Title: Telemedicine and E-Health

Title: Telemedicine and E-Health

ISO Abbreviated Title:

JCR Abbreviated Title:

ISSN:

Journal Country/Territory:

Language:

Publisher:

Publisher Address:

Subject Categories:

: Impact Factor

? Jones, A., Hedges-Chou, J., Bates, J., Loyola, M., Lear, S.A. and Jarvis-Selinger, S. (2014), Home telehealth for chronic disease management: Selected findings of a narrative synthesis. Telemedicine and E-Health, 20 (4), 346-380.

Full Tex: 2014\Tel E-Hea20, 346.pdf

Abstract: Background: Chronic disease has become an increasingly important issue for individuals and healthcare organizations across Canada. Home telehealth may have the potential to alleviate the economic and social challenges associated with rising rates of chronic disease. An aim of this review was to gather and synthesize the evidence on the effectiveness of home telehealth in chronic disease management. Materials and Methods: We searched the Medline, EMBASE, Web of Science, CINAHL, and PAIS databases for studies published in English from January 1, 2005, and December 31, 2010. Academic publications, white papers, and gray literature were all considered eligible for inclusion, provided an original research element was present. Articles were screened for relevance. Results: One hundred one articles on quantitative or mixed-methods studies reported the effects of home telehealth on disease state, symptoms, and quality of life in chronic disease patients. Studies were consistent in finding that home telehealth was equivalent or superior to usual care. Conclusions: the literature strongly supports the use of home telehealth as an equally effective alternative to usual care. The circumstances under which home telehealth emerges as significantly better than usual care have not been extensively researched. Further research into factors affecting the effectiveness of home telehealth would support more widespread realization of telehealth’s potential benefits.

Keywords: Academic, Academic Publications, Alternative, Articles, Benefits, Canada, Cardiology, Cardiovascular Disease, Care, Care Coordination, Home-Telehealth, Chronic, Chronic Disease, Chronic Heart-Failure, Databases, Diabetes Self-Management, Disease, Disease Management, E-Health, Economic, Effectiveness, Effects, Embase, English, Evidence, Glucose Monitoring-System, Gray Literature, Home Health Monitoring, Improves Glycemic Control, Life, Literature, Management, Materials, Medline, Methods, Obstructive Pulmonary-Disease, Papers, Patients, Potential, Publications, Quality, Quality Of, Quality of Life, Quality-Of-Life, Randomized Controlled-Trial, Rates, Relevance, Research, Results, Review, Science, Short Message Service, Social, State, Support, Symptoms, Synthesis, Telehealth, Telemedicine, Web of Science, Web-Based Intervention

? Ramnath, V.R., Ho, L., Maggio, L.A. and Khazeni, N. (2014), Centralized monitoring and virtual consultant models of tele-ICU care: A systematic review. Telemedicine and E-Health, 20 (10), 936-961.

Full Tex: 2014\Tel E-Hea20, 936.pdf

Abstract: Background: Increasing intensivist shortages and demand coupled with the escalating cost of care have created enthusiasm for intensive care unit (ICU)-based telemedicine (“tele-ICU”). This systematic literature review compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. Materials and Methods: With an experienced medical reference librarian, we identified all language publications addressing the employment and efficacy of the centralized monitoring and virtual consultant tele-ICU systems through PubMed, CINAHL, and Web of Science. We performed quantitative and qualitative reviews of documents regarding financial sustainability, clinical outcomes, and ICU staff workflow and acceptance. Results: Of 1,468 documents identified, 1,371 documents were excluded, with the remaining 91 documents addressing clinical outcomes (46 documents [enhanced guideline compliance, 5; mortality and length of stay, 28; and feasibility, 13]), financial sustainability (9 documents), and ICU staff workflow and acceptance (36 documents). Quantitative review showed that studies evaluating the Centralized Monitoring Model were twice as frequent, with a mean of 4,891 patients in an average of six ICUs; Virtual Consultant Model studies enrolled a mean of 372 patients in an average of one ICU. Ninety-two percent of feasibility studies evaluated the Virtual Consultant Model, of which 50% were in the last 3 years. Qualitative review largely confirmed findings in previous studies of centralized monitoring systems. Both the Centralized Monitoring and Virtual Consultant Models showed clinical practice adherence improvement. Although definitive evaluation was not possible given lack of data, the Virtual Consultant Model generally indicated lean absolute cost profile in contrast to centralized monitoring systems. Conclusions: Compared with the Virtual Consultant tele-ICU Model, studies addressing the Centralized Monitoring Model of tele-ICU care were greater in quantity and sample size, with qualitative conclusions of clinical outcomes, staff satisfaction and workload, and financial sustainability largely consistent with past systematic reviews. Attention should be focused on performing more high-quality studies to allow for equitable comparisons between both models.

