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1.
Endocrine Practice ; 2022.
Article in English | ScienceDirect | ID: covidwho-2165284

ABSTRACT

Objectives Diabetes management presents a substantial burden to individuals living with the condition and their families, healthcare professionals, and healthcare systems. Although an increasing number of digital tools are available to assist with tasks such as blood glucose monitoring and insulin dose calculation, multiple persistent barriers continue to prevent their optimal use. Methods As a guide to creating an equitable connected digital diabetes ecosystem, we propose a roadmap with key milestones that need to be achieved along the way. Results During the Coronavirus 2019 pandemic, there was an increased use of digital tools to support diabetes care, but at the same time, the pandemic also highlighted problems of inequities in access to and use of these same technologies. Based on these observations, a connected diabetes ecosystem should incorporate and optimize the use of existing treatments and technologies, integrate tasks such as glucose monitoring, data analysis, and insulin dose calculations, and lead to improved and equitable health outcomes. Conclusions Development of this ecosystem will require overcoming multiple obstacles, including interoperability and data security concerns. However, an integrated system would optimize existing devices, technologies and treatments to improve help to improve outcomes.

2.
JMIR Nurs ; 5(1): e39866, 2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2154530

ABSTRACT

BACKGROUND: Digital health literacy is the use of information and communication technology to support health and health care. Digital health literacy is becoming increasingly important as individuals continue to seek medical advice from various web-based sources, especially social media, during the pandemics such as COVID-19. OBJECTIVE: The study aimed to assess health professionals' digital health literacy level and associated factors in Southwest Ethiopia in 2021. METHODS: An institution-based cross-sectional study was conducted from January to April 2021 in Ethiopia. Simple random sampling technique was used to select 423 study participants among health professionals. SPSS (version 20) software was used for data entry and analysis. A pretested self-administered questionnaire was used to collect the required data. Multivariable logistic regression was used to examine the association between the digital health literacy skill and associated factors. Significance value was obtained at 95% CI and P<.05. RESULTS: In total, 401 study subjects participated in the study. Overall, 43.6% (n=176) of respondents had high digital health literacy skills. High computer literacy (adjusted odds ratio [AOR] 4.43, 95% CI 2.34-5.67; P=.01); master's degree and above (AOR 3.42, 95% CI 2.31-4.90; P=.02); internet use (AOR 4.00, 95% CI 1.78-4.02; P=.03); perceived ease of use (AOR 2.65, 95% CI 1.35-4.65; P=.04); monthly income of >15,000 Ethiopian birr (>US $283.68; AOR 7.55, 95% CI 6.43-9.44; P<.001); good knowledge of eHealth (AOR 2.22, 95% CI 1.32-4.03; P=.04); favorable attitudes (AOR 3.11, 95% CI 2.11-4.32; P=.04); and perceived usefulness (AOR 3.43, 95% CI 2.43-5.44; P=.02) were variables associated with eHealth literacy level. CONCLUSIONS: In general, less than half of the study participants had a high digital health literacy level. High computer literacy, master's degree and above, frequent internet use, perceived ease to use, income of >15,000 Ethiopian birr (>US $283.68), good knowledge of digital health literacy, favorable attitude, and perceived usefulness were the most determinant factors in the study. Having high computer literacy, frequent use of internet, perceived ease of use, perceived usefulness, favorable attitude, and a high level of education will help to promote a high level of digital health literacy.

