Mobile Self-Operated Home Ultrasound System for Remote Fetal Assessment During Pregnancy

Hadar, Eran; Wolff, Leor; Tenenbaum-Gavish, Kinneret; Eisner, Michal; Shmueli, Anat; Barbash‐Hazan, Shiri; Bergel, Riki; Shmuel, Elyasaf; Houri, Ohad; Dollinger, Sarah; Brzezinski-Sinai, Noa A; Sukenik, Shay; Pardo, Anat; Navon, Inbal; Wilk, Yulia; Zafrir-Danieli, Hadas; Wiznitzer, Arnon

doi:10.1089/tmj.2020.0541

Cited by 13 publications

(21 citation statements)

References 18 publications

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“…However, it is critical to bear in mind that delivering medical documents raises ethical and legal issues, such as whether to rely on a patient’s online history and whether to renew a prescription without examining the patient [ 60 , 61 ]. Telebiometry-based consultation is used in Israel much more than in other countries, perhaps as it is a service delivered in the framework of the HMOs, which have the required technical infrastructure [ 62 , 63 ]. Triggers for using telemedicine include being close to people who have used it, the need to feel safe by reducing the number of physical contacts, and the perception that it saves time by reducing unnecessary visits to the provider.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Reasons for Utilizing Telemedicine during and after the COVID-19 Pandemic: An Internet-Based International Study

Benis

Banker

Pinkasovich

et al. 2021

JCM

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The COVID-19 pandemic challenges healthcare services. Concomitantly, this pandemic had a stimulating effect on technological expansions related to telehealth and telemedicine. We sought to elucidate the principal patients’ reasons for using telemedicine during the COVID-19 pandemic and the propensity to use it thereafter. Our primary objective was to identify the reasons of the survey participants’ disparate attitudes toward the use of telemedicine. We performed an online, multilingual 30-question survey for 14 days during March–April 2021, focusing on the perception and usage of telemedicine and their intent to use it after the pandemic. We analyzed the data to identify the attributes influencing the intent to use telemedicine and built decision trees to highlight the most important related variables. We examined 473 answers: 272 from Israel, 87 from Uruguay, and 114 worldwide. Most participants were women (64.6%), married (63.8%) with 1–2 children (52.9%), and living in urban areas (84.6%). Only a third of the participants intended to continue using telemedicine after the COVID-19 pandemic. Our main findings are that an expected substitution effect, technical proficiency, reduced queueing times, and peer experience are the four major factors in the overall adoption of telemedicine. Specifically, (1) for most participants, the major factor influencing their telemedicine usage is the implicit expectation that such a visit will be a full substitute for an in-person appointment; (2) another factor affecting telemedicine usage by patients is their overall technical proficiency and comfort level in the use of common web-based tools, such as social media, while seeking relevant medical information; (3) time saving as telemedicine can allow for asynchronous communications, thereby reducing physical travel and queuing times at the clinic; and finally (4) some participants have also indicated that telemedicine seems more attractive to them after watching family and friends (peer experience) use it successfully.

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Section: Discussionmentioning

confidence: 99%

“…Telebiometry-based consultation is used in Israel much more than in other countries, perhaps as it is a service delivered in the framework of the HMOs, which have the required technical infrastructure [ 62 , 63 ].…”

Section: Discussionmentioning

confidence: 99%

Reasons for Utilizing Telemedicine during and after the COVID-19 Pandemic: An Internet-Based International Study

Benis

Banker

Pinkasovich

et al. 2021

JCM

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“…Mhajna et al found that remote fetal heart monitoring is achievable 14 . Hadar et al added that hand‐held self‐operated US assessment is feasible 20 . Our novelty lies in the integration and application of these technologies to establish fetal well‐being assessment based on the mBPP.…”

Section: Discussionmentioning

confidence: 99%

“…Seminal studies established feasibility and utility of each technology independently and set the stage for a paradigm shift towards remote maternal-fetal assessment. [14][15][16][17][18][19][20] However, the combination of the fetal nonstress test heart monitoring and US amniotic fluid evaluation scored by the modified biophysical profile (mBPP) achieve a better detection rate for fetal acidemia than either of the technologies apart. [21][22][23][24][25][26] In most centers, maternal-fetal surveillance requires that the patients physically arrive at the unit and spend up to several hours waiting between tests.…”

