The Efficacy of Telepsychiatry in Addiction Patients: A Systematic Review.

Psychiatry is one of the many medical subspecialties that have benefited from the advent of telemedicine. Substance abuse treatment via telepsychiatry expeditiously increased with the start of the pandemic and has brought changes to its rules and regulations. In this study, we focused on the prognosis of substance abuse patients treated with telepsychiatry, the various changes that occurred during the pandemic, and the difficulties faced by clinicians using telepsychiatry. PubMed and Google Scholar were searched for relevant articles between January 2010 and July 2022 using both broad and narrow keywords in addition to the MeSH (Medical Subject Heading) approach. The total number of records found was 765. Strict criteria for inclusion and exclusion ensured that only relevant information was collected. After removing duplicates, irrelevant studies, and research that did not meet the inclusion criteria, we were left with 373 studies from both electronic databases. From those, we ultimately retrieved 35 studies, which were subjected to a thorough content search and quality evaluation with the help of specialized instruments, and a total of 19 papers were included in our systematic review. We concluded that telepsychiatry use for substance abuse patients increased during the pandemic, and the prognosis of these patients treated with telepsychiatry was similar to that of in-person treatment. However, a combination of telepsychiatry with in-person sessions showed much better results.

Technology and HealthCare in the Coming Era

The fast-emerging technologies in this century fueled by covid19 crises has taught every stakeholder (technology giants, pharmacists, hospitals, patients etc.) a great lesson. Hospital with good healthcare system will have some of these technologies while there are least developed countries with no infrastructure and no technology. Using technology in healthcare will change the working of existing healthcare system to brighter one. This paper will portray different technology trends like Artificial Intelligence, Machine Learning, Block chain, Robotic Surgery, Smart devices, telemedicine and so on. The promises and the obstacles with impact of the technology are discussed too. © 2022 IEEE.

Investigations on machine learning models to envisage coronavirus in patients

The outbreak of the novel coronavirus pandemic (COVID-19) caused severe threats to humankind across the globe. The COVID-19 virus fits to the large family of virus that stimulate illness that may range from common flu to severe diseases like Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV). Hence, the virus affects the mankind variably ranging from mild to moderate and sometimes very severe leading to mortality. The virus is contagious, and necessary prevention and protection mechanism protocols have been strictly adhered by the public to prevent the community spread which has not succeeded. Researchers have investigated that the spread of the severity of spread could be achieved through herd immunity. This pandemic outbreak has affected the globe to a great extent;hence, effective mechanisms are under investigation to diagnose the disease at the initial stages to prevent spread. Machine learning (ML), a subset of artificial intelligence (AI), provides models that have the ability to inevitably learn and evolve over experience. The ML algorithms are used in diverse applications, its contribution to medical management especially in preventive medicines, medicinal chemistry, imaging, and genetic medicines are inevitable. The sovereign intelligence and capability of ML algorithms make it manifest to use it in the COVID-19-based research. This chapter focusses on usage of ML algorithms to detect the severity of COVID-19 virus in human kind. The model investigates on predicting the severity of risk, risk of infection, and who is at risk of developing a severe case. The ML algorithms described in this chapter aims at identifying the presence of the disease in a patient. This work analyzes the foreseen of the diseased people from people with minor indications built on 111 impute relating to medical and the clinical examination facts. The diagnostic knowledge entailed attributes, such as age group, gender, body temperature, respiratory proportion, heart rate, and BP. The blood/urine examination data contain information related to various categories of blood examination values and urine examination values. Numerous ML models, such as Naive Bayes, SVM, artificial neural network, k-nearest neighbor (kNN), convolutional neural network (CNN), logistic regression, and decision tree were used in prediction and severity analysis. The experimentation may investigate the effectiveness of the above algorithms for detecting the patients infected with the virus as well as the severity level. Further, this research could be enhanced to provide treatment recommendations in the future. © 2022 Scrivener Publishing LLC.

Evolution of Disparities in Outpatient Ophthalmic Care at a Tertiary Care Center in California at the Beginning of and One Year into the COVID-19 Public Health Emergency.