3.
J Med Internet Res ; 24(10): e39218, 2022 10 21.
Article in English | MEDLINE | ID: covidwho-2154529

ABSTRACT

BACKGROUND: It is recommended that caregivers receive oral health education and in-person training to improve toothbrushing for young children. To strengthen oral health education before COVID-19, the 21-Day FunDee chatbot with in-person toothbrushing training for caregivers was used. During the pandemic, practical experience was difficult to implement. Therefore, the 30-Day FunDee chatbot was created to extend the coverage of chatbots from 21 days to 30 days by incorporating more videos on toothbrushing demonstrations and dialogue. This was a secondary data comparison of 2 chatbots in similar rural areas of Pattani province: Maikan district (Study I) and Maelan district (Study II). OBJECTIVE: This study aimed to evaluate the effectiveness and usability of 2 chatbots, 21-Day FunDee (Study I) and 30-Day FunDee (Study II), based on the protection motivation theory (PMT). This study explored the feasibility of using the 30-Day FunDee chatbot to increase toothbrushing behaviors for caregivers in oral hygiene care for children aged 6 months to 36 months without in-person training during the COVID-19 pandemic. METHODS: A pre-post design was used in both studies. The effectiveness was evaluated among caregivers in terms of oral hygiene practices, knowledge, and oral health care perceptions based on PMT. In Study I, participants received in-person training and a 21-day chatbot course during October 2018 to February 2019. In Study II, participants received only daily chatbot programming for 30 days during December 2021 to February 2022. Data were gathered at baseline of each study and at 30 days and 60 days after the start of Study I and Study II, respectively. After completing their interventions, the chatbot's usability was assessed using open-ended questions. Study I evaluated the plaque score, whereas Study II included an in-depth interview. The 2 studies were compared to determine the feasibility of using the 30-Day FunDee chatbot as an alternative to in-person training. RESULTS: There were 71 pairs of participants: 37 in Study I and 34 in Study II. Both chatbots significantly improved overall knowledge (Study I: P<.001; Study II: P=.001), overall oral health care perceptions based on PMT (Study I: P<.001; Study II: P<.001), and toothbrushing for children by caregivers (Study I: P=.02; Study II: P=.04). Only Study I had statistically significant differences in toothbrushing at least twice a day (P=.002) and perceived vulnerability (P=.003). The highest overall chatbot satisfaction was 9.2 (SD 0.9) in Study I and 8.6 (SD 1.2) in Study II. In Study I, plaque levels differed significantly (P<.001). CONCLUSIONS: This was the first study using a chatbot in oral health education. We established the effectiveness and usability of 2 chatbot programs for promoting oral hygiene care of young children by caregivers. The 30-Day FunDee chatbot showed the possibility of improving toothbrushing skills without requiring in-person training. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20191223005; http://www.thaiclinicaltrials.org/show/TCTR20191223005 and TCTR20210927004; https://www.thaiclinicaltrials.org/show/TCTR20210927004.


Subject(s)
COVID-19 , Toothbrushing , Child , Child, Preschool , Humans , COVID-19/prevention & control , Oral Health , Oral Hygiene , Pandemics/prevention & control
4.
Frontiers in Medicine ; 9, 2022.
Article in English | Web of Science | ID: covidwho-2163046

ABSTRACT

BackgroundThe COVID-19 pandemic led to transformations in healthcare infrastructures and increased use of (innovative) telemedicine (TM) tools. Comparison of the use of video consultation (VC) in rheumatology in the pre-pandemic period and during the pandemic might allow for evaluating this new form of consultancy in healthcare due to changing conditions and possibilities. Materials and methodsCross-sectional nationwide online survey among German rheumatologists and rheumatologists in training between March and May 2021 promoted by newsletters and Twitter posts. ResultsResults refer to 205 participants. The majority was male (59%), older than 40 years (90%). Thirty-eight percent stated to have employed TM before ("digital users"), 27% were using VC as part of their TM expertise ("VC-users"), 10% stated to have experience with TM but not VC ("TM-users"). Those negating the use of any TM (62%) were designated as "digital non-users." TM-Knowledge was self-rated as 4 [median on a Likert Scale 1 (very high) to 6 (very low)] with a significant difference between digital users (VC-user 2.7 +/- 1.2, TM-user 3.2 +/- 1.1) and digital non-users (4.4 +/- 1.3). The reported significant increase of VC use during the lockdown periods and between the lockdowns compared to the pre-pandemic phase was regarded as a proxy for VC acceptance in the pandemic. Reasons for VC non-use were administrative/technical efforts (21%), lack of technical equipment (15%), time constraints (12%), time required for individual VC sessions (12%), inadequate reimbursement (11%), lack of demand from patients (11%), data security concerns (9%), poor internet connection (8%), and lack of scientific evaluation/evidence (5%). Physicians considered the following clinical situations to be particularly suitable for VC: follow-up visits (VC-user 79%, TM-user 62%, digital non-user 47%), emergency consultations (VC-user 20%, TM-user 33%, digital non-user 20%), and patients presenting for the first time (VC-user 11%, TM-user 19%, digital non-user 8%). ConclusionEven though the pandemic situation, with social distancing and several lockdowns, provides an ideal environment for the implementation of new remote care forms as VC, its use and acceptance remained comparatively low due to multiple reasons. This analysis may help identify hurdles in employing innovative digital care models for rheumatologic healthcare.

