Статті в журналах: "Telemedicine complex"

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Gurov, I. P., V. O. Nikiforov, N. P. Belashenkov, A. S. Potapov, A. V. Lyamin, Ya V. Rudin, L. L. Varlamova, and A. A. Skshidlevskiĭ. "Diagnostic optodigital complex for telemedicine." Journal of Optical Technology 79, no. 11 (November 30, 2012): 712. http://dx.doi.org/10.1364/jot.79.000712.

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Jalalabadi, Faryan, Kelly Shultz, Norman Sussman, William Fisher, and Edward Reece. "Initiating Telehealth in a Complex Organization." Seminars in Plastic Surgery 32, no. 04 (October 22, 2018): 159–61. http://dx.doi.org/10.1055/s-0038-1672132.

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AbstractMedicine has been praised for breakthroughs that improve the quality and longevity of human life. In the setting of today's fast-paced, tech-savvy society in combination with increased patient volume entering hospital doors, telemedicine proves an effective tool to enable the industry to adapt to the changing world around us. A review of the current literature and legislative laws was conducted along with knowledge from the experience gathered at starting a telehealth platform at Texas Children's Hospital to find the necessary steps for starting a telehealth program. Through digital platform, telemedicine offers remote delivery of medical services to all parts of the country, urban and rural, while enhancing interprofessional referral patterns in the local setting. Telemedicine sets to preemptively triage and guide patients through their appropriate phases of care all the meanwhile, bringing the patient and physician closer together. This discussion delves into the further added benefits to large hospital systems, breaks down the basics of the technological platform, and addresses current barriers to entry in the telehealth industry. This article serves as an introduction to a series regarding effective implementation of telemedicine into the hospital system.

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Belov, M. V., and S. V. Rassamakhin. "Complex Revision Arthroplasty Planning with Telemedicine Expert Advice." Traumatology and Orthopedics of Russia 26, no. 3 (September 29, 2020): 119–29. http://dx.doi.org/10.21823/2311-2905-2020-26-3-119-129.

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Willard, April, Elizabeth Brown, Marjorie Masten, Marisa Brant, Nicole Pouppirt, Kevin Moran, Janet Lioy, and John Chuo. "Complex Surgical Infants Benefit From Postdischarge Telemedicine Visits." Advances in Neonatal Care 18, no. 1 (February 2018): 22–30. http://dx.doi.org/10.1097/anc.0000000000000460.

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Jue, Joshua S., Sydney A. Spector, and Seth A. Spector. "Telemedicine broadening access to care for complex cases." Journal of Surgical Research 220 (December 2017): 164–70. http://dx.doi.org/10.1016/j.jss.2017.06.085.

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Sukhov, Renat, Afua Asante, and Gavriil Ilizarov. "Telemedicine for pediatric physiatry: How social distancing can bring physicians and families closer together." Journal of Pediatric Rehabilitation Medicine 13, no. 3 (November 23, 2020): 329–38. http://dx.doi.org/10.3233/prm-200747.

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The coronavirus (COVID-19) pandemic triggered wide scale implementation of telemedicine in the United States. The government response, Coronavirus Aid, Relief, and Economic Security (CARES) Act, permitted loosening of existing restrictions on telemedicine enabling its rapid incorporation into the delivery of medical care for children and adults. Prior to COVID-19, few pediatric physiatrists had opportunities to access high fidelity telemedicine platforms to provide health care for patients with special needs, mobility impairments, developmental delays, neuromuscular disorders or other complex medical conditions. This literature review will explore how telemedicine can optimize health care delivery options for pediatric physiatrists in various inpatient and outpatient settings such as consultations, acute inpatient units, outpatient clinics and long-term care facilities. Detailed analysis of the current research in telemedicine applications as well as a critical review of the limitations and barriers for its use offers a plethora of opportunities for enhancement of continuity and coordination of care. Telemedicine may decrease healthcare disparities and increase access of care for children with special needs. Additional research is needed to assess the efficacy of telemedicine when addressing complex medical conditions in children.

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Téot, Luc, Chloé Geri, Julie Lano, Marjorie Cabrol, Christine Linet, and Grégoire Mercier. "Complex Wound Healing Outcomes for Outpatients Receiving Care via Telemedicine, Home Health, or Wound Clinic: A Randomized Controlled Trial." International Journal of Lower Extremity Wounds 19, no. 2 (December 18, 2019): 197–204. http://dx.doi.org/10.1177/1534734619894485.

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Use of telemedicine has expanded rapidly in recent years, yet there are few comparative studies to determine its effectiveness in wound care. To provide experimental data in the field of telemedicine with regard to wound care, a pilot project named “Domoplaies” was publicly funded in France in 2011. A randomized, controlled trial was performed to measure the outcomes of patients with complex wounds who received home wound care from a local clinician guided by an off-site wound care expert via telemedicine, versus patients who received in-home or wound clinic visits with wound care professionals. The publicly funded network of nurses and physicians highly experienced in wound healing was used to provide wound care recommendations via telemedicine for the study. The healing rate at 6 months was slightly better for patients who received wound care via telemedicine (61/89; 68.5%) versus wound care professional at home (38/59; 64.4%) versus wound care clinic (22/35; 62.9%), but the difference was not significant ( P = .860833). The average time to healing for the 121/183 wounds that healed within 6 months was 66.8 ± 32.8 days for the telemedicine group, 69.3 ± 26.7 for the wound care professional at home group, and 55.8 ± 25.0 days for the wound care clinic group. Transportation costs for the telemedicine and home health care groups were significantly lower than the wound clinic group, and death rate was similar between all the 3 groups ( P < .01). Telemedicine performed by wound healing clinicians working in a network setting offered a safe option to remotely manage comorbid, complex wound care patients with reduced mobility.

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Wade, Victoria, Adrian G. Barnett, Melinda Martin-Khan, and Trevor Russell. "Designing quantitative telemedicine research." Journal of Telemedicine and Telecare 23, no. 9 (October 27, 2016): 786–91. http://dx.doi.org/10.1177/1357633x16671240.

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When designing quantitative trials and evaluation of telehealth interventions, researchers should think ahead to the intended way that the intervention could be implemented in routine care and consider how trial participants with similar characteristics to the target population can be included. The telehealth intervention and the context in which it is placed should be clearly described, and consideration given to conducting pragmatic trials in order to show the effect of telehealth in complex environments with rapidly changing technology. Types of research designs, comparators and outcome measures are discussed and common statistical issues are introduced.