PURPOSE: To compare disparities in outpatient ophthalmic care during early and later periods of the COVID-19 public health emergency. METHODS: This cross-sectional study compared non-peri-operative outpatient ophthalmology visits by unique patients at an adult ophthalmology practice affiliated with a tertiary-care academic medical center in the Western US during three time periods: pre-COVID (3/15/19-4/15/19), early-COVID (3/15/20-4/15/20), and late-COVID (3/15/21-4/15/21). Differences in participant demographics, barriers to care, visit modality (telehealth, in person), and subspeciality of care were studied using unadjusted and adjusted models. RESULTS: There were 3095, 1172 and 3338 unique patient-visits during pre-COVID, early-COVID and late-COVID (overall age 59.5 ± 20.5 years, 57% female, 41.8% White, 25.9% Asian, 16.1% Hispanic). There were disparities in patient age (55.4 ± 21.8 vs. 60.2 ± 19.9 years), race (21.9% vs. 26.9% Asian), ethnicity (18.3% Hispanic vs. 15.2% Hispanic), and insurance (35.9% vs. 45.1% Medicare) as well as changes in modality (14.2% vs. 0% telehealth) and subspecialty (61.6% vs. 70.1% internal exam specialty) in early-COVID vs. pre-COVID (p < .05 for all). In late-COVID, only insurance (42.7% vs. 45.1% Medicare) and modality of care (1.8% vs. 0% telehealth) persisted as differences compared to pre-COVID. CONCLUSIONS: There were disparities in patients receiving outpatient ophthalmology care during early-COVID that returned close to pre-COVID baseline one year later. These results suggest that there has not been a lasting positive or negative disruptive effect of the COVID-19 pandemic on disparities in outpatient ophthalmic care.

Evaluation of the Hand and Wrist via Telephone and Video Visit.

BACKGROUND:  The COVID-19 pandemic has highlighted the utility of telemedicine, with rapid incorporation throughout 2020. Telemedicine is a timely, safe, and effective means of evaluating, triaging, and treating patient conditions, including those of the musculoskeletal system. Hand and wrist complaints are frequently encountered in the primary care setting, and some can have serious consequences if not promptly diagnosed. Prior to the pandemic, over a quarter of the nation's allopathic degree-granting medical schools had initiated telemedicine training as part of the preclinical phase of their curriculum, and about half had implemented it into clerkships prior to the pandemic. Despite rapid acceptance, increased ease of access, and prior attempts to incorporate telemedicine into the educational curriculum, telemedicine evaluation continues to pose challenges to both the patient and provider. This is likely due to a lack of established protocols outlining clinical data collection through a virtual interface. Although telemedicine requires the patient to perform a physical examination, it allows the physician to collect clinically important information while observing the patient in their home environment. AIMS:  The aim of this paper is to provide a step-by-step method to evaluate and triage hand and wrist complaints. METHODS:  Our group has created a step-by-step evaluation pathway to help physicians direct their patients through typical hand and wrist examination elements, including inspection, palpation, range of motion (ROM), strength, special, and functional testing. RESULTS:  We have developed a table of evaluation questions and instructions and a glossary of images of each maneuver to facilitate hand and wrist examination via telemedicine. CONCLUSION:  This paper provides a guide for extracting clinically relevant information while performing telemedicine examinations of the hand.

Telemedicine as technoinnovation to tackle COVID-19: A bibliometric analysis

Telemedicine has become fundamental for the challenges posed to healthcare. This set of instruments turns pivotal for facing one of the most relevant emergencies in human history: the COVID-19 pandemic. The multisectoral crisis led to a vigorously sustained adoption of innovations, including telemedicine technology. Telehealth was proven, in this context, to be a relevant tool to reduce healthcare costs, reduce not-needed hospitalizations, and improve the results in health care. Some barriers such as the costs of technologies, patient privacy and technical literacy have slowed down telemedicine adoption. Amidst the COVID-19 era, telemedicine calls for a managerial duty to change healthcare's organizational models. The present work aims to explore the growing literature to illuminate the relationships between telemedicine, innovations and healthcare in the COVID-19 framework. A bibliometric analysis of the existing literature based on 285 published works in 2019–2020 is put forward with the aim to detect the relevant literature, themes and approaches on telemedicine and COVID-19. Making use of community detection on the co-occurrence keywords network, we identify the "semantic cores” in the literature representing the relevant results on critical themes. The sorting implications are important for researchers and policymakers by mapping the existing literature and results in evidence-based analysis. We provide the key communities as the "semantic core” of the publications and results for the considered period. This allows for future research to be oriented towards perduring health policies that could lead to the adoption of telemedicine technologies in a post-pandemic scenario. © 2021

Remote Psychotherapy during the COVID-19 Pandemic: A Mixed-Methods Study on the Changes Experienced by Austrian Psychotherapists.