5.
2022 IEEE-EMBS International Conference on Biomedical and Health Informatics, BHI 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2161380

ABSTRACT

Healthcare continuity and remote care are among the key components for tackling disease-related effects using technological solutions. People recovering from home need high-quality of care and timely monitoring, resembling hospital care. This study proposes the use of a new device for person - machine interaction for home monitoring. The system takes advantage of automatic interaction initiated by the device on detecting patients' symptoms and providing remote care in order to improve technology engagement features. The feasibility of the proposed system was tested in COVID-19 patients as a definitive case of stay-at-home care where the treatment depends on the current state of health and the severity of the symptoms. The study shows promising results in terms of usability. The vast majority of the answers are perceiving the system as useful (90.9%) and easy to use (95.5%) and the overall System Usability Score (SUS) of the system is 65.25. The system usage adherence was also promising for the quarantine period (on average 7.2 days) but dropped after that. However, the results from the clinical team interviews showed that there is a need for sufficient allocated time for clinicians to get acquainted with the system and for ED staff to explain the device to patients. © 2022 IEEE.

6.
11th International Conference on Health Information Science, HIS 2022 ; 13705 LNCS:189-196, 2022.
Article in English | Scopus | ID: covidwho-2148638

ABSTRACT

Introduction: Teledentistry has allowed for the provision of dental care remotely. It has benefitted people living in regional, rural and remote communities. The use of teledentistry rapidly increased during the COVID-19 pandemic to minimise transmission risk while still allowing for the provision of care, especially during mandated lockdowns. Aim: This study aims to pilot and assess the validity of a questionnaire developed to understand early career dental practitioners’ opinions regarding teledentistry in Australia. Method: Registered early career dental practitioners currently working in Australia were invited to participate. Participants were asked to respond to a series of questions regarding teledentistry on themes containing diagnosis, accessibility, patient care, technology and finances. In addition, participants were asked for feedback upon the conclusion of the questionnaire. Results: A total of 23 dental practitioners (60% female, age range 20–34) participated in this study. Work experiences ranged from 0–10 years. A total of 18 participants worked in metropolitan areas, while five worked in regional areas. All participants used teledentistry for approximately 1–9 hours per week. Over 82% of participants believed that telehealth was effective for consultations, and over 90% believed it was more convenient than face-to-face consultations. However, over 78% believed teledentistry was ineffective for diagnosing complex dental cases. Over 95% of participants believed that teledentistry improved patient healthcare access and was beneficial during the coronavirus (COVID-19) pandemic. All participants believed that teledentistry was a useful tool for post-operative care, and over 86% of participants felt that patients accepted teledentistry. Conclusion: This questionnaire effectively determines the utilisation of teledentistry during a global pandemic from the perspective of early career dental practitioners. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

7.
9th International Conference on Culture and Computing, C and C 2021, Held as Part of the 23rd HCI International Conference, HCII 2021 ; 12795 LNCS:3-16, 2021.
Article in English | Scopus | ID: covidwho-2148494

