Utilization of Telemedicine in the U.S. Military in a Deployed Setting

Hwang, Jane; Lappan, Charles M.; Sperling, Leonard C.; Meyerle, Jon H

doi:10.7205/milmed-d-14-00115

Cited by 40 publications

(24 citation statements)

References 9 publications

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“…8 In the military, the US army has a strong track record in leveraging telemedicine to deliver virtual medical support for remote or resource-limited locations. 9 These range from synchronous medical consultations to asynchronous services such as tele-radiology. 10 The US Veteran's Health Administration has also adopted telemedicine to increase accessibility to chronic disease management to veterans at their homes, including screening of diabetic retinopathy, 11 cancer care coordination 12 and mental-health delivery through screening and treatment.…”

Section: Introductionmentioning

confidence: 99%

Virtual care to increase military medical centre capacity in the primary health care setting: A prospective self-controlled pilot study of symptoms collection and telemedicine

et al. 2020

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Introduction The Singapore Armed Forces (SAF) recognises the potential benefits and looks to harnessing telemedicine for primary health care services. In this prospective self-controlled pilot study, we aimed to evaluate the safety, efficiency and user satisfaction outcomes of virtual care (VC) at a military medical centre. Methods Out of 320 patients seen during the study period, 28 were enrolled in this study and underwent on-premises VC, comprising digital symptoms collection and telemedicine in addition to the usual in-person physician consultation. Safety outcomes were measured based on the diagnostic concordance between physicians. Efficiency was measured based on consultation times, and user satisfaction was evaluated using a standard questionnaire. Results There was a higher caseload of both upper respiratory infections and dermatological conditions in our population, in which telemedicine performed well. In terms of safety, telemedicine achieved a mean diagnostic concordance of 92.8% compared to in-person consultations. In terms of efficiency, consultation times were 26.2% – or 2 minutes and 15 seconds – shorter on average with telemedicine ( p = 0.0488). User satisfaction was favourable, with 85.5% of patients satisfied with the VC experience. Discussion This study has been invaluable in showing that on-premises telemedicine is a safe, efficient and effective means to extend and increase our surge capacity for primary health care. Our results have given us reasonable confidence to explore a larger-scale implementation in our network of military medical centres in the future.

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Section: Introductionmentioning

confidence: 99%

Virtual care to increase military medical centre capacity in the primary health care setting: A prospective self-controlled pilot study of symptoms collection and telemedicine

et al. 2020

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“…Furthermore, it is applied in countries (e.g., Switzerland, the Netherlands, and the USA) known for their long patient waiting times and/or capacity limits for dermatologic consultation. Teledermatology has been used during wars, in military and maritime settings and reduced the number of medical evacuations ( 10 , 11 ). Finally, it provides care to patients in developing countries who have no access to (dermatologic) care ( 12 •).…”

Section: Introductionmentioning

confidence: 99%

Two Decades of Teledermatology: Current Status and Integration in National Healthcare Systems

et al. 2016

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Teledermatology, originating in 1995, has been one of the first telemedicine services to see the light of day. Two decades of teledermatology research is summarized in this review. A literature search was conducted in PubMed. Search terms included “teledermatology,” “teledermoscopy,” “tele wound care,” “telederm*,” “(dermatology OR dermoscopy OR wound care OR skin) AND (telemedicine OR ehealth or mhealth OR telecare OR teledermatology OR teledermoscopy).” Inclusion criteria were (i) Dutch or English written papers and (ii) publication year from 2011 to present or (iii) (systematic) reviews with publication year before 2011. One hundred fourteen publications and 14 (systematic) reviews were included for full text reading. Focus of this review is on the following outcomes: (i) actors (primary, secondary, tertiary), (ii) purposes (consultation, triage, follow-up, education) and subspecialties (tele-wound care, burn care, teledermoscopy (teledermatoscopy), teledermatopathology, and mobile teledermatology), (iii) delivery modalities and technologies (store and forward, real-time interactive, and hybrid modalities using web-based systems, email, mobile phones, tablets, or videoconferencing equipment), (iv) business models, (v) integration of teledermatology into national healthcare systems, (vi) preconditions and requirements for implementation (security, ethical issues, responsibility, reimbursement, user satisfaction, technique, and technology standards), and (vii) added value.To conclude, teledermatology is an efficient and effective healthcare service compared to in-person care. Teledermatology reduces patients’ travel time and waiting time, avoids (unnecessary) dermatologic visits, and improves access of care to underserved patients.

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“…A retrospective analysis of a U.S. Department of Defense (DoD) teledermatology program for mostly military personnel deployed in ''austere'' environments from 2004 to 2012 was published in 2014. 79 During this period, in total, 10,817 teleconsultations were conducted using an electronic e-mail system, labeled Army Knowledge Online, ''. to collect, organize, and consolidate incoming consults from around the world via a store-and-forward process.''…”

Section: Empirical Foundations Of Teledermatologymentioning

confidence: 99%

The Empirical Foundations of Teledermatology: A Review of the Research Evidence

Bashshur

Shannon

Tejasvi

et al. 2015

Telemedicine and e-Health

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Despite these complexities, sufficient evidence was observed consistently supporting the effectiveness of teledermatology in improving accessibility to specialty care, diagnostic and treatment concordance, and skin care provided by primary care physicians, while also reducing cost. One study reported suboptimal clinical results from teledermatology for patients with pigmented skin lesions. On the other hand, confocal microscopy and advanced dermoscopy improved diagnostic accuracy, especially when rendered by experienced teledermatologists.

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Utilization of Telemedicine in the U.S. Military in a Deployed Setting

Cited by 40 publications

References 9 publications

Virtual care to increase military medical centre capacity in the primary health care setting: A prospective self-controlled pilot study of symptoms collection and telemedicine

Virtual care to increase military medical centre capacity in the primary health care setting: A prospective self-controlled pilot study of symptoms collection and telemedicine

Two Decades of Teledermatology: Current Status and Integration in National Healthcare Systems

The Empirical Foundations of Teledermatology: A Review of the Research Evidence

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