| Title | Health System Approaches Are Needed To Expand Telemedicine Use Across Nine Latin American Nations. |
| Authors | LeRouge, CM; Gupta, M; Corpart, G; Arrieta, A |
| Journal | Health affairs (Project Hope) |
| Publication Date | 1 Feb 2019 |
| Date Added to PubMed | 5 Feb 2019 |
| Abstract | Doctors are unequally distributed across different regions in virtually all Latin American countries, which results in limited access to consistent health services. Telemedicine may address such challenges. This study profiles current levels of telemedicine use and assesses forces driving that use for nine Latin American countries (Argentina, Chile, Colombia, Costa Rica, Guatemala, Mexico, Panama, Peru, and Uruguay). Specifically, we examined current national policy and legislation, health organization characteristics, and national culture as driving forces in telemedicine expansion. Action by Latin American policy makers, health care leaders, and funders requires the recognition of telemedicine services as an interconnected system to comprehensively address commonly acknowledged domains of telemedicine barriers (regulatory, legal, financial, technological, organizational, and human factors). Although the specific issues within each of these domains may differ across countries, it is very difficult to maximize the potential impact of telemedicine in any country without comprehensive approaches to addressing these interrelated areas of concern. |
| Link | http://doi.org/10.1377/hlthaff.2018.05274 |
| Title | The Development of a Telemedicine Planning Framework Based on Needs Assessment. |
| Authors | AlDossary, S; Martin-Khan, MG; Bradford, NK; Armfield, NR; Smith, AC |
| Journal | Journal of medical systems |
| Publication Date | 1 May 2017 |
| Date Added to PubMed | 23 Mar 2017 |
| Abstract | Providing equitable access to healthcare services in rural and remote communities is an ongoing challenge that faces most governments. By increasing access to specialty expertise, telemedicine may be a potential solution to this problem. Regardless of its potential, many telemedicine initiatives do not progress beyond the research phase, and are not implemented into mainstream practice. One reason may be that some telemedicine services are developed without the appropriate planning to ascertain community needs and clinical requirements. The aim of this paper is to report the development of a planning framework for telemedicine services based on needs assessment. The presented framework is based on the key processes in needs assessment, Penchansky and Thomas's dimensions of access, and Bradshaw's types of need. This proposed planning framework consists of two phases. Phase one comprises data collection and needs assessment, and includes assessment of availability and expressed needs; accessibility; perception and affordability. Phase two involves prioritising the demand for health services, balanced against the known limitations of supply, and the implementation of an appropriate telemedicine service that reflects and meets the needs of the community. Using a structured framework for the planning of telemedicine services, based on need assessment, may help with the identification and prioritisation of community health needs. |
| Link | http://doi.org/10.1007/s10916-017-0709-4 |
| Title | eHealth and mHealth initiatives in Bangladesh: a scoping study. |
| Authors | Ahmed, T; Lucas, H; Khan, AS; Islam, R; Bhuiya, A; Iqbal, M |
| Journal | BMC health services research |
| Publication Date | 16 Jun 2014 |
| Date Added to PubMed | 18 Jun 2014 |
| Abstract | The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O'Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully. Additional formative and operational research is essential to explore the true potential of the technology. Frameworks for regulation in regards to eHealth governance should be the aim of future research on the integration of eHealth and mHealth into the Bangladesh health system. |
| Link | http://doi.org/10.1186/1472-6963-14-260 |
| Title | Utilizing patient geographic information system data to plan telemedicine service locations. |
| Authors | Soares, N; Dewalle, J; Marsh, B |
| Journal | Journal of the American Medical Informatics Association : JAMIA |
| Publication Date | 1 Sep 2017 |
| Date Added to PubMed | 25 Mar 2017 |
| Abstract | To understand potential utilization of clinical services at a rural integrated health care system by generating optimal groups of telemedicine locations from electronic health record (EHR) data using geographic information systems (GISs). This retrospective study extracted nonidentifiable grouped data of patients over a 2-year period from the EHR, including geomasked locations. Spatially optimal groupings were created using available telemedicine sites by calculating patients' average travel distance (ATD) to the closest clinic site. A total of 4027 visits by 2049 unique patients were analyzed. The best travel distances for site groupings of 3, 4, 5, or 6 site locations were ranked based on increasing ATD. Each one-site increase in the number of available telemedicine sites decreased minimum ATD by about 8%. For a given group size, the best groupings were very similar in minimum travel distance. There were significant differences in predicted patient load imbalance between otherwise similar groupings. A majority of the best site groupings used the same small number of sites, and urban sites were heavily used. With EHR geospatial data at an individual patient level, we can model potential telemedicine sites for specialty access in a rural geographic area. Relatively few sites could serve most of the population. Direct access to patient GIS data from an EHR provides direct knowledge of the client base compared to methods that allocate aggregated data. Geospatial data and methods can assist health care location planning, generating data about load, load balance, and spatial accessibility. |
| Link | http://doi.org/10.1093/jamia/ocx011 |
| Title | Harnessing Telemedicine for the Provision of Health Care: Bibliometric and Scientometric Analysis. |
| Authors | Waqas, A; Teoh, SH; Lapão, LV; Messina, LA; Correia, JC |
| Journal | Journal of medical Internet research |
| Publication Date | 2 Oct 2020 |
| Date Added to PubMed | 3 Oct 2020 |
| Abstract | In recent decades, advances in information technology have given new momentum to telemedicine research. These advances in telemedicine range from individual to population levels, allowing the exchange of patient information for diagnosis and management of health problems, primary care prevention, and education of physicians via distance learning. This scientometric investigation aims to examine collaborative research networks, dominant research themes and disciplines, and seminal research studies that have contributed most to the field of telemedicine. This information is vital for scientists, institutions, and policy stakeholders to evaluate research areas where more infrastructural or scholarly contributions are required. For analyses, we used CiteSpace (version 4.0 R5; Drexel University), which is a Java-based software that allows scientometric analysis, especially visualization of collaborative networks and research themes in a specific field. We found that scholarly activity has experienced a significant increase in the last decade. Most important works were conducted by institutions located in high-income countries. A discipline-specific shift from radiology to telestroke, teledermatology, telepsychiatry, and primary care was observed. The most important innovations that yielded a collaborative influence were reported in the following medical disciplines, in descending order: public environmental and occupational health, psychiatry, pediatrics, health policy and services, nursing, rehabilitation, radiology, pharmacology, surgery, respiratory medicine, neurosciences, obstetrics, and geriatrics. Despite a continuous rise in scholarly activity in telemedicine, we noticed several gaps in the literature. For instance, all the primary and secondary research central to telemedicine was conducted in the context of high-income countries, including the evidence synthesis approaches that pertained to implementation aspects of telemedicine. Furthermore, the research landscape and implementation of telemedicine infrastructure are expected to see exponential progress during and after the COVID-19 era. |
| Link | http://doi.org/10.2196/18835 |
| Title | Government capacities and stakeholders: what facilitates ehealth legislation? |
| Authors | Lang, A |
| Journal | Globalization and health |
| Publication Date | 13 Jan 2014 |
| Date Added to PubMed | 15 Jan 2014 |
| Abstract | Newly established high-technology areas such as eHealth require regulations regarding the interoperability of health information infrastructures and data protection. It is argued that government capacities as well as the extent to which public and private organizations participate in policy-making determine the level of eHealth legislation. Both explanatory factors are influenced by international organizations that provide knowledge transfer and encourage private actor participation. Data analysis is based on the Global Observatory for eHealth-ATLAS eHealth country profiles which summarizes eHealth policies in 114 countries. Data analysis was carried out using two-component hurdle models with a truncated Poisson model for positive counts and a hurdle component model with a binomial distribution for zero or greater counts. The analysis reveals that the participation of private organizations such as donors has negative effects on the level of eHealth legislation. The impact of public-private partnerships (PPPs) depends on the degree of government capacities already available and on democratic regimes. Democracies are more responsive to these new regulatory demands than autocracies. Democracies find it easier to transfer knowledge out of PPPs than autocracies. Government capacities increase the knowledge transfer effect of PPPs, thus leading to more eHealth legislation. All international regimes--the WHO, the EU, and the OECD--promote PPPs in order to ensure the construction of a national eHealth infrastructure. This paper shows that the development of government capacities in the eHealth domain has to be given a higher priority than the establishment of PPPs, since the existence of some (initial) capacities is the sine qua non of further capacity building. |
| Link | http://doi.org/10.1186/1744-8603-10-4 |
| Title | Radiation Oncologist Perceptions of Telemedicine from Consultation to Treatment Planning: A Mixed-Methods Study. |
| Authors | Zhang, H; Cha, EE; Lynch, K; Cahlon, O; Gomez, DR; Shaverdian, N; Gillespie, EF |
| Journal | International journal of radiation oncology, biology, physics |
| Publication Date | 1 Oct 2020 |
| Date Added to PubMed | 6 Sep 2020 |
| Abstract | Telemedicine was rapidly implemented for initial consultations and radiation treatment planning in the wake of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we explore utilization of and physician perspectives on this approach in an attempt to identify patient populations that may benefit most from virtual care. This is a mixed-methods study with a convergent design. Approximately 6 to 8 weeks after implementation of telemedicine, all radiation oncologists in a single academic radiation oncology department were invited to participate in either semistructured interviews with embedded survey questions or a concurrently administered survey only. Rapid qualitative analysis was used to identify common themes, and quantitative data was assessed using descriptive statistics and univariable analyses. At the apex of the pandemic, 92% of radiation oncology visits were conducted via telemedicine. In total, 51 of 61 radiation oncologists participated in the study (response rate 84%). Most (71%) reported no difference in ability to treat cancer appropriately via