Background: As an ever-growing popular service, telehealth catered for better access to high-quality healthcare services. It is more valuable and cost-effective, particularly in the middle of the current COVID-19 pandemic. Accordingly, this study aimed to systematically review the features and challenges of telehealth-based services developed to support COVID-19 patients and healthcare providers.Methods: A comprehensive search was done for the English language and peer-reviewed articles published until November 2020 using PubMed and Scopus electronic databases. In this review paper, only studies focusing on the telehealth-based service to support COVID-19 patients and healthcare providers were included. The first author's name, publication year, country of the research, study objectives, outcomes, function type including screening, triage, prevention, diagnosis, treatment or follow-up, target population, media, communication type, guideline-based design, main findings, and challenges were extracted, classified, and tabulated.Results: Of the 5,005 studies identified initially, 64 met the eligibility criteria. The studies came from 18 countries. Most of them were conducted in the United States and China. Phone calls, mobile applications, videoconferencing or video calls, emails, websites, text messages, mixed-reality, and teleradiology software were used as the media for communication. The majority of studies used a synchronous communication. The articles addressed the prevention, screening, triage, diagnosis, treatment, and follow-up aspects of COVID-19 which the most common purpose was the patients' follow-up (34/64, 53%). Thirteen group barriers were identified in the literature, which technology acceptance and user adoption, concerns about the adequacy and accuracy of subjective patient assessment, and technical issues were the most frequent ones.Conclusion: This review revealed the usefulness of telehealth-based services during the COVID-19 outbreak and beyond. The features and challenges identified through the literature can be helpful for a better understanding of current telehealth approaches and pointed out the need for clear guidelines, scientific evidence, and innovative policies to implement successful telehealth projects.
Background Continues positive airway pressure (CPAP) therapy is a gold standard treatment for moderate to severe cases of OSA (obstructive sleep apnea). The present research aimed to describe the analysis, design, and evaluation of a telemonitoring system to improve CPAP adherence in patients afflicted with OSA. Methods The telemonitoring system was developed in five phases. In the exploratory phase, the body of related literature was reviewed. Then a need analysis was conducted through a focus group discussion with sleep medicine specialists and sales company representatives and an interview with patients. The third phase involved data integration. Then the content and system development were done based on the previous phases. Finally, usability and functionality tests were used to evaluate the system. Results The exploratory phase and the needs analysis were conducted by four sleep medicine specialists, two medical informatics specialists, six key figures of the sales companies, two system developers, and 46 patients in different phases. Based on the results obtained from the data integration phase, the telemonitoring system involved three main parts: a patient’s application, a doctor’s portal, a selling companies’ portal (operator’s portal) along with facilitating software for patients to send the CPAP data. Usability and functionality tests were given to 7 and 10 patients, respectively. The total number of usability issues reported by users in the evaluation process was 18, with an average of 2.5 issues per user. The installation problems, disrupted links and improper playing of videos were the main functionalities problems that were solved. Conclusion The telemonitoring system, as a means of communication between patients, doctors, and selling companies, can be used to support patients clinically and technically. It has the potential to improve CPAP adherence in patients with OSA.
The process of storage and transportation of the red blood cells (RBCs) out of the standard temperature range lead to some biochemical reactions. Infusing inappropriately stored RBCs may cause severe complications. The main objective of this study was to investigate the RBC bags' temperature during the transfusion chain including storage, transportation, and transfusion. A crosssectional study was performed on 100 RBC bags that were sent from the blood bank to the cardiac surgical intensive care unit (CSICU) and the operating room (OR). To record the temperature of RBCs, a temperature monitoring device was attached to each bag of RBCs that were transported from the blood bank to the CSICU and the OR. The stored temperature samples in the devices related to different stages were separated. Finally, the normal and non-normal samples of each phase were segregated based on the current guidelines. The results indicated that 10% of 121,262 recorded temperatures samples (per 2 min) were out of the standard range. Of these, 65, 17, 13, and 5% of samples were related to the blood bank, the OR, transportation, and the CSICU, respectively. The minimum and maximum temperatures were 0°C and 19.5°C that were below and above the standard, respectively. In the light of findings of the present study, different stages of blood transportation and storage suffer a number of shortcomings, which are more evident in the blood bank. Thus, it is recommended to better manage blood transfusion chain from the blood bank to hospital wards so as to avoid the inadvertent and undesirable consequences of blood transfusion. Because various judgments made by the personnel about the status of blood bags are subjective, a temperature monitoring device can be employed to better monitor the blood transfusion process and compensate for the errors unnoticed by the personnel.
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