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Coppock, Dagan, Christine Quimby, Jonathan Nunez, Cynthia Whitener, and John Zurlo. "People Living With Human Immunodeficiency Virus During the COVID-19 Pandemic: Experiences With Telemedicine." Health Promotion Practice 22, no. 3 (March 12, 2021): 298–99. http://dx.doi.org/10.1177/15248399211001071.

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Preserving routine primary care for people living with human immunodeficiency virus (PLWH) has been an important challenge during the COVID-19 pandemic. Telemedicine platforms have offered novel means through which care for these individuals may be maintained. Opt-In for Life is a unique mobile health application that contains telemedicine capabilities as well as other features designed specifically for the care of PLWH. Opt-In for Life was implemented early in the pandemic at Hershey Medical Center, although the center is now using a different telemedicine platform across its health care system. Institutional decisions regarding telemedicine platforms are complex. Opt-In for Life contains features that may improve the care of PLWH where telemedicine software alone may be limited.

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Le Goff-Pronost, Myriam, Bénédicte Mourgeon, Jean-Pierre Blanchère, Luc Teot, Hervé Benateau, and Anne Dompmartin. "REAL-WORLD CLINICAL EVALUATION AND COSTS OF TELEMEDICINE FOR CHRONIC WOUND MANAGEMENT." International Journal of Technology Assessment in Health Care 34, no. 6 (2018): 567–75. http://dx.doi.org/10.1017/s0266462318000685.

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Background:Chronic wounds are frequent, affect quality of life, and increase care costs. Telemedicine provides potential for effective wound care management, especially for the monitoring of complex wounds at home.Objectives:The objective of the present study was to determine the clinical effects and costs of telemedicine for the follow-up of complex chronic wounds from the perspective of the public health insurance. The study ran over a period of 9 months.Methods:We conducted a prospective, pragmatic, open-label, observational study and carried out a cost-effectiveness analysis. A total of 116 patients with chronic wounds were assigned to their choice of two groups: telemedicine (N = 77) and traditional follow-up (control; N = 39). The primary outcome was the time to healing. Secondary outcomes included percentage of wounds reaching target objective, percentage of wounds healed completely, outpatient care costs, travel costs, and hospitalizations.Results:Time to healing was shorter in the telemedicine group than in the control group (137 versus 174 days; p < .05). The percentage of wounds completely healed was not statistically different between the telemedicine and control group (66 percent versus 61 percent; p > .05). Outpatient care and hospitalization costs were not significantly different. The main results in terms of economic savings were medical transport costs reimbursed by the French public health insurance, which were significantly lower in the telemedicine group. Telemedicine costs were found to be €4,583 less per patient compared with standard practice over 9 months.Conclusions:This trial suggests that telemedicine saves travel costs and results in a shorter healing time than traditional follow-up.

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Apolihin, Oleg I., Igor A. Shadjorkin, Vladimir I. Perhov, Tamara P. Sabgajda, and Sergej A. Leonov. "Scientific background of telemedicine-based approaches for medical care organization in urology." Urologicheskie vedomosti 7, no. 3 (September 15, 2017): 14–21. http://dx.doi.org/10.17816/uroved7314-21.

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The paper includes organizational issues of telemedicine usage in field of urology. Negative outcomes of an urological care had been described and classified. Proposed complex telemedicine system allows to decrease influence of a set of negative factors linked with bad outcomes in urology. (For citation: Apolihin OI, Shadjorkin IA, Perhov VI, et al. Scientific background of telemedicine-based approaches for medical care organization in urology. Urologicheskie vedomosti. 2017;7(3):14-21. doi: 10.17816/uroved7314-21).

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van Gool, K., M. R. Haas, and R. Viney. "From Flying Doctor to Virtual Doctor: An Economic Perspective on Australia's Telemedicine Experience." Journal of Telemedicine and Telecare 8, no. 5 (October 2002): 249–54. http://dx.doi.org/10.1177/1357633x0200800501.

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Current funding mechanisms can impede the efficient use and integration of telemedicine services. Telemedicine has developed in Australia against a background of complex funding arrangements and interwoven health-care responsibilities. These impediments are not unique to telemedicine but are accentuated by its ability to cover different locations, clinical areas and purposes. There is also a link between economic evaluation and funding mechanisms for telemedicine. While economic evaluations provide important information for the efficient allocation of resources, the funding environment in which telemedicine is established is also crucial in ensuring that services are efficient. Given these complexities, should telemedicine be funded? We conclude that this will depend on: the objectives and priorities of the health system; the efficiency of telemedicine relative to that of other forms of health-care delivery; and the funding environment. In terms of resource allocation processes, the optimum scenario is likely to be where the decision to invest in telemedicine services is made taking local needs into account, but where considerations such as market structure and network compatibility are examined on a broader scale and balanced against the principles of efficiency and equity.

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Ivanova, A. A., E. V. Zavaleva, A. V. Pavluk, and G. A. Novichkova. "Possibilities, difficulties and prospects for using telemedicine technologies in the field of pediatric oncohematology." Pediatric Hematology/Oncology and Immunopathology 19, no. 3 (October 9, 2020): 189–93. http://dx.doi.org/10.24287/1726-1708-2020-19-3-189-193.

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Telemedicine is an integral health service in conditions when distance is a critical factor for both the delivery of medical care and the physicians’ trainings. Nowadays due to significant location remoteness, a pronounced personnel shortage as well as the necessity to make complex diagnostic and therapeutic decisions that often require a multidisciplinary communication, telemedicine allows to promote the quick delivery of quality medical services. Telemedicine today is a tool that may be considered to optimize the logistics of medical care and to reduce the financial costs of clinics. The article presents a brief report on the Center’s activities in the field of “telemedicine” and identifies the main difficulties and prospects for this work.

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Amir, Muzakkir, Idar Mappangara, Robertus Setiadji, and Sitti Multa Zam. "Characteristics and Prevalence of Premature Ventricular Complex: A Telemedicine Study." Cardiology Research 10, no. 5 (2019): 285–92. http://dx.doi.org/10.14740/cr887.

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O. S. Morales et al.,, O. S. Morales et al ,. "Telemedicine Platforms as a Complex System, Model and Prototyping Approach." International Journal of Mechanical and Production Engineering Research and Development 10, no. 5 (2020): 511–22. http://dx.doi.org/10.24247/ijmperdoct202051.

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Sayganov, Sergey A., Vadim I. Mazurov, and Alexey Shmatko. "Portable telemedicine complex as the health service digital transformation technology." IOP Conference Series: Materials Science and Engineering 940 (October 8, 2020): 012034. http://dx.doi.org/10.1088/1757-899x/940/1/012034.

