Knowledge, Applicability, and Barriers of Telemedicine in Egypt: A National SurveyRead the full article
International Journal of Telemedicine and Applications focuses on the applications of medical practice and care at a distance and their supporting technologies such as, computing, communications, and networking technologies.
International Journal of Telemedicine and Applications maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.
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Teleophthalmology Service: Organization, Management, Actual Current Applications, and Future Prospects
Teleophthalmology (TO) consists of the clinical and therapeutic approach to the patient (e-Health) using informatic and telecommunication systems. Already widespread worldwide, it aims to improve patient care, expand the healthcare offer, and access to medical care by reducing overall costs. Despite the organizational, legal, and management difficulties, the substantial economic investments necessary for the start-up of equipped structures and efficient territorial services are amply rewarded by economic results and optimal services for professionals and patients. This review specifically analyses the current scenario of teleophthalmology, the points for and against its application in different sociodemographic realities, and in particular, the current and future fields of use.
Telehealth Interventions for Family Caregivers of Persons with Chronic Health Conditions: A Systematic Review of Randomized Controlled Trials
Objective. The purpose of this study was to provide an in-depth analysis of the components and outcomes of telehealth interventions for family caregivers of individuals with chronic health conditions. Methods. A systematic review of 17 databases was conducted for randomized controlled trials published between January 2002 and January 2017. Interventions were analyzed based on type of telecommunication modality, caregiver and care recipient characteristics, intervention components, and caregiver outcomes. Results. A total of 57 articles met criteria for inclusion. Telephone was the most frequently used mode of telehealth delivery and focused primarily on caregivers of older adults with dementia and stroke. Skills training was the most prevalent treatment strategy across telephone, web, and combined telephone and web modalities. Improved psychological functioning was reported most frequently across telehealth modalities. Conclusion. Telehealth is an effective tool in delivering caregiver interventions and leads to significant improvement in caregiver outcomes. Telephone was used most often to deliver cognitive-behavioral and psychoeducational strategies as compared to web and combined telephone and web modalities. Further research is needed to examine the effects of telehealth interventions on caregiving skills and self-efficacy, as well as health outcomes.
Referral Activity in Three Store-and-Forward Networks during the COVID-19 Coronavirus Pandemic
We surveyed three well-established store-and-forward telemedicine networks to identify any changes during the first half of 2020, which might have been due to the effect of the COVID-19 coronavirus pandemic on their telemedicine operations. The three networks all used the Collegium Telemedicus system. Various quantitative performance indicators, which included the numbers of referrals and the case-mix, were compared with their values in previous years. Two of the three networks surveyed (A and B) provided telemedicine services for any type of medical or surgical case, while the third (network C) handled only pediatric radiology cases. All networks operated in Africa, but networks A and C also provided services in other resource-constrained regions. Two of the networks (networks B and C) used local staff to submit referrals, while network A relied mainly on its expatriate staff. During the first half of 2020, the numbers of referrals received on network B increased substantially, while in contrast, the numbers of referrals on network A declined. All three networks had relatively stable referral rates during 2018 and 2019. All three networks delivered a service that was rated highly by the referrers. One network operated at relatively high efficiency compared to the other two, although it is not known if this is sustainable. The networks which were more reliant on local referrers saw little reduction—or even an increase—in submitted cases, while the network that had the most dependence on international staff saw a big fall in submitted cases. This was probably due to the effect of international travel restrictions on the deployment of its staff. We conclude that organizations wanting to build or expand their telemedicine services should consider deliberately empowering local providers as their referrers.
Antecedents of Intention to Adopt Mobile Health (mHealth) Application and Its Impact on Intention to Recommend: An Evidence from Indonesian Customers
Introduction. Mobile health (mHealth) applications gain popularity due to the increasing number of mobile phone usage and internet penetration, which might help some of Indonesia’s medical issues. However, the uptake of mHealth applications is still low in Indonesia. This study is aimed at understanding the factors that drive individuals to adopt mHealth applications and their impact on the intention to recommend. Methods. We applied a new model that combines three different theories with some other constructs: an extended unified theory of acceptance and use of technology, diffusion of innovation, and the internet customer trust model. The study used a cross-sectional study design with partial least squares causal modeling approach. Results. There are 787 respondents in our study, with the majority of them being female, young adults. Our model could explain 53.2% of the variance of intention to adopt while explaining 48.3% of the variance of intention to recommend. Initial trust in mHealth platform (, ), facilitating conditions (, ), and performance expectancy (, ) are the top three most important drivers of intention to adopt mHealth applications. Lastly, importance-performance map analysis (IPMA) showed that the mHealth application’s initial trust is the most important construct with a high-performance score. Discussion. Mobile health developers and managers need to improve initial trust in the mHealth platform, facilitating conditions, and performance expectancy when developing the applications. With a medium , these factors can be applied out of the research context with medium predictive power.
Telerehabilitation Using Fitness Application in Patients with Severe Cystic Fibrosis Awaiting Lung Transplant: A Pilot Study
Purpose. The purpose of this study was to pilot a home-based pulmonary rehabilitation (PR) program administered via a telemedicine approach using a combination of fitness application and self-selected activity in lung transplant candidates with cystic fibrosis (CF). Methods. We recruited adult patients with CF. The main outcome was adherence, measured by number of sessions completed in 12 weeks. Secondary outcomes were adverse events, six-minute walk distance (6MWD), and dyspnea. Participants were provided a personalized exercise program and equipment including a fitness application that provided exercise videos, recorded exercise time, and corresponding heart rate. We reviewed data daily and provided text messages with feedback. We compared our study outcomes to a retrospective data set of CF patients who participated in a 24-session outpatient hospital-based PR program. Data presented as . Results. Eleven patients participated in the home PR program, 45% female, age , FEV1 predicted. Sessions completed were home-based PR vs. hospital-based PR, . Fifty percent of the home-based group completed ≥24 sessions in 12 weeks versus 0% of the hospital-based patients (). There were no adverse events during exercise. Completers of the home-based program demonstrated a clinically meaningful lower decline in 6 MWD than noncompleters (6MWD vs. ). Only one participant performed a post 6 MWD in the hospital-based PR. Conclusion. Patients with severe CF demonstrated adherence to home PR delivered using fitness application and self-selected activity with no adverse events. This program style may be a viable solution for telerehabilitation in severe CF and is particularly relevant in the COVID era.
Teledentistry: A Boon Amidst COVID-19 Lockdown—A Narrative Review
The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease (COVID-19) has caused widespread public health concerns. Despite huge efforts to contain the disease spread, it is still on the rise because of the community spread pattern of this infection. In order to prevent the community spread, a nationwide lockdown was implemented, due to which many restrictions were imposed on movements of citizens within the country. Since the dental professionals were at the forefront of acquiring the infection, the majority of the dental clinics were shut for routine dental procedures. Only emergency treatment was provided to the patients. However, due to restrictions in movement, it was difficult for the patients to visit the clinics for routine check-ups. This was overcome by the advancements in technology which has a major impact on medicine. Due to increased usage of smartphones and related software applications, the clinical data exchange was facilitated between patients and clinicians which has been termed as “teledentistry.” Teledentistry is a combination of telecommunications and dentistry, involving the exchange of clinical information and images for dental consultation and treatment planning. This technology served as a boon for the dentists to manage dental emergencies during the lockdown period. This narrative review discusses teledentistry and its applications in general and specialty dental practice amidst the COVID-19 lockdown.