Subject(s)
Burns/therapy , Practice Guidelines as Topic/standards , Telemedicine/organization & administration , Burns/diagnosis , Communication , Computer Security/standards , Confidentiality/standards , Humans , Medical History Taking/standards , Telemedicine/standards , United States , Videoconferencing/standardsABSTRACT
The purpose of this study was to determine whether a telecommunications diabetes self-management (DSM) intervention would improve health-related outcomes among frontier participants with diabetes. A one-group pre-test/post-test quasi-experimental design with two groups of participants was used. Differences between pre and post-test periods on measures of physical and emotional health, knowledge of diabetes, and self-care behaviors were measured. Overall, participants did better along measures of blood pressure, HbA(1c), self-efficacy, knowledge of diabetes, understanding of DSM, monitoring behaviors, and reported less personal and social disruption from diabetes. Six-month follow-up results showed continued positive outcomes.
Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/administration & dosage , Self Care/standards , Telecommunications/organization & administration , Adaptation, Psychological , Adult , Aged , Attitude to Health , Blood Glucose Self-Monitoring/methods , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/psychology , Female , Humans , Male , Middle Aged , Patient Compliance/statistics & numerical data , Patient Education as Topic , Program Evaluation , Risk Assessment , Self Care/trends , Self Efficacy , Severity of Illness Index , Treatment Outcome , Young AdultABSTRACT
The home telehealth market is rapidly expanding. The technology and capabilities currently available have the potential to significantly affect the clinical management of an aging population, particularly, the large number with multiple coexisting disease processes. Potential benefits of home-monitoring systems for patients with heart failure range from decreased rates of mortality and improved quality of life to providing third party payers, including the federal government (ie, Centers for Medicare and Medicaid Services), with significant long-term cost savings. The current regulatory process does not provide adequate oversight and standards for these systems that transmit and process data (telehealth systems) critical for patient management. Home telehealth vendors must address the possibility that increased utilization increases their risk of liability due to patient safety issues. In all, 5 major areas need to be addressed to maximize the benefits and safety of this technology: effectiveness of patient management; evidence-based outcomes; regulation; cost, including cost effectiveness and reimbursement; and certification to ensure reliability.
Subject(s)
Chronic Disease/therapy , Home Care Services/standards , Quality of Health Care/standards , Telemedicine/standards , Equipment Safety , Heart Failure/therapy , Home Care Services/organization & administration , Humans , Monitoring, Physiologic/instrumentation , Quality of Health Care/organization & administration , Reimbursement Mechanisms , Telemedicine/organization & administration , United States , United States Food and Drug AdministrationABSTRACT
The purpose of this evaluation study was to learn more about psychiatrists' satisfaction with telepsychiatry. Telepsychiatry will succeed only if psychiatrists are satisfied with this service delivery method and offer it to their patients. While telepsychiatry appears to be effective and most patients report that they are satisfied with it, less information is available about factors that lead to psychiatrists' satisfaction. We interviewed psychiatrists who treat rural/frontier patients and asked them to describe factors that encouraged or discouraged their use of telepsychiatry. Only 4 were mostly satisfied with telepsychiatry and all offered suggestions for improving this delivery method. Most agreed that it was a hardship for many of their patients to travel 100 to 750 roundtrip miles over a 1-3 day period for a 20-minute consultation and that telepsychiatry could be a lifeline to many of them. Nevertheless, they identified significant technical and interpersonal barriers that discouraged their use of telepsychiatry.