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Aminoff, Hedvig, and Sebastiaan Meijer. "Context and Complexity in Telemedicine Evaluation: Work Domain Analysis in a Surgical Setting." JMIR Perioperative Medicine 4, no. 2 (September 16, 2021): e26580. http://dx.doi.org/10.2196/26580.

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Many promising telemedicine innovations fail to be accepted and used over time, and there are longstanding questions about how to best evaluate telemedicine services and other health information technologies. In response to these challenges, there is a growing interest in how to take the sociotechnical complexity of health care into account during design, implementation, and evaluation. This paper discusses the methodological implications of this complexity and how the sociotechnical context holds the key to understanding the effects and outcomes of telemedicine. Examples from a work domain analysis of a surgical setting, where a telemedicine service for remote surgical consultation was to be introduced, are used to show how abstracted functional modeling can provide a structured and rigorous means to analyze and represent the implementation context in complex health care settings.

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Hung, William, Becky Powers, and Stuti Dang. "Scaling Geriatric and Telemedicine Care for Older Adults in Rural Areas Through Clinical Strategies and Training." Innovation in Aging 4, Supplement_1 (December 1, 2020): 795. http://dx.doi.org/10.1093/geroni/igaa057.2883.

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Abstract Telemedicine, the use of electronic information and communication technologies to deliver care, has grown substantially over the past few years, potentially benefiting older adults who have difficulty accessing and traveling to care locations. Given that providers and interprofessional staff with training in geriatric medicine often practice in urban rather than rural areas, older adults’ access to quality geriatric care is limited. Prior experiences with telemedicine adoption for geriatric team consultation, though limited in scope, were well accepted by older adults and demonstrated benefits such as identifying and meeting care needs for older adults. Bringing geriatric team care to large regions across the country requires further consideration of population needs, local contexts and training and enhancement of an interprofessional workforce to deliver geriatric care through telemedicine. The Veteran healthcare system has been a pioneer in telemedicine care and considers the use of telemedicine necessary for all providers in its system. This symposium aims to discuss approaches to identify and target older adults who may benefit from geriatric consultation, how care delivery is scaled through identifying common approaches and local adaptations, what the important elements are for providers and teams to deliver care effectively for the older adult population, especially those with multiple complex chronic conditions and functional limitations, and considerations for training the next generation of providers to provide care for older adults with complex conditions, particularly in rural areas with limited access.

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Dayal, Parul, Celia H. Chang, William S. Benko, Aaron M. Ulmer, Stephanie S. Crossen, Brad H. Pollock, Jeffrey S. Hoch, Jamie L. Kissee, Leslie Warner, and James P. Marcin. "Appointment completion in pediatric neurology telemedicine clinics serving underserved patients." Neurology: Clinical Practice 9, no. 4 (April 22, 2019): 314–21. http://dx.doi.org/10.1212/cpj.0000000000000649.

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BackgroundTo determine whether telemedicine improves access to outpatient neurology care for underserved patients, we compared appointment completion between urban, in-person clinics and telemedicine clinics held in rural and underserved communities where neurology consultations are provided remotely.MethodsIn this retrospective study, we identified patients scheduled for outpatient care from UCDH pediatric neurologists between January 1, 2009, and July 31, 2017, in person and by telemedicine. Demographic and clinical variables were abstracted from electronic medical records. We evaluated the association between consultation modality and visit completion in overall and matched samples using hierarchical multivariable logistic regression.ResultsWe analyzed 13,311 in-person appointments by 3,831 patients and 1,158 telemedicine appointments by 381 patients. The average travel time to the site of care was 45.8 ± 52.1 minutes for the in-person cohort and 22.3 ± 22.7 minutes for the telemedicine cohort. Telemedicine sites were located at an average travel time of 217.1 ± 114.8 minutes from UCDH. Telemedicine patients were more likely to have nonprivate insurance, lower education, and lower household income. They had different diagnoses and fewer complex chronic conditions. Telemedicine visits were more likely to be completed than either “cancelled” or missed (“no show”) compared with in-person visits (OR 1.57, 95% CI: 1.34–1.83; OR 1.66, 95% CI: 1.31–2.10 matched on travel time to the site of care; OR 2.22, 95% CI: 1.66–2.98 matched on travel time to UCDH).ConclusionsThe use of telemedicine for outpatient pediatric neurology visits has high odds of completion and can serve as an equal adjunct to in-person clinic visits.

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Hoi, Karen K., Stuart H. Curtis, Lynn Driver, Erica Wisnosky, David A. Zopf, and Lauren A. Bohm. "Adoption of Telemedicine for Multidisciplinary Care in Pediatric Otolaryngology." Annals of Otology, Rhinology & Laryngology 130, no. 10 (February 25, 2021): 1105–11. http://dx.doi.org/10.1177/0003489421997651.

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Objective: The COVID-19 pandemic has introduced a period of social isolation that has challenged the ability of providers to uphold in-person patient care. Although commonplace in pediatric otolaryngology, multidisciplinary clinics pose a unique challenge during this time due to increased infection risk from multiple patient-provider interactions. Guidance on the application of telemedicine for multidisciplinary clinics in pediatric otolaryngology is limited. Methods: We provide comprehensive guidance on best practices for conducting telemedicine visits for a number of multidisciplinary otolaryngology clinics using our experiences at a single tertiary care children’s hospital. A review of literature to support the adoption of telemedicine in multidisciplinary pediatric otolaryngology is also incorporated. Results: Telemedicine was successfully adopted for 7 multidisciplinary pediatric clinics with a variety of specialists: aerodigestive disorders, congenital hearing loss, microtia/aural atresia, orofacial clefting, sleep disorders, tracheostomy care, and velopharyngeal dysfunction. Conclusions: Telemedicine is feasible for a variety of multidisciplinary clinics and its optimization is critical for providing care to complex pediatric otolaryngology patients during the COVID-19 pandemic and beyond.

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Kiernan, Terri-Ellen J., and Bart M. Demaerschalk. "Nursing Roles within a Stroke Telemedicine Network." Journal of Central Nervous System Disease 2 (January 2010): JCNSD.S4284. http://dx.doi.org/10.4137/jcnsd.s4284.

