Telemedicine reports最新文献

Background: The use of telemedicine can contribute to patient satisfaction, support hygienic concepts by avoiding physical contact when not required, and reduce waiting and travel time. We aimed to evaluate our recently implemented telemedical approach of remote pre-anesthesia assessment.

Methods: We designed a questionnaire to assess patient satisfaction with remote pre-anesthesia assessment procedures, completeness of understanding, and technical feasibility. In total, 250 patients were asked to voluntarily complete the questionnaire after their pre-anesthesia assessment via telephone. Digital anesthesia records were subsequently reviewed for unexpected events and complications to investigate the quality and safety of the approach.

Results: Patients included in our study were 51 years old (median, range 18-85 years), mostly female (58%) and had an American Society of Anesthesiologists (ASA) physical status of 1-3 (22.8%, 56.4%, and 20.8%, respectively). Patient satisfaction was high with ratings of "very good" or "good" in over 90% of all questions related to the pre-anesthesia assessment via telephone. Patient's evaluation for the use of telemedicine in general also showed a wide acceptance with 84.4% rating the idea as "very good" (55.6%) or "good" (28.8%). Duration of patient-physician interaction positively correlated with age (p = 0.005) and ASA status (p = 0.003). Upon review of the digital anesthesia records, there were no intraoperative complications or unexpected events related to the remote pre-anesthesia assessment.

Conclusion: Remote pre-anesthesia assessment via telephone is safe, technically feasible, and satisfactorily accepted in selected patients. These results encourage the continuing implementation of telemedical approaches for pre-anesthesia assessment.

Background: Inpatient teledermatology (ITD) is a growing telemedicine modality aimed at addressing the shortage of dermatologists in hospitals, particularly for the management of complex skin disorders. Generalized pustular psoriasis (GPP) is a rare and potentially life-threatening condition characterized by widespread sterile pustules and systemic inflammation. Despite advances in targeted therapies, treatment is often limited to traditional agents such as cyclosporine and infliximab, due to restrictions in formulary access and insurance coverage.

Objective: This study aimed to characterize the clinical features, treatment outcomes, and the impact of ITD on the management of hospitalized GPP patients at the University of Pittsburgh Medical Center (UPMC), with a particular focus on hospitalization duration and time to pustule resolution.

Methods: A retrospective analysis of 35 patients with pustular skin disorders between January 2015 and August 2024 was conducted. Nine biopsy-confirmed GPP cases requiring hospitalization were included. Data on demographics, comorbidities, treatment regimens, and outcomes were collected. ITD consultations provided recommendations for corticosteroid tapering and immunosuppressive therapy initiation.

Results: The cohort included nine patients, predominantly White (88.9%), with a median age of 66 years. Preexisting psoriasis and obesity were the most common comorbidities (55.6%). Leukocytosis was the most frequent lab abnormality (77.8%). The average hospitalization duration was 6.1 ± 3.8 days, and readmission occurred in 33.3% of cases. ITD consultations led to early tapering of systemic corticosteroids and initiation of immunosuppressive therapy (55.6% with cyclosporine and 33.3% with infliximab). Significant pustule improvement was achieved in 16.1 ± 7.5 days, with full resolution in 22.5 ± 17.7 days.

Conclusion: ITD significantly reduced hospitalization duration for GPP patients compared with historical controls, likely due to timely therapeutic interventions. While newer biological therapies remain restricted in many hospitals, ITD facilitated the effective use of traditional immunosuppressive therapies, improving patient outcomes. This study supports the integration of ITD in hospital care models, especially in institutions lacking in-house dermatologists. Further research should explore long-term outcomes and the role of ITD in managing other emergent dermatologic conditions.

Background: Around 15% of pregnancies develop complications requiring detailed monitoring. With technological advancements, home cardiotocography has emerged as a potential alternative to the conventional approach, aiming to alleviate the stress and logistical challenges associated with in-clinic care. The objective of this study was to evaluate the capability of a portable device to collect data for accurate interpretation of the examination and to evaluate patient satisfaction, along with physical and emotional comfort during the monitoring process.

Methods: This retrospective study included 32 women with high-risk pregnancies, who independently performed 581 examinations utilizing the portable cardiotocography device Pregnabit Pro (Nestmedic, Poland). Moreover, participants were asked to provide feedback on their experiences through a comprehensive survey.

Results: In total, 95.7% of examinations successfully captured all necessary diagnostic data. Patients reported a high satisfaction rate, recognizing the potential of the home-based approach to improve their overall pregnancy experience. A preference for home-based testing over in-clinic visits was consistently noted among patients.

Discussion: This study shows evidence that home cardiotocography is a feasible and patient-preferred method for monitoring high-risk pregnancies. Our findings underline the importance of technological integration in prenatal care, advocating for a shift toward more patient-centered, accessible, and potentially cost-effective health care solutions.

Background: The introduction of new digital-based services such as telehealth, telemedicine, telepharmacy, and other digital health services is expected to continue to evolve, both for the benefit of science. Increasing pharmacists' roles in pharmaceutical services is critical and strategic in accelerating and recovering public health in the digital era because pharmacists can ensure the availability of appropriate, safe, and effective drugs while also monitoring the rational use of drugs to achieve therapeutic goals.

Objective: This study will look at patient and pharmacist preferences for telepharmacy. This study examines pharmacist preferences for telepharmacy.

Material and methods: This study includes a sample of 457 Indonesian pharmacists. This cross-sectional study was carried out on pharmacists throughout Indonesia in December 2023. The tool utilized was a questionnaire with an online data collection mechanism. The online questionnaire was designed to capture pharmacists' expectations for existing telepharmacy service practices using the inclusion criteria listed below. This study followed the standards of the Declaration of Helsinki, and electronic informed participant consent was acquired. The Medical Ethics Committee of the Faculty of Pharmacy, Universitas Airlangga, approved the study.

