Use of Smartphones in Telemedicine: Comparative Study Between Standard and Teledermatological Evaluation of High-Complex Care Hospital Inpatients

Okita, Aline Lissa; Tinoco, Luisa Juliatto Molina; Patatas, Olivia Helena Gomes; Guerreiro, Alinie; Criado, Paulo Ricardo; Gabbi, Tatiana Villas Boas; Ferreira, Paula Silva; Neto, Cyro Festa

doi:10.1089/tmj.2015.0086

Cited by 21 publications

(14 citation statements)

References 22 publications

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“…8 For hospitalized patients there are numerous reports of using telehealth for rapid evaluation for intensive care and subspecialty consults such as dermatology, infectious diseases, and psychiatry, where a thorough chart review, history, and visual exam may provide consultants with sufficient information to make clinical recommendations. [9][10][11][12][13][14][15][16][17][18] Telehealth has also been used to engage patients and families in their care during and after hospitalization. [19][20][21] One major limitation to the widespread adoption of telehealth initiatives has been the lack of payment models 22 however, in response to the COVID-19 pandemic both federal and state governments have loosened restrictions on privacy and billing for telehealth visits in an effort to allow health care providers to continue to care for patients while reducing potential exposure to the virus.…”

Section: Background and Significancementioning

confidence: 99%

Rapid Implementation of an Inpatient Telehealth Program during the COVID-19 Pandemic

et al. 2020

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Abstract Background Relaxation of laws and regulations around privacy and billing during the COVID-19 pandemic provide expanded opportunities to use telehealth to provide patient care at a distance. Many health systems have transitioned to providing outpatient care via telehealth; however, there is an opportunity to utilize telehealth for inpatients to promote physical distancing. Objective This article evaluates the use of a rapidly implemented, secure inpatient telehealth program. Methods We assembled a multidisciplinary team to rapidly design, implement, and iteratively improve an inpatient telehealth quality improvement initiative using an existing videoconferencing system at our academic medical center. We assigned each hospital bed space a unique meeting link and updated the meeting password for each new patient. Patients and families were encouraged to use their own mobile devices to join meetings when possible. Results Within 7 weeks of go-live, we hosted 1,820 inpatient telehealth sessions (13.3 sessions per 100 bedded days). We logged 104,647 minutes of inpatient telehealth time with a median session duration of 22 minutes (range 1–1,961). There were 5,288 participant devices used with a mean of 3 devices per telehealth session (range 2–22). Clinicians found they were able to build rapport and perform a reasonable physical exam. Conclusion We successfully implemented and scaled a secure inpatient telehealth program using an existing videoconferencing system in less than 1 week. Our implementation provided an intuitive naming convention for providers and capitalized on the broad availability of smartphones and tablets. Initial comments from clinicians suggest the system was useful; however, further work is needed to streamline initial setup for patients and families as well as care coordination to support clinician communication and workflows. Numerous use cases identified suggest a role for inpatient telehealth will remain after the COVID-19 crisis underscoring the importance of lasting regulatory reform.

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Section: Background and Significancementioning

confidence: 99%

Rapid Implementation of an Inpatient Telehealth Program during the COVID-19 Pandemic

et al. 2020

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“…This can determine a considerable delay in skin tumor detection in elderly poorly movable people living in large territories. [20][21][22] This study refers to the first experience of a teledermoscopic experimental setting, where a representative sample of participants of different skill ranger was recruited to perform multiple teledermoscopic testing sessions on difficult aMSLs, by spontaneously choosing among four type of electronic device for each connection to our TWP (Table 1). To date, no significant difference in image quality of clinical pictures or impact on reported outcome measures was noted between the tested smartphone models, whereas no study has compared the impact of the use of different device on the same data set of dermoscopic pictures of aMSL.…”

Section: Discussionmentioning

confidence: 99%

The Comparative Use of Multiple Electronic Devices in the Teledermoscopic Diagnosis of Early Melanoma