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Time sensitive acute stroke treatments and the growing shortage of vascular neurologists compound to create a gap in the delivery of care to meet the American Stroke Association guidelines in underserviced regions. Audio/video consultation (telemedicine), which has been evolving since the late 1990's, is a putative solution. While telemedicine can serve as a valuable facilitative tool, the telestroke consultation is only one piece of a complex collaboration between hub and spoke environments and clinical personnel. The growing use of telemedicine in stroke offers more opportunities for all nurses to participate in the continuum of cerebrovascular disease care. A review of this collaboration will include but will not be limited to: algorithms of the acute stroke evaluation, hub and spoke staff meetings, stroke education for spoke staff, and patient follow–up post acute treatment. Our team's telemedicine experience, utilizing research, education, and clinical practice, will be described.

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Jánki, Zoltán Richárd. "A graph-based data quality analysis in distributed telemedicine systems." Pollack Periodica 17, no. 1 (March 25, 2022): 18–23. http://dx.doi.org/10.1556/606.2021.00389.

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Abstract Telemedicine is one of the most rapidly developing areas of healthcare and it plays an increasing role in modern medicine. As the amount of data and demand for features increase, the data paths are becoming ever-more complex. Owing to this, it is vital in telemedicine to find a proper balance between consistency and availability under any given circumstances. However, making a trade-off can significantly influence the quality of the data. This study seeks to get an in-depth view of the problem by considering a real-world telemedicine use-case and elaborating the formal system specification of the scenario. After evaluating the specification, the constructed state graph is examined using graph coloring and other graph algorithms.

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Aminoff, Hedvig, Sebastiaan Meijer, Urban Arnelo, and Kristina Groth. "Modeling the Implementation Context of a Telemedicine Service: Work Domain Analysis in a Surgical Setting." JMIR Formative Research 5, no. 6 (June 21, 2021): e26505. http://dx.doi.org/10.2196/26505.

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Background A telemedicine service enabling remote surgical consultation had shown promising results. When the service was to be scaled up, it was unclear how contextual variations among different clinical sites could affect the clinical outcomes and implementation of the service. It is generally recognized that contextual factors and work system complexities affect the implementation and outcomes of telemedicine. However, it is methodologically challenging to account for context in complex health care settings. We conducted a work domain analysis (WDA), an engineering method for modeling and analyzing complex work environments, to investigate and represent contextual influences when a telemedicine service was to be scaled up to multiple hospitals. Objective We wanted to systematically characterize the implementation contexts at the clinics participating in the scale-up process. Conducting a WDA would allow us to identify, in a systematic manner, the functional constraints that shape clinical work at the implementation sites and set the sites apart. The findings could then be valuable for informed implementation and assessment of the telemedicine service. Methods We conducted observations and semistructured interviews with a variety of stakeholders. Thematic analysis was guided by concepts derived from the WDA framework. We identified objects, functions, priorities, and values that shape clinical procedures. An iterative “discovery and modeling” approach allowed us to first focus on one clinic and then readjust the scope as our understanding of the work systems deepened. Results We characterized three sets of constraints (ie, facets) in the domain: the treatment facet, administrative facet (providing resources for procedures), and development facet (training, quality improvement, and research). The constraints included medical equipment affecting treatment options; administrative processes affecting access to staff and facilities; values and priorities affecting assessments during endoscopic retrograde cholangiopancreatography; and resources for conducting the procedure. Conclusions The surgical work system is embedded in multiple sets of constraints that can be modeled as facets of the system. We found variations between the implementation sites that might interact negatively with the telemedicine service. However, there may be enough motivation and resources to overcome these initial disruptions given that values and priorities are shared across the sites. Contrasting the development facets at different sites highlighted the differences in resources for training and research. In some cases, this could indicate a risk that organizational demands for efficiency and effectiveness might be prioritized over the long-term outcomes provided by the telemedicine service, or a reduced willingness or ability to accept a service that is not yet fully developed or adapted. WDA proved effective in representing and analyzing these complex clinical contexts in the face of technological change. The models serve as examples of how to analyze and represent a complex sociotechnical context during telemedicine design, implementation, and assessment.

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Fujimoto, M., K. Miyazaki, and N. Von Tunzelmann. "Complex systems in technology and policy: telemedicine and telecare in Japan." Journal of Telemedicine and Telecare 6, no. 4 (August 2000): 187–92. http://dx.doi.org/10.1258/1357633001935284.

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Mirel, Barbara, Ellen Barton, and Mark Ackerman. "Researching Telemedicine: Capturing Complex Clinical Interactions with a Simple Interface Design." Technical Communication Quarterly 17, no. 3 (June 6, 2008): 358–78. http://dx.doi.org/10.1080/10572250802100477.

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Lu, Wei, Zhan Meng, Yichuan Wang, Yu Wang, and Yunkai Zhai. "Supply-demand matching in a complex telemedicine environment considering intermediary intervention." Computers & Industrial Engineering 169 (July 2022): 108194. http://dx.doi.org/10.1016/j.cie.2022.108194.

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Nagendran, Shyamala, David Moores, Rick Spooner, and Jean Triscott. "Is telemedicine a subset of medical informatics?" Journal of Telemedicine and Telecare 6, no. 2_suppl (August 2000): 50–51. http://dx.doi.org/10.1258/1357633001935563.

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Informatics has a key characteristic of a new discipline in a technically transient environment—there is no universal definition of it. This is not surprising, given its complex and diverse nature. In a broad sense informatics is the interface between developing technologies and the decision sciences, in particular clinical sciences. Telemedicine has no universally accepted definition either. Telemedicine requires the use of electronic communication networks for the transmission of information and data related to the diagnosis and treatment of, as well as education about, medical conditions. The debate ensues over whether it is or is not a subset of medical informatics. The care of the elderly diploma programme is a telemedicine project within the department of family medicine at the University of Alberta; it is a distance learning programme directed towards educating and training physicians in rural Alberta. This project provided us with the practical experience of addressing both informatics and telemedicine issues jointly.

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Doolittle, Gary C. "Telemedicine in Kansas: The successes and the challenges." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 43–46. http://dx.doi.org/10.1258/1357633011937092.

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Based on our experience of telemedicine in Kansas, we have identified several key factors in the success of a telemedicine practice. Very early in any project, it is important to bring together all participants (especially the physicians who are expected to refer patients) to define the need, outline specific goals, analyse and test the technology, and develop a plan for the implementation. As with traditional health-care, many partners must come together, including primary-care practitioners willing to shoulder day-to-day responsibility for management of complex patients, nurses with special expertise and consultants willing to work with a remote team using telemedicine. These individuals must accept the challenges and appreciate the rewards of working in a different practice model, in which communication and interdependence are critical for success. The telemedicine consultant is only as good as the local health-care team. The technology itself is only a small part of the equation.