ABSTRACT

Digital literacy is not based solely on an understanding of technology, but is highly influenced by social and cultural context. This study focused on developing mobile applications for medication allergy care for respiratory-related patients in daily life, which is based on inclusiveness and digital literacy. With COVID-19, there are growing needs to share the role of primary care hospitals, with, for example GPs, and self-care symptom records applications, in order to supplement the saturated medical service of general hospitals. The mobile application of ‘medication-allergy record for respiratory-related patients’ which is developed in this study considers cultural digital literacy and provides the solutions to the local people’s needs. For these objectives this study has conducted field research and analyzed the influential factors and needs in digital interaction, by interviewing 120 outpatients of respiratory and allergic internal medicine department in general hospital in Cheongju. Based on this, the direction of the mobile application has developed new information architecture and relevant wire-frames. This study will contribute to the future direction of non-face communication in health-care service by suggesting a self-data-producing digital health care service by bridging the personal culture and user-centered technology. © Springer Nature Switzerland AG 2021.

8.
9.
JMIR Form Res ; 6(11): e40242, 2022 Nov 22.
Article in English | MEDLINE | ID: covidwho-2141423

ABSTRACT

BACKGROUND: Symptoms of depression and anxiety, suicidal ideation, and self-harm have escalated among adolescents to crisis levels during the COVID-19 pandemic. As a result, primary care providers (PCPs) are often called on to provide first-line care for these youth. Digital health interventions can extend mental health specialty care, but few are evidence based. We evaluated the feasibility of delivering an evidence-based mobile health (mHealth) app with an embedded conversational agent to deliver cognitive behavioral therapy (CBT) to symptomatic adolescents presenting in primary care settings during the pandemic. OBJECTIVE: In this 12-week pilot study, we evaluated the feasibility of delivering the app-based intervention to adolescents aged 13 to 17 years with moderate depressive symptoms who were treated in a practice-based research network (PBRN) of academically affiliated primary care clinics. We also obtained preliminary estimates of app acceptability, effectiveness, and usability. METHODS: This small, pilot randomized controlled trial (RCT) evaluated depressive symptom severity in adolescents randomized to the app or to a wait list control condition. The primary end point was depression severity at 4-weeks, measured by the 9-item Patient Health Questionnaire (PHQ-9). Data on acceptability, feasibility, and usability were collected from adolescents and their parent or legal guardian. Qualitative interviews were conducted with 13 PCPs from 11 PBRN clinics to identify facilitators and barriers to incorporating mental health apps in treatment planning for adolescents with depression and anxiety. RESULTS: The pilot randomized 18 participants to the app (n=10, 56%) or to a wait list control condition (n=8, 44%); 17 participants were included in the analysis, and 1 became ineligible upon chart review due to lack of eligibility based on documented diagnosis. The overall sample was predominantly female (15/17, 88%), White (15/17, 88%), and privately insured (15/17, 88%). Mean PHQ-9 scores at 4 weeks decreased by 3.3 points in the active treatment group (representing a shift in mean depression score from moderate to mild symptom severity categories) and 2 points in the wait list control group (no shift in symptom severity category). Teen- and parent-reported usability, feasibility, and acceptability of the app was high. PCPs reported preference for introducing mHealth interventions like the one in this study early in the course of care for individuals presenting with mild or moderate symptoms. CONCLUSIONS: In this small study, we demonstrated the feasibility, acceptability, usability, and safety of using a CBT-based chatbot for adolescents presenting with moderate depressive symptoms in a network of PBRN-based primary care clinics. This pilot study could not establish effectiveness, but our results suggest that further study in a larger pediatric population is warranted. Future study inclusive of rural, socioeconomically disadvantaged, and underrepresented communities is needed to establish generalizability of effectiveness and identify implementation-related adaptations needed to promote broader uptake in pediatric primary care. TRIAL REGISTRATION: ClinicalTrials.gov NCT04603053; https://clinicaltrials.gov/ct2/show/NCT04603053.