telemedicine, which was more common among specialized physicians (P = .01) but not those with higher visit volume or years of experience. Over half (55%) perceived no difference or even improvement in overall visit quality with telemedicine. Virtual visits were deemed acceptable for a median of 70% to 96% of patients, which varied by disease site. Need for physical examination, and availability of an acceptable proxy, factored into telemedicine acceptability. Most (88%) found telemedicine better than expected, but opinions were split on how telemedicine would affect physician burnout. Almost all (96%) foresaw a role for telemedicine beyond the pandemic and would opt for a median of 50% (interquartile range 20%-66%) of visits conducted via telemedicine. Among radiation oncologists in an academic setting, telemedicine was perceived to be highly appropriate and acceptable for most patients. Future studies should focus on identifying the 5% to 30% of patients whose care may be optimized with in-person visits, and if there is alignment with patient preferences. |
| Link | http://doi.org/10.1016/j.ijrobp.2020.07.007 |
| Title | Addition of mHealth (mobile health) for family planning support in Kenya: disparities in access to mobile phones and associations with contraceptive knowledge and use. |
| Authors | Lee, S; Begley, CE; Morgan, R; Chan, W; Kim, SY |
| Journal | International health |
| Publication Date | 13 Nov 2019 |
| Date Added to PubMed | 24 Dec 2018 |
| Abstract | Recently mobile health (mHealth) has been implemented in Kenya to support family planning. Our objectives were to investigate disparities in mobile phone ownership and to examine the associations between exposure to family planning messages through mHealth (stand-alone or combined with other channels such as public forums, informational materials, health workers, social media and political/religious/community leaders' advocacy) and contraceptive knowledge and use. Logistic and Poisson regression models were used to analyze the 2014 Kenya Demographic and Health Survey. Among 31 059 women, 86.7% had mobile phones and were more likely to have received higher education, have children ≤5 y of age and tended to be wealthier or married. Among 7397 women who were sexually active, owned a mobile phone and received family planning messages through at least one channel, 89.8% had no exposure to mHealth. mHealth alone was limited in improving contraceptive knowledge and use but led to intended outcomes when used together with four other channels compared with other channels only (knowledge: incidence rate ratio 1.084 [95% confidence interval {CI} 1.063-1.106]; use: odds ratio 1.429 [95% CI 1.026-1.989]). Socio-economic disparities existed in mobile phone ownership, and mHealth alone did not improve contraceptive knowledge and use among Kenyan women. However, mHealth still has potential for family planning when used with existing channels. |
| Link | http://doi.org/10.1093/inthealth/ihy092 |
| Title | Infectious Diseases Society of America Position Statement on Telehealth and Telemedicine as Applied to the Practice of Infectious Diseases. |
| Authors | Siddiqui, J; Herchline, T; Kahlon, S; Moyer, KJ; Scott, JD; Wood, BR; Young, J |
| Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |
| Publication Date | 1 Feb 2017 |
| Date Added to PubMed | 18 Jan 2017 |
| Abstract | The use of telehealth and telemedicine offers powerful tools for delivering clinical care, conducting medical research, and enhancing access to infectious diseases physicians. The Infectious Diseases Society of America (IDSA) has prepared a position statement to educate members on the use of telehealth and telemedicine technologies. The development of telehealth and telemedicine programs requires the consideration of several issues such as HIPAA, state and local licensure requirements, credentialing and privileging, scope of care, quality, and responsibility and liability. IDSA supports appropriate use of telehealth and telemedicine to provide timely, cost-effective specialty care to resource-limited populations. |
| Link | http://doi.org/10.1093/cid/ciw773 |
| Title | Recent Worldwide Developments in eHealth and mHealth to more Effectively Manage Cancer and other Chronic Diseases - A Systematic Review. |
| Authors | Lewis, J; Ray, P; Liaw, ST |
| Journal | Yearbook of medical informatics |
| Publication Date | 10 Nov 2016 |
| Date Added to PubMed | 11 Nov 2016 |
| Abstract | This paper is a systematic literature review intended to gain an understanding of the most original, excellent, stateof- the-art research in the application of eHealth (including mHealth) in the management of chronic diseases with a focus on cancer over the past two years. This review looks at peer-reviewed papers published between 2013 and 2015 and examines the background and trends in this area. It systematically searched peer-reviewed journals in databases PubMed, Proquest, Cochrane Library, Elsevier, Sage and the Institute of Electrical and Electronic Engineers (IEEE Digital Library) using a set of pre-defined keywords. It then employed an iterative process to filter out less relevant publications. From an initial search return of 1,519,682 results returned, twenty nine of the most relevant peer reviewed articles were identified as most relevant. Based on the results we conclude that innovative eHealth and its subset mHealth initiatives are rapidly emerging as an important means of managing cancer and other chronic diseases. The adoption is following different paths in the developed and developing worlds. Besides governance and regulatory issues, barriers still exist around information management, interoperability and integration. These include medical records available online information for clinicians and consumers on cancer and other chronic diseases, mobile app bundles that can help manage co-morbidities and the capacity of supporting communication technologies. |
| Link | http://doi.org/10.15265/IY-2016-020 |