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Tecklenburg, Johanna. "Telemedicine – chances and challenges for medical genetics in Germany." Medizinische Genetik 33, no. 1 (April 1, 2021): 53–59. http://dx.doi.org/10.1515/medgen-2021-2057.

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Abstract Telemedicine has been in practical use for many years, mostly within the context of model projects. The current Covid-19 pandemic has accelerated the process of implementing telemedicine in standard care. Numerous regulations, as well as complex reimbursement structures play a role in the application of telemedicine in medical genetics in Germany. Discipline- and technology-specific challenges complicate the integration of technical solutions into the medical genetic practice. In previous studies teleconsultations and virtual consultations in medical genetics have proven their value as indicated by high levels of satisfaction in the users and showing no inferiority to in-person consultation in terms of psychosocial outcome. The next years will bring an increasing demand for genetic counseling that can hardly be met by the limited number of specialists in Germany. In this context telemedicine can help to close these gaps in standard care while strengthening the field by ensuring comprehensive medical genetic care. The German medical genetics community is asked to actively shape the process of implementation by defining areas of genetic counseling that are suitable for telemedicine, by regulating access for physicians and by contributing to the renumeration structures.

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Marttos, Antonio C., Mariana Fernandes Juca Moscardi, Rossano Kepler Alvim Fiorelli, Gerd Daniel Pust, Enrique Ginzburg, Carl Ivan Schulman, April Anne Grant, and Nicholas Namias. "Use of Telemedicine in Surgical Education: A Seven-Year Experience." American Surgeon 84, no. 8 (August 2018): 1252–60. http://dx.doi.org/10.1177/000313481808400831.

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Uniformity in surgical education is challenging because surgical experience is based on rotation assignments. With work hour restrictions, the likelihood of residents being exposed to rare or unusual cases is diminished. Telemedicine may create a new learning paradigm for surgical education and supplement exposure for rare or unusual cases. A retrospective review (2010–2016) of teleconferences involving trauma centers worldwide was conducted. Participating hospitals included centers from underdeveloped countries to first world nations. Trauma cases were discussed among surgeons with different levels of experience and resource availability. Data collected included types of cases, anatomic injury patterns, hospital location, and the number of telemedicine centers and viewers participating. Seventy-three hospitals in 64 cities, spanning 27 countries, participated in 276 telemedicine grand round conferences. Cases discussed included penetrating trauma (47%), blunt trauma (42%), and blast injury (4%). The anatomic regions included were the thorax (28%), abdomen (26%), thoracoabdominal region (13%), neck (7%), and pelvis (6%). The most common injury discussed was vascular in nature (18%), followed by the lung, liver, diaphragm, and heart. The most common vascular lesion was in the aorta (18%), followed by the iliac vessels (8%) and the vena cava (7%). Telemedicine is a valuable tool, allowing the dissemination of diverse experiences. Most cases presented evaluated rare injuries or complex surgical approaches, which are not commonly seen on trauma sites. Learning different approaches in the management of complex trauma will make surgeons more prepared to deal with challenging cases.

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Abdalla, Yousif Salim. "Critical Factors Determining Adoption of Telemedicine." International Journal of Online and Biomedical Engineering (iJOE) 15, no. 11 (July 16, 2019): 124. http://dx.doi.org/10.3991/ijoe.v15i08.10492.

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<p><strong>Abstract—</strong> Health service is a very complex and expensive public service and it is a highly sensitive service that highly determines the human capital besides knowledge. In this study we used six technology dimensions (product design, patient relationship management, supply chain management, knowledge management, environment, and governance structure), that highly determine an effective adoption of telehealth health care service. We used DNAP model (DEMATEL and ANP) to evaluate and prioritize the weights of the factors that influence an investment in telemedicine health care service. The results of this study show that product design and patient relationship management has a higher interaction with the rest of the selected dimensions such as knowledge management, supply chain management, governance, and environment. Within the product design with respect to the rest of the dimensions, behavioral requirement ranks first, next knowledge requirement, and third technology requirement; patient relationship management with respect to the rest of the dimensions, the ranking is: social network ranks first, next patient service, and third empowerment.</p>

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Quinn, Charlene C., Anthony Roggio, Barr Erik, and Ann Gruber-Baldini. "NURSING HOME TELEED INTERVENTION: ADVANCING NEW CARE MODELS." Innovation in Aging 3, Supplement_1 (November 2019): S337—S338. http://dx.doi.org/10.1093/geroni/igz038.1225.

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Abstract New reimbursement and managed care models demonstrate the need to reduce avoidable Emergency Department (ED) use and limit preventable inpatient admissions for older adults in Skilled Nursing Facilities (SNF). The objective was to develop an ED telemedicine consultation intervention for SNF residents with acute medical problems. Secondary objectives including evaluation of health care utilization, provider satisfaction. Demonstration evaluation in three urban SNFs, telemedicine linked to university medical center ED. Mobile telemedicine cart equipment assessed SNF residents for any change in condition. ED physicians used tablets with secure access to conduct the resident assessment. Provider satisfaction measures imbedded in EMRs were completed at consultation visit end. 460 patients had changes in condition, 327 resulted in 911 calls, 85 deemed eligible for telemedicine consult. Conducted 57 telehealth consults. Forty (70%) telemedicine consult residents remained in the SNF. Fourteen residents were transferred to the ED. Average satisfaction scores were 5.8/7 for SNF nurses (n=49) and 5.6 for ED physicians (n=45). Lower-rated items related to technical equipment problems. ED physicians reported residents transferred to ED after telehealth visit had better continuity of care. The intervention was effective in preventing or delaying transfer of acutely ill, medically complex SNF residents. Implementation of the intervention identified need for SNF admission policy and procedure changes; weekly telemedicine training; SNF clinical advocates; on-site tracking and linkage of EMRs across providers; HIPAA shared medical record concerns. Future research plans include analyses of detailed SNF resident characteristics and business case assessment for reduction of transfers, ED and hospital utilization.

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Seetharam, Karthik, Nobuyuki Kagiyama, and Partho P. Sengupta. "Application of mobile health, telemedicine and artificial intelligence to echocardiography." Echo Research and Practice 6, no. 2 (June 2019): R41—R52. http://dx.doi.org/10.1530/erp-18-0081.

