TeleHealth or TeleWealth? Equity challenges for the future of cystic fibrosis care (Commentary)

Franciosi, Alessandro N; Quon, Bradley S.

doi:10.1016/j.jcf.2021.08.025

Cited by 8 publications

(7 citation statements)

References 15 publications

(12 reference statements)

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“…Moreover, individual CF centres have detailed the changing practices, acceptance and challenges of integrating telehealth into clinics, 13,14 and therefore, it should be acknowledged that the adoption of telehealth services within CF will also be associated with numerous financial, ethical and local and national regulatory challenges. For example, equity of access to sufficient internet services and technology (e.g., computers and smartphones), patient access to home monitoring devices (e.g., spirometers), clinician access to patients (i.e., for physical examination and collection of sputum and blood samples) and compliance with digital regulations (e.g., generation, transfer and storage of data) will all pose logistical challenges for patients and clinical teams alike to overcome 15–17 …”

Section: Discussionmentioning

confidence: 99%

“…For example, equity of access to sufficient internet services and technology (e.g., computers and smartphones), patient access to home monitoring devices (e.g., spirometers), clinician access to patients (i.e., for physical examination and collection of sputum and blood samples) and compliance with digital regulations (e.g., generation, transfer and storage of data) will all pose logistical challenges for patients and clinical teams alike to overcome. [15][16][17] The adoption of digital services aligns with the longterm NHS strategy of utilising more technology in routine care, 18 with the recent 'Carter Report'; reviewing efficiency and productivity within the NHS; and highlighting the need for enhanced digital solutions. 19 The present findings that CF MDTs are currently adapting practice and using digital tools, with a view to long-term adoption of these services, is therefore encouraging.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The impact of COVID‐19 upon the delivery of exercise services within cystic fibrosis clinics in the United Kingdom

Tomlinson

Saynor

Stevens

et al. 2022

Clinical Respiratory J

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Objectives: The COVID-19 pandemic has resulted in unprecedent changes to clinical practice, and as the impact upon delivery of exercise services for people with cystic fibrosis (CF) in the United Kingdom was unknown, this was characterised via a national survey.Methods: An electronic survey was distributed to healthcare professionals involved in the exercise management of CF via established professional networks.Results: In total, 31 CF centres participated. Findings included significant reductions in exercise testing and widespread adaptation to deliver exercise training using telehealth methods. Promisingly, 71% stated that they would continue using virtual methods of engaging patients in future practice. Conclusion:These findings highlight adaptation to the COVID-19 pandemic and the need to develop sustainable and standardised telehealth services to manage patients moving forwards.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The impact of COVID‐19 upon the delivery of exercise services within cystic fibrosis clinics in the United Kingdom

Tomlinson

Saynor

Stevens

et al. 2022

Clinical Respiratory J

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“…Standardized definitions will help further to evaluate the system and measure and follow impacts on equity. There are observed trends in the adoption of telehealth from a patient perspective [ 4 , 23 , 36 - 38 ]. As Rodriguez shows, there are differences in the use of telehealth services across various ethnic groups [ 23 ].…”

Section: Evaluationsmentioning

confidence: 99%

Defining Telehealth for Research, Implementation, and Equity

Roy¹,

Levy²,

Senathirajah³

2022

J Med Internet Res

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When the COVID-19 pandemic spurred a disruption in health care delivery, the role of telehealth shifted from an option to a near necessity to maintain access when in-person care was deemed too risky. Each state and many organizations developed temporary telehealth policies for the COVID-19 emergency, each policy with its own definitions, coverage, government cases, and regulations. As pandemic-era policies are now being replaced with more permanent guidelines, we are presented with an opportunity to reevaluate how telehealth is integrated into routine health care delivery. We believe that the timing and nature of the sequential steps for redefining telehealth are critical and that it is important to develop a clear and agreed-on definition of telehealth and its components at this time. We further suggest a necessary preliminary step is to support clear communication and interoperability throughout the development of this definition. Precise and standardized definitions could create an unambiguous environment for clinical care for both patients and providers while enabling researchers to have more precise control over their investigations of telehealth. A consensus when defining telehealth and its derivatives at this critical stage could create a consistent expectation of care for all patients and those who set the standards of care, as it has for other clinical scenarios with clear guidelines.

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“…Considerable research has been conducted to understand the trends in the recent adoption of telehealth, to identify the barriers to telehealth utilization, and to quantify the disparities in the adoption of telehealth ( Smith & Raskin, 2021 ). Prior literature has established that telehealth utilization varies by age ( Chang et al, 2021 ), gender ( Darrat et al, 2021 ), income ( Dixit et al, 2021 ; Franciosi & Quon, 2021 ), race ( Chunara et al, 2020 ; Jain et al, 2020 ; Weber et al, 2020 ), ethnicity ( Chunara et al, 2020 ; Weber et al, 2020 ), and geographical region ( Jain et al, 2020 ; Lau et al, 2022 ; Perzynski et al, 2017 ). A number of barriers to telehealth, such as conceptual comfort ( Odeh, 2015 ), access to technology ( Franciosi & Quon 2021 ; Sieck 2021 ), and comfort with technology ( Haynes et al 2021 ), contribute to disparities in telehealth utilization ( Perzynski 2017 ).…”

mentioning

confidence: 99%

The Confounding Influence of Older Age in Statistical Models of Telehealth Utilization

Shilane,

Lu,

Zheng

2023

Int J Telerehab

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Older age is a potentially confounding variable in models of telehealth utilization. We compared unified and stratified logistic regression models using data from the 2021 National Health Interview Survey. A total of 27,626 patients were identified, of whom 38.9% had utilized telehealth. Unified and stratified modeling showed a number of important differences in their quantitative estimates, especially for gender, Hispanic ethnicity, heart disease, COPD, food allergies, high cholesterol, weak or failing kidneys, liver conditions, difficulty with self-care, the use of mobility equipment, health problems that limit the ability to work, problems paying bills, and filling a recent prescription. Telehealth utilization odds ratios differ meaningfully between younger and older patients in stratified modeling. Traditional statistical adjustments in logistic regression may not sufficiently account for the confounding influence of older age in models of telehealth utilization. Stratified modeling by age may be more effective in obtaining clinical inferences.

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TeleHealth or TeleWealth? Equity challenges for the future of cystic fibrosis care (Commentary)

Cited by 8 publications

References 15 publications

The impact of COVID‐19 upon the delivery of exercise services within cystic fibrosis clinics in the United Kingdom

The impact of COVID‐19 upon the delivery of exercise services within cystic fibrosis clinics in the United Kingdom

Defining Telehealth for Research, Implementation, and Equity

The Confounding Influence of Older Age in Statistical Models of Telehealth Utilization

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