Tele-transitions of care (TTOC): a 12-month, randomized controlled trial evaluating the use of Telehealth to achieve triple aim objectives

Noel, Kimberly; Messina, Catherine R.; Hou, Wei; Schoenfeld, Elinor; Kelly, Gerald

doi:10.1186/s12875-020-1094-5

Cited by 24 publications

(27 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies also ranged in disciplinary perspective. Six of the studies were conducted by nursing ( Bull et al, 2000 ; Chen et al, 2018 ; Jangland et al, 2012 ; Lenaghan, 2019 ; Schmaderer et al, 2016 ; Ulin et al, 2016 ), followed by four by medicine ( Coleman et al, 2004 ; Epstein-Lubow et al, 2014 ; Kvale et al, 2016 ; Noel et al, 2020 ) and the remaining two were implemented by occupational and physical therapy ( Arnetz et al, 2010 ; Smith & Fields, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…The theoretical framework differed between studies. The four studies contributed by the discipline of medicine were grounded in a medical transitional care perspective known as the Care-transition Initiative (CTI) ( Coleman et al, 2004 ; Epstein-Lubow et al, 2014 ; Kvale et al., 2016 ; Noel et al, 2020 ). This conceptual framework, derived from patient and caregiver feedback of factors considered most valuable during times of care-transition, is composed of four transitional care pillars designed to mitigate quality and safety care-transition risks and support active and independent participation in care-transitions.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies examining interventions intended to partner the healthcare professional and patient in a mutual, agreed-upon goal setting and coaching session, were implemented by nurses and limited to the pre-discharge time period ( Bull et al, 2000 ; Chen et al., 2018 ; Coleman et al, 2004 ; Jangland et al, 2012 ; Lenaghan, 2019 ). Coleman et al (2004) , Lenaghan (2019) and Chen et al (2018) implemented programs that expanded care settings and two programs were solely focused on the time period following hospital discharge with interventions delivered by physicians and occupational and physical therapists ( Noel et al, 2020 ; Smith & Fields, 2020 ). Finally, the study by Kvale et al (2016) was conducted in the ambulatory setting by a Master's degree-prepared mental health professional.…”

Section: Resultsmentioning

confidence: 99%

“…Patient and healthcare team partnerships in individualized transition planning led to higher perceived health, satisfaction with planning, and a greater feeling of preparedness. Ulin et al (2016) determined early discharge planning and communication between the hospital and community healthcare team members resulted in shorter hospital stays, while Noel et al (2020) found statistically significant greater medication adherence and positive feedback for those participatory in a telehealth care-transitions program. In the study by Arnetz et al (2010) , an inverse relationship between patient ratings of planning inclusion and goal achievement was identified.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Perceived Self-Efficacy, Confidence, and Skill Among Factors of Adult Patient Participation in Transitional Care: A Systematic Review of Quantitative Studies

2022

View full text Add to dashboard Cite

Introduction An advancing healthcare system in which patients are often required to self-manage care needs across countless settings and clinicians is increasing focus on participation in care. Mismanagement of care during already risky care-transitions further increases adverse care outcomes. Understanding factors of patient participation in transitional care in an adult population can help guide ways to reduce this burden. Methods A systematic review of the literature guided by the PRISMA method was conducted to identify factors of patient participation in transitional care. Quantitative studies in which patient participation was measured as an outcome variable and related statistics reported, and data were collected from an adult sample, were included. Two authors independently reviewed, critiqued, and synthesized the articles, and later categorized study variables according to identified trends. Results Twelve studies across international and multidisciplinary backgrounds were identified. Across studies, efforts were largely based on understanding or improving patient self-management of care during transitions. The majority of studies were experimental and care interventions grounded in patient and healthcare team partnerships, delivered beyond the hospital setting. An array of measures was used to quantify patient participation. Factors of patient participation in transitional care included higher perceived levels of self-efficacy, confidence, and skills to participate in care. Conclusion The results of this study suggest patient participation in transitional care is largely based on perceptions of self-efficacy, confidence, and skill. Patient-centric transitional care interventions targeting these factors and delivered beyond the hospital setting may improve care outcomes. Implications and direction for further studies includes conceptual clarity, the study of a broader-reaching patient population demographic, and use of multidisciplinary interventions. Outcome variables should remain focused on patient perception of care involvement and participation and expanded to include variables such as functional abilities and social determinants of health.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Perceived Self-Efficacy, Confidence, and Skill Among Factors of Adult Patient Participation in Transitional Care: A Systematic Review of Quantitative Studies