Section: Introductionmentioning

confidence: 99%

Integrating technologies to provide comprehensive remote fetal surveillance: A prospective pilot study

Nir,

Dvir,

Galler

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo determine the feasibility of extending remote maternal‐fetal care to include fetus well‐being.MethodsThe authors performed a prospective pilot study investigating low‐risk pregnant participants who were recruited at the time of their first full‐term in‐person visit and scheduled for a follow‐up telemedicine visit. Using novel self‐operated fetal monitoring and ultrasound devices, fetal heart monitoring and amniotic fluid volume measurements were obtained to complete a modified biophysical profile (mBPP). Total visit length was measured for both the in‐person first visit and the subsequent telemedicine encounter. A patient satisfaction survey form was obtained.ResultsTen women between 40 + 1 and 40 + 6 weeks of gestation participated in telemedicine encounters. Nine women (90%) were able to complete remote mBPP assessment. For one participant, fetal assessment was not completed due to technically inconclusive fetal monitoring. Another participant was referred for additional assessment in the delivery room. Satisfactory amniotic fluid volume measurements were achieved in 100% of participants. The telemedicine encounter was significantly shorter (93.1 ± 33.1 min) than the in‐person visit (247.2 ± 104.7 min; P < 0.001). We observed high patient satisfaction.ConclusionRemote fetal well‐being assessment is feasible and time‐saving and results in high patient satisfaction. This novel paradigm of comprehensive remote maternal and fetal assessment is associated with important clinical, socioeconomic, and logistics advantages.

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“…Hader reported that among 100 women, there was 95.3% success for detecting fetal heart activity, 88.3% for body movements, and 92% for normal amniotic fluid volume, although only 23% success in detecting fetal breathing. They concluded the system was a potential solution for remote sonographic fetal assessment although further study was required [ 56 ].…”

Section: Self-performed Home Obstetrical Ultrasoundmentioning

confidence: 99%

Patient Self-Performed Point-of-Care Ultrasound: Using Communication Technologies to Empower Patient Self-Care

Kirkpatrick

McKee²,

Couperus³

et al. 2022

Diagnostics

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Point-of-Care ultrasound (POCUS) is an invaluable tool permitting the understanding of critical physiologic and anatomic details wherever and whenever a patient has a medical need. Thus the application of POCUS has dramatically expanded beyond hospitals to become a portable user-friendly technology in a variety of prehospital settings. Traditional thinking holds that a trained user is required to obtain images, greatly handicapping the scale of potential improvements in individual health assessments. However, as the interpretation of ultrasound images can be accomplished remotely by experts, the paradigm wherein experts guide novices to obtain meaningful images that facilitate remote care is being embraced worldwide. The ultimate extension of this concept is for experts to guide patients to image themselves, enabling secondary disease prevention, home-focused care, and self-empowerment of the individual to manage their own health. This paradigm of remotely telementored self-performed ultrasound (RTMSPUS) was first described for supporting health care on the International Space Station. The TeleMentored Ultrasound Supported Medical Interventions (TMUSMI) Research Group has been investigating the utility of this paradigm for terrestrial use. The technique has particular attractiveness in enabling surveillance of lung health during pandemic scenarios. However, the paradigm has tremendous potential to empower and support nearly any medical question poised in a conscious individual with internet connectivity able to follow the directions of a remote expert. Further studies and development are recommended in all areas of acute and chronic health care.

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Mobile Self-Operated Home Ultrasound System for Remote Fetal Assessment During Pregnancy

Cited by 13 publications

References 18 publications

Reasons for Utilizing Telemedicine during and after the COVID-19 Pandemic: An Internet-Based International Study

Reasons for Utilizing Telemedicine during and after the COVID-19 Pandemic: An Internet-Based International Study

Integrating technologies to provide comprehensive remote fetal surveillance: A prospective pilot study

Patient Self-Performed Point-of-Care Ultrasound: Using Communication Technologies to Empower Patient Self-Care

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