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The intersection of global broadband technology and miniaturized high-capability computing devices has led to a revolution in the delivery of healthcare and the birth of telemedicine and mobile health (mHealth). Rapid advances in handheld imaging devices with other mHealth devices such as smartphone apps and wearable devices are making great strides in the field of cardiovascular imaging like never before. Although these technologies offer a bright promise in cardiovascular imaging, it is far from straightforward. The massive data influx from telemedicine and mHealth including cardiovascular imaging supersedes the existing capabilities of current healthcare system and statistical software. Artificial intelligence with machine learning is the one and only way to navigate through this complex maze of the data influx through various approaches. Deep learning techniques are further expanding their role by image recognition and automated measurements. Artificial intelligence provides limitless opportunity to rigorously analyze data. As we move forward, the futures of mHealth, telemedicine and artificial intelligence are increasingly becoming intertwined to give rise to precision medicine.

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Jandovitz, Nicholas, Hanlin Li, Brady Watts, Jonathan Monteiro, Diana Kohlberg, and Demetra Tsapepas. "Telemedicine pharmacy services implementation in organ transplantation at a metropolitan academic medical center." DIGITAL HEALTH 4 (January 2018): 205520761878932. http://dx.doi.org/10.1177/2055207618789322.

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Transplant patients represent a complex patient population for which telemedicine may allow enhanced access to the healthcare team and promote active engagement in health improvement. This retrospective study summarizes a multi-pronged approach that was instituted to implement a pharmacy telemedicine practice at our institution. Telemedicine visits included the provision of six key elements for our patients: (1) medication reconciliation, (2) vaccination history, (3) medication teaching, (4) pharmacotherapy review, (5) medication adherence, and (6) triage to other providers. From January through June 2017, 46 patients were registered for a visit (recipients n = 32 and living donors n = 14). Three-fourths of the patients who completed a visit connected using a mobile device. Time from discharge to the visit was 5.4 days. The average visit duration was 11.6 ± 8 minutes. Medication reconciliation was performed for 24 patients where 6 (25%) required medication list adjustments. An average of 1.2 ± 0.4 medication changes were updated in the medical record. During visits, patients were asked questions to assess adherence to their regimen, all patients responded favorably indicating that they were following instructions provided by the healthcare team. Telemedicine has the potential to improve the healthcare delivery model by providing increased patient-to-healthcare team interactions and access, which optimize engagement and outcomes.

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Farand, Lambert, Jean-Philippe Lafrance, and José F. Arocha. "Collaborative problem-solving in telemedicine and evidence interpretation in a complex clinical case." International Journal of Medical Informatics 51, no. 2-3 (August 1998): 153–67. http://dx.doi.org/10.1016/s1386-5056(98)00112-9.

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Peters, Christoph, Ivo Blohm, and Jan Marco Leimeister. "Anatomy of Successful Business Models for Complex Services: Insights from the Telemedicine Field." Journal of Management Information Systems 32, no. 3 (July 3, 2015): 75–104. http://dx.doi.org/10.1080/07421222.2015.1095034.

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Cohn, Ellen R., and Jana Cason. "Telepractice, Telehealth, and Telemedicine: Acquiring Knowledge From Other Disciplines." Perspectives of the ASHA Special Interest Groups 1, no. 18 (March 2016): 19–29. http://dx.doi.org/10.1044/persp1.sig18.19.

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Telepractice for speech-language pathology and audiology operates within a complex and dynamic environment that is beset with many influencers: state and federal regulations, state professional licensure boards, reimbursement policies, standards and guidelines, and the interests of powerful financial drivers. While much that is written about telepractice does not reference telemedicine-based standards and guidelines, the latter can provide valuable information. Knowledge of the aspirational practices of other healthcare professions will benefit speech-language pathologists (SLPs) and audiologists and is essential for practitioners who work as part of interdisciplinary teams. The aspirational practices of other professions can also be drawn upon when devising telepractice curricula for university programs.

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Penteado, Silvio Pires, and Ricardo Ferreira Bento. "Hearing rehabilitation through telemedicine to enhance public policies in Brazil." Einstein (São Paulo) 9, no. 1 (March 2011): 102–4. http://dx.doi.org/10.1590/s1679-45082011md1810.

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ABSTRACT Since 2004, the Brazilian government has run one of the most all-inclusive hearing rehabilitation program based on hearing aids worldwide. In 2007 this investment in hearing aids topped U$ 68 million, apart from covering the cost of physicians and audiologists. Nearly 140 centers are certified by the government to dispense fitted hearing aids, figures which are still low when one considers the size of the country. Telemedicine can represent a field of knowledge which broadens hearing rehabilitations services in Brazil, for it may help increase the number of hearing rehabilitation centers, enable remote training and provide for an “online second opinion”. As far as public administration is concerned, it may enable process standardization and the very control over this hugely complex operation. The present article aimed to consider Telemedicine a powerful ally to improve hearing health care policies in Brazil.

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Bidmead, Elaine, Mabel Lie, Alison Marshall, Stephen Robson, and Vikki J. Smith. "Service user and staff acceptance of fetal ultrasound telemedicine." DIGITAL HEALTH 6 (January 2020): 205520762092592. http://dx.doi.org/10.1177/2055207620925929.

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Objective We present qualitative findings from interviews with frontline clinicians and service users of a fetal telemedicine service. Methods Semi-structured interviews with clinical stakeholders and service users were conducted, undertaken as part of a service evaluation. Data collection was undertaken by different teams, using interview schedules aligned to independent evaluation aims. Data were subjected to thematic analysis. Results Sonographers reported four main challenges: delivering a shared consultation; the requirement to resist scanning intuitively; communications during the scan; and restricted room space. Notwithstanding, all clinicians reported that participating women were accepting of the technology. Service users reported few concerns. The main benefits of fetal telemedicine were identified as upskilled staff, increased access to specialist support and improved management of complex pregnancies. Convenience was identified as the main benefit by service users, including savings in time and money from not having to travel, take time off work, and arrange childcare. Conclusions Service users and clinical stakeholders were accepting of the service. Service users reported satisfaction with communications during the consultation and awareness that telemedicine had facilitated local access to clinical expertise. Whilst clinical stakeholders reported challenges, the iterative nature of the evaluation meant that concerns were discussed, responded to, and overcome as the pilot developed. Clinical stakeholders’ perception of benefits for service users encouraged their acceptance. Moreover, the evaluation established that fetal ultrasound telemedicine is a viable method to access expertise safely and remotely. It provided demonstrable evidence of a potential solution to some of the healthcare challenges facing rural hospitals.

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Muñoz-Bonet, Juan I., José L. López-Prats, Eva M. Flor-Macián, Teresa Cantavella, Amparo Domínguez, Yvan Vidal, and Juan Brines. "Medical complications in a telemedicine home care programme for paediatric ventilated patients." Journal of Telemedicine and Telecare 26, no. 7-8 (April 25, 2019): 462–73. http://dx.doi.org/10.1177/1357633x19843761.