The outbreak of the COVID-19 pandemic and associated measures to contain the SARS-CoV-2 coronavirus required a change in treatment format from face-to-face to remote psychotherapy. This study investigated the changes experienced by Austrian therapists when switching to psychotherapy at a distance. A total of 217 therapists participated in an online survey on changes experienced when switching settings. The survey was open from 26 June until 3 September 2020. Several open questions were evaluated using qualitative content analysis. The results show that the setting at a distance was appreciated by the therapists as a possibility to continue therapy even during an exceptional situation. Moreover, remote therapy offered the respondents more flexibility in terms of space and time. Nevertheless, the therapists also reported challenges of remote therapy, such as limited sensory perceptions, technical problems and signs of fatigue. They also described differences in terms of the therapeutic interventions used. There was a great deal of ambivalence in the data regarding the intensity of sessions and the establishment and/or maintenance of a psychotherapeutic relationship. Overall, the study shows that remote psychotherapy seems to have been well accepted by Austrian psychotherapists in many settings and can offer benefits. Clinical studies are also necessary to investigate in which contexts and for which patient groups the remote setting is suitable and where it is potentially contraindicated.

Tele Health Self-Management (THSM) Innovation for Patients with COVID-19: A Conceptual Design

The coronavirus disease 2019 (COVID-19) is an emerging disease that has continued from 2019 to the present. It has affected every country both major and minor pictures. Therefore, effective management reflecting the lessons learned is necessary and urgent for the management. Disaster management consists of three key periods including the mitigation and preparedness phase, response phase, and recovery and rehabilitation phase through clear-fast-safe and build-back-better concepts. Innovation by new application is one of the important tools in such issue. Previous research was found to paying attention only to recording the number of infected cases, resources, and basic self-care. Severe epidemic situations make a service place an inadequate healthcare provider. Therefore, disaster management that encourage infected people to manage themselves is essential. The research team developed tele health self-management (THSM) as a medium for communication of management and self-care guidelines during stay at home isolation and awaiting hospitalization. A proposed guideline is expected to supporting the caring of patients with COVID-19 and providing effective self-management services, reduce the loss rate, and improve the quality of life during infection. © Fuji Technology Press Ltd.

Empathy in patient-clinician interactions when using telecommunication: A rapid review of the evidence.

Objectives: The COVID-19 pandemic accelerated the replacement of many face-to-face healthcare consultations with telephone consultations. Little is known about the extent to which empathy can be expressed in telephone consultations. Our objective is to review evidence related to empathy in telephone consultations including clinical outcomes, and patient/practitioner experiences. Methods: Searches of Medline/Ovid and PsycINFO/Ovid were undertaken. Titles and abstract screening, data extraction, and risk of bias were undertaken by two reviewers. Discrepancies were resolved in discussion with additional reviewers. Included studies were specific to tele-communications with empirical data on empathy related to patient outcomes/views, published (in English), 2010-2021. Studies that did not mention empathy explicitly were excluded. Results: Our search yielded 740 individual records and 8 studies (527 patients, 20 practitioners) met inclusion criteria: Some barriers to expression of empathy were noted, but no major obstacles were reported. However, data was sparse and most studies had a high risk of bias. Conclusion: Empathy in telephone consultations is possible, (though the loss of non-verbal cues and touch can present barriers) however the research does not yet identify how. Innovation: It is possible to establish and display empathy in telephone consultations, but future research needs to identify how this can be optimized. Funding: This work was supported by a National Institute for Health Research (NIHR) School for Primary Care Research grant (project number 389). The University of Southampton's Primary Care Department is a member of the NIHR School for Primary Care Research and supported by NIHR Research funds. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Protocol registration. PROSPERO (CRD42021238087).