10.
JMIR Res Protoc ; 11(11): e36174, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2141380

ABSTRACT

BACKGROUND: Globally, COVID-19-related psychological distress is seriously eroding health care workers' mental health and well-being, especially in low-income countries like Nigeria. The use of mobile health (mHealth) interventions is now increasingly recognized as an innovative approach that may improve mental health and well-being. This project aims to develop an mHealth psychological intervention (mPsyI) to reduce COVID-19-related psychological distress among health care workers in Nigeria. OBJECTIVE: Our objective is to present a study protocol to determine the level of COVID-19-related psychological distress among health care workers in Nigeria; explore health care workers' experience of COVID-19-related psychological distress; develop and pilot test mPsyI to reduce this distress; and assess the feasibility of this intervention (such as usability, engagement, and satisfaction). METHODS: A mixed (quantitative and qualitative) methods approach is used in which health care workers will be recruited from 2 tertiary health care facilities in southwest Nigeria. The study is divided into 4 phases based on the study objectives. Phase 1 involves a quantitative survey to assess the type and levels of psychosocial distress. Phase 2 collects qualitative data on psychosocial distress among health care workers. Phase 3 involves development of the mHealth-based psychological intervention, and phase 4 is a mixed methods study to assess the feasibility and acceptability of the intervention. RESULTS: This study was funded in November 2020 by the Global Effort on COVID-19 Health Research, and collection of preliminary baseline data started in July 2021. CONCLUSIONS: This is the first study to report the development of an mHealth-based intervention to reduce COVID-19-related psychological distress among health care workers in Nigeria. Using a mixed methods design in this study can potentially facilitate the adaptation of an evidence-based treatment method that is culturally sensitive and cost-effective for the management of COVID-19-related psychological distress among health care workers in Nigeria. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36174.

11.
Orv Hetil ; 163(29): 1159-1165, 2022 Jul 17.
Article in English | MEDLINE | ID: covidwho-2140891

ABSTRACT

INTRODUCTION: The impact of digitalisation on healthcare has become one of the most important research areas in recent years. The COVID-19 epidemic has been a major driver in this process. OBJECTIVE: In our nationally representative, population-based survey (n = 1500), we sought to find out how patients in Hungary use digital health tools, what the advantages and disadvantages of introducing and using these technologies are, and how this is transforming the doctor-patient relationship. METHODS: We conducted a national representative telephone questionnaire survey (CATI). The sample is representative of the adult population of Hungary in terms of gender, age, type of settlement and education. RESULTS: 81.3% of the respondents use the internet - 87.6% of whom use it in relation to health and illness, too. This is 71.2% of the total sample. Websites (76.3%) and social media (47.3%) are the main sources of information on the internet; e-prescription and online appointment booking are the most known by patients (92.6% and 85.2%, respectively), while almost half of the respondents would like to try telehealth and would welcome a recommendation from their doctor on reliable websites, apps and sensors. Our results highlighted that the effect of the type of settlement on access to digital health is not significant, but that the effect of age, education and gender is decisive. CONCLUSION: Data from our national representative population survey indicate that the use of digital health solutions is already an integral part of care and that there is a strong demand for further digital options. Orv Hetil. 2022; 163(29): 1159-1165.


Subject(s)
COVID-19 , Digitalis , Telemedicine , Adult , COVID-19/epidemiology , Humans , Hungary , Physician-Patient Relations , Surveys and Questionnaires , Telemedicine/methods
12.
Digit Health ; 8: 20552076221139694, 2022.
Article in English | MEDLINE | ID: covidwho-2139047

ABSTRACT

Objective: Half of older adults undergoing hip surgery do not recover their previous functional status. mHealth is a promising tool for rehabilitating older adults after hip surgery. This study aimed to test the feasibility of the ActiveHip+ mHealth system in older adults after hip surgery. Methods: Sixty-nine older adults who had undergone hip surgery and their family caregivers were recruited from hospitals in Spain and Belgium and used the ActiveHip+ mHealth system for 12 weeks. Assessments were made during hospital stay and 3 months after surgery. Feasibility assessment included: adoption (participation proportion), usage (access to the app), satisfaction with the app (Net Promoter Score) and user perception of the quality of the app (Mobile App Rating Scale). Clinical assessment included: patient-reported outcomes, such as functional status (Functional Independence Measure) and performance-based outcomes, such as physical fitness (Short Physical Performance Battery). Results: The ActiveHip+ mHealth system obtained satisfactory feasibility results in both countries. In Spain, we observed 85% adoption, 64% usage, 8.86/10 in satisfaction with the app and 4.42/5 in perceived quality of the app. In Belgium, we observed 82% adoption, 84% usage, 5.16/10 in satisfaction with the app and 3.52/5 in app's perceived quality. The intervention had positive effects on levels of functional status, pain and physical fitness. Conclusions: The ActiveHip+ mHealth system is a feasible tool to conduct the rehabilitation in older adults after hip surgery. Although the intervention seemed beneficial clinically, we do not recommend its implementation in clinical settings until appropriately designed randomised clinical trials confirm these results.

