ObjectivesMusic therapy has been shown to be effective for reducing anxiety and pain in people with a serious illness. Few studies have investigated the feasibility of integrating music therapy into general inpatient care of the seriously ill, including the care of diverse, multiethnic patients. This leaves a deficit in knowledge for intervention planning. This study investigated the feasibility and effectiveness of introducing music therapy for patients on 4 inpatient units in a large urban medical center. Capacitated and incapacitated patients on palliative care, transplantation, medical intensive care, and general medicine units received a single bedside session led by a music therapist.MethodsA mixed-methods, pre-post design was used to assess clinical indicators and the acceptability and feasibility of the intervention. Multiple regression modeling was used to evaluate the effect of music therapy on anxiety, pain, pulse, and respiratory rate. Process evaluation data and qualitative analysis of observational data recorded by the music therapists were used to assess the feasibility of providing music therapy on the units and patients’ interest, receptivity, and satisfaction.ResultsMusic therapy was delivered to 150 patients over a 6-month period. Controlling for gender, age, and session length, regression modeling showed that patients reported reduced anxiety post-session. Music therapy was found to be an accessible and adaptable intervention, with patients expressing high interest, receptivity, and satisfaction.Significance of ResultsThis study found it feasible and effective to introduce bedside music therapy for seriously ill patients in a large urban medical center. Lessons learned and recommendations for future investigation are discussed.

The extraordinary successes and refinement of modern telemedicine applications in recent years have been diminished somewhat by the anachronistic licensure laws of the 50 state jurisdictions that limit the practice of medicine to specific state geographic boundaries. This approach is deficient when applied to telemedicine because, with the advent of the Internet and modern technological advances, differences in space and time are rendered nearly meaningless. It is recommended in this paper that the practice of telemedicine be handled differently than the practice of face-to-face medicine, as related to licensure. Although it may be argued persuasively that a national licensure model for telemedicine should be advanced, the political and constitutional hurdles may be too great to overcome. It is therefore recommended that a voluntary, regional geographic approach be instituted by jurisdictions already demonstrating a commonality of interests, such as through the Southern Governors' Association or the Western Governors' Association. The benefits to be derived from this approach would include improving access to healthcare and medical specialists, enhancing the quality and timeliness of care, cutting medical costs by moving information instead of people, securing patients' access to medical records and information, and facilitating commercial export of American telemedicine services.

En esta segunda ronda de la encuesta HMA participaron 329 profesionales de salud de Lima y Callao entre septiembre y octubre de 2018. La difusión de la encuesta HMA 2018 contó con el apoyo del Colegio Médico del Perú y Florida International University. Del total de profesionales de salud que completaron la encuesta, 46% fueron médicos, 14% enfermeras, 11% médicos residentes y 30% otros profesionales. Por otro lado, 38% de profesionales trabajaban en un establecimiento del Ministerio de Salud (MINSA), 25% en el Seguro Social de Salud del Perú (EsSalud), 31% en el sistema privado y 6% en las instituciones hospitalarias de las Fuerzas Armadas y Policía Nacional. Cultura de seguridad del paciente en el Perú Arrieta A, et al.