Digital health &amp; low-value care

O’Reilly-Jacob, Monica; Mohr, Penny; Ellen, Moriah; Petersen, Carolyn; Sarkisian, Catherine A.; Attipoe, Sharon; Rich, Eugene C.

doi:10.1016/j.hjdsi.2021.100533

Cited by 17 publications

(10 citation statements)

References 57 publications

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“…This type of research will ensure all stakeholders play a role in identifying possible solutions to the different socioecological determinants of health levels. Concerns about low-value care 39 warrant investigation of most appropriate indications and use of telemedicine, incorporating patient and provider preference into its clinical utility. Additionally, prioritizing barriers, such as technologic literacy versus broadband access, transportation to a local public health center versus a local library, etc.…”

Section: Discussionmentioning

confidence: 99%

Inequity in Telemedicine Use Among Patients with Cancer in the Deep South During the COVID-19 Pandemic

et al. 2022

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Background Telemedicine use has increased significantly during the COVID-19 pandemic. It remains unclear if its rapid growth exacerbates disparities in healthcare access. We aimed to characterize telemedicine use among a large oncology population in the Deep South during the COVID-19 pandemic. Materials and Methods A retrospective cohort study was performed at the only National Cancer Institute designated-cancer center in Alabama March 2020 to December 2020. With a diverse (26.5% Black, 61% rural) population, this southeastern demographic uniquely reflects historically vulnerable populations. All non-procedural visits at the cancer center from March to December 2020 were included in this study excluding those with a department that had fewer than 100 visits during this time period. Patient and clinic level characteristics were analyzed using t-test and Chi-square to compare characteristics between visit types (in-person versus telemedicine, and video versus audio within telemedicine). Generalized estimating equations were used to identify independent factors associated with telemedicine use and type of telemedicine use. Results There were 50 519 visits and most were in-person (81.3%). Among telemedicine visits, most were phone based (58.3%). Black race and male sex predicted in-person visits. Telemedicine visits were less likely to have video among patients who were Black, older, male, publicly insured, and from lower income areas. Conclusions Telemedicine use, specifically with video, is significantly lower among historically vulnerable populations. Understanding barriers to telemedicine use and preferred modalities of communication among different populations will help inform insurance reimbursement and interventions at different socioecological levels to ensure the continued evolution of telemedicine is equitable.

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Section: Discussionmentioning

confidence: 99%

Inequity in Telemedicine Use Among Patients with Cancer in the Deep South During the COVID-19 Pandemic

et al. 2022

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“…[7][8][9] It remains unknown how this shift affected the quality of care delivered to adults. 10 High-value care, or care that is likely to benefit a patient, and low-value care, or care that is considered either inappropriate or of little to no benefit, may have been influenced. Prior work has demonstrated that Americans receive about half the high-value care they should and receive significant care that is wasteful and of low-value, leading to morbidity, mortality, and cost.…”

Section: Introductionmentioning

confidence: 99%

The Association of the First Surge of the COVID-19 Pandemic with the High- and Low-Value Outpatient Care Delivered to Adults in the USA

et al. 2022

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Background The first surge of the COVID-19 pandemic entirely altered healthcare delivery. Whether this also altered the receipt of high- and low-value care is unknown. Objective To test the association between the April through June 2020 surge of COVID-19 and various high- and low-value care measures to determine how the delivery of care changed. Design Difference in differences analysis, examining the difference in quality measures between the April through June 2020 surge quarter and the January through March 2020 quarter with the same 2 quarters’ difference the year prior. Participants Adults in the MarketScan® Commercial Database and Medicare Supplemental Database. Main Measures Fifteen low-value and 16 high-value quality measures aggregated into 8 clinical quality composites (4 of these low-value). Key Results We analyzed 9,352,569 adults. Mean age was 44 years (SD, 15.03), 52% were female, and 75% were employed. Receipt of nearly every type of low-value care decreased during the surge. For example, low-value cancer screening decreased 0.86% (95% CI, −1.03 to −0.69). Use of opioid medications for back and neck pain (DiD +0.94 [95% CI, +0.82 to +1.07]) and use of opioid medications for headache (DiD +0.38 [95% CI, 0.07 to 0.69]) were the only two measures to increase. Nearly all high-value care measures also decreased. For example, high-value diabetes care decreased 9.75% (95% CI, −10.79 to −8.71). Conclusions The first COVID-19 surge was associated with receipt of less low-value care and substantially less high-value care for most measures, with the notable exception of increases in low-value opioid use. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-022-07757-1.

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“…The Covid-19 epidemic we are in today also shows us that the high level of digitalization and technologies used in health carries health services forward. This issue is particularly important due to the rapid proliferation of digital health technologies to support healthcare as well as public health during the Covid-19 pandemic (O;reilly-Jacob et. al., 2021).…”

Section: Resultsmentioning

confidence: 99%

Endüstri̇ 4.0 Etki̇si̇ İle Covi̇d 19 Pandemi̇si̇'nde Sağlik Sektöründe Di̇ji̇tal Dönüşümün Yansimalari

ZENGİN

Yontar

2022

Tarsus Üniversitesi İktisadi Ve İdari Bilimler Fakültesi Dergisi

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In the abstract, the scope, purpose, method and result of the study should be given briefly. With the influence of Industry 4.0, the whole world and our country are in a digital transformation process. With the effect of the Covid-19 pandemic process we are in, digitalization in health is developing rapidly and is of great importance. In this study, the four main topics of digital transformation in the field of digital health, telemedicine, e-Health, m- Health, algorithmic medicine, e-pulse and the latest developments in this field are discussed. The developments in health with the effect of Industry 4.0, artificial intelligence applications in the health sector are given and the aims of the study are presented. Studies on the subject between the years 2019-2021 are examined. With the fact that only 2% of the studies examined are literature studies and the acceleration of digitalization in health with the effect of the Covid- 19 pandemic process we are in, the need for a literature study of current studies has emerged. In the literature study; studies including current application examples are included and the current status of digitalization in health is given. The rapid development and importance of digitalization in health, also with the effect of Covid-19 is emphasized.

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Digital health & low-value care

Cited by 17 publications

References 57 publications

Inequity in Telemedicine Use Among Patients with Cancer in the Deep South During the COVID-19 Pandemic

Inequity in Telemedicine Use Among Patients with Cancer in the Deep South During the COVID-19 Pandemic

The Association of the First Surge of the COVID-19 Pandemic with the High- and Low-Value Outpatient Care Delivered to Adults in the USA

Endüstri̇ 4.0 Etki̇si̇ İle Covi̇d 19 Pandemi̇si̇'nde Sağlik Sektöründe Di̇ji̇tal Dönüşümün Yansimalari

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