13.
NeuroQuantology ; 20(15):4210-4233, 2022.
Article in English | EMBASE | ID: covidwho-2145498

ABSTRACT

This study reveals essential aspects of communication done by medical practitioners through telemedicine during the Covid-19 pandemic and their relation to increasing the quality of telemedicine services in Indonesia post-pandemic. The study used a qualitative approach with 22 doctors participating in the Bandung City area, Indonesia. Data collection uses semi-structured interviews, which are then analyzed thematically to reveal essential aspects of communication through telemedicine. The results of the analysis consist of several things, namely: (1) personal aspects;including knowledge, psychological conditions, and socio-cultural background (2) process aspects;including interactivity, time context, spatial context, and sensory context;and also (3) technical aspects covering information systems, quality of communication media, availability of health technology, and work coordination systems. Each aspect relates to instrumental and socioemotional information that plays a role in medical decision-making. The results also suggest that to support the usage of telemedicine services, the literacy of its users needs to enhance. Sensitivity to psychological and socio-cultural variations is also required to communicate effectively through telemedicine. Strengthening the technical aspect of telemedicine services, such as integrating information systems, increasing communication media quality, and providing access to health technology instruments, is also essential to improve the completeness and clarity of information,,doctor-patient relationships, and confidence that meet the expectations of all of the users in telemedicine services. Copyright © 2022, Anka Publishers. All rights reserved.

14.
Design for Health ; : 1-20, 2022.
Article in English | Academic Search Complete | ID: covidwho-2134627

ABSTRACT

The COVID 19 pandemic necessitated a rapid implementation of virtual care within the Canadian healthcare system generating previously unimagined levels of virtual care uptake and accessibility. The transition to virtual care provided benefits for both patients and providers including a reduction in cost, time saved, and greater protection from infection. However, to date, the system in the Canadian province of Ontario has focussed on ‘replacing’ discrete in-person ‘moments’ of care with digital interactions such as phone and video visits. This design research study contributes to the health design community by incorporating a strategic futures approach to existing discussions surrounding virtual care. Collecting, analyzing and adding patient and primary care provider voices through this design research study provides new insights into virtual care experiential gaps and highlights opportunities for virtual care within primary care modalities. As a result of this new data, and through consultation with stakeholders, a roadmap for future virtual care possibilities in Ontario was developed answering noted needs of patients and providers by extending digital health interactions across a broader spectrum of synchronous and asynchronous care modalities and folding in an amalgam of digital, virtual, and in person connection for patient care experiences. [ FROM AUTHOR]

15.
Practice Nurse ; 52(8):25-30, 2022.
Article in English | CINAHL | ID: covidwho-2125118

ABSTRACT

The article focuses on digital delivery of care that underpins the national aims for Integrated Care Systems (ICSs). It mentions that ICSs improve population health;tackle unequal outcomes and access;and help the Great Britain National Health System (NHS) support broader social and economic development.

16.
Clin J Oncol Nurs ; 26(4): 333-334, 2022 07 25.
Article in English | MEDLINE | ID: covidwho-2123321

ABSTRACT

Exactly where are we in the practice of clinical oncology nursing, now indelibly altered by the COVID-19 pandemic? Depending on the day or hour, experts in clinical oncology care claim that clinical oncology practice has stab.


