Delivering telemedicine interventions in chronic respiratory disease

Hernández, Carme; Mallow, Jennifer; Narsavage, Georgia L.

doi:10.1183/20734735.008314

Cited by 30 publications

(19 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There were no sex differences in these percentages, but older people and those with more health problems were more likely to see a known provider. These appear to be positive trends from a patient care standpoint, consistent with monitoring of chronic conditions [33] and provision of patient-centered care [34]. Not seeing a known provider may reflect a desire for convenience over continuity [35], but may also indicate (at least in some cases) a specific preference for a new provider, such as for questions or care (eg, contraception) that patients wish to keep from their regular providers.…”

Section: Discussionmentioning

confidence: 90%

Virtual Visits and Patient-Centered Care: Results of a Patient Survey and Observational Study

2017

View full text Add to dashboard Cite

BackgroundVirtual visits are clinical interactions in health care that do not involve the patient and provider being in the same room at the same time. The use of virtual visits is growing rapidly in health care. Some health systems are integrating virtual visits into primary care as a complement to existing modes of care, in part reflecting a growing focus on patient-centered care. There is, however, limited empirical evidence about how patients view this new form of care and how it affects overall health system use.ObjectiveDescriptive objectives were to assess users and providers of virtual visits, including the reasons patients give for use. The analytic objective was to assess empirically the influence of virtual visits on overall primary care use and costs, including whether virtual care is with a known or a new primary care physician.MethodsThe study took place in British Columbia, Canada, where virtual visits have been publicly funded since October 2012. A survey of patients who used virtual visits and an observational study of users and nonusers of virtual visits were conducted. Comparison groups included two groups: (1) all other BC residents, and (2) a group matched (3:1) to the cohort. The first virtual visit was used as the intervention and the main outcome measures were total primary care visits and costs.ResultsDuring 2013-2014, there were 7286 virtual visit encounters, involving 5441 patients and 144 physicians. Younger patients and physicians were more likely to use and provide virtual visits (P<.001), with no differences by sex. Older and sicker patients were more likely to see a known provider, whereas the lowest socioeconomic groups were the least likely (P<.001). The survey of 399 virtual visit patients indicated that virtual visits were liked by patients, with 372 (93.2%) of respondents saying their virtual visit was of high quality and 364 (91.2%) reporting their virtual visit was “very” or “somewhat” helpful to resolve their health issue. Segmented regression analysis and the corresponding regression parameter estimates suggested virtual visits appear to have the potential to decrease primary care costs by approximately Can $4 per quarter (Can –$3.79, P=.12), but that benefit is most associated with seeing a known provider (Can –$8.68, P<.001).ConclusionsVirtual visits may be one means of making the health system more patient-centered, but careful attention needs to be paid to how these services are integrated into existing health care delivery systems.

show abstract

Section: Discussionmentioning

confidence: 90%

Virtual Visits and Patient-Centered Care: Results of a Patient Survey and Observational Study

2017

View full text Add to dashboard Cite

show abstract

“…To make the best use of this communications network, it should be possible to take diagnostic medicine to the most rural and isolated regions, provided that simple but robust sensors could be developed to measure the appropriate physiological functions. Delivering healthcare to populations with limited access to care is one of the most advantageous aspects of telemedicine [6]. To achieve this, raw physiological data captured by staff with little or no medical training could be transmitted back to clinics for processing, allowing fast diagnosis by the district nurse or doctor there.…”

Section: Using the Cellphone Networkmentioning

confidence: 99%

A Telespirometer for the Developing World

Brooker

2020

Electronics

View full text Add to dashboard Cite

There are numerous examples in which the introduction of expensive medical equipment into the developing world fail for lack of a basic understanding of the device operation, lack of spare parts and poor maintenance. This paper describes the development of a Fleisch pneumotachograph and cellphone based telespirometer that can easily be built from “junk box” medical and electronic components available in the developing world. This approach should introduce a sense of local ownership to the project as well as encouraging participation by the local electronics repair industry. Experimental results confirm that the forced expiratory flow data are reliably modulated onto an audio signal and transmitted by cellphone to a base station for examination by a district nurse or doctor. Flow measurement and data transmission accuracies are sufficiently good for remote diagnoses of chronic obstructive pulmonary disease.

show abstract

“…Despite its feasibility, the adoption of telehealth during the pandemic has witnessed several challenges. The HCT, as well as the patients or caregivers, are mostly unfamiliar with the technology and the relevant communication interface [10]. In addition, not all members of the HCT had received adequate training to achieve proper competency, especially in dealing with unexpected emergencies.…”

Section: @Erspublicationsmentioning

confidence: 99%