2022

View full text Add to dashboard Cite

show abstract

“…Family Medicine could also greatly bene t from exploring provision of a gap service such as tele-transitions of care, an approach to reduce 30-day readmission by incorporating telehealth technologies into patient care, and targeting patients most at risk for readmission. [57] Implications for widespread sustainability in telehealth use in a post-pandemic era This review indicates that lack of telehealth training, lack of reimbursement, orientation to gatekeeper role and resistance to changing the doctor-patient relationship, could all hinder telehealth adoption at the provider (micro) level. Specialty and hospital organizations could play a proactive and organized role in addressing each of these barriers, by advocating for consistent payment policies from payers; providing guidelines for telehealth use; training providers on how to design & implement a successful telemedicine infrastructure; advocating for telehealth training in the medical residency curriculum; and engaging patients in telehealth through outreach and education.…”

Section: Strategies For Reducing Variation In Telehealth Use Across Mmentioning

confidence: 99%

Specialty-level Factors Historically Influencing Telehealth Use Can Provide Implications for Sustainability in a Post-Pandemic Era: A Systematic Review and Narrative Synthesis

Rangachari

Mushiana

Herbert

2021

Preprint

View full text Add to dashboard Cite

Background: Recent studies in the US have found wide variation in telehealth use across medical specialties (e.g., 6.1% in Allergy-Immunology vs. 24.1% in Cardiology). This is a problem-of-interest, because the US lacks a standardized set of telehealth reimbursement policies, which in turn has hindered telehealth use across all specialties. Despite these policy-level constraints experienced by all specialties, some have normalized telehealth use to mainstream practice, while others are just getting started during the pandemic. Despite accelerated telehealth use during COVID-19 through removal of federal coverage restrictions, uncertainties remain regarding future sustainability. This paper conducts a systematic review to identify “specialty-level factors” historically influencing telehealth use, with a view to identifying implications for widespread sustainability in the post-pandemic era.Methods: We conducted a systematic review and narrative synthesis to examine factors historically influencing telehealth use across six medical specialties in the US, including three “lower-using” specialties (Allergy-Immunology, Gastroenterology, Family Medicine) and three “higher-using” specialties (Cardiology, Psychiatry, Radiology). The “macro-meso-micro” framework was used to guide the review. Article searches were conducted on PubMed. The PRISMA checklist was used to guide reporting of literature reviewed. Three reviewers worked to develop a preliminary synthesis, identify eligibility criteria, explore themes in the data, and assess robustness of final synthesis.Results: Fifty-three articles were reviewed across six medical specialties. The review identified 12 factors across 3 layers, including: 1) macro-layer (policy-level, legal, other-structural), 2) meso-layer (specialty-level historical telehealth rationale, hospital-organizational, specialty-society, treatment, technological, research, cultural) and 3) micro-layer (individual-level provider-and-patient-specific) factors. A key finding was that among “higher-using” medical specialties, the specialty societies and hospital organizations in the meso-layer, proactively promoted telehealth use by influencing both macro- and micro-layer factors (e.g., advocating for consistent payment policies and enabling provider practices to be more tech-savvy & patient-centric, respectively).Conclusion: By identifying a comprehensive set of contextual, individual (and interaction) factors influencing telehealth use across six medical specialties, this review addresses a gap and provides a foundation for future research. Importantly, it identifies: 1) strategies for reducing variation in telehealth use across medical specialties, and 2) implications for ensuring widespread sustainability in the post-pandemic era.

show abstract

Implications for Telehealth in a Postpandemic Future

Shachar¹,

Engel

Elwyn

2020

JAMA

287

244

View full text Add to dashboard Cite

The coronavirus disease 2019 pandemic has required health care systems to radically and rapidly rethink the delivery of care. One of the most remarkable ongoing changes has been the unprecedented accelerated expansion of telehealth. The pandemic may provide the incentive needed to realize the potential of telehealth. Nevertheless, concerns remain that safety and privacy may be compromised by rapid deregulation, despite data, although limited, regarding good overall quality. 1 In studies conducted before the COVID-19 pandemic, patients reported high levels of satisfaction. 2 This Viewpoint describes some of the most important telehealth regulatory changes that have occurred in response to COVID-19 and discusses some of the opportunities and challenges inherent in successfully harnessing the unexpected expanded role recently given to telehealth in the US.

show abstract

Tele-transitions of care (TTOC): a 12-month, randomized controlled trial evaluating the use of Telehealth to achieve triple aim objectives

Cited by 24 publications

References 27 publications

Perceived Self-Efficacy, Confidence, and Skill Among Factors of Adult Patient Participation in Transitional Care: A Systematic Review of Quantitative Studies

Perceived Self-Efficacy, Confidence, and Skill Among Factors of Adult Patient Participation in Transitional Care: A Systematic Review of Quantitative Studies

Specialty-level Factors Historically Influencing Telehealth Use Can Provide Implications for Sustainability in a Post-Pandemic Era: A Systematic Review and Narrative Synthesis

Implications for Telehealth in a Postpandemic Future

Contact Info

Product

Resources

About