Conclusion: According to the study's findings, the vast majority of pharmacists support the extensive and integrated usage of telepharmacy. This is backed by the belief that pharmaceutical services will be a lucrative possibility in the future. Overall, the data show that patients and pharmacists are willing to adopt and incorporate telepharmacy services.

Libraries can play a valuable role in the delivery and support of telehealth services. This article is based on a panel of experts convened for the Virtual Care Symposium 2024, "From Novelty to Sustainability: How to Embed Virtual Care Into the Post-Pandemic Healthcare Delivery Template," to discuss ways to leverage community spaces to expand telehealth access. Strategies for successful implementation and operation are provided along with insights into possible challenges based on real-world examples. Libraries can play a crucial role in bridging the digital divide by providing internet access and digital devices to the public, particularly in rural and underserved communities.

Introduction: The use of telehealth in psychological interventions has experienced a significant increase in recent years. This form of patient interaction has important implications, especially in neuropsychological assessment. Given the limited research on this subject in Portugal, the reliability of neuropsychological tests and acceptance of this format by the Portuguese elderly must be studied.

Methods: The sample consisted of 43 healthy Portuguese adults. They were assessed by cognitive measures and questionnaires regarding sociodemographic aspects, memory complaints, computer literacy, functionality, depressive symptoms, and satisfaction with the teleconsultation via videoconference and in-person approaches. The order of the two conditions was randomized.

Results: There were no significant differences between scores on the Logical Memory Test. However, higher scores were found in the online condition for the Paired Associate Learning Test. The level of satisfaction with teleconsultation was high, but it did not translate into a greater preference for this format.

Discussion: The neuropsychological assessment of auditory-verbal episodic memory through teleconsultation is promising and well accepted by the older Portuguese population. The data indicate that teleconsultation provides reliable results for episodic memory assessment.

The rapid evolution of digital health technologies has significantly transformed health care delivery, particularly in the realm of virtual care. This article synthesizes insights from the Annual Virtual Care Symposium entitled "Virtual Care: Embedding Virtual Care into Post-Pandemic Healthcare Delivery" held on March 13, 2024, hosted by Yale School of Medicine, Emory University, University of Washington, and Mayo Clinic Arizona. By examining the initiatives presented by faculty from Yale, Houston Methodist, and Emory in this session, we explore the integration of advanced technologies in virtual care, the challenges faced, and the potential for improving patient outcomes and health care efficiency as these novel practices become systematized and sustainable. The session focused on artificial intelligence and technology-enabled clinical workflow redesign.

Background: Telehealth programs exhibit strong potential to improve health measures and quality of life among obese and overweight individuals for whom medical nutritional therapy remains a challenge due to poor adherence and dietary compliance. Supporting weight-management programs with dietary interventions or "telenutrition" and integrating telemonitoring and/or telehealth coaching have had a significant positive impact on weight-loss patients achieving their goals in long-term interventions.

Methods: The aim of the current study was to identify the factors leading patients to drop out of a telenutrition weight-loss program, including weekly telemonitoring (total of 36 weeks) and monthly telehealth coaching (total of 6 months). Descriptive qualitative semistructured interviews were held with 10 obese and overweight participants. The data gathered through these interviews were then thematically analyzed through a content analysis.

Results: The findings showed that 50% of participants who dropped out of the study felt pressured at work and/or university. Specifically, 60% reported being influenced by marital responsibilities, and 50% indicated that they did not achieve their goals. Nevertheless, participants who dropped out of the study reported that they were not negatively influenced by family factors and/or financial status. Participants also indicated feeling happy to take part in the program and noted that the diet positively influenced their psychological status. Participants also noted the clarity of instructions and that they were fully motivated during the trial.

Conclusions: The factors associated with dropouts in this study were different from those identified in the literature, given that our weight-loss program was delivered remotely and supported with weekly telemonitoring and monthly telehealth coaching. Despite the dropouts, the interview data highlighted positive factors that could enhance adherence to the dietary program and reduce dropout rates in larger and longer interventions. Future research should highlight the need to develop clear guidelines related to telenutrition programs or other digital health interventions to ensure successful long-term positive outcomes.

Objective: To qualitatively explore Medicaid-enrolled parents' and young adult patients' perspectives and experiences with telemedicine in pediatric primary care.

Methods: We conducted semi-structured interviews with participants to explore their experiences with telemedicine. Participants consisted of English- and Spanish-speaking parents and young adults (18-21) who engaged in a telemedicine visit between March 15, 2021 and December 31, 2022 at two pediatric primary care clinics whose patients are predominantly insured by Medicaid. A qualitative descriptive design was used to develop a taxonomy. Frequencies were obtained to identify the most prevalent themes.

Results: Twenty-six participants (22 parents, 4 young adults) were interviewed. Twelve (46%) participants were English-speaking and 14 (53%) were Spanish-speaking. Four domains were identified, each further classified into themes: pre-visit expectations (option for in-person visit, general anticipation, and specific worries), visit experience (general sentiment, technology, and quality of care), comfort (with overall process, privacy, and communication), and feelings about telemedicine (advantages, disadvantages, and loss of telemedicine). Although many participants had negative expectations of telemedicine prior to their appointment, a majority indicated positive experiences with visits and concerns about a possible future where telemedicine visits at home were no longer covered by their health insurance.

Discussion: Most participants indicated positive experiences with telemedicine and perceived negative impact if access was removed. Findings related to perceived quality of care, advantages, and disadvantages suggest that patient preferences and individual circumstances should be taken into account when choosing visit modality in similar settings.