Keywords: Acceptance, Adherence, Attention, Care, Clinical, Clinical Outcomes, Clinical Practice, Clinical-Outcomes, Compliance, Cost, Cost Of Care, Critically-Ill Patients, Data, Demand, Documents, Economic Outcomes, Efficacy, Employment, Evaluation, Feasibility, Guideline, Health Information-Technology, Icu, Improvement, Intensive Care, Intensive Care Unit, Language, Length, Length Of Stay, Length-Of-Stay, Literature, Literature Review, Materials, Medical, Methods, Model, Models, Monitoring, Monitoring Systems, Mortality, Neonatal Intensive-Care, Outcomes, Patient Outcomes, Patients, Practice, Provider Attitudes, Publications, Pubmed, Qualitative, Reference, Remote Monitoring, Remote Presence, Remote Presence Technology, Results, Review, Reviews, Sample Size, Satisfaction, Science, Size, Sustainability, Systematic, Systematic Literature Review, Systematic Review, Systematic Reviews, Systems, Tele-Intensive Care Unit, Teleconsultation, Telecritical Care, Telehealth, Telemedicine, Unit Telemedicine Program, Web Of Science, Workload

? Ramnath, V.R. and Khazeni, N. (2014), Centralized monitoring and virtual consultant models of tele-ICU Care: A side-by-side review. Telemedicine and E-Health, 20 (10), 962-971.

Full Tex: 2014\Tel E-Hea20, 962.pdf

Abstract: Background: Telemedicine-based “tele-intensive care unit” (“tele-ICU”) solutions represent an increasingly popular hospital platform to provide ICU specialist expertise while remaining sensitive to healthcare costs. This side-by-side review directly compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. Materials and Methods: We identified all publications in any language addressing the use and efficacy of centralized monitoring and virtual consultant tele-ICU systems through reviews of the PubMed, CINAHL, and Web of Science Web sites, corporate documents, corporate Internet sites, and discussions with corporate representatives. Of the 1,468 documents identified, 1,371 documents were excluded, with the 91 included documents addressing the following: clinical outcomes, 46 documents (enhanced guideline compliance, 5; mortality and length of stay, 28; and feasibility, 13); financial sustainability, 9 documents; and ICU staff workflow and acceptance, 36 documents. We performed qualitative comparative reviews of documents addressing technology, financial sustainability, clinical outcomes, and ICU staff workflow and acceptance. Results: The Centralized Monitoring tele-ICU Model showed improved mortality and/or length of stay and staff acceptance, particularly in rural or specific patient populations, likely because of the presence of integrated clinical information systems and analytics. However, there are high costs and unclear savings. The Virtual Consultant Model could not be adequately evaluated for effects on clinical outcomes or staff acceptance given minimal data. This model can be both portable and implemented at a lower cost profile but cannot integrate different data streams. Improved compliance with clinical practice guidelines was seen in both models. Conclusions: Further study is required to adequately compare these tele-ICU models with regard to clinical outcomes and financial sustainability. With respect to tele-ICU effects on mortality and length of stay improvements and on-site staff acceptance, existing evidence favors the Centralized Monitoring Model. Studies addressing the Virtual Consultant Model are growing in number and are necessary before proper comparisons can be made.