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Introduction Advances in paediatric medicine have increased survival rates for patients with severe chronic illnesses, of which the most complex are ventilator-dependent children (VDCs). Although home care improves their quality of life, morbidity and mortality rates are high. Our aim was to study the medical complications (events) that occur at home and assess the usefulness of telemedicine in their detection and treatment. Methods A prospective clinical study (2007–2017) was performed for tracheotomised VDCs. We used a high-density data telemedicine monitoring system from our Paediatric Intensive Care Unit and analysed events during the first two years of home care to study how different variables inter-correlated with the four most common ones: hospital admissions, admissions avoided, event durations and life-threatening events (LTEs); the significance level was set at an alpha of 0.05 in all cases. Results All our VDCs were included ( n = 12); there were 141 events, and these were homogeneously distributed over the study period. The incidence was higher in children who were ventilator dependent for more than 12 h a day (70.9%, p < 0.001) and the main cause was respiratory (69.5%, p < 0.001). Telemedicine was the main initial care and monitoring approach (86.5% and 90.1%, respectively, p < 0.001); 13 events were LTEs, nine were resolved telemedically, four required medicalised transfer to hospital and three resulted in a hospital admission. Discussion Clinical complications are frequent in VDCs receiving home care, and respiratory decompensation is the most frequent cause. Telemedicine facilitated diagnosis and early treatment, and was useful in managing LTEs.

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Aleksanin, S., and V. Rybnikov. "(A120) Implementation of Advanced Technologies in Emergency Medicine." Prehospital and Disaster Medicine 26, S1 (May 2011): s34. http://dx.doi.org/10.1017/s1049023x1100121x.

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Increase in the number of emergency situations (ES), technogenic accidents and disasters and terrorist threats defines the need for implementation of advanced medical technologies. One of these technologies is to deploy an airmobile hospital (AH) in emergency situation to provide skilled medical care in case of a large number of casualties. AH is equipped with inflatable modules, deployment of which takes no more than an hour. Each module is equipped with specialized departments. AH consists of triage department, OR, intensive care department, outpatient department, X-ray and diagnostic department and inpatient department as well. The station is equipped with modern intensive care unit including ALV apparatus, defibrillator-monitor with built-in pacemaker, as well as endovideosurgery complex, laboratory and telemedicine equipment, radiation control monitors, communication and global positioning units. One of the advanced technologies of emergency medicine is implementation of telemedicine equipment. EMERCOM of Russia on the basis of our institution has opened a telemedicine center that provides videoconferencing, any audio-visual information both text (extracts from case histories), and instrumental studies (radiographs, echograms, ECG, etc.). EMERCOM of Russia specialists use airmobile medicine technologies including specially equipped aviation facilities with airmobile medicine modules (aircraft, helicopter). In addition, we have developed a hardware system of individual monitoring the functional state of a rescuer. It is designed to transmit to the senior officer of the division the data about functional status of 10 rescuers (heart rate, respiratory rate, temperature), motor activity and the current coordinates to detect deterioration and freezing (immobilization) of the rescuer. The complex is equipped with an emergency radio-beacon to accelerate the search for a rescuer.

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Haimi, Motti, Shuli Brammli-Greenberg, Yehezkel Waisman, Nili Stein, and Orna Baron-Epel. "The role of non-medical factors in physicians’ decision-making process in a pediatric telemedicine service." Health Informatics Journal 26, no. 2 (September 30, 2019): 1152–76. http://dx.doi.org/10.1177/1460458219870660.

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The complex process of medical decision-making is prone also to medically extraneous influences or “non-medical” factors. We aimed to investigate the possible role of non-medical factors in doctors’ decision-making process in a telemedicine setting. Interviews with 15 physicians who work in a pediatric telemedicine service were conducted. Those included a qualitative section, in which the physicians were asked about the role of non-medical factors in their decisions. Their responses to three clinical scenarios were also analyzed. In an additional quantitative section, a random sample of 339 parent -physician consultations, held during 2014–2017, was analyzed retrospectively. Various non-medical factors were identified with respect to their possible effect on primary and secondary decisions, the accuracy of diagnosis, and “reasonability” of the decisions. Various non-medical factors were found to influence physicians’ decisions. Those factors were related to the child, the applying parent, the physician, the interaction between the doctor and parents, the shift, and to demographic considerations, and were also found to influence the ability to make an accurate diagnosis and “reasonable” decisions. Our conclusion was that non-medical factors have an impact on doctor’s decisions, even in the setting of telemedicine, and should be considered for improving medical decisions in this milieu.

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Stevenson, V., E. Keenan, K. Nutman, and M. Koch. "POC30 Telemedicine--a useful tool to link people with complex disabilities to specialist neurological services." Journal of Neurology, Neurosurgery & Psychiatry 81, no. 11 (October 22, 2010): e42-e42. http://dx.doi.org/10.1136/jnnp.2010.226340.100.

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Ross, Melissa H., Lisa S. Parnell, Tracy G. Spears, and David Y. Ming. "Telemedicine Video Visits for Children with Medical Complexity in a Structured Clinical Complex Care Program." Global Pediatric Health 7 (January 2020): 2333794X2095219. http://dx.doi.org/10.1177/2333794x20952196.

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Kon, Alexander A., Ben Rich, Candace Sadorra, and James P. Marcin. "Complex bioethics consultation in rural hospitals: using telemedicine to bring academic bioethicists into outlying communities." Journal of Telemedicine and Telecare 15, no. 5 (July 2009): 264–67. http://dx.doi.org/10.1258/jtt.2009.081209.

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Fisher, Alexander V., Stephanie A. Campbell-Flohr, Kristine M. Leahy-Gross, Maria Brenny-Fitzpatrick, Alexandra W. Acher, Amy J. Kind, Sean M. Ronnekleiv-Kelly, Daniel E. Abbott, Emily R. Winslow, and Sharon M. Weber. "Improving Transitional Care after Complex Abdominal Operation: Results of a Telemedicine-Based Transitional Care Intervention." Journal of the American College of Surgeons 227, no. 4 (October 2018): S150—S151. http://dx.doi.org/10.1016/j.jamcollsurg.2018.07.319.

