Methodology to carry out medical meeting online, based on low-cost solutions

One of the effects of the COVID-19 pandemic is the adaptation of most of the activities remotely or virtually, in the case of medical appointments, in the different specialties other than emergencies produced by COVID-19. Most of them continued in the format through online appointments. One of the important processes in medical evaluations is related to the so-called specialist boards, where special cases are evaluated, for which several physicians must be connected online, in addition to being able to make reports jointly. In this paper we develop a methodology to perform medical meetings of specialists, using a platform dedicated to the use in video games, through the DISCORD tool interconnectivity from various devices is performed, the results demonstrate the interactivity and applicability of the methodology, so it can be applied in different processes where interconnectivity between different devices and the concurrence of several users is required. We present a methodology to configure virtual appointment rooms, the results allow us to verify that the methodology can be replicated and scaled according to the needs. © 2022 ACM.

The Roles of Trust and Its Antecedent Variables in Healthcare Consumers' Acceptance of Online Medical Consultation during the COVID-19 Pandemic in China.

Online medical consultation (OMC) is generating considerable interest among researchers and practitioners due to the mandatory quarantine measures implemented during the COVID-19 pandemic in China. However, the acceptance rate of OMC has declined over time. This paper aims to empirically investigate OMC acceptance using a proposed research model by integrating the technology acceptance model (TAM) with trust and its antecedent variables. A quantitative self-administered cross-sectional survey was conducted to collect data from 260 healthcare consumers. A partial least squares structural equation modeling method was used to examine the data. Results revealed that healthcare consumers' behavioral intention was influenced by attitudes, while perceived usefulness and trust significantly influenced behavioral intention through attitude as a mediator. In addition, perceived risk, perceived privacy protection, network externalities, cognitive reputation, and interactivity directly influenced trust. Overall, the research model explained 50% of the variance in attitude and 71% of the variance in behavioral intention. The study's findings should provide useful insights into making effective design, development, and implementation decisions for OMC services.

Counseling for Health: How Psychological Distance Influences Continuance Intention towards Mobile Medical Consultation.

As mobile healthcare services entered the public sight with high frequency during the COVID-19 pandemic, patients are increasingly recognizing the effectiveness of mobile medical consultation (MMC). Earlier studies have investigated what influences continuance intention (CI) towards MMC, but few studies have scrutinized it from the perspective of patients' psychological distance. We formulated a framework to examine the psychological factors influencing CI towards MMC by integrating the information systems continuance model and psychological distance theory. The framework was validated using the partial least squares structural equation modeling (PLS-SEM) approach and data from 475 MMC users in China. The empirical results revealed that immediacy, telepresence, intimacy, and substitutability were significant predictors of CI, while satisfaction mediated these pathways. Pandemic-induced anxiety positively moderated the effect of immediacy on satisfaction and the effect of satisfaction on CI. Practical implementations for MMC healthcare practitioners, designers, and marketers are drawn.

Would Illness Representations of COVID-19 and COVID-19 Fears During Clinic Visits Promote or Reduce Behavioral Intention to Seek Medical Consultations for Flu Symptoms? A Random Telephone Survey in Hong Kong, China.

Background: The study investigated the level of behavioral intention to consult doctors for flu symptoms (BICDFS) during the Coronavirus Disease 2019 (COVID-19) pandemic and examined its associations with illness representations of COVID-19 and fear of COVID-19 during clinic visits in a general Chinese adult population. Methods: A random telephone survey was conducted among 300 residents in Hong Kong, China in April 2020 when the second wave of COVID-19 was just ended in the region. The participants were asked about their intention to consult doctors if they had mild or severe flu symptoms in the next week (from 1 = definitely no to 5 = definitely yes). Illness representations of COVID-19 were measured by the Chinese version of the Brief Illness Perception Questionnaire (BIPQ). The fear of COVID-19 during clinic visits were assessed by two single items. Linear regression adjusted for background variables and hierarchical strategies were employed. Results: Of the participants, 52.3 and 92.0% showed an intention to consult doctors for mild and severe flu symptoms, respectively. Adjusted for background factors, COVID-19-related cognitive representations (consequences: standardized b = 0.15, p = 0.010; understanding: standardized b = 0.21, p = 0.001) and emotional representations (concern: standardized b = 0.17, p = 0.001; negative emotions: standardized b = 0.19, p = 0.001) were positively associated with BICDFS. In the hierarchical model, independent significant factors of BICDFS included understanding (standardized b = 0.16, p = 0.013) and negative emotions (standardized b = 0.17, p = 0.008). The fear-related variables showed non-significant associations with the BICDFS. Conclusions: Promotion of care-seeking behaviors for flu symptoms during the COVID-19 pandemic should consider improving people's understanding of COVID-19 and providing advice on related coping strategies for emotional responses to COVID-19.