Tognetti

Cartocci

Balistreri

et al. 2021

Telemedicine and e-Health

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Background: The use of mobile electronic devices as support to medical activity was largely implemented in the past decade. Introduction: Our first aim was to evaluate the frequency of use of different electronic devices, that is, personal computer (PC), notebook, tablet, smartphone, in a pool of dermatologists recruited to perform multiple online testing session on difficult melanocytic skin lesions (MSLs) cases. The second aim was to evaluate the feasibility of each device in terms of teledermatologic diagnostic performance; the use of four different diagnostic methods, that is, intuitive diagnosis and three dermoscopic algorithms, was also investigated. Materials and Methods: A total of 111 dermatologists with 4 different levels of experience in dermoscopy, performed 4 tests (intuitive diagnosis and iDScore, ABCD rule, 7-point-checklist-based diagnosis) on 979 MSLs blinded cases. Each testing session was performed with a preferred device. Results: The overall highest areas under the receiver operating characteristic (AUROC) (82%) was obtained by young generation dermoscopists 1-4 years experience) when using an integrated clinical dermoscopic algorithm (iDScore) on a notebook. The average dermatologist using the iDScore obtained AUROC 77.40% with large screen devices (PC and notebook) 77.6% with small screen (tablet, smartphone) and 78.2% by combining the two. Discussion: Young generation of dermoscopists alternately use different devices, whereas elderly generation still prefer to use the PC. The diagnostic performances obtained with small/ large screen were not statistically different from those obtained with fixed/mobile devices. Conclusions: Mobile devices were feasible tools to achieve adequate diagnostic accuracy in difficult MSLs, on a teledermatology setting, independently from participant skill level/age.

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“…Although a majority of physicians surveyed reported receiving SMS text messages and images from Web-based patients, Web-based encounters still provide less information compared with face-to-face encounters [ 42 ]. Inadequate information through Web-based consultation may lead to an inaccurate assessment or misdiagnosis, and physicians may, thus, be reluctant to rely on Web-based consultation alone [ 43 ]. Further research is needed to understand the benefits and risks associated with Web-based medical services.…”

Section: Discussionmentioning

confidence: 99%

The Web-Based Physician is Ready to See You: A Nationwide Cross-Sectional Survey of Physicians Using a Mobile Medical App to Evaluate Patients With Sexually Transmitted Diseases in China

Cao¹,

Zhao²,

Bien-Gund³

et al. 2018

JMIR Mhealth Uhealth

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BackgroundWeb-based medical service provision is increasingly becoming common. However, it remains unclear how physicians are responding to this trend and how Web-based and offline medical services are linked.ObjectiveThe objectives of this study were to examine physicians’ use of mobile medical apps for sexually transmitted disease (STD) consultations and identify the physicians who frequently use mobile medical apps to evaluate patients with STD.MethodsIn August 2017, we conducted a nationwide cross-sectional survey among physicians registered on a mobile medical app in China. We collected data on physicians’ demographic information, institutional information, and Web-based medical practices. We compared physicians who used mobile medical apps to evaluate patients with STD frequently (at least once a week) with infrequent users. Bivariate and multivariate logistic regressions were used to identify physicians who frequently evaluated patients with STD on mobile medical apps.ResultsA total of 501 physicians participated in the survey. Among them, three-quarters were men and the average age was 37.6 (SD 8.2) years. Nearly all physicians (492/501, 98.2%) recommended their last Web-based patient with STD to subsequently see a physician in the clinic. More than half (275/501, 54.9%) of physicians recommended STD testing to Web-based patients, and 43.9% (220/501) provided treatment advice to patients with STD. Of all physicians, 21.6% (108/501) used mobile medical apps to evaluate patients with STD through Web more than once a week. Overall, 85.2% (427/501) physicians conducted follow-up consultation for patients with STD using mobile medical apps. Physicians working at institutions with STD prevention materials were associated with frequent evaluation of patients with STD on mobile medical apps (adjusted odds ratio=2.10, 95% CI 1.18-3.74).ConclusionsPhysicians use mobile medical apps to provide a range of services, including Web-based pre- and posttreatment consultations and linkage to offline clinical services. The high rates of referral to clinics suggest that mobile medical apps are used to promote clinic-seeking, and not replace it. Physicians’ use of mobile medical apps could benefit sexual minorities and others who avoid formal clinic-based services.

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Use of Smartphones in Telemedicine: Comparative Study Between Standard and Teledermatological Evaluation of High-Complex Care Hospital Inpatients

Cited by 21 publications

References 22 publications

Rapid Implementation of an Inpatient Telehealth Program during the COVID-19 Pandemic

Rapid Implementation of an Inpatient Telehealth Program during the COVID-19 Pandemic

The Comparative Use of Multiple Electronic Devices in the Teledermoscopic Diagnosis of Early Melanoma

The Web-Based Physician is Ready to See You: A Nationwide Cross-Sectional Survey of Physicians Using a Mobile Medical App to Evaluate Patients With Sexually Transmitted Diseases in China

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