Improving Access to Care: Telemedicine Across Medical Domains

Barbosa, William; Zhou, Kina; Waddell, Emma; Myers, Taylor; Dorsey, E. Ray

doi:10.1146/annurev-publhealth-090519-093711

Cited by 157 publications

(114 citation statements)

References 91 publications

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“…Physicians also use high-resolution imaging cameras to give accurate diagnostic photographs to experts. [ [82] , [83] , [84] , [85] ] 2 Facilitate service to disabled patients Telemedicine facilitates access to services for a patient having disabilities. It also increases access for other groups, such as the elderly, the culturally isolated, and the incarcerated.…”

Section: Telemedicine In Healthcare: Significant Application Areasmentioning

confidence: 99%

Telemedicine for healthcare: Capabilities, features, barriers, and applications

Haleem

Javaid

Singh

et al. 2021

Sensors International

686

206

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Regular hospital visits can be expensive, particularly in rural areas, due to travel costs. In the era of the Covid-19 Pandemic, where physical interaction becomes risky, people prefer telemedicine. Fortunately, medical visits can be reduced when telemedicine services are used through video conferencing or other virtual technologies. Thus, telemedicine saves both the patient's and the health care provider time and the cost of the treatment. Furthermore, due to its fast and advantageous characteristics, it can streamline the workflow of hospitals and clinics. This disruptive technology would make it easier to monitor discharged patients and manage their recovery. As a result, it is sufficient to state that telemedicine can create a win-win situation. This paper aims to explore the significant capabilities, features with treatment workflow, and barriers to the adoption of telemedicine in Healthcare. The paper identifies seventeen significant applications of telemedicine in Healthcare. Telemedicine is described as a medical practitioner to diagnose and treat patients in a remote area. Using health apps for scheduled follow-up visits makes doctors and patients more effective and improves the probability of follow-up, reducing missing appointments and optimising patient outcomes. Patients should have an accurate medical history and show the doctor any prominent rashes, bruises, or other signs that need attention through the excellent quality audio-video system. Further, practitioners need file management and a payment gateway system. Telemedicine technologies allow patients and doctors both to review the treatment process. However, this technology supplements physical consultation and is in no way a substitute for a physical consultation. Today this technology is a safe choice for patients who cannot go to the doctor or sit at home, especially during a pandemic.

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Section: Telemedicine In Healthcare: Significant Application Areasmentioning

confidence: 99%

Telemedicine for healthcare: Capabilities, features, barriers, and applications

Haleem

Javaid

Singh

et al. 2021

Sensors International

686

206

View full text Add to dashboard Cite

show abstract

“…This was the case even though telemedicine was never used in the Polish primary healthcare institutions before. 55.5% of the respondents believe that the medical care they received during teleconsultation was as good as meeting their GP face to face [82] The previous studies confirmed that, for some patients, telehealth can be as good as or even better than personal care, especially for those faced with problems concerning physical appointments, e.g., people living in rural areas [83].…”

Section: Discussionmentioning

confidence: 91%

“…Systematic studies have shown that telemedicine has already been successfully used in other countries to provide routine and specialist medical services and has led to greater access to medical care. Moreover, telemedicine has shown similar, and in selected circumstances better, health effects compared to the conventional models of care [83,86], while demonstrating the ability to reduce unnecessary hospitalisations and costs [87].…”

Section: Discussionmentioning

confidence: 99%

“…Teleconsultations cannot replace personal medical care in all cases. Several studies have shown that patients were satisfied with the remote consultations, but would also like to be able to have face-to-face appointments [83]. The teleconsultations should not be used in rare or unstable conditions, or when a physical examination is needed.…”

Section: Discussionmentioning

confidence: 99%

“…In areas such as type 2 diabetes, research shows that telemedicine intervention is comparable to the standards of traditional medical care and does not cause unnecessary risk or harm to patients [102]. Also, neurological and cardiological signs and simple ophthalmic symptoms such as strabismus can be safely diagnosed and treated through teleconsultation [83,88]. However, this study is the first one to show the impact of medical care accessibility on treatment effectiveness in primary healthcare in a crisis situation, such as the COVID pandemic.…”

Section: Discussionmentioning

confidence: 99%

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The Quality of Medical Care in the Conditions of the COVID-19 Pandemic, with Particular Emphasis on the Access to Primary Healthcare and the Effectiveness of Treatment in Poland