Patient Activeness During Online Medical Consultation in China: Multilevel Analysis.

BACKGROUND: Online medical consultation is an important complementary approach to offline health care services. It not only increases patients' accessibility to medical care, but also encourages patients to actively participate in consultation, which can result in higher shared decision making, patient satisfaction, and treatment adherence. OBJECTIVE: This study aims to explore multilevel factors that influence patient activeness in online medical consultations. METHODS: A data set comprising 40,505 patients from 300 physicians in 10 specialties was included for multilevel analysis. Patient activeness score (PAS) was calculated based on the frequency and the proportion of patient discourses to the total frequency of doctor-patient interactions. Intraclass correlation coefficients were calculated to identify between-group variations, and the final multilevel regression model included patient- and physician-level factors. RESULTS: Patients were not equally active in online medical consultations, with PASs varying from 0 to 125.73. Patient characteristics, consultation behavioral attributes, and physician professional characteristics constitute 3 dimensions that are associated with patient activeness. Specifically, young and female patients participated more actively. Patients' waiting times online (ß=-.17; P<.001) for physician responses were negatively correlated with activeness, whereas patients' initiation of conversation (ß=.83; P<.001) and patient consultation cost (ß=.52; P<.001) in online medical consultation were positively correlated. Physicians' online consultation volumes (ß=-.10; P=.01) were negatively associated with patient activeness, whereas physician online consultation fee (ß=.03; P=.01) was positively associated. The interaction effects between patient- and physician-level factors were also identified. CONCLUSIONS: Patient activeness in online medical consultation requires more scholarly attention. Patient activeness is likely to be enhanced by reducing patients' waiting times and encouraging patients' initiation of conversation in online medical consultation. The findings have practical implications for patient-centered care and the improvement of online medical consultation services.

A Teleconsultation Device, Consult Station, for Remote Primary Care: Multisite Prospective Cohort Study.

BACKGROUND: Telemedicine technology is a growing field, especially in the context of the COVID-19 pandemic. Consult Station (Health for Development) is the first telemedicine device enabling completely remote medical consultations, including the concurrent collection of clinical parameters and videos. OBJECTIVE: Our aim was to collect data on the multisite urban and suburban implementation of the Consult Station for primary care and assess its contribution to health care pathways in areas with a low density of medical services. METHODS: In a proof-of-concept multisite prospective cohort study, 2134 consecutive patients had teleconsultations. Consultation characteristics were analyzed from both the patient and practitioner perspective. RESULTS: In this study, the main users of Consult Station were younger women consulting for low-severity seasonal infections. Interestingly, hypertension, diabetes, and preventive medical consultations were almost absent, while they accounted for almost 50% of consultations with a general practitioner (GP). We showed that for all regions where the Consult Station was implemented, the number of consultations increased as GP density decreased. The study of practitioner characteristics showed GPs from metropolitan areas are motivated to work with this device remotely, with a high level of technology acceptability. CONCLUSIONS: The multisite implementation of Consult Station booths is suitable for primary care and could also address the challenge of "medical deserts." In addition, further studies should be performed to evaluate the possible contribution of Consult Station booths to limiting work absenteeism.

The Influence of Perceived Social Presence on the Willingness to Communicate in Mobile Medical Consultations: Experimental Study.