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Agrawal, Siddarth, Bartłomiej Strzelec, Rafał Poręba, Anil Agrawal, and Grzegorz Mazur. "Clinical Characteristics, Preventive Care and Attitude to Telemedicine among Patients with Diabetic Retinopathy: A Cross-Sectional Study." Journal of Clinical Medicine 10, no. 2 (January 12, 2021): 249. http://dx.doi.org/10.3390/jcm10020249.

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Diabetic retinopathy (DR) is the most frequent and one of the most severe complications of both types of diabetes. Despite the development of versatile diabetes management programs in most developed countries, many patients remain at increased risk for developing this life-limiting and life-threatening condition. This cross-sectional analysis objective was to examine and compare the prevalence of diabetic retinopathy and comorbidities, as well as the clinical characteristics, prevention patterns, and attitude to telemedicine in patients with diabetes. We found that, when compared to the non-DR group, patients with DR significantly more often utilize clinical preventive services and counseling; however, there is still a significant gap in the receipt of preventative care. Moreover, in the DR subgroup, inadequate diabetic control and the presence of various signs and symptoms of diseases were observed. Although less than a fifth of all patients use mobile applications to monitor their health status, the patients indicate their willingness to use telemedical technology, particularly if it is recommended by the physician and provided without additional costs. The evolution of telemedicine offers a possibility of inexpensive, continuous monitoring of the disease that could improve treatment outcomes. Our observations emphasize DR’s perception as a complex disease in which education and continuous monitoring, particularly with telemedicine methods, are critical for further improvement in chronic care.

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Quinzi, Vincenzo, Licia Coceani Paskay, Rebecca Jewel Manenti, Silvia Giancaspro, Giuseppe Marzo, and Sabina Saccomanno. "Telemedicine for a Multidisciplinary Assessment of Orofacial Pain in a Patient Affected by Eagle’s Syndrome: A Clinical Case Report." Open Dentistry Journal 15, no. 1 (March 16, 2021): 102–10. http://dx.doi.org/10.2174/1874210602115010102.

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Background: Orofacial pain has a broad range of origins and a multidisciplinary approach occupies a relevant role. Objective: The aim of this study was to review the literature regarding the evolution of telemedicine and orofacial pain related to a case report of a patient affected by Eagle's syndrome. Materials and Methods: Two authors (RJM and SG) independently reviewed the literature up to March 2020. A case report was developed by including the interdisciplinary assessment and initial treatment of orofacial pain in a 38-year-old female patient affected by Eagle’s syndrome. The patient was interviewed by two different specialists (from Rome, Italy and Los Angeles, California) through an online meeting platform in order to evaluate her complex situation, demonstrating the possibilities that telemedicine offered during the COVID-19 pandemic. Conclusion: An interdisciplinary approach can be performed for future follow ups on patients as various advantages were found by the patient and by the clinicians themselves.

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Monakov, D. M., V. A. Shaderkina, S. A. Reva, and A. A. Gritskevich. "Protection of patients' personal data when using telemedicine technologies during the COVID-19 pandemic." Russian Journal of Telemedicine and E-Health 7, no. 4 (December 30, 2021): 48–57. http://dx.doi.org/10.29188/2712-9217-2021-7-4-48-57.

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Introduction. The pandemic of COVID-19 has promoted the development of information and telemedicine technologies but also has risen some questions about their challenges. One of them is the secure of personal data. This review is aim to discuss those issues. Materials and methods. We have sought publications in the databases PubMed, e-Library, Google Scholar, Guarantor, Consultant and on the official websites of Russian state institutions using the keywords «personal data», «telemedicine», «protection», «threats», «personal data», «security», «threats», «telemedicine». Forty three publications were found and included in this review. Results. The review presents the basic concepts related to personal data, lists the types of threats to them and the levels of security, systematizes measures to ensure the protection of personal data and provides a brief description of them. The features of the collection, processing, storage and use of personal data when using telemedicine technologies are also outlined. Discussion. Personal data may be collected for administrative, scientific, commercial or criminal purposes. The emergence of modern "big data" technologies has greatly facilitated the process of data collection and processing, as well as access to them, but also increased their vulnerability. The process of information protection requires the complex application of various legal, organizational and technical measures, which requires significant financial, material and time costs. For the rational use of resources, information requiring protection is grouped by security levels, which are determined by the category, characteristics of the data and the type of threats to them. Conclusions. The current legislative principles of regulation in this area are significantly lagging behind the rapid development of technologies, which requires a fundamental revision of them. To date, the leading role in ensuring the security of personal data belongs to organizational and technical measures.

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Wong, Rachel, Patricia Ng, Tracey Spinnato, Erin Taub, Amit Kaushal, Mark Lerman, Alice Fernan, Erin Dainer, and Kimberly Noel. "Expanding Telehealth Competencies in Primary Care: A Longitudinal Interdisciplinary Simulation to Train Internal Medicine Residents in Complex Patient Care." Journal of Graduate Medical Education 12, no. 6 (December 1, 2020): 745–52. http://dx.doi.org/10.4300/jgme-d-20-00030.1.

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ABSTRACT Background Despite increasing use of telehealth, there are limited published curricula training primary care providers in utilizing telehealth to deliver complex interdisciplinary care. Objective To describe and evaluate a telehealth curriculum with a longitudinal objective structured clinical examination (OSCE) to improve internal medicine residents' confidence and skills in coordinating complex interdisciplinary primary care via televisits, electronic consultation, and teleconferencing. Methods In 2019, 56 first- and third-year residents participated in a 3-part, 5-week OSCE training them to use telehealth to manage complex primary care. Learners conducted a standardized patient (SP) televisit in session 1, coordinated care via inter-visit e-messaging, and led a simulated interdisciplinary teleconference in session 2. Surveys measured confidence before session 1 (pre), post-session 1 (post-1), and post-session 2 (post-2). SP televisit checklists and investigators' assessment of e-messages evaluated residents' telehealth skills. Results Response rates were pre 100%, post-1 95% (53 of 56), and post-2 100%. Post-intervention, more residents were “confident/very confident” in adjusting their camera (33%, 95% CI 20–45 vs 85%, 95% CI 75–95, P < .0001), e-messaging (pre 36%, 95% CI 24–49 vs post-2 80%, 95% CI 70–91, P < .0001), and coordinating interdisciplinary care (pre 35%, 95% CI 22–47 vs post-2 84%, 95% CI 74–94, P < .0001). More residents were “likely/very likely” to use telemedicine in the future (pre 56%, 95% CI 43–69, vs post-2 79%, 95% CI 68–89, P = .001). Conclusions A longitudinal, interdisciplinary telehealth simulation is feasible and can improve residents' confidence in using telemedicine to provide complex patient care.

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