such as coronavirus infection, candidiasis of the vulva and vagina, and malaria, constituted the third most frequently recorded diagnostic category. CONCLUSIONS: Telehealth utilization in Uganda was documented across diverse demographic groups and diagnostic categories over three distinct periods. These findings inform future telehealth policy and planning in Uganda and sub-Saharan Africa.
Revolutionizing Sports Rehabilitation: Unleashing the Power of Tele-Rehabilitation for Optimal Physiotherapy Results.
Telemed J E Health · 2026 Jul · PMID 42348762 · Publisher ↗
Abstract loading — click title to view on PubMed.
Teleconsultation Competencies in Undergraduate Medical Education: A Critical Narrative Review and Evidence-Gap Analysis.
Glinkowski WM, Doniec R, Cedro T … +3 more , Michalak B, Jankowska AK, Śliwczyński A
Telemed J E Health · 2026 Jun · PMID 42332930 · Publisher ↗
BACKGROUND: The rapid expansion of telemedicine has increased the relevance of teleconsultations in everyday clinical practice. However, the manner in which teleconsultation competencies are conceptualized, taught, and a...
BACKGROUND: The rapid expansion of telemedicine has increased the relevance of teleconsultations in everyday clinical practice. However, the manner in which teleconsultation competencies are conceptualized, taught, and assessed in undergraduate medical education remains unclear. METHODS: A narrative review was conducted using a transparent methodology to identify and select studies. Several bibliographic databases were searched using predefined eligibility criteria, focusing on educational interventions that specifically targeted teleconsultation competencies among undergraduate medical students. The selection process emphasized conceptual clarity, curricular intent, and the inclusion of empirically reported educational outcomes. The eligibility criteria were intentionally designed to identify studies that explicitly conceptualized teleconsultation as a distinct undergraduate clinical competency. RESULTS: The search process yielded 199 records. After screening and comprehensive full-text evaluation, only one study explicitly conceptualized teleconsultation as a distinct undergraduate clinical competency and met all predefined eligibility criteria. This study details a structured educational intervention that frames teleconsultation as a distinct clinical competency. The outcomes concerning communication, clinical reasoning in virtual environments, technical aspects of teleconsultation, and components of remote physical examination were reported. CONCLUSIONS: The principal finding was the identification of substantial evidence gaps in the conceptualization, assessment, and longitudinal teaching of teleconsultation competencies. Current evidence regarding the instruction of teleconsultation competencies in undergraduate medical education is limited. The prevailing literature addresses telemedicine primarily as a mode of care delivery rather than emphasizing teleconsultation as a distinct clinical skill. These observations highlight a discrepancy between contemporary clinical practice and undergraduate training, emphasizing the need for well-defined educational frameworks that incorporate teleconsultation competencies.
Variation in Telehealth Use in a National Home Test-to-Treat Program for Acute Respiratory Infections.
Losos WR, Wang B, Fisher K … +3 more , O'Connor L, Soni A, Gerber BS
Telemed J E Health · 2026 Jun · PMID 42313632 · Publisher ↗
BACKGROUND: Home test-to-treat (HTTT) programs deliver timely antiviral treatment for acute respiratory infections, including COVID-19 and influenza, through at-home testing and telehealth. Because access is often measur...
BACKGROUND: Home test-to-treat (HTTT) programs deliver timely antiviral treatment for acute respiratory infections, including COVID-19 and influenza, through at-home testing and telehealth. Because access is often measured by visit occurrence, variation in how and when care is delivered may be overlooked. We hypothesized that telehealth access follows distinct process-based patterns. METHODS: We analyzed de-identified encounters from the national HTTT program (September 2023-July 2024); 6,213 of 8,160 eligible individuals remained after exclusions for missing data. Phenotypes were derived by k-means clustering of standardized variables capturing encounter timing, modality preference, process duration, and sociodemographic and digital access attributes. Ten-day surveys assessed symptom duration and health care utilization. RESULTS: Three phenotypes emerged: Delayed/Disrupted Access ( = 1,537; 24.7%), Digitally Engaged but Socioeconomically Vulnerable ( = 1,460; 23.5%), and Mainstream Access and Efficient Utilization ( = 3,216; 51.8%). Mean process duration differed (15.93 [SD 3.84] vs. 3.69 [3.31] vs. 2.87 [2.41] h; < 0.001). Synchronous preference was lowest in the Digitally Engaged group (22.9%); antiviral prescribing was high (88.6-91.9%). Among 10-day respondents ( = 1,023), symptom duration did not differ. Emergency department visits were most frequent in the Digitally Engaged group (2.3% vs. 0.0% and 0.5%; = 0.02) and urgent care in the Delayed/Disrupted group (5.8% vs. 4.1% vs. 2.0%; = 0.02). CONCLUSIONS: Telehealth use in a national HTTT program formed distinct phenotypes defined by timing, modality, and care-process efficiency. Evaluating equity requires attention to how and when care is delivered, not simply whether it occurred.