BACKGROUND: With the rise of online health care service, there is growing discussion on the relationship between physicians and patients online, yet few researchers have paid attention to patients' perception of social presence, especially its influence on their willingness to communicate (WTC). OBJECTIVE: The goal of the research is to investigate the influence of perceived social presence (PSP) on WTC in mobile medical consultations. METHODS: Participants living in Yunnan province during the period of middle to high risk of COVID-19 infection were recruited via the internet. They were assigned randomly into 2 groups interacting with a virtual physician presenting high and low levels of social presence and then asked to complete a questionnaire. Based on the theoretical framework, the study puts forward a model evaluating the relationships among participants' PSP, communication apprehension (CA), self-perceived communication competence (SPCC), and willingness to communicate about health (WTCH) in the computer-mediated communication between virtual physicians and patients. RESULTS: In total 206 (106 in group 1 and 100 in group 2) valid samples were gathered (from 276 log-ins) and 88.8% (183/206) of them were aged 18 to 44 years, which approximately resembles the age distribution of the main population engaging in online medical consultation in China. Independent t test shows that there is significant difference between the PSP of the 2 groups (P=.04), indicating a successful manipulation of social presence. The total effect of PSP on WTCH is 0.56 (P<.001), among which 74.4% is direct effect (P<.001). Among the indirect effects between PSP and WTCH, the mediating effect of SPCC accounts for 68.8% (P<.001) and the sequential mediating effect of CA→SPCC accounts for 19.2% (P<.001), while the mediating effect of CA alone is not significant (P=.08). CONCLUSIONS: This study provides a comprehensible model, demonstrating that PSP is an important antecedent of WTCH, and the sequential mediating effect of CA and SPCC found in this study also proves that in the environment of online mobile medical services, CA cannot affect communication directly. The findings will provide some practical inspiration for the popularization of online medical service, especially for the promotion of online physician-patient communication.

Acceptance of virtual consultations among older adults and caregivers in Malaysia: a pilot study during the COVID-19 pandemic.

AIM: The COVID-19 pandemic has disrupted the delivery of healthcare to vulnerable older adults, prompting the expansion of telemedicine usage. This study surveyed the acceptance of virtual medical consultations among older adults and caregivers within geriatric outpatient services in a tertiary hospital during the pandemic. METHODS: A cross-sectional survey was conducted among caregivers and patients attending geriatric outpatient services in Kuala Lumpur, Malaysia. The survey measured the availability of equipment for virtual consultations, prior knowledge and experience of telemedicine, and willingness to consult geriatricians through virtual technology, using the Unified Theory of Acceptance and Use of Technology (UTAUT) scale. RESULTS: A total of 197 caregivers and 42 older patients with a mean age of 54.28 (±13.22) and 75.62 (±7.32) years, respectively, completed the survey. One hundred and fifty-six (79.2%) of the caregivers were adult children accompanying patients. The mean UTAUT score was 65.97 (±13.71) out of 90, with 66.64 (±13.25) for caregivers and 62.79 (±15.44) for older adults, suggesting a high acceptance of adopting virtual consultations in lieu of face-to-face care. The independent predictors of acceptance of virtual consultation were : possession of an electronic device capable of video-communication, living with someone, living in a care home, weekly online banking usage, and perceived familiarity with virtual platforms. CONCLUSION: Caregivers and patients indicated a high level of acceptance of virtual medical consultations, which is likely facilitated by caregivers such as adult children or spouses at home or staff in care homes. To minimize the transmission of COVID-19 in a highly vulnerable group, virtual consultations are an acceptable alternative to face-to-face consultations for older people and their caregivers in our setting.

Online medical consultation: Covid-19 system using software object-oriented approach

The internet has been a source of medical information, it has been used for online medical consultation (OMC). OMC is now offered by many providers internationally with diverse models and features. In OMC, consultations and treatments are available 24/7. The covid-19 pandemic across-the-board, many people unable to go to hospital or clinic because the spread of the virus. This paper tried to answer two research questions. The first one on how the OMC can help the patients during covid-19 pandemic. A literature review was conducted to answer the first research question. The second one on how to develop system in OMC related to covid-19 pandemic. The system was developed by Visual Studio 2019 using software object-oriented approach. Online expert review was conducted within 6 experts from health and academic industry to verify the model. Also, the system was validated by 11 users from heath and academic industry to confirm its usability. The statistical package for social science (SPSS 22) was used to analyze the collected data. The result of expert review confirmed that covid-19 system can help the patients. Also, the validity of the system was confirmed by 11 users from health and academic industry. © 2021, Institute of Advanced Engineering and Science. All rights reserved.

Mobile Remote Presence Robots for Medical Consultation and Social Connectedness.