Subject(s)
COVID-19 , Humans , Medical Oncology , Oncology Nursing , Pandemics
17.
On - Line Journal of Nursing Informatics ; 26(2), 2022.
Article in English | ProQuest Central | ID: covidwho-2112156

ABSTRACT

Background: When the COVID-19 pandemic struck, primary care and specialist visits declined.  During the pandemic, Baltimore City Mobile Integrated Health (MIH) continued with targeted home visits among complex patients to help reduce hospital readmission rates. Many provider offices and specialists were closed for in-person clinic visits, creating disruption in continual care of chronic disease. To fill in gaps in care, MIH sought to facilitate these visits via telemedicine for their complex patient population. Methods: A retrospective chart review of MIH-enrolled patients was performed from March 2020 to August 2020. State health information exchange systems were also reviewed for hospital contact. To evaluate if the telemedicine visit was effective in reducing the readmission rate, the study compared the risk-adjusted readmission rate and chi square analysis of patients who received a telemedicine visit with their primary care/specialist as a part of their MIH visit versus MIH patients who did not. Results: From March 2020-August 2020, telemedicine was utilized 26 times for 14 patients to connect with their providers. The risk-adjusted readmission rate for MIH patients that received telemedicine primary care/specialist visits were 7.7%;the rate for MIH patients who did not was 16%.  Chi square analysis did not reveal statistical significance among the two groups. Conclusion: Flexible and innovative use of telemedicine technology improves team communication and can also be used to facilitate existing care relationships between underserved populations and their care providers. The University of Maryland Medical Center (UMMC) partnered with the Baltimore City Fire Department (BCFD) to form Mobile Integrated Health (MIH) in 2018. This partnership aims to support medically complex patients’ transition to home after hospital admissions. This innovative, community-based program supports the health of individuals through a comprehensive, multidisciplinary care model that provides patient care outside the hospital setting. The program is designed to reduce health disparities, decrease emergency department visits, and prevent hospital readmissions. One of the main objectives for this MIH program is to have patients connect with their primary care providers (PCPs) shortly after discharge so that the PCPs can continue to manage their chronic health conditions and medications and prevent readmission to the hospital. Prior to March 2020, none of the patients enrolled in UMMC-BCFD MIH utilized telemedicine for their medical visits (Mobile Integrated Health Community Paramedicine Program, 2020). During the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) issued guidance advising patients and health care providers to practice social distancing and encouraged the use of telehealth (Koonin et al., 2020). A study conducted by the Department of Veteran Affairs (VA) found that there was a 56% decrease in in-person outpatient visits during the COVID-19 pandemic (Baum, et al., 2021). However, the UMMC-BCFD MIH program remained in operation with no change in staffing or practice. With the need to connect patients with their PCPs, the UMMC-BCFD MIH program needed to pivot their normal operations to continue to meet the needs of the patients. A retrospective chart review was completed to evaluate the enrollment rate of visits facilitating PCP and/or specialist encounters and if in-person visits impacted hospital re-admission rates among this population. Prior to the pandemic, patients that were enrolled in the MIH program regularly saw their PCPs in-person from 40-80% of the time during their enrollment. However, when COVID restrictions began, those in-person visits decreased to about 20% of the enrolled patients seeing their PCPs. The MIH program was able to change its normal operation to connect patients to primary care providers and specialists via telemedicine to meet the needs of medically complex patients during a pandemic.

