Telehealth Fatigue: Is It Real? What Should Be Done?

Huang, Jingtong; Yeung, Andrea M; Eiland, Leslie; Huang, Erich; Raymond, Jennifer; Klonoff, David C.

doi:10.1177/19322968221127253

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…Increasing patient preference for in-person consultation, waning concerns about COVID-19 infection and variable administrative and regulatory support for hybrid care delivery models (i.e. face-to-face and telehealth) have all been posed as contributors to reduced telehealth availability [8]. Given that telerehabilitation is a recommended alternative to CBPR in international guidelines [2], and clinical services demonstrated ability to deliver telerehabilitation under COVID conditions, understanding the factors that underpin reduced telerehabilitation provision currently is important if models are to be sustainable.…”

Section: Discussionmentioning

confidence: 99%

Telerehabilitation services have declined post-COVID-19

May,

Holland,

Alison

et al. 2024

Preprint

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Objective: To characterize Pulmonary rehabilitation (PR) service delivery, investigate the impact of the pandemic on PR services, and describe centre-based PR (CBPR) and telerehabilitation with reference to PR essential components. Design: Online national cross-sectional survey. Setting: Australian PR services. Participants: Representatives of PR programs listed within the Lung Foundation Australia national database (n=295). Interventions: Not applicable. Main Outcome Measure(s): Availability of PR in CBPR and telerehabilitation settings. Results: 97% of Australian PR services (n=114/117) delivered CBPR, similarly to pre-COVID-19 pandemic availability (96%). 43% (n=50/116) of services delivered telerehabilitation, which was significantly less than availability during COVID-19 restrictions (74%; p<0.001). CBPR was primarily delivered in a group setting (99%; median (IQR) 7 (6-8) participants/group), and telerehabilitation primarily via individual telephone calls (94%). 39% of respondents report CBPR group size has reduced. PR essential components of initial centre-based assessments and individually prescribed/progressed endurance and resistance training were achieved by most CBPR and telerehabilitation programs. Staff training in delivery of telerehabilitation models was undertaken in 33% of services. Conclusions: PR essential components are generally met in current Australian programs. However, telerehabilitation services and CBPR program capacity have declined indicating reduced program capacity. Sustainability of effective PR programs is required to support access for people with chronic respiratory diseases.

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Section: Discussionmentioning

confidence: 99%

Telerehabilitation services have declined post-COVID-19

May,

Holland,

Alison

et al. 2024

Preprint

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“…In addition, resources such as video visit platforms designed for patients with low technological literacy, readily available tech support, and virtual patient education materials optimized for patients with low health literacy can help ensure equitable access to high-quality care for all patients. Recent calls to combat “telehealth fatigue” focus on using patient-centered care to guide changes to telemedicine for diabetes in order to enhance equity and outcomes [ 25 ]. Future studies can build on this work, recent Endocrine Society recommendations, and our findings by examining the impacts of telemedicine, face-to-face, and hybrid models of diabetes specialty care on clinical and patient-reported outcomes for populations that are underresourced or have greater clinical complexity.…”

Section: Discussionmentioning

confidence: 99%

Specialist Perspectives on Delivering High-Quality Telemedicine for Diabetes: A Mixed Methods Survey Study

Zupa

Alexopoulos

Esteve

et al. 2023

Journal of the Endocrine Society

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Background Recent recommendations guiding appropriate use of telemedicine for endocrinology care have largely relied on expert opinion due to limited evidence on factors that increase quality of telemedicine care. In this study, we assessed the perspectives of front-line specialists on factors and strategies perceived to increase quality of diabetes care delivered via telemedicine after more than two years of widespread use. Methods Adult diabetes specialists in two academic health systems who recently used video-based telemedicine to provide diabetes care were invited to participate in an online survey study between March and April 2022. Likert-style questions, followed by related open-ended questions, assessed perspectives on availability of key resources, factors affecting quality, and anticipated benefits from telemedicine for diabetes. Results Response rate was 52% (56/111). More than half (54%) of participants reported better overall quality of diabetes care with face-to-face care vs. telemedicine. Participants reported clinical data supporting high-quality care, such as home blood glucose readings and vital signs, was often not available with telemedicine. Patient factors, including comorbidities and communication barriers, reduced anticipated benefit from telemedicine, while geographic and mobility barriers increased expected benefit. Providers described multiple healthcare setting resources that could promote high-quality telemedicine diabetes care, including greater support for sharing patient-generated health data and coordinating multidisciplinary care. Conclusions After two years of sustained use, diabetes specialists identified telemedicine as an important way to enhance access to care. However, specialists identified additional supports needed to increase appropriate use and delivery of high-quality telemedicine care for patients with complex clinical needs.

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“…However, since its initial spike in March/ April of 2020, the use of telemedicine, defined as synchronous video and phone visits for medical purposes, has been in steady decline in the United States and much of the world. 9 At the same time, there has been growth of other services including e-consults, RPM, and requests for asynchronous care via patient portal messaging. The following four key issues in clinical and policy debate are contributing to the uncertain future of telehealth: (1) impact on health care spending, (2) impact of telehealth on quality, (3) impact on health care disparities, and (4) limitations of state licensure requirements for clinicians.…”

Section: Delivering Telehealth To a County Hospital Populationmentioning

confidence: 99%

Diabetes Technology Meeting 2022

Huang

Yeung

DuBord

et al. 2023

J Diabetes Sci Technol

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Diabetes Technology Society hosted its annual Diabetes Technology Meeting from November 3 to November 5, 2022. Meeting topics included (1) the measurement of glucose, insulin, and ketones; (2) virtual diabetes care; (3) metrics for managing diabetes and predicting outcomes; (4) integration of continuous glucose monitor data into the electronic health record; (5) regulation of diabetes technology; (6) digital health to nudge behavior; (7) estimating carbohydrates; (8) fully automated insulin delivery systems; (9) hypoglycemia; (10) novel insulins; (11) insulin delivery; (12) on-body sensors; (13) continuous glucose monitoring; (14) diabetic foot ulcers; (15) the environmental impact of diabetes technology; and (16) spinal cord stimulation for painful diabetic neuropathy. A live demonstration of a device that can allow for the recycling of used insulin pens was also presented.

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Telehealth Fatigue: Is It Real? What Should Be Done?

Cited by 5 publications

References 24 publications

Telerehabilitation services have declined post-COVID-19

Telerehabilitation services have declined post-COVID-19

Specialist Perspectives on Delivering High-Quality Telemedicine for Diabetes: A Mixed Methods Survey Study

Diabetes Technology Meeting 2022

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