We demonstrate that Mobile Remote Presence systems (MRP) aka telepresence robots can be successfully used in certain types of medical consultation such as consultation from a distance with residents of nursing homes. We argue that MRP afforded media richness also allows for supporting social connectedness during medically recommended isolation regimes similar to the ones that are implemented in residential care homes around the world during the SARS-CoVID-2 pandemic. Specifically, our research found that MRP are perceived as a more natural medium compared to typical telephones or videoconferencing via computers or tablets. MRP allow conversations to become more dynamic and engaging since remote participants are able to adjust their remote position and perspective during a conversation. Participants in our experiments reported they would be willing to engage even in difficult or emotional topics when using MRP however there are also certain types of situations that would still ask for face-to-face conversations.

An internet-based multidisciplinary online medical consultation system to help cope with pediatric medical needs during the COVID-19 outbreak: a cross-sectional study.

BACKGROUND: Telemedicine is becoming an emerging innovative supplement to the traditional medical system in China. In the present study, we described the rapid implementation of the telemedicine in pediatrics during the coronavirus disease 2019 (COVID-19) outbreak and explored its value in response to the demand for pediatric medical services during the epidemic. METHODS: An Internet-based platform for multidisciplinary online medical consultation was established on February 8, 2020, by a national children's medical center in China. The medical data of the traditional hospital visits and novel online visits from the first two months (February 8 to March 31) after the establishment of the platform were collected and analyzed. The demographic features, changes in the disease spectrum and characteristics of online medical services were described. RESULTS: The total number of visits was significantly lower (by 75.3%) than that of in the same period in the previous year. The disease spectrum was different with a significant decrease of >95% in the number of patients with infectious or contagious diseases. The online visits accounted for 14.7% of all visits. Online patients came from all over the country, covering 91% of the administrative regions of China, and the largest proportion of inquiries were for infants (33.7%) (P<0.01). The response rate of experts to requests for online consultations was 100%. During the study period, 266 experts from 25 pediatric specialties completed 12,318 effective consultations, proving different degrees of online supplementation for various specialties (4.3-168.4%). Online consultations mainly addressed two types of problems: (I) accessibility of the traditional hospital visits and (II) consultations regarding an illness. Data from pediatric nephrology showed that 96% of the patients with stable chronic kidney disease successfully received follow-up medication adjustment guidance through the online platform. CONCLUSIONS: The traditional hospital medical services have been affected by the COVID-19 outbreak. The multidisciplinary online medical consultation system is a strategy to actively respond to the medical needs of children during unique periods.

Diabetic foot and COVID-19. Medical consultation and severity of lesions compared to 2019.

At the end of 2019 a novel coronavirus was identified as a cause of pneumonia in Wuhan, China. This emerging disease has caused an unexpected turn in the economy and in society, which has led to the necessity of social isolation and confinement. Diabetic foot consultation was affected by the ongoing situation. The aim of this study was to compare the number of medical visits and the severity of new lesions at presentation at the Diabetic Foot Unit during June 2020 compared to June 2019. Three hundred and fifty six medical visits were analyzed, resulting in a 29% reduction in the number of visits during 2020. The number of patients presenting with new lesions increased from 6.4% to 10.3% (p = ns) during pandemic. The number of visits from the patients' relatives was higher during June 2020 (16.3% vs. 1.4%) (p < 0.05). Controls of feet without active lesions (i.e.: closed wound or periodic control) decreased from 16.8% to 4.5% (p < 0.05). Consultation for medical prescription only was higher in 2020 (22.4%) than in 2019 (7.3%) (p < 0.05). In our sample, there were no significant differences in the severity of new lesions at presentation or on the days of evolution of new ones in comparison with the previous year. During 2020, telehealth consults represented a 7% of all medical visits. There were no major amputations during 2019 and 4 during 2020. Given the dynamics of confinement, further studies about this topic are required to make sound and accurate decisions.

A fines de 2019 se identificó un nuevo coronavirus como causa de neumonía, en Wuhan, China. Esta nueva enfermedad (COVID-19) causó un inesperado vuelco en la economía y en la sociedad. El aislamiento social y el confinamiento provocaron cambios en la dinámica de las consultas médicas. En este estudio se compararon la cantidad de consultas y la gravedad de las lesiones nuevas en la Unidad de Pie Diabético entre junio de 2020 y junio de 2019. Se analizaron en total 356 visitas médicas, hallando un 29% de reducción en el número de visitas en 2020. El número de consultas por lesión nueva aumentó del 6.4% a 10.3% (p = ns) durante la pandemia. Las visitas de familiares por diversos motivos en lugar del paciente aumentaron durante 2020 de 1.4% a 16.3% (p < 0.05). Los controles de pacientes sin lesión (pie de alto riesgo, control post alta), disminuyeron de 16.8% a 4.5% (p < 0.05) y también aumentaron las visitas únicamente para prescripciones médicas (7.3% a 22.4%, p < 0.05). En nuestra muestra, no hubo diferencias significativas en la gravedad de la presentación ni en los días de evolución de las lesiones nuevas en relación al año anterior. Durante 2020 las teleconsultas representaron el 7% del total. En junio de 2019 no se registraron amputaciones mayores y en 2020 se registraron 4. Dada la dinámica del confinamiento, se requiere un continuo seguimiento y nuevos estudios para evaluar las consecuencias que se producirán en los pacientes con esta enfermedad con el fin de tomar decisiones acertadas.

Turn to the Internet First? Using Online Medical Behavioral Data to Forecast COVID-19 Epidemic Trend.

The surveillance and forecast of newly confirmed cases are important to mobilize medical resources and facilitate policymaking during a public health emergency. Digital surveillance using data available online has increasingly become a trend with the advancement of the Internet. In this study, we assessed the predictive value of multiple online medical behavioral data, including online medical consultation (OMC), online medical appointment (OMA), and online medical search (OMS) for the regional outbreak of coronavirus disease 2019 in Shenzhen, China during January 1, 2020 to March 5, 2020. Multivariate vector autoregression models were used for the prediction. The results identified a novel predictor, OMC, which can forecast the disease trend up to 2 days ahead of the official reports of confirmed cases from the local health department. OMS data had relatively weaker predictive power than OMC in our model, and OMA data failed to predict the confirmed cases. This study highlights the importance of OMC data and has implication in providing evidence-based guidelines for local authorities to evaluate risks and allocate resources during the pandemic.

Investigating Patients' Intention to Continue Using Teleconsultation to Anticipate Postcrisis Momentum: Survey Study.

BACKGROUND: The COVID-19 crisis has drastically changed care delivery with teleconsultation platforms experiencing substantial spikes in demand, helping patients and care providers avoid infections and maintain health care services. Beyond the current pandemic, teleconsultation is considered a significant opportunity to address persistent health system challenges, including accessibility, continuity, and cost of care, while ensuring quality. OBJECTIVE: This study aims at identifying the determinants of patients' intention to continue using a teleconsultation platform. It extends prior research on information technology use continuance intention and teleconsultation services. METHODS: Data was collected in November 2018 and May 2019 with Canadian patients who had access to a teleconsultation platform. Measures included patients' intention to continue their use; teleconsultation usefulness; teleconsultation quality; patients' trust toward the digital platform, its provider. and health care professionals; and confirmation of patients' expectations toward teleconsultation. We used structural equation modeling employing the partial least squares component-based technique to test our research model and hypotheses. RESULTS: We analyzed a sample of 178 participants who had used teleconsultation services. Our findings revealed that confirmation of expectations had the greatest influence on continuance intention (total effects=0.722; P<.001), followed by usefulness (total effects=0.587; P<.001) and quality (total effects=0.511; P<.001). Usefulness (ß=.60; P<.001) and quality (ß=.34; P=.01) had direct effects on the dependent variable. The confirmation of expectations had direct effects both on usefulness (ß=.56; P<.001) and quality (ß=.75; P<.001) in addition to having an indirect effect on usefulness (indirect effects=0.282; P<.001). Last, quality directly influenced usefulness (ß=.34; P=.002) and trust (ß=.88; P<.001). Trust does not play a role in the context under study. CONCLUSIONS: Teleconsultation is central to care going forward, and it represents a significant lever for an improved, digital delivery of health care in the future. We believe that our findings will help drive long-term teleconsultation adoption and use, including in the aftermath of the current COVID-19 crisis, so that general care improvement and greater preparedness for exceptional situations can be achieved.