18.
On - Line Journal of Nursing Informatics ; 26(2), 2022.
Article in English | ProQuest Central | ID: covidwho-2112094

ABSTRACT

Background: During the COVID-19 surge and shutdown of New York City from March 2020 through May 2020, we transitioned to telemedicine to provide routine and urgent care to our pediatric heart transplant patients. The effectiveness of telemedicine in this population has not been described. Methods: A retrospective cohort study was conducted at the Children’s Hospital at Montefiore.  Electronic health records of all pediatric heart transplant patients who received care from January 3, 2020, to August 31, 2020 were queried. Data collected included frequency of telemedicine visits, in person, and emergency room visits, hospitalizations, immunosuppression levels requiring adjustment, and out-of-window patient follow-up. The proportion of immunosuppression levels out of range was compared among four identified groups by chi-square analysis. Results: During the shutdown period (March 13, 2020, to May 12, 2020) there were 54 telemedicine visits: 61% routine and 39% urgent. Five (24%) urgent telemedicine visits justified an in-person follow-up: three clinic visits, two ED visits, one patient hospitalized.  During the post-shutdown period 1 (May 13, 2020, to June 20, 2020) when in person visits resumed, nine patient visits were out of window for routine follow-up, with a median of six weeks delayed.  Immunosuppression levels were not therapeutic in 29% of patients in the pre-shutdown period (January 3, 2020, to March 18, 2020) compared to 46% during the post-shutdown period 1 (p=0.06). By post-shutdown period 2 (June 12, 2020, to August 31, 2020), out of range immunosuppression levels had returned to pre-shutdown out of range levels (25% of patients) with a p=0.6. The percent of immunosuppression levels out of range between post-shutdown period 1 and post-shutdown period 2 was statistically significant (p=0.04). Conclusion: Telemedicine can be utilized to stay connected to patients when routine in person care is disrupted.  The higher percentage of patients with immunosuppression levels out of range seen during post COVID-19 shutdown period 1 reinforces the importance of routine immunosuppression level surveillance.

19.
Asia Pacific Journal of Health Management ; 17(2), 2022.
Article in English | Web of Science | ID: covidwho-2111373

ABSTRACT

INTRODUCTION: Since the outbreak of the COVI D-19 pandemic in December 2019, public policy debate has been increasingly focusing on developing and implementing new disease prevention measures based on tracking of geographical location, in particular during the quarantine period. Limited studies have so far investigated possible public acceptance of such measures.METHODS: We analyzed a sample data of 1,000 respondents from the 2021 Korean Social Science Data Center using descriptive statistics and logistic regression modelling. The outcome variable was the binary variable measuring the public acceptance of COVID-19 related tracking devices for people subjected to quarantine, explanatory variable included socio-economic characteristics and subjective perception measures.RESULTS: The results suggest that subjective factors, such as perceived likelihood of virus contraction (OR=1.78) and severity of the disease (OR=2.21), rather than socio-economic factors, are key determinants of public acceptance of COVID-19 related location tracking technology. Elderly participants in the middle socio-economic class have shown the highest acceptance rate for tracking device implementationCONCLUSION: Although the use of location tracking devices has been increasing exponentially, there is still limited understanding in terms of public acceptance of such devices. The results of this study contribute to identifying such determinants, this contributing to policy design related to COVID-19 prevention.

20.
Acta Polytechnica Hungarica ; 19(9):179-199, 2022.
Article in English | Scopus | ID: covidwho-2110989

ABSTRACT

Digital health has accelerated, in part, due to the recent COVID-19 pandemic in terms of both implementation and acceptability. However, while digitalization in healthcare brings an opportunity to improve the quality of care, this creates a need for sustainability through funding of these technologies by healthcare payers. Traditional innovations such as pharmaceuticals are rigorously evaluated by health technology assessment (HTA) bodies in many countries to advise payers on how scarce funds can be efficiently distributed. The aim of this study was to review the HTA evidence frameworks being applied by HTA bodies or payers for the evaluation of digital health interventions. We reviewed recent literature and the websites of the leading payer and HTA bodies to understand the frameworks which have been used for the evaluation of digital health innovations. We found that 6 frameworks directly addressed digital health technologies for the purposes of pricing and reimbursement. Building on previous work, we reviewed the context and evidence domains of each framework. The evidence requirements of the included frameworks were diverse, and their domains extended the European Network for Health Technology Assessment (EUnetHTA) Core HTA Model. Our research concluded that while some frameworks exist, they require additional refinement to ensure that the level of evidence is commensurate with the technology being assessed and that relevant stakeholders are included to more holistically assess the outcomes produced. Developers of digital health technologies need to be aware of the evidence requirements by payers or HTA bodies, which differ from HTA requirements for traditional health technologies and may represent additional hurdle before entering publicly financed healthcare markets. © 2022, Budapest Tech Polytechnical Institution. All rights reserved.

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