Kludacz-Alessandri

Walczak

Hawrysz

et al. 2021

JCM

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Health has a significant influence on the quality of life of a society. The COVID-19 pandemic has forced many countries to implement restrictive measures to prevent its wider spread, including, inter alia, the introduction of remote healthcare in the form of teleconsultations. Therefore, there is the question of how such a change affects the quality of treatment and the primary healthcare of patients during the COVID-19 pandemic. The article aims to examine patient satisfaction with the access to primary healthcare and the effectiveness of treatment in a condition of remote medical care caused by the COVID-19 pandemic. We also analyse the impact of access to primary healthcare on the treatment effectiveness. Patient satisfaction was measured using a questionnaire assessing the quality of primary medical care. Of the 36 items studied, seven were related to the accessibility dimension and four were related to the treatment effectiveness dimension. Our results suggest that the treatment effectiveness and the access to primary healthcare services during the COVID-19 pandemic through telemedicine are quite highly rated by patients. Hence, further implementation of telemedicine in primary healthcare should improve the quality of lives of the wide society. We have also identified the access to primary healthcare has a considerable impact on the treatment effectiveness. Therefore, we recommend increasing the contact between patients and GPs via telemedicine under lockdown conditions.

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Effect of Mixed Reality on Delivery of Emergency Medical Care in a Simulated Environment

Lawson,

Martin,

Guha

et al. 2023

JAMA Netw Open

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ImportanceMixed-reality (MR) technology has the potential to enhance care delivery, but there remains a paucity of evidence for its efficacy and feasibility.ObjectiveTo assess the efficacy and feasibility of MR technology to enhance emergency care delivery in a simulated environment.Design, Setting, and ParticipantsThis pilot randomized crossover trial was conducted from September to November 2021 at a single center in a high-fidelity simulated environment with participants block randomized to standard care (SC) or MR-supported care (MR-SC) groups. Participants were 22 resident-grade physicians working in acute medical and surgical specialties prospectively recruited from a single UK Academic Health Sciences Centre. Data were analyzed from September to December 2022.InterventionParticipants resuscitated a simulated patient who was acutely unwell, including undertaking invasive procedures. Participants completed 2 scenarios and were randomly assigned to SC or MR-SC for the first scenario prior to crossover. The HoloLens 2 MR device provided interactive holographic content and bidirectional audiovisual communication with senior physicians in the MR-SC group.Main Outcomes and MeasuresThe primary outcome was error rate assessed via the Imperial College Error Capture (ICECAP) multidimensional error-capture tool. Secondary outcomes included teamwork (Observational Teamwork Assessment for Surgery [OTAS]; range, 0-6 and Teamwork Skills Assessment for Ward Care [T-SAW-C]; range, 1-5), scenario completion, stress and cognitive load (NASA Task Load Index [NASA-TLX; range 0-100]), and MR device user acceptability.ResultsA total of 22 physicians (15 males [68.2%]; median [range] age, 28 [25-34] years) were recruited. MR technology significantly reduced the mean (SD) number of errors per scenario compared with SC (5.16 [3.34] vs 8.30 [3.09] errors; P = .003), with substantial reductions in procedural (0.79 [0.75] vs 1.52 [1.20] errors; P = .02), technical (1.95 [1.40] vs 3.65 [2.03] errors; P = .01), and safety (0.37 [0.96] vs 0.96 [0.85] errors; P = .04) domains. MR resulted in significantly greater scenario completion rates vs SC (22 scenarios [100%] vs 14 scenarios [63.6%]; P = .003). It also led to significant improvements in the overall quality of teamwork and interactions vs SC as measured by mean (SD) OTAS (25.41 [6.30] vs 16.33 [5.49]; P &lt; .001) and T-SAW-C (27.35 [6.89] vs 18.37 [6.09]; P &lt; .001) scores. As reported via mean (range) NASA-TLX score, there were significant reductions for MR-SC vs SC in participant temporal demands (38 [20-50] vs 46 [30-70]; P = .03) and significant improvements in self-reported task performance (50 [30-60] vs 39 [10-70]; P = .01). Overall, 19 participants (86.4%) reported that they were more confident in making clinical decisions and undertaking clinical procedures with MR support.Conclusions and RelevanceThis study found that the use of MR technology reduced error, improved teamwork, and enhanced practitioner confidence when used to support the delivery of simulated emergency medical care.Trial RegistrationClinicalTrials.gov Identifier: NCT05870137

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Improving Access to Care: Telemedicine Across Medical Domains

Cited by 157 publications

References 91 publications

Telemedicine for healthcare: Capabilities, features, barriers, and applications

Telemedicine for healthcare: Capabilities, features, barriers, and applications

The Quality of Medical Care in the Conditions of the COVID-19 Pandemic, with Particular Emphasis on the Access to Primary Healthcare and the Effectiveness of Treatment in Poland

Effect of Mixed Reality on Delivery of Emergency Medical Care in a Simulated Environment

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