Advancing Neonatal Tele-Resuscitation in Community Settings: Effects of Targeted Workshops on Provider Perception and Procedural Confidence.
Sandhu T, DeShea L, Fang JL … +2 more , Umoren R, Makkar A
Telemed J E Health · 2026 Jun · PMID 42313572 · Publisher ↗
BACKGROUND: Approximately 50,000 neonates weighing under 1,500 grams are born annually in the United States, with 15-20% delivered in smaller community hospitals without a neonatal intensive care unit. These "outborn" in...
BACKGROUND: Approximately 50,000 neonates weighing under 1,500 grams are born annually in the United States, with 15-20% delivered in smaller community hospitals without a neonatal intensive care unit. These "outborn" infants face higher risks of adverse outcomes due to limited resources. Implementing tele-resuscitation services with targeted training workshops may enhance providers' technical skills, confidence, and perceptions of feasibility and acceptability. METHODS: In January 2023, Oklahoma Children's Hospital launched a tele-resuscitation program offering real-time, audio-video support to community hospital staff. This service targeted neonates ≤32 weeks' gestation, <1,500 g, and those >32 weeks requiring advanced resuscitation. Workshops were hosted to give community hospital providers a first hand experience with the technology, and it included background on tele-resuscitation, technical skills training, and neonatal resuscitation simulations incorporating telemedicine. Pre- and postworkshop surveys with Likert scale questions assessed attendees' confidence in advanced resuscitation and feasibility of integrating tele-resuscitation into practice. RESULTS: Briefly, 20 community providers attended two interprofessional workshops, including 5 physicians (25%), 11 nurses (55%), and 4 respiratory therapists (20%). One-quarter of attendees reported prior experience with telemedicine, and one attendee reported prior experience with tele-resuscitation. Following the workshops, participant confidence in performing tasks such as intubation, umbilical line placement, needle thoracentesis, and debriefing increased significantly ( < 0.001 for all procedures). While ratings for the appeal and applicability of telemedicine to their practice showed no significant changes ( = 0.267 and = 0.056, respectively), the perceived feasibility of tele-resuscitation significantly improved after the workshop ( = 0.029). CONCLUSIONS: Neonatal tele-resuscitation workshops improved providers' perceptions of this service and increased their acceptance of such a program. Additionally, the skill sessions and simulated resuscitations increased their confidence with procedures commonly performed during advanced neonatal resuscitation.
Resilience of Pediatric Telemedicine: Therapeutic Alliance and Practice-Level Experience During a Pandemic-Driven System Transformation.
Ramezanzadeh J, Zikos D
Telemed J E Health · 2026 Jun · PMID 42313568 · Publisher ↗
BACKGROUND: The COVID-19 pandemic caused a sudden transition from in-person to virtual pediatric care, creating a natural experiment to evaluate patient experience with telemedicine under operational stress. As hybrid ca...
BACKGROUND: The COVID-19 pandemic caused a sudden transition from in-person to virtual pediatric care, creating a natural experiment to evaluate patient experience with telemedicine under operational stress. As hybrid care models mature, understanding perceptions during this disruption can inform durable delivery strategies, particularly regarding the therapeutic alliance and practice-level experience. PURPOSE: To determine whether family experience with telemedicine was comparable to or differed from in-person care during the COVID-19 transition and to assess how delivery modality, pandemic phase, and patient characteristics were associated with experience outcomes. METHODS: We conducted a retrospective, cross-sectional secondary analysis of 18,452 patient and family experience surveys linked to ambulatory pediatric encounters at a large academic medical center between January 1 and September 30, 2020. Encounters were categorized into pre-COVID, early COVID rapid deployment, and later COVID hybrid stabilization phases. Surveys reflected both in-person and synchronous video-based telemedicine visits; telemedicine accounted for approximately 30% of responses during the study period. Independent-samples tests and multiple linear regression models evaluated associations among visit modality, experience metrics, and demographic characteristics. Primary outcomes were Overall Rating of Provider and Recommend Office. RESULTS: During Early COVID, telemedicine visits demonstrated significantly higher provider ratings than in-person visits, indicating preservation of the therapeutic alliance during rapid system change, although the absolute difference was small. In the later COVID phase, telemedicine was associated with higher unadjusted office recommendation scores; however, this effect was not independently associated with delivery modality in adjusted models. Telemedicine remained an independent predictor of higher provider ratings. CONCLUSIONS: Telemedicine sustained clinician-level experience outcomes comparable to, and in some contexts higher than, in-person care across pandemic phases. Findings support institutionalizing hybrid pediatric care models, strengthening clinician virtual communication skills, and advancing digital equity efforts.
Effect of Person-Centered Telehealth Service Implementation on 30-Day Readmissions and Hospital Reimbursement: A Prospective Comparative Study.
Ezzeldin M, Matairi AA, El-Ghanem M … +7 more , Mealer L, Anderson E, Ezzeldin R, Washer R, Greco L, Ali Z, Alderazi YJ
Telemed J E Health · 2026 Jun · PMID 42305030 · Publisher ↗
OBJECTIVE: To evaluate the association between implementation of a personalized, postdischarge telehealth support program and 30-day hospital readmission among patients hospitalized with stroke. METHODS: This observation...
OBJECTIVE: To evaluate the association between implementation of a personalized, postdischarge telehealth support program and 30-day hospital readmission among patients hospitalized with stroke. METHODS: This observational pre-post implementation study was conducted within an acute care hospital system and included adult patients (≥18 years) admitted with ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Following discharge, eligible patients were offered enrollment in a person-centered telehealth support program. The primary outcome was all-cause 30-day readmission. Multivariable regression models were used to adjust for baseline clinical characteristics. RESULTS: Among 405 patients, 258 were admitted before telehealth implementation, 31 were enrolled in the telehealth program after implementation, and 116 were postimplementation nonenrollees. Thirty-day readmission occurred in 23 of 258 patients (8.9%) before implementation, in 0 of 31 telehealth enrollees (0%), and in 3 of 116 nonenrollees (2.6%). After adjustment for clinical covariates, postimplementation patients demonstrated a lower estimated risk of 30-day readmission compared with preimplementation patients, with the lowest risk observed among telehealth enrollees. Based on a 6.3% absolute reduction in readmissions and published cost estimates, telehealth implementation corresponded to an annual savings of approximately $112,000-$124,000 in avoided uncompensated care for uninsured patients and $545,000-$602,000 in reduced exposure to denied claims for insured patients per 1,000 strokes. Anticoagulant use was associated with a higher estimated probability of readmission. CONCLUSION: Implementation of a person-centered postdischarge telehealth service was associated with substantially lower 30-day readmissions among patients hospitalized with stroke and may provide meaningful economic benefits by reducing costly readmissions and financial burden on hospitals.
Disparities in Initial Usage of Direct-to-Patient Teledermatology: A Retrospective Observational Study.
Peracca SB, Sturgeon DJ, Lamkin RP … +10 more , Zepeda ED, Mohr DC, Lachica O, King HA, Jackson GL, Morris IJ, Gifford AL, Whited JD, Weinstock MA, Oh DH
Telemed J E Health · 2026 Jun · PMID 42296049 · Publisher ↗
BACKGROUND: While telehealth has potential to enhance patients' access to care, uneven implementation may limit its impact. My VA Images (), a clinician-gated, patient-facing asynchronous teledermatology application deve...
BACKGROUND: While telehealth has potential to enhance patients' access to care, uneven implementation may limit its impact. My VA Images (), a clinician-gated, patient-facing asynchronous teledermatology application developed by the Department of Veterans Affairs (VA) was piloted at three VA facilities, and then sequentially offered to groups of seven facilities every 3 months for 1 year. We characterized patients who were exposed to and used and we identified associated characteristics. METHODS: We used VA's mobile health and administrative databases to examine activity and dermatology patient demographics over a 17-month period during 2019 and 2020. RESULTS: At 11 VA facilities, 494 established dermatology patients were invited to a follow-up visit using . Invitees were more likely than Non-Invitees to be White and urban, have shorter drive times to specialty care, and have more outpatient and dermatology visits before and after use. Forty-eight percent of Invitees successfully used and were most likely to do so in the 8-30 day interval. Successful Users were more likely than Unsuccessful Users to be younger and have a dermatology visit 1 year after use. Patients requiring multiple attempts before successfully using were older than initially Successful Users, though younger than Unsuccessful Users. CONCLUSIONS: Not all patients benefited equally during the initial rollout of . Disparities in VA where other forms of patient-facing telehealth are already common illustrate challenges for health care organizations in equitably implementing direct-to-patient teledermatology. Specific groups may benefit from targeted outreach or support.
Revolutionary Ideas in Health Care Delivery.
Doarn CR
Telemed J E Health · 2026 Jul · PMID 42274409 · Publisher ↗
Abstract loading — click title to view on PubMed.
Veterans Affairs Clinical Resource Hub Improve Access to Mental Health Services for Rural Veterans.
Jaske E, Wheat CL, Nelson K … +3 more , Curtis I, Wahlberg L, Felker B
Telemed J E Health · 2026 Jun · PMID 42273918 · Publisher ↗
BACKGROUND: Access to high-quality mental health (MH) care in rural communities remains a persistent challenge. In 2019, the Veterans Health Administration (VA) developed 18 regional Clinical Resource Hubs (CRH) to incre...
BACKGROUND: Access to high-quality mental health (MH) care in rural communities remains a persistent challenge. In 2019, the Veterans Health Administration (VA) developed 18 regional Clinical Resource Hubs (CRH) to increase Veteran access to clinical services, mainly through telemedicine and telemental health. This study evaluates trends in CRH MH services among Veterans residing in rural areas for the first 5 years of the program. METHODS: This retrospective cohort study utilized CRH MH encounter data (i.e., clinical visits or patient contacts) from the VA Corporate Data Warehouse for the first 5 years of the CRH program (Fiscal years [FY] 2020-2024) with a focus on rural and highly rural Veterans. Veteran demographics and clinic characteristics were collected, and measures were aggregated for each FY. Descriptive statistics were calculated using independent -tests for continuous variables and Fisher's exact or Chi-square tests for categorical variables. RESULTS: Using primarily telemental health services, CRH MH teams completed 627,436 encounters, with 81.9% delivered via telemedicine among Veterans residing in rural or highly rural areas. Care delivery shifted substantially over 5 years, with video visits to a patient's homes increasing from 9.2% to 64.3% while clinic-based video visits declined from 77.5% to 7.1%. Racial and ethnic diversity increased steadily over time, especially among Black and Hispanic Veterans. Between FY20 and FY24, encounters for depressive disorders decreased slightly while encounters for anxiety disorders, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder diagnoses increased. CONCLUSIONS: Veterans in rural and highly rural communities often struggle to access MH care, and the CRH MH program was designed to utilize primarily telemental health to fill in these gaps to improve Veteran access. During the first 5 years of the CRH MH program, the amount of MH care provided to rural Veterans more than doubled with expanded site participation and an increasingly diverse patient population over time.
Population-Level Teleretinal Screening Bulk Orders to Improve Diabetic Retinopathy Screening Rates: A Randomized Quality Improvement Trial.
Takimoto SW, Freeby M, Han M … +4 more , Vangala S, Fujimoto J, Dermenchyan A, Lambrechts S
Telemed J E Health · 2026 Jun · PMID 42236467 · Publisher ↗
BACKGROUND: Diabetic retinopathy (DR) is a leading cause of blindness; however, many patients with type 2 diabetes (T2DM) are not up to date with screening guidelines. This study explored the impact of teleretinal screen...
BACKGROUND: Diabetic retinopathy (DR) is a leading cause of blindness; however, many patients with type 2 diabetes (T2DM) are not up to date with screening guidelines. This study explored the impact of teleretinal screening bulk orders on the DR screening completion rate. METHODS: In this randomized controlled trial, eligible patients with T2DM due for DR screening were randomly assigned to receive a teleretinal screening bulk order at one of four monthly time points, following a stepped-wedge design. Teleretinal screening bulk orders are placed by a centralized provider for a defined patient cohort. They include a retinal fundus photo order and an associated electronic patient education message. Logistic regression at the patient-month level, with errors clustered at the patient level, was used to evaluate the effect of bulk orders on DR screening completion rate. Two-stage least squares was used to evaluate the effects of opening the message, using random assignment as an instrument. RESULTS: A total of 5,665 eligible patients were identified for this study. At six months from the first bulk order, the overall DR screening completion rate was 17.5% ( = 994). Receiving a bulk order increased odds of completing screening (odds ratio [OR]: 1.78; confidence interval [CI] 95%: 1.49, 2.14; < 0.001). 2,763 patients (48.7%) opened the electronic patient message. Opening the message increased completion rates by 8.5% (95% CI; 6.0%, 11.1%; < 0.001) and retinal fundus photo appointments scheduled by 19.1% (95% CI; 16.8%, 21.3%; < 0.001). CONCLUSION: Teleretinal screening bulk orders were associated with a significant increase in DR screening. Population-level interventions should be implemented to improve diabetes preventative care.
State Policy Variation and Telehealth Use by Oncology Specialists Treating Medicaid Patients.
Vichare A, Bodas M, Luo QE … +4 more , Khera N, Gandhi A, Shipman SA, Erikson C
Telemed J E Health · 2026 May · PMID 42202051 · Publisher ↗
Telehealth may improve access to specialized oncology care for Medicaid beneficiaries with hematological malignancies who face geographic and financial barriers. During the COVID-19 public health emergency, telehealth us...
Telehealth may improve access to specialized oncology care for Medicaid beneficiaries with hematological malignancies who face geographic and financial barriers. During the COVID-19 public health emergency, telehealth use expanded rapidly, yet state policies governing telehealth coverage/payment parity varied. Evidence is limited on how these policy differences influenced oncology telehealth use for Medicaid patients. We conducted a cross-sectional analysis of 2020-2021 multistate Medicaid claims. Adult and pediatric oncology specialists were identified based on board certification data. Telehealth video visits were measured monthly at the extensive margin, defined as the proportion of specialists providing any telehealth, and the intensive margin, defined as average monthly telehealth visits among telehealth providing specialists. States were categorized by private insurance telehealth policy environment: coverage and payment parity, coverage parity only, or no or unspecified parity. Telehealth use increased sharply across all states in early 2020, rising from less than 1% of specialists before the pandemic to peak levels by April 2020. Specialists practicing in coverage and payment parity states demonstrated higher and more sustained telehealth use through 2021 compared with those in coverage only or no parity states. By December 2021, 15.1% of adult specialists in coverage and payment parity states provided telehealth, compared with 8.1% in coverage-only states and 7.8% in no-parity states. Pediatric specialists showed similar patterns, though overall telehealth use remained lower. Specialists in parity states also maintained higher monthly telehealth visit volumes over time. State-level coverage and payment parity policies may have been associated with greater and sustained telehealth provision by oncology specialists treating Medicaid beneficiaries with hematologic malignancies. Maintaining supportive telehealth policies may be essential for promoting equitable access to specialized cancer care and reducing disparities among underserved populations. These findings inform future telehealth policy decisions nationally statewide.
Effectiveness of Telemedicine-Based Interventions in Primary Health Care: A Systematic Review in a Universal Health System.
Oliveira GM, Ferreira MCFLA, Filho SS … +2 more , Netto OM, Cade JR
Telemed J E Health · 2026 May · PMID 42201879 · Publisher ↗
INTRODUCTION: Telemedicine has increasingly been adopted as a digital care strategy to support access, continuity, and care coordination in primary health care (PHC). While its use accelerated during the COVID-19 pandemi...
INTRODUCTION: Telemedicine has increasingly been adopted as a digital care strategy to support access, continuity, and care coordination in primary health care (PHC). While its use accelerated during the COVID-19 pandemic, evidence regarding the effectiveness of telemedicine-based interventions in routine primary care remains heterogeneous and highly context-dependent. The objective of this review was to critically assess the effectiveness of telemedicine-based interventions in PHC, focusing on their effects on access, continuity, and care coordination, and to identify implementation-related barriers and facilitators based on empirical evidence from a universal health system context. METHODS: A systematic review was conducted in accordance with PRISMA 2020 and registered in PROSPERO (CRD420251005446). Searches were performed in PubMed/MEDLINE, SciELO, and BVS/LILACS for studies published between 2015 and 2025. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using RoB 2.0 and ROBINS-I. Due to methodological heterogeneity, findings were synthesized through a structured narrative approach (SWiM), and certainty of evidence was interpreted qualitatively based on study design, risk of bias, and consistency of findings. RESULTS: Twenty-two studies were included, evaluating teleconsultations, telemonitoring, telediagnosis, tele-regulation, and tele-education in PHC settings. Telemedicine-based interventions were associated with improved access, reduced waiting times, and enhanced care coordination, particularly when embedded within primary care teams and integrated with information systems. Telemonitoring showed more consistent benefits for chronic disease management and continuity of care. User and provider acceptability was generally high, although technical limitations, workload concerns, and digital inequities were frequently reported. Certainty of evidence ranged from low to moderate. CONCLUSIONS: Telemedicine-based interventions can strengthen core PHC functions when implemented as integrated organizational components of routine care delivery rather than as standalone technologies. Their effectiveness is strongly shaped by implementation context, digital infrastructure, and workforce readiness, highlighting the need for pragmatic and implementation-focused evaluations to inform sustainable telemedicine integration in primary care systems.
Telehealth Utilization Patterns among Patients with Chronic Conditions Across Age, Gender, Geography, and Insurance in Arkansas.
Bravo R, Owsley K, Longo M … +3 more , Shi L, Hidalgo B, Walker B
Telemed J E Health · 2026 May · PMID 42201838 · Publisher ↗
BACKGROUND: Telehealth utilization patterns have been variably studied across diabetes, hyperlipidemia, and asthma settings. This study aims to evaluate telehealth patterns in these disease settings through the COVID-19...
BACKGROUND: Telehealth utilization patterns have been variably studied across diabetes, hyperlipidemia, and asthma settings. This study aims to evaluate telehealth patterns in these disease settings through the COVID-19 pandemic across age, gender, geography, and insurance dimensions. METHODS: We identified patients with asthma, diabetes, or hyperlipidemia aged 18-64 with commercial or Medicaid insurance between 2017 and 2022 using Arkansas All-Payer Claims Database (APCD) data. The primary outcome variable was an indicator for any telehealth use. We plotted telehealth visits by quarter for each disease state by age, gender, rurality, and insurance strata. We also conducted linear regression analyses to associate telehealth use with each year relative to 2019 while controlling for patient characteristics. RESULTS: Telehealth was seldom used pre-pandemic but sharply increased during the pandemic, reaching 11.8% in asthma, 9.1% in diabetes, and 9.0% in hyperlipidemia. Following the pandemic (2020-2022), females, urban residents, and younger patients were generally more likely to utilize telehealth. In adjusted analyses, relative to 2019, telehealth use sharply increased in 2020 between 12.7 and 15.1 percentage points (all < 0.05) across the conditions. Utilization dipped in later years but remained much higher than prepandemic levels with the largest increases being among patients with asthma. CONCLUSION: These findings suggest that differences in telehealth adoption are not solely and uniformly attributable to observable patient characteristics but may also reflect structural and clinical factors particular to patient demographics and the specific disease setting. Ongoing efforts should support clinically-appropriate, even, and sustained access across groups.
Real-World Use, Usability, and User Experience of a Teledentistry Platform for Oral Lesion Screening in the Brazilian Public Health System.
Pernambuco CM, Martins HDD, Carvalho LIM … +5 more , de Araújo EGO, Dias LMRP, de Lucena EHG, Bonan PRF, Reis LAD
Telemed J E Health · 2026 May · PMID 42184214 · Publisher ↗
BACKGROUND: This study evaluated the real-world use of the TeleEstomato-MG platform, an asynchronous teledentistry system designed for oral lesion screening within the Brazilian Unified Health System, with a focus on use...
BACKGROUND: This study evaluated the real-world use of the TeleEstomato-MG platform, an asynchronous teledentistry system designed for oral lesion screening within the Brazilian Unified Health System, with a focus on user profile, distribution across levels of care, usability, and satisfaction. METHODS: This retrospective observational study analyzed data from 601 dental professionals registered on the TeleEstomato-MG platform. Variables included sex, age, specialist status, and level of care. Usability and satisfaction were assessed using a structured questionnaire completed by a subset of users ( = 90). Descriptive statistics were performed, and the association between specialist status and level of care was evaluated using the chi-square test, with Cramér's used to assess effect size. RESULTS: Most professionals were female ( = 417; 69.4%), with a mean age of 38.6 ± 11.0 years. The majority worked in primary health care ( = 424; 70.2%), followed by private practice ( = 119; 19.7%), secondary care ( = 34; 5.8%), tertiary care ( = 12; 2.0%), and educational institutions ( = 14; 2.3%). Specialists accounted for 56.4% ( = 339) of users, and a significant association was observed between specialist status and level of care (χ = 56.58; < 0.001; Cramér's = 0.31). Usability results indicated high acceptance, with most users reporting willingness to use the platform frequently ( = 84; 93.4%), ease of use ( = 84; 93.3%), confidence ( = 82; 91.1%), rapid learnability ( = 77; 85.5%), and a low need for technical support ( = 64; 71.1%). Satisfaction was also high, with 87.7% ( = 79) rating the platform as excellent or very good and 90.0% ( = 81) considering it highly necessary. CONCLUSIONS: The TeleEstomato-MG platform is predominantly used in primary health care and demonstrates high usability and user satisfaction in a real-world public health context. These findings support asynchronous teledentistry as a scalable strategy to enhance oral lesion screening, improve access to specialist support, and strengthen integration across levels of care.
Healthcare Professionals' Telehealth Education and Training Experiences and Needs.
Duffy CMC, Moreno O, Wall CSJ … +4 more , DuBose-Morris RA, Cardinale-McGinnis G, Schult D, Benotsch EG
Telemed J E Health · 2026 May · PMID 42176261 · Publisher ↗
BACKGROUND: Medical education institutions and healthcare systems have increasingly adopted telehealth education/training since the COVID-19 pandemic. However, the duration, content, and activities included in these educ...
BACKGROUND: Medical education institutions and healthcare systems have increasingly adopted telehealth education/training since the COVID-19 pandemic. However, the duration, content, and activities included in these education/training interventions are inconsistent, and the effectiveness of existing telehealth curricula is unclear. This study investigates healthcare professionals' telehealth education/training experiences and needs. METHOD: A sample of 69 health care professionals who have used telehealth, including physicians, nurses, nurse practitioners, physician associates, social workers, and psychologists, completed an online questionnaire in December 2024. Questionnaire items assessed receipt, duration, content, and activities included in prior telehealth education/training, and open-ended questions further explored participants' education/training experiences and needs. Three coders analyzed qualitative data using reflexive thematic analysis. RESULTS: Over 80% of participants reported receiving telehealth education/training during their professional careers. A higher proportion of participants reported didactic (vs. experiential) activities, and the topics explored most frequently in participants' education/training were conducting assessments/evaluations in telehealth, communication skills, and ethical considerations. Open-ended responses indicated that experiential forms of training are particularly valuable in building telehealth skills. While participants were generally confident using telehealth, troubleshooting technological difficulties was a persistent gap in existing education/training. CONCLUSIONS: Existing telehealth education/training interventions provide essential baseline knowledge and skills in telehealth delivery. However, these interventions could be enhanced by emphasizing experiential learning and providing opportunities for healthcare professionals to practice telehealth skills in realistic settings. Future research should expand upon these findings by exploring these topics among certain groups of healthcare professionals and in specific medical contexts to develop tailored telehealth education/training interventions.
Telemedicine-Enabled Surgical Outreach across the Surgical Continuum to Bridge the Gap in Low- and Middle-Income Countries: Lessons from the COVID-19 Era and Applications Beyond.
Abdelhady E, Abdo Khalafallah M, Alkajah HA … +3 more , Reda Elmahadi R, Willer BL, Tobias JD
Telemed J E Health · 2026 May · PMID 42176257 · Publisher ↗
INTRODUCTION: Telemedicine has revolutionized health care delivery globally, reducing health care costs, increasing patient satisfaction, and improving surgical outcomes. Innovation is often born out of necessity, and du...
INTRODUCTION: Telemedicine has revolutionized health care delivery globally, reducing health care costs, increasing patient satisfaction, and improving surgical outcomes. Innovation is often born out of necessity, and during the Coronavirus disease 2019 (COVID-19) pandemic, there was a surge of telemedicine initiatives both in surgical education and surgical care delivery. This has been well documented in high-income countries, but there has been less evaluation of the use and potential application of telemedicine in low- and middle-income countries (LMICs) to support surgical outreach efforts. This review seeks to describe telemedicine-enabled surgical outreach across the surgical continuum that emerged from the COVID-19 era in LMICs and provide recommendations for future practices. METHODS: A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Identified studies on telemedicine indexed in PubMed, Web of Science, Scopus, and Embase from January 2020 to February 2025 were aggregated. The search terms included "telemedicine," "surgery," "COVID-19," "SARS-CoV-2," "e-learning," "remote," "tele-simulation," and "LMICs." Of 713 papers, 15 eligible studies were found. Data were summarized by study type, intervention type, and outcomes. Themes of accessibility, efficacy, and user satisfaction were analyzed. Key implementation challenges were reviewed. Summary recommendations for future directions are provided. RESULTS: The 15 studies identified provide evidence for the feasibility and effectiveness of a variety of surgical teleinterventions within LMICs. The majority of the qualifying research consisted of prospective cohort studies that involved physicians, surgical residents, and patients. The primary findings include improvements in surgical skills, positive perception by participants, and high satisfaction with tele-simulation and e-learning. Key implementation challenges identified were technical issues, insufficient infrastructure, and unreliable internet. CONCLUSION: Preliminary experience suggests that telemedicine applications during the COVID-19 pandemic proved to be effective tools for both surgical education and patient care. These initiatives may hold promise for augmenting surgical outreach efforts in a more sustainable fashion to facilitate both surgeon training and improved care delivery for underserved communities in LMICs. However, numerous challenges must be addressed to ensure long-term effectiveness and sustainability.
Diagnostic Performance of an Artificial Intelligence Model for Retinal Abnormalities in Primary Health Care: A Real-World Teleophthalmology Study.
Ferreira ACM, Freitas MAC, Perillo RD … +2 more , Amaral CEM, Santos AF
Telemed J E Health · 2026 May · PMID 42170796 · Publisher ↗
INTRODUCTION: Timely access to ophthalmological care is a challenge in primary health care (PHC). Teleophthalmology and artificial intelligence (AI) are tools to expand access, but real-world evidence remains limited. Th...
INTRODUCTION: Timely access to ophthalmological care is a challenge in primary health care (PHC). Teleophthalmology and artificial intelligence (AI) are tools to expand access, but real-world evidence remains limited. This study evaluates the diagnostic performance of an AI model for detecting retinal abnormalities in PHC, analyzing variability across clinical and demographic subgroups. METHODS: This cross-sectional study analyzed 2,158 initial retinal exams, resulting in a final paired sample of 824 retinographies for accuracy analysis. The exams were conducted within a teleophthalmology workflow in the PHC of six municipalities in Minas Gerais, Brazil. A commercial AI model based on a convolutional neural network (Eyer Maps) evaluated the images and was compared with classifications performed by an ophthalmologist, considered the reference standard. Cluster analysis was performed, and sensitivity, specificity, positive and negative predictive values, Cohen's Kappa coefficient, and area under the receiver operating characteristic curve (AUC) were calculated. RESULTS: The AI model demonstrated almost perfect agreement with the human specialist (Kappa = 0.819; < 0.001). In the global sample, sensitivity was 83.0%, specificity was 98.0%, positive predictive value was 98.0%, negative predictive value was 86.0%, and AUC was 0.91. Eight distinct clusters were identified, in which the model maintained high specificity (96.0-100.0%), with sensitivity varying only in one specific subgroup. CONCLUSIONS: In a real-world teleophthalmology context within PHC, AI showed robust diagnostic performance and a high capacity for confirming retinal abnormalities, minimizing unnecessary referrals. The findings reinforce its potential as a supportive tool for organizing ophthalmological care and optimizing assistance workflows in PHC.
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