Human-like tele-health robotics for older adults - A preliminary feasibility trial and vision.

Introduction: The global increase of the aging population presents major challenges to healthcare service delivery. Further, the COVID-19 pandemic exposed older adults' vulnerability to rapid deterioration of health when deprived of access to care due to the need for social distancing. Robotic technology advancements show promise to improve provision of quality care, support independence for patients and augment the capabilities of clinicians to perform tasks remotely. Aim: This study explored the feasibility and end-user acceptance of using a novel human-like tele-robotic system with touch feedback to conduct a remote medical examination and deliver safe care. Method: Testing of a remotely controlled robot was conducted with in-person clinician support to gather ECG readings of 11 healthy participants through a digital medical device. Post-study feedback about the system and the remote examinations conducted was obtained from study participants and study clinicians. Results: The findings demonstrated the system's capability to support remote examination of participants, and validated the system's perceived acceptability by clinicians and end-users who all reported feeling safe interacting with the robot and 72% preferred remote robotic exam over in-person examination. Conclusion: This paper discusses potential implications of robot-assisted telehealth for patients including older adults who are precluded from having in-person medical visits due to geographic distance or mobility, and proposes next steps for advancing robot-assisted telehealth delivery.

Measured and Perceived Effects of Upper Limb Home-Based Exergaming Interventions on Activity after Stroke: A Systematic Review and Meta-Analysis.

After discharge from the hospital to home, stroke patients may experience weakness and reduced movement in their hemiparetic arms that limits their ability to perform daily activities. Therapists can use exercise games (exergames) to maintain functional abilities and daily use of the arm at home. A systematic review and meta-analysis was conducted to determine the efficiency of upper limb home-based rehabilitation, using exergaming on activity abilities in stroke.&nbsp;Randomized controlled trials were reviewed in the CENTRAL, MEDLINE, CINAHL, EMBASE, and SCOPUS online databases. Clinical measures of observation and self-reporting were studied in post-intervention and follow-up. Nine studies were included in this systematic review (535 participants). The Physiotherapy Evidence Database (PEDro) score was 6.6/10 (SD 1.0, range 5-8), indicating good quality. This systematic review and meta-analysis showed that upper limb home-based exergaming interventions were no more effective in terms of activity than conventional therapy after stroke, according to the observational and subjective assessments in post-intervention and follow-up. Using this same approach, future studies should focus on evaluating home-based exergames through subgroup analysis to be able to propose recommendations.

The perceived quality of video consultations in geriatric outpatient care by early adopters.

PURPOSE: The COVID-19 pandemic caused rapid implementation and upscaling of video consulting. This study examined the perceived quality of care delivered through video consulting at a geriatric outpatient clinic, and how this related to adoption issues and barriers early adopting professionals found themselves confronted with. METHODS: We performed a qualitative study using semi-structured interviews with healthcare professionals complemented by the views of geriatric patients, family caregivers and medical secretaries. Participants from five academic centers and six teaching hospitals were included. Three researchers conducted the interviews, coded the data, and used thematic analysis. RESULTS: Interviews were conducted with 13 healthcare professionals, 8 patients, 7 family caregivers, and 4 medical secretaries. From these early adopters, we infer five criteria positively contributing to perceived quality of care provided by video consulting: (1) the patient has an intact cognitive function; (2) a family caregiver with digital literacy can be present; (3) doctor and patient already have an established relationship; (4) no immediate need for physical examination or intervention; and (5) the prior availability of a comprehensive and concise medical history. Overall, the uptake of video consulting in geriatric outpatient care appeared to be slow and laborious due to several implementation barriers. CONCLUSION: The implementation of video consulting use among geriatricians and geriatric patients at the geriatric outpatient clinic was slow due to the absence of many facilitating factors, but video consulting might be offered as an alternative to face-to-face follow-up to suitable patients in geriatric outpatient clinics.

