The Medieval Offices of Saint Thomas Aquinas (original) (raw)
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Telemedicine--is the cart being put before the horse?
The Medical journal of Australia, 2014
A large literature base on telemedicine exists, but the evidence base for telemedicine is very limited. There is little practical or useful information to guide clinicians and health policymakers. Telemedicine is often implemented based on limited or no prior formal analysis of its appropriateness to the circumstances, and adoption of telemedicine by clinicians has been slow and patchy. Formal analysis should be conducted before implementation of telemedicine to identify the patients, conditions and settings that it is likely to benefit. Primary studies of telemedicine tend to be of insufficient quality to enable synthesis of formal evidence. Methods typically used to assess effectiveness in medicine are often difficult, expensive or impractical to apply to telemedicine. Formal studies of telemedicine should examine efficacy, effectiveness, economics and clinician preferences. Successful adoption and sustainable integration of telemedicine into routine care could be improved by evid...
Cureus
Many health care providers adopted telehealth during the coronavirus disease 2019 (COVID-19) pandemic. This unprecedented transformation in medical practice posed challenges to both physicians and patients. However, little is known about the adaptation of attendings, residents, and patients to this new normal. Thus, a survey was sent out to investigate the feedback of both physicians and patients on telehealth. Methods Surveys were administered via phone call to patients and electronic survey to physicians at an internal medicine resident clinic in one tertiary community hospital from April to June 2020. Demographic information and assessment of overall experience, satisfaction, and concerns of telehealth were collected. Statistical analyses were performed to compare feedback between patients and physicians. Results Fifty patients and 45 physicians participated in the study. Eighty-four percent of patients were first-or second-time users, and 50% of patients were older than 60 years. Eighty-four percent of patients were very or extremely satisfied with telehealth, while 72% wanted to continue telehealth in the future. Ninety-four percent of patients believed that their concerns were adequately addressed, but 14% experiencing technical issues. Physicians' feedback to telehealth was less positive than the patients'. More than 60% of physicians experienced technical issues, and nearly 60% of physicians were neutral or not satisfied with telehealth. Nearly 50% of physicians had difficulty transitioning to telehealth, while only 29% believed that their patients' complaints were adequately addressed. Most physicians had to schedule in-person visits after telehealth. Patients were more satisfied with telehealth than physicians (84% vs. 42%; p<0.001) and were more likely to believe that their concerns were properly addressed by telehealth (94% vs. 29%; p<0.001). Conclusion This survey revealed that patients were more satisfied with telehealth than physicians. Further research with a larger sample should be considered to confirm this conclusion, and subjective studies are needed to determine the imbalance of satisfaction.
Practical aspects of telehealth: are my patients suited to telehealth?
Internal Medicine Journal, 2013
Telehealth video consultation is fast becoming an important method of delivery of clinical care by physicians. This is because it brings with it important benefits, including an increase in the flexibility of interactions with patients, enhancement of the availability of services in remote or poorly supported locations, and reduction in waste by cutting travel and waiting times. Connecting to telehealth, however, is not always completely straightforward. There are important considerations relating to technical issues, as well as to the conduct of the clinical interactions themselves. There are questions about the selection of patients, relationships between providers, consent and confidentiality, and business issues. Even where efficient, high-resolution technologies are available, there may be crucial differences between what can be achieved in a face-to-face clinical encounter and what occurs through the computer screen, although whether these differences generate better or worse clinical or ethical outcomes, it is as yet too early to tell. The article that follows is the first in a series of seven proposed papers developed by the RACP Telehealth Working Group to fill some of the gaps in the available literature about telemedicine, and thereby, it is hoped, to improve its accessibility to physicians. The various contributions will provide practical guidance, as well as highlight strengths and limitations, and opportunities and possible pitfalls, including potential ethical problems. As always, responses from readers will be welcome: in particular, we are especially interested to hear about the range of experiences of telemedicine that practitioners have already encountered and their opinions about what its proper place in clinical practice should be.
Narrative review of telemedicine consultation in medical practice
Patient Preference and Adherence, 2015
The use of telemedicine has grown across several medical fields, due to the increasing number of &amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;e-patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;. This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care. A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty). Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions. Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time.
Interactive telemedicine: effects on professional practice and health care outcomes
The Cochrane database of systematic reviews, 2015
Telemedicine (TM) is the use of telecommunication systems to deliver health care at a distance. It has the potential to improve patient health outcomes, access to health care and reduce healthcare costs. As TM applications continue to evolve it is important to understand the impact TM might have on patients, healthcare professionals and the organisation of care. To assess the effectiveness, acceptability and costs of interactive TM as an alternative to, or in addition to, usual care (i.e. face-to-face care, or telephone consultation). We searched the Effective Practice and Organisation of Care (EPOC) Group's specialised register, CENTRAL, MEDLINE, EMBASE, five other databases and two trials registers to June 2013, together with reference checking, citation searching, handsearching and contact with study authors to identify additional studies. We considered randomised controlled trials of interactive TM that involved direct patient-provider interaction and was delivered in additi...
Journal of Medical Internet Research, 2021
Background Telemedicine technology is a growing field, especially in the context of the COVID-19 pandemic. Consult Station (Health for Development) is the first telemedicine device enabling completely remote medical consultations, including the concurrent collection of clinical parameters and videos. Objective Our aim was to collect data on the multisite urban and suburban implementation of the Consult Station for primary care and assess its contribution to health care pathways in areas with a low density of medical services. Methods In a proof-of-concept multisite prospective cohort study, 2134 consecutive patients had teleconsultations. Consultation characteristics were analyzed from both the patient and practitioner perspective. Results In this study, the main users of Consult Station were younger women consulting for low-severity seasonal infections. Interestingly, hypertension, diabetes, and preventive medical consultations were almost absent, while they accounted for almost 50...