Keywords: Acceptance, Care, Clinical, Clinical Outcomes, Clinical Practice, Clinical Practice Guidelines, Clinical-Outcomes, Compliance, Cost, Costs, Critically-Ill Patients, Data, Documents, Effects, Efficacy, Evidence, Facilitated Program, Feasibility, Guideline, Guidelines, Health Information-Technology, Healthcare Costs, Hospital, Icu, Information, Information Systems, Intensive-Care, Internet, Language, Length, Length Of Stay, Length-Of-Stay, Materials, Methods, Model, Models, Monitoring, Mortality, Outcomes, Populations, Practice, Practice Guidelines, Provider Attitudes, Publications, Pubmed, Qualitative, Remote Monitoring, Remote Presence, Remote Presence Technology, Results, Review, Reviews, Robotic Telepresence, Rural, Science, Solutions, Streams, Sustainability, Systems, Technology, Tele-Intensive Care Unit, Teleconsultation, Telecritical Care, Telehealth, Unit Telemedicine Program, Web Of Science

? Torre-Diez, I., Lopez-Coronado, M., Vaca, C., Aguado, J.S. and de Castro, C. (2015), Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: A systematic review. Telemedicine and E-Health, 21 (2), 81-85.

Full Tex: 2015\Tel E-Hea21, 81.pdf

Abstract: Objective: A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Materials and Methods: Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as “cost-utility” OR “cost utility” AND “telemedicine,” “cost-effectiveness” OR “cost effectiveness” AND “mobile health,” etc. In the articles searched, there were no limitations in the publication date. Results: The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. Conclusions: There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.

Keywords: Academic, Articles, Business Administration, Economics, Care, Congenital Heart-Disease, Control, Cost Effectiveness, Cost-Effectiveness, Cost-Utility, Costs, Data, Databases, Depression, Diabetic-Retinopathy, Disorders, E-Health, Economic, Health, Interventions, Isi, Isi Web Of Science, Literature, Management, Materials, Measures, Methods, Mobile, Mobile Health, Population, Publication, Pubmed, Quality, Randomized, Research, Results, Review, Reviews, Science, Scopus, Small, Systematic, Systematic Review, Systems, Telemedicine, Web, Web Of Science

? Perera, C.M. and Chakrabarti, R. (2015), A review of m-health in medical imaging. Telemedicine and E-Health, 21 (2), 132-137.

Full Tex: 2015\Tel E-Hea21, 132.pdf

Abstract: Objective: The increasing capabilities of camera-equipped mobile phones have led to a growing body of evidence regarding their use in medical imaging across a broad range of medical specialties. This article reviews the current evidence for the use of mobile health (m-health) in medical imaging. Materials and Methods: We performed a structured review of the published literature regarding m-health in medical imaging using the Medline, PubMed, and Web of Science databases (January 2002-August 2013). The two authors independently extracted data regarding type of specialty, purpose, and study design of publications. Results: In total, 235 articles were identified. The majority of studies were case reports or noncomparative product validation studies. The greatest volume of publications originated in the fields of radiology (21%), dermatology (15%), laboratory techniques (15%), and plastic surgery (12%). Among these studies, m-health was used as diagnostic aids, for patient monitoring, and to improve communication between health practitioners. With the growing use of mobile phones for medical imaging, considerations need to be given to informed consent, privacy, image storage and transfer, and guidelines for healthcare workers and patients. Conclusions: There are several novel uses of mobile devices for medical imaging that show promise across a variety of areas and subspecialties of healthcare. Currently, studies are mostly exploratory in nature. To validate these devices, studies with higher methodological rigor are required.

Keywords: Aids, Article, Articles, Authors, Case Reports, Case Series, Cellular Phones, Communication, Consent, Data, Databases, Dermatology, Design, Diagnostic, Diagnostic-Accuracy, Evidence, Guidelines, Health, Images, Imaging, Informed Consent, Iphone, Laboratory, Literature, Materials, Medical, