F. Campion, S. Ommen, Helayne Sweet, N. Shah, Barbra Rabson, Nick Dougherty, J. Goldsack, Peter Sylvester, Karen Jones, A. Burgman, N. McIntosh, L. Sangaralingham, D. Jiang, Jeffrey McGinn, Ricardo L. Rojas, Tim Suther, Brian Anderson, J. Halamka
Importance: This three-part study characterizes the widespread implementation of telehealth during the first year of the COVID-19 pandemic, giving us insight into the role of telehealth as we enter a stage of “new normal” healthcare delivery in the U.S. Objective: The COVID-19 Telehealth Impact Study was designed to describe the natural experiment of telehealth adoption during the pandemic. Using a large claims data stream and surveys of providers and patients, we studied telehealth in all 50 states to inform healthcare leaders. Design, Setting, Participants: In March 2020, the MITRE Corporation and Mayo Clinic founded the COVID-19 Healthcare Coalition (C19HCC), to respond to the pandemic. We report trends using a dataset of over 2 billion healthcare claims covering over 50% of private insurance activity in the U.S. (January 2019-December 2020), along with key elements from our provider survey (July-August 2020) and patient survey (November 2020 - February 2021). Main Outcomes and Measures: There was rapid and widespread adoption of telehealth in Spring 2020 with over 12 million telehealth claims in April 2020, accounting for 49.4% of total health care claims. Providers and patients expressed high levels of satisfaction with telehealth. 75% of providers indicated that telehealth enabled them to provide quality care. 84% of patients agreed that quality of their telehealth visit was good. Results: Peak levels of telehealth use varied widely among states ranging from 74.9% in Massachusetts to 25.4% in Mississippi. Every clinical discipline saw a steep rise with the largest claims volume in behavioral health. Provision of care by out-of-state provider was common at 6.5% (October-December 2020). Providers reported multiple modalities of telehealth care delivery. 74% of patients indicated they will use telehealth services in the future. Conclusions and Relevance: Innovation shown by providers and patients during this period of rapid telehealth expansion constitutes a great natural experiment in care delivery with evidence supporting widespread clinical adoption and satisfaction on the part of both patients and clinicians. The authors encourage continued broad access to telehealth over the next 12 months to allow telehealth best practices to emerge, creating a more effective and resilient system of care delivery.
{"title":"COVID-19 Telehealth Impact Study","authors":"F. Campion, S. Ommen, Helayne Sweet, N. Shah, Barbra Rabson, Nick Dougherty, J. Goldsack, Peter Sylvester, Karen Jones, A. Burgman, N. McIntosh, L. Sangaralingham, D. Jiang, Jeffrey McGinn, Ricardo L. Rojas, Tim Suther, Brian Anderson, J. Halamka","doi":"10.30953/tmt.v6.280","DOIUrl":"https://doi.org/10.30953/tmt.v6.280","url":null,"abstract":"Importance: This three-part study characterizes the widespread implementation of telehealth during the first year of the COVID-19 pandemic, giving us insight into the role of telehealth as we enter a stage of “new normal” healthcare delivery in the U.S. \u0000Objective: The COVID-19 Telehealth Impact Study was designed to describe the natural experiment of telehealth adoption during the pandemic. Using a large claims data stream and surveys of providers and patients, we studied telehealth in all 50 states to inform healthcare leaders. \u0000Design, Setting, Participants: In March 2020, the MITRE Corporation and Mayo Clinic founded the COVID-19 Healthcare Coalition (C19HCC), to respond to the pandemic. We report trends using a dataset of over 2 billion healthcare claims covering over 50% of private insurance activity in the U.S. (January 2019-December 2020), along with key elements from our provider survey (July-August 2020) and patient survey (November 2020 - February 2021). \u0000Main Outcomes and Measures: There was rapid and widespread adoption of telehealth in Spring 2020 with over 12 million telehealth claims in April 2020, accounting for 49.4% of total health care claims. Providers and patients expressed high levels of satisfaction with telehealth. 75% of providers indicated that telehealth enabled them to provide quality care. 84% of patients agreed that quality of their telehealth visit was good. \u0000Results: Peak levels of telehealth use varied widely among states ranging from 74.9% in Massachusetts to 25.4% in Mississippi. Every clinical discipline saw a steep rise with the largest claims volume in behavioral health. Provision of care by out-of-state provider was common at 6.5% (October-December 2020). Providers reported multiple modalities of telehealth care delivery. 74% of patients indicated they will use telehealth services in the future. \u0000Conclusions and Relevance: Innovation shown by providers and patients during this period of rapid telehealth expansion constitutes a great natural experiment in care delivery with evidence supporting widespread clinical adoption and satisfaction on the part of both patients and clinicians. The authors encourage continued broad access to telehealth over the next 12 months to allow telehealth best practices to emerge, creating a more effective and resilient system of care delivery.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128814462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To identify, describe, and address gaps in telehealth training at the graduate medical education level Materials and Methods We designed a 12-question survey to capture the telehealth experiences and educational opportunities for residents and fellows in the Minneapolis/St Paul, MN region. Results There were 213 responses from 51 different specialties across 7 levels of training (PGY1-7). 66% had previously completed a telehealth visit, 89% stated that they had not performed any telehealth prior to the COVID-19 pandemic, and only 15% of respondents had any formal telehealth training. Conclusions & Recommendations While telehealth volumes have seen exponential increases, training on how to effectively and efficiently carry out telehealth visits for medical trainees at the GME level has remained relatively stagnant or even non-existent. We provide examples of specialty-specific telehealth competencies, and hope that improving telehealth training quality will ultimately expand access, improve outcomes of chronic disease management and strengthen the patient-provider relationship across all specialties.
{"title":"Identification of Gaps in Graduate Medical Education Telehealth Training","authors":"Matthew Sakumoto, Ryan Jelinek, A. Joshi","doi":"10.30953/tmt.v6.276","DOIUrl":"https://doi.org/10.30953/tmt.v6.276","url":null,"abstract":"Objective \u0000To identify, describe, and address gaps in telehealth training at the graduate medical education level \u0000Materials and Methods \u0000We designed a 12-question survey to capture the telehealth experiences and educational opportunities for residents and fellows in the Minneapolis/St Paul, MN region. \u0000Results \u0000There were 213 responses from 51 different specialties across 7 levels of training (PGY1-7). 66% had previously completed a telehealth visit, 89% stated that they had not performed any telehealth prior to the COVID-19 pandemic, and only 15% of respondents had any formal telehealth training. \u0000Conclusions & Recommendations \u0000While telehealth volumes have seen exponential increases, training on how to effectively and efficiently carry out telehealth visits for medical trainees at the GME level has remained relatively stagnant or even non-existent. We provide examples of specialty-specific telehealth competencies, and hope that improving telehealth training quality will ultimately expand access, improve outcomes of chronic disease management and strengthen the patient-provider relationship across all specialties.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126179115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Buck, R. Kobb, Ron Sandreth, Lisa Alexander, Sherron Olliff, C. Anderson, Carol Westfall, Laurie Graaff, Joseph Giovannucci, Aszur Rollins
Abstract Objective: The Veterans Health Administration has one of the largest remote patient monitoring programs in the United States and is supported by an enterprise-wide infrastructure for providers, clinicians, staff, Veterans, and caregivers. The COVID-19 pandemic, however, presented new challenges: a sudden need to provide large-scale remote monitoring for a new disease that did not yet have a disease management protocol. VHA needed to be ready within weeks to provide this daily monitoring for hundreds — even thousands — of Veterans. Methods: The U.S. Department of Veterans Affairs Office of Connected Care already had a comprehensive infrastructure in place for its Remote Patient Monitoring – Home Telehealth (RPM – HT) program. Connected Care activated and built on this infrastructure to support providers, clinicians, and staff in their efforts to rapidly bring RPM – HT to Veterans across the nation when they had COVID-19 symptoms or exposure. To do this, Connected Care activated an emergency management plan, rapidly developed a new COVID-19-specific disease management protocol, added weekend monitoring, and procured critically needed monitoring supplies, such as thermometers and pulse oximeters. Connected Care’s strong foundation allowed for innovation and flexibility, such as the training of non-RPM – HT staff in RPM – HT processes, RPM – HT enrollment within acute care settings, and new strategic partnerships. Outcomes: More than 23,500 Veterans were enrolled for COVID-19-related monitoring from March 2020 to May 2021. At points in December 2020 and January 2021, the number of Veterans being monitored in a single day topped 2,000. Even with this rapid buildup, patient satisfaction levels remained at about 90% in numerous categories. In addition, the percentage of Veterans admitted to VA facilities while on COVID-19-related home monitoring has been extremely low, at 4%, a potential indicator that the monitoring system has been helpful in enabling Veterans who did have the virus to convalesce at home. Further study is needed to determine the impact RPM – HT enrollment for COVID-19 care had on the need for inpatient care. Conclusion: The Office of Connected Care’s established, enterprise-wide RPM – HT business, clinical, and technical infrastructure enabled VHA to enter the COVID-19 public health emergency well-positioned for the rapid deployment and growth of at-home and mobile monitoring. As the COVID-19 emergency made at-home management of Veterans increasingly important, the national RPM – HT program successfully adapted its practices to meet Veteran, caregiver, and staff needs.
{"title":"Maximizing VA Remote Patient Monitoring During the COVID-19 Response","authors":"C. Buck, R. Kobb, Ron Sandreth, Lisa Alexander, Sherron Olliff, C. Anderson, Carol Westfall, Laurie Graaff, Joseph Giovannucci, Aszur Rollins","doi":"10.30953/tmt.v6.281","DOIUrl":"https://doi.org/10.30953/tmt.v6.281","url":null,"abstract":"Abstract \u0000 Objective: The Veterans Health Administration has one of the largest remote patient monitoring programs in the United States and is supported by an enterprise-wide infrastructure for providers, clinicians, staff, Veterans, and caregivers. The COVID-19 pandemic, however, presented new challenges: a sudden need to provide large-scale remote monitoring for a new disease that did not yet have a disease management protocol. VHA needed to be ready within weeks to provide this daily monitoring for hundreds — even thousands — of Veterans. \u0000 Methods: The U.S. Department of Veterans Affairs Office of Connected Care already had a comprehensive infrastructure in place for its Remote Patient Monitoring – Home Telehealth (RPM – HT) program. Connected Care activated and built on this infrastructure to support providers, clinicians, and staff in their efforts to rapidly bring RPM – HT to Veterans across the nation when they had COVID-19 symptoms or exposure. To do this, Connected Care activated an emergency management plan, rapidly developed a new COVID-19-specific disease management protocol, added weekend monitoring, and procured critically needed monitoring supplies, such as thermometers and pulse oximeters. Connected Care’s strong foundation allowed for innovation and flexibility, such as the training of non-RPM – HT staff in RPM – HT processes, RPM – HT enrollment within acute care settings, and new strategic partnerships. \u0000Outcomes: More than 23,500 Veterans were enrolled for COVID-19-related monitoring from March 2020 to May 2021. At points in December 2020 and January 2021, the number of Veterans being monitored in a single day topped 2,000. Even with this rapid buildup, patient satisfaction levels remained at about 90% in numerous categories. In addition, the percentage of Veterans admitted to VA facilities while on COVID-19-related home monitoring has been extremely low, at 4%, a potential indicator that the monitoring system has been helpful in enabling Veterans who did have the virus to convalesce at home. Further study is needed to determine the impact RPM – HT enrollment for COVID-19 care had on the need for inpatient care. \u0000Conclusion: The Office of Connected Care’s established, enterprise-wide RPM – HT business, clinical, and technical infrastructure enabled VHA to enter the COVID-19 public health emergency well-positioned for the rapid deployment and growth of at-home and mobile monitoring. As the COVID-19 emergency made at-home management of Veterans increasingly important, the national RPM – HT program successfully adapted its practices to meet Veteran, caregiver, and staff needs.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"197 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126031681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing Xu, H. Hamadi, K. Hicks-Roof, R. Zeglin, Chloe E. Bailey, Mei Zhao
Objective: During the Coronavirus Disease 2019 (COVID-19) pandemic, many other health providers needed to rapidly adopt telehealth services to ensure continuity of patient care, without the opportunity to extensively evaluate the usability of the adopted technology. Therefore, this study aims to examine health professionals’ telehealth usability during COVID-19 in Florida. Design: This cross-sectional study employed the Telehealth Usability Questionnaire (TUQ) to licensed healthcare providers in Florida in June 2020. Setting and Participants: A total of 399,660 selected health professionals with Florida licensure were recruited from open-access Florida healthcare to participate in a Qualtrics web-based survey. A total of 1868 health professionals completed the survey. Multiple linear and mixed regression models were applied to analyze the overall and subdomain scores from TUQ. Main outcome measures: Telehealth Usability. Results: The analysis of overall TUQ score showed younger, female healthcare professionals, and participants who reported an increase of telehealth usage during pandemic had a significantly higher overall TUQ score. Compared with the score from physicians and nurses, the scores from the mental health group and social work group were significantly higher, while the score rehabilitation group was significantly lower. Analysis of the subdomain scores were consistent with the overall scores. Conclusion: The findings from this study indicate that the health professionals’ telehealth usability is related to age, gender, and the change of telehealth usage during the COVID-19 pandemic. While pandemics represent only one possible impetus for the healthcare system to swiftly switch to telehealth platforms, each profession should consider providing adequate resources to accommodate the need for change.
{"title":"Healthcare Professionals and Telehealth Usability During COVID-19","authors":"Jing Xu, H. Hamadi, K. Hicks-Roof, R. Zeglin, Chloe E. Bailey, Mei Zhao","doi":"10.30953/tmt.v6.270","DOIUrl":"https://doi.org/10.30953/tmt.v6.270","url":null,"abstract":"Objective: During the Coronavirus Disease 2019 (COVID-19) pandemic, many other health providers needed to rapidly adopt telehealth services to ensure continuity of patient care, without the opportunity to extensively evaluate the usability of the adopted technology. Therefore, this study aims to examine health professionals’ telehealth usability during COVID-19 in Florida. \u0000Design: This cross-sectional study employed the Telehealth Usability Questionnaire (TUQ) to licensed healthcare providers in Florida in June 2020. \u0000Setting and Participants: A total of 399,660 selected health professionals with Florida licensure were recruited from open-access Florida healthcare to participate in a Qualtrics web-based survey. A total of 1868 health professionals completed the survey. Multiple linear and mixed regression models were applied to analyze the overall and subdomain scores from TUQ. \u0000Main outcome measures: Telehealth Usability. \u0000Results: The analysis of overall TUQ score showed younger, female healthcare professionals, and participants who reported an increase of telehealth usage during pandemic had a significantly higher overall TUQ score. Compared with the score from physicians and nurses, the scores from the mental health group and social work group were significantly higher, while the score rehabilitation group was significantly lower. Analysis of the subdomain scores were consistent with the overall scores. \u0000Conclusion: The findings from this study indicate that the health professionals’ telehealth usability is related to age, gender, and the change of telehealth usage during the COVID-19 pandemic. While pandemics represent only one possible impetus for the healthcare system to swiftly switch to telehealth platforms, each profession should consider providing adequate resources to accommodate the need for change.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131807077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Measuring The Early Impact of COVID-19 for Future Market and Policy Corrections in the United States","authors":"Tory Cenaj","doi":"10.30953/tmt.v6.288","DOIUrl":"https://doi.org/10.30953/tmt.v6.288","url":null,"abstract":"","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122606607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
COVID19’s silver lining in healthcare technology ushered in a massive adoption of virtual care by health systems, clinicians, and patients. In the post pandemic world, as consumer/patient adoption for digital health access exponential continues to grow—Health systems, Insurers, and clinicians all need re-evaluate strategies create larger budgets, and commitments towards Digital health. The growth and rapid adoption seen during the early months of the pandemic was stimulated by removal of legislative, financial and reimbursement barriers. Healthcare systems must carefully and strategically evaluate secure, purpose built, and strategic technological investment.
{"title":"The Expanding Divide between Videoconferencing and Enterprise-Grade Virtual Care Platforms for Healthcare Systems","authors":"Shayan Vyas","doi":"10.30953/tmt.v6.274","DOIUrl":"https://doi.org/10.30953/tmt.v6.274","url":null,"abstract":"COVID19’s silver lining in healthcare technology ushered in a massive adoption of virtual care by health systems, clinicians, and patients. In the post pandemic world, as consumer/patient adoption for digital health access exponential continues to grow—Health systems, Insurers, and clinicians all need re-evaluate strategies create larger budgets, and commitments towards Digital health. The growth and rapid adoption seen during the early months of the pandemic was stimulated by removal of legislative, financial and reimbursement barriers. Healthcare systems must carefully and strategically evaluate secure, purpose built, and strategic technological investment.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116660765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Navratil-Strawn, Stephen K. Hartley, S. MacLeod, A. Lindsay
Background: The complexity of today’s healthcare system has led to the growth of an emerging healthcare function known as healthcare advocacy. A telephonic healthcare advocate or advisor can play an essential role in care coordination, a better understanding of health benefits, and ease in navigating the healthcare system. A healthcare advocate’s role may be filled by clinical staff (i.e., registered nurses), non-clinical staff, or both, with varying levels of training depending on the intended scope of service. Objective: With a higher number of employers seeking customized health advocacy programing, this study serves to determine if more favorable healthcare outcomes offset the additional operating costs associated with a more dedicated delivery system. Therefore, this study’s primary objective was to evaluate the impact of patient access to a customized health advocacy program on downstream medical costs and healthcare utilization compared to a control (CON) group without access to this service. The secondary aim was to provide information to employers on whether a higher investment in a more complex customized delivery model provides significant value compared to a less customized program. Methods: The study treatment (TRT) group included 89,372 individuals with access to a customized advocacy program for employees, while the CON group of 115,465 had access to a non-customized program. Key outcomes included total healthcare expenditures, hospital admissions, emergency room visits, and physician office visits 12 months after the advocacy start date compared to 6 months before the start date. Researchers evaluated the impact the customized advocacy intervention had on expenditures by comparing differences in pre- and post-expenditures between customized health advisor and non-customized health advisor groups after controlling for various demographic, socioeconomic, and health status characteristics. Inverse propensity score weighting helped minimize differences in characteristics between the TRT and CON groups. Results: With the customized advocacy product, healthcare expenditures increased by only $2.03 per member per month (PMPM) compared with a $26.35 PMPM larger increase for controls with a non-customized product. Also, customized health advisor participants experienced reduced hospital admissions and ER visits compared with the CON group. Conclusions: Study participants with access to customized healthcare advocacy services experienced significant healthcare cost savings, along with fewer ER visits, and reduced inpatient admissions compared with the CON group. Thus, these findings suggest that healthcare advocacy programs justify the increased delivery cost and can lead to reduced healthcare costs and utilization, along with the potential to improve health outcomes and quality of life.
{"title":"The Effect of a Customized Advocacy Product on Downstream Medical Expenditures and Utilization","authors":"J. Navratil-Strawn, Stephen K. Hartley, S. MacLeod, A. Lindsay","doi":"10.30953/TMT.V6.250","DOIUrl":"https://doi.org/10.30953/TMT.V6.250","url":null,"abstract":"Background: The complexity of today’s healthcare system has led to the growth of an emerging healthcare function known as healthcare advocacy. A telephonic healthcare advocate or advisor can play an essential role in care coordination, a better understanding of health benefits, and ease in navigating the healthcare system. A healthcare advocate’s role may be filled by clinical staff (i.e., registered nurses), non-clinical staff, or both, with varying levels of training depending on the intended scope of service.\u0000Objective: With a higher number of employers seeking customized health advocacy programing, this study serves to determine if more favorable healthcare outcomes offset the additional operating costs associated with a more dedicated delivery system. Therefore, this study’s primary objective was to evaluate the impact of patient access to a customized health advocacy program on downstream medical costs and healthcare utilization compared to a control (CON) group without access to this service. The secondary aim was to provide information to employers on whether a higher investment in a more complex customized delivery model provides significant value compared to a less customized program.\u0000Methods: The study treatment (TRT) group included 89,372 individuals with access to a customized advocacy program for employees, while the CON group of 115,465 had access to a non-customized program. Key outcomes included total healthcare expenditures, hospital admissions, emergency room visits, and physician office visits 12 months after the advocacy start date compared to 6 months before the start date. Researchers evaluated the impact the customized advocacy intervention had on expenditures by comparing differences in pre- and post-expenditures between customized health advisor and non-customized health advisor groups after controlling for various demographic, socioeconomic, and health status characteristics. Inverse propensity score weighting helped minimize differences in characteristics between the TRT and CON groups.\u0000Results: With the customized advocacy product, healthcare expenditures increased by only $2.03 per member per month (PMPM) compared with a $26.35 PMPM larger increase for controls with a non-customized product. Also, customized health advisor participants experienced reduced hospital admissions and ER visits compared with the CON group.\u0000Conclusions: Study participants with access to customized healthcare advocacy services experienced significant healthcare cost savings, along with fewer ER visits, and reduced inpatient admissions compared with the CON group. Thus, these findings suggest that healthcare advocacy programs justify the increased delivery cost and can lead to reduced healthcare costs and utilization, along with the potential to improve health outcomes and quality of life.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129576188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vijayalakshmi Poreddi, Kathyayani B. Veerabhadraiah, S. Reddy, N. Manjunatha, N. Channaveerachari, S. Math
Background: Telemedicine is a fast-emerging health sector in India. While nurses play an important role in delivering healthcare services through telemedicine, little is known about whether nursing interns are prepared adequately. Aim: To evaluate nursing interns’ perceptions of telenursing and to find out their opinion on whether telenursing should be added to the curriculum. Methods: This was a cross-sectional descriptive survey carried out among conveniently selected nursing interns (N = 183) from renowned colleges in Bangalore, South India. The data were collected using a self-reported questionnaire. Results: In this study, a majority of the participants had smartphones (74.8%), were accessible to the internet (96.7%), and were using the internet for more than 3 h/day (73.3%). While a majority (65.6%) of the participants were able to correctly identify the definition of telenursing, only 33.9% of them rightly answered the definition of telemedicine. Most of the participants indicated that the inclusion of telenursing in undergraduate studies would be useful for future healthcare workers (92.4%), and telenursing can be practiced in all the medical specialties. Conclusion: The majority of the nursing interns hold positive perceptions of telenursing and acknowledge its usefulness in nursing practice. However, their knowledge of telenursing is limited. Hence, the findings strongly suggest the need to introduce concepts of telenursing in curricula to prepare future healthcare providers to be able to provide safe and competent care in a highly technical and digital environment.
{"title":"Nursing Interns’ Perceptions of Telenursing: Implications for Nursing Education","authors":"Vijayalakshmi Poreddi, Kathyayani B. Veerabhadraiah, S. Reddy, N. Manjunatha, N. Channaveerachari, S. Math","doi":"10.30953/TMT.V6.258","DOIUrl":"https://doi.org/10.30953/TMT.V6.258","url":null,"abstract":"Background: Telemedicine is a fast-emerging health sector in India. While nurses play an important role in delivering healthcare services through telemedicine, little is known about whether nursing interns are prepared adequately.\u0000Aim: To evaluate nursing interns’ perceptions of telenursing and to find out their opinion on whether telenursing should be added to the curriculum.\u0000Methods: This was a cross-sectional descriptive survey carried out among conveniently selected nursing interns (N = 183) from renowned colleges in Bangalore, South India. The data were collected using a self-reported questionnaire.\u0000Results: In this study, a majority of the participants had smartphones (74.8%), were accessible to the internet (96.7%), and were using the internet for more than 3 h/day (73.3%). While a majority (65.6%) of the participants were able to correctly identify the definition of telenursing, only 33.9% of them rightly answered the definition of telemedicine. Most of the participants indicated that the inclusion of telenursing in undergraduate studies would be useful for future healthcare workers (92.4%), and telenursing can be practiced in all the medical specialties.\u0000Conclusion: The majority of the nursing interns hold positive perceptions of telenursing and acknowledge its usefulness in nursing practice. However, their knowledge of telenursing is limited. Hence, the findings strongly suggest the need to introduce concepts of telenursing in curricula to prepare future healthcare providers to be able to provide safe and competent care in a highly technical and digital environment.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132587561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
[...]a global telemedicine ecosystem will incorporate three prongs: people in proximity to the patient, such as primary care doctor, nurse, technician, or family member;domain experts in different medical specialties who are at a distance from the patient and located in a different suburb, city, district, state, country, or continent;and advanced computer and communication technologies. The second paper ‘The AmbuPod Project: Learnings of a Government-certified, Telemedicine-enabled, Rural Healthcare Startup in India’ by Lavanian Dorairaj and the third paper ‘The Mobile Tele-Ophthalmology Unit in Rural and Underserved Areas of South India’ by Lavanya Allimuthu, Ranjitha Kannan, Ramesh BabuSekar, Martin Manoj Mathiyazahan, Padmavathy Appasamy, Sangeetha Srinivasan, and Sheila John reveal examples of new rural efforts that can be gradually replicated in other states and nations using a bottom-up approach to foster transformation and improvement of healthcare services in terms of quality of healthcare services, the speed at which it is provided, and the number of patients who receive care. The sixth paper ‘Telepsychiatry During the COVID-Pandemic: Reflections from India’ by Harihara Suchandra, Dinakaran Damodaran, Barikar C. Malathesh, Lakshmi Nirisha, Narayana Manjunatha, C. Naveen Kumar, Gopi Gajera, Sujai Ramachandraiah, Chethan Basavarajappa, Rajendra Gowda, and Suresh Bada Math and the seventh paper ‘Tele-Mentoring and Monitoring of National Mental Health Program: A Bird’s-eye View of Initiatives from India’ by Gopi Gajera, Barikar C Malathesh, Lakshmi Nirisha, C. Naveen Kumar, Narayana Manjunatha, Harihara Suchandra, Sujai Ramachandraiah, Chethan Basavarajappa, Rajendra Gowda, and Suresh Bada Math focus on addressing mental health issues in a vast country.
[…全球远程医疗生态系统将包括三个方面:接近患者的人员，如初级保健医生、护士、技术人员或家庭成员;距离患者较远且位于不同郊区、城市、地区、州、国家或大陆的不同医学专业领域专家;以及先进的计算机和通信技术。第二篇论文“AmbuPod项目”:Lavanian Dorairaj的《印度政府认证、远程医疗支持的农村医疗初创公司的经验》和Lavanya Allimuthu、Ranjitha Kannan、Ramesh BabuSekar、Martin Manoj Mathiyazahan、Padmavathy Appasamy、Sangeetha Srinivasan的第三篇论文《印度南部农村和服务不足地区的移动远程眼科》。和希拉·约翰揭示了新的农村努力的例子，这些努力可以在其他州和国家逐步复制，使用自下而上的方法来促进医疗服务的转型和改进，包括医疗服务的质量、提供的速度和接受护理的患者数量。Harihara Suchandra、Dinakaran Damodaran、Barikar C. Malathesh、Lakshmi Nirisha、Narayana Manjunatha、C. Naveen Kumar、Gopi Gajera、Sujai Ramachandraiah、Chethan Basavarajappa、Rajendra Gowda和Suresh Bada Math撰写的第六篇论文《新冠肺炎大流行期间的远程精神病学:来自印度的反思》，以及第七篇论文《国家精神卫生计划的远程指导和监测》:由Gopi Gajera、Barikar C Malathesh、Lakshmi Nirisha、C. Naveen Kumar、Narayana Manjunatha、Harihara Suchandra、Sujai Ramachandraiah、Chethan Basavarajappa、Rajendra Gowda和Suresh Bada Math撰写的《鸟瞰来自印度的倡议》聚焦于解决这个大国的心理健康问题。
{"title":"Sixteenth International Conference of Telemedicine Society of India: Experiences and Lessons Learnt for Evolving Transformation at a Global Level","authors":"Amar Gupta","doi":"10.30953/TMT.V6.268","DOIUrl":"https://doi.org/10.30953/TMT.V6.268","url":null,"abstract":"[...]a global telemedicine ecosystem will incorporate three prongs: people in proximity to the patient, such as primary care doctor, nurse, technician, or family member;domain experts in different medical specialties who are at a distance from the patient and located in a different suburb, city, district, state, country, or continent;and advanced computer and communication technologies. The second paper ‘The AmbuPod Project: Learnings of a Government-certified, Telemedicine-enabled, Rural Healthcare Startup in India’ by Lavanian Dorairaj and the third paper ‘The Mobile Tele-Ophthalmology Unit in Rural and Underserved Areas of South India’ by Lavanya Allimuthu, Ranjitha Kannan, Ramesh BabuSekar, Martin Manoj Mathiyazahan, Padmavathy Appasamy, Sangeetha Srinivasan, and Sheila John reveal examples of new rural efforts that can be gradually replicated in other states and nations using a bottom-up approach to foster transformation and improvement of healthcare services in terms of quality of healthcare services, the speed at which it is provided, and the number of patients who receive care. The sixth paper ‘Telepsychiatry During the COVID-Pandemic: Reflections from India’ by Harihara Suchandra, Dinakaran Damodaran, Barikar C. Malathesh, Lakshmi Nirisha, Narayana Manjunatha, C. Naveen Kumar, Gopi Gajera, Sujai Ramachandraiah, Chethan Basavarajappa, Rajendra Gowda, and Suresh Bada Math and the seventh paper ‘Tele-Mentoring and Monitoring of National Mental Health Program: A Bird’s-eye View of Initiatives from India’ by Gopi Gajera, Barikar C Malathesh, Lakshmi Nirisha, C. Naveen Kumar, Narayana Manjunatha, Harihara Suchandra, Sujai Ramachandraiah, Chethan Basavarajappa, Rajendra Gowda, and Suresh Bada Math focus on addressing mental health issues in a vast country.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115322683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Shroff, Bagmisikha Puhan, Lavanian Dorairaj, Mayank Agarwal, M. Rajendran, R. Modali, Suchitra Mankar, P. S. Ramkumar, Sandeep Patil
The Telemedicine Practice Guidelines (TPG) released in 2020 provide legal framework for registered medical practitioners (RMPs) to consult with patients deploying Information and Communication Technology. Necessary compliance requirements have also been included. This article analyses the effectiveness of the ‘Train to Practice’ course designed by the Telemedicine Society of India to train doctors in India to follow ethical and safe standards of practice of telemedicine. The online course was taught by a faculty of 18 members, over a period of 6 months using four modules. The course comprised of a pre-course assessment, live lectures, and a post-course assessment to ascertain the level of preparedness and knowledge imparted to the RMPs by way of the course. The article highlights that the RMPs had a preliminary understanding of the concept of telemedicine prior to the course. Post-course assessment indicated improvement in knowledge levels. Pre- and post-course assessments were conducted using multiple choice Yes or No response-based questionnaires. Participating RMPs exhibited a real drive to understand the legalities and operational procedures of the practice of telemedicine as was evidenced by queries posed to the lecturers. While the course was rated generously by all the attendee RMPs, there were also evidences of a lack of seriousness from certain RMPs who did not have to pay for participating in the course. The researchers have also suggested that the presence of a TPG qualification paper online and the swift introduction of TPG aligned courses in medical schools would streamline implementation challenges in the future. The researchers have also recommended the amendment of the TPG and the Medical Council of India (MCI) Code of Ethics Regulations, 2002, to provide better protection to RMPs from possible litigation occurring during telemedicine practice.
{"title":"Education and Training for Ethical Practice of Telemedicine for Registered Medical Practitioners in India","authors":"S. Shroff, Bagmisikha Puhan, Lavanian Dorairaj, Mayank Agarwal, M. Rajendran, R. Modali, Suchitra Mankar, P. S. Ramkumar, Sandeep Patil","doi":"10.30953/TMT.V6.254","DOIUrl":"https://doi.org/10.30953/TMT.V6.254","url":null,"abstract":"The Telemedicine Practice Guidelines (TPG) released in 2020 provide legal framework for registered medical practitioners (RMPs) to consult with patients deploying Information and Communication Technology. Necessary compliance requirements have also been included. This article analyses the effectiveness of the ‘Train to Practice’ course designed by the Telemedicine Society of India to train doctors in India to follow ethical and safe standards of practice of telemedicine. The online course was taught by a faculty of 18 members, over a period of 6 months using four modules.\u0000The course comprised of a pre-course assessment, live lectures, and a post-course assessment to ascertain the level of preparedness and knowledge imparted to the RMPs by way of the course. The article highlights that the RMPs had a preliminary understanding of the concept of telemedicine prior to the course. Post-course assessment indicated improvement in knowledge levels. Pre- and post-course assessments were conducted using multiple choice Yes or No response-based questionnaires.\u0000Participating RMPs exhibited a real drive to understand the legalities and operational procedures of the practice of telemedicine as was evidenced by queries posed to the lecturers. While the course was rated generously by all the attendee RMPs, there were also evidences of a lack of seriousness from certain RMPs who did not have to pay for participating in the course. The researchers have also suggested that the presence of a TPG qualification paper online and the swift introduction of TPG aligned courses in medical schools would streamline implementation challenges in the future. The researchers have also recommended the amendment of the TPG and the Medical Council of India (MCI) Code of Ethics Regulations, 2002, to provide better protection to RMPs from possible litigation occurring during telemedicine practice.","PeriodicalId":320236,"journal":{"name":"Telehealth and Medicine Today","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126834972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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