Tele-Audiology in India: Current and Future Trends in Knowledge, Attitude, and Practice Among Audiologists.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic has led to widespread use of telepractice in hearing health care services. In this study, we investigated the knowledge, attitude, and practice (KAP) of tele-audiology among Indian audiologists. The current study is based on tele-practice guidelines recommended by the Indian Speech and Hearing Association for tele-audiology services in India. SUBJECTS AND METHODS: An internet-based KAP questionnaire survey was performed among 108 audiologists. The questionnaire included 33 items categorized under the following domains: demographic information and KAP of tele-audiology. Of the 108 audiologists included in the study, 38 admitted to the practice of tele-audiology previously and during the COVID-19 pandemic (tele-practitioners), and 70 respondents had no experience of tele-audiology (non-telepractitioners). RESULTS: Overall higher scores were observed with regard to the knowledge domain, and a mixed attitude regarding tele-practice was observed among audiologists. Most respondents acknowledged the advantages of tele-audiology in clinical practice. However, audiologists were hesitant to utilize this technology owing to the challenges associated with tele-practice. CONCLUSIONS: Despite adequate awareness and a positive attitude, a gap is observed between available knowledge and its actual application/utilization in tele-audiology. Tele-audiology practice was limited to counseling, hearing impairment treatment, and troubleshooting tips for hearing aids. Evidence-based practices to perform diagnostic test battery in tele-mode, hands-on training to run diagnostic test battery/rehabilitation using a tele-mode approach, and greater understanding of the technical requirements for tele-practice may result in a positive perception and encourage tele-audiology practice among audiologists. Specialized training and regular continuing education programmes are important to promote tele-audiology services in clinical practice.

Phone-Based Breasts Self-Examination as an Intervention in Breast Cancer Control During the COVID-19 Pandemic.

Importance: Exploring methods to mitigate the effect of COVID-19 pandemic on routine cancer screening activities among women. Objective: To investigate the effectiveness of telephone-based outreach as a substitute for physical screening for breast among screened women, during COVID-19 lockdown. Design/Setting/Subjects: Asymptomatic women aged 30-59 years were screened for breast and cervix cancers in the Chennai region, between January 2017 and March 2020 and are due for screening follow-up. A database from the population-based cancer screening program organized by the Cancer Institute during the above period was used for the study. Outcome data were obtained through the period from October 2020 to March 2021. Intervention: Phone-based breast self-examination awareness, inquiry about breast cancer symptoms, and guiding clinical management. Outcome Measure: Compliance to BSE protocol after 8-16 weeks, presence of significant symptoms, and incidence of early breast cancer. Results: Among 12,242 screened women, 6716 (56.8%) responded to a phone-based BSE intervention and 53 women had breast-related symptoms. Thirty-two (60.4%) women reported for further evaluation, and five invasive breast cancers were identified. Conclusion and Relevance: In a low-resource setting where there are no existent screening programs, simple interventions like teaching breast self-examination of women through tele-counseling can result in early detection of breast cancers.

The Effect of a Tele-Health Intervention Program on Home-Dwelling Persons with Dementia or MCI and on Their Primary Caregivers during the Stay-at-Home-Order Period in the COVID-19 Pandemic Outbreak: Evidence from Taiwan.

BACKGROUND: The Taiwanese government implemented a stay-at-home order that restricted all community-based health promotion activities for the elderly by shutting down all community care centers from May 2021 to August 2021 to control the spread of COVID-19. Community-based dementia care centers were barely able to provide dementia care services during that period. METHODS: The data used in this study were collected from a community-based dementia care center that was able to continue their dementia care services through a Tele-Health intervention program. The difference-in-differences methodology was applied to evaluate the effects of the Tele-Health intervention program on home-dwelling persons with dementia or mild cognitive impairment and on their primary caregivers during the COVID-19 pandemic. RESULTS: The Tele-Health intervention program significantly increased the well-being of the participants and their primary caregivers, but the negative correlations between the Tele-Health intervention program and family functioning were also found to be significant. CONCLUSIONS: The significant substitution (negative) effects between the Tele-Health intervention program and family functioning raises the concern that promotion of the Tele-Health intervention program comes at the potential cost of a loss of family functioning. Policymakers should be cautious when considering the Tele-Health intervention program in response to pandemics and demographic transitions.

Integration of advanced health technology within the healthcare system to fight the global pandemic: Current challenges and future opportunities

The COVID-19 pandemic presents a significant challenge for providing adequate healthcare services in the context of patient isolation. Discussion: The ability of our current healthcare system to cope with the current situation is mainly dependent on advanced health technology, such as telehealth, chatbots, virtual reality (VR), and artificial intelligence (AI). Telehealth can be a novel tool for improving our current healthcare system and allowing for greater delivery of healthcare services during global crises (i.e., the COVID-19 pandemic). Technology, such as chatbots, VR, and AI, could be utilized to reduce the burden of both communicable and noncommunicable diseases, as well as to build a patient-centered decision-making healthcare system. Objectives: Understanding the various methods of enhancing healthcare services using advanced health technology will help to develop new applications that can be integrated into regular healthcare and in time of healthcare crises. Conclusion: Advanced health technology is a main tool to face a pandemic that decreased the burden on physicians and patients as well as the entire healthcare system. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

EU-Funded Telemedicine Projects - Assessment of, and Lessons Learned From, in the Light of the SARS-CoV-2 Pandemic.

The SARS-CoV-2 health emergency has demonstrated the need for developing structured telemedicine systems to protect citizens from the spread of the virus. Thereby, their importance and the necessity to tailor their diffusion at large scale for providing services both at a distance and in time has been shown. For these reasons, the European Union advocates the digital transition of health systems for the next 5 years. The main aim of this work is to revisit the telemedicine research projects financed by European Community during the period 2000-2020 with particular respect to the results derived from their application. The analysis showed that some integration of tele-care and tele-health could be obtained with tele-monitoring systems and the implementation of Electronic Personal Record (EPR). Furthermore, telemedicine allows enhancing health care in critical environments, to protect health and life of the most vulnerable patients, and to encourage cross-border dialogue. The criteria of "from distance" and "timely delivered" are granted, but the effectiveness of the overall offered services highly depends on the availability and the quality of the input data. Unfortunately, this remains a relevant problem in the SARS-CoV-2 pandemic.

A study of assessment of knowledge, perception and attitude of using tele health services among college going students of Uttarakhand

Tele medicine or Tele health services are available in the world before 1970. Recent surge has been observed in the tele medicine during Covid 19. It is observed that tele health services usage has increased from 11% to 70% and the satisfaction level among the patients is around 78% in US and China. As per the Press information bureau report, in India around 35000 patients use E Sanjeevni portal for tele health services. The purpose of the study is to assess the knowledge perception and attitude towards tele health services by the students because they are young generation and their adoption rate of technology and skill set in technology is very high. A questionnaire was floated through Google forms to students of various colleges in Uttarakhand primarily in the district of Dehradun, Haridwar and Nainital. Around 1000 students were targeted through their Gmail accounts and WhatsApp groups. It was found that there is lack of awareness among students about telemedicine apps and related aspects;there perception towards it is positive as they want to use it as well as willing to refer it as well. It is concluded that the tele health services can be boon for the state like Uttarakhand as the health infrastructure is poor in the state because of its geography. If the organisation providing tele health services will try to improve the awareness, the willingness to adapt tele health services will be very high. © The author(s) 2021.

Tele health in the digital era during covid -19 a case study of Uttarakhand

Tele-health services area very old facility available, but it never became a forefront technology or option for patients. During Covid 19 lockdown, when all the hospitals OPD and Private Clinics were closed then there was certainly a need for a therapy that could be available, keeping the social distancing in mind. This study on Tele-health is both a primary and secondary data-based study. The first objective of the study is based on a survey of patients and service providers. The other two objectives are studied through secondary data. Options left for chronic patients were explored, their awareness and satisfaction regarding these options were studied if there is a surge in Tele-health services usage, then what strategies should organizations adopt for the continuous use of these services after covid was also studied. The study shows a surge in the usage of Tele-Health services and remote monitoring of patients. Approximately 80% of the patients have cancelled their personal visits to doctors, and patients' satisfaction rate is more than 70%. A survey on service providers was also carried out, and the satisfaction level of doctors in providing Tele-health services were more than 65%. The study reflects that Tele-health services can be a boon for a state like Uttarakhand, where health services are scarce and were treating patients in remote areas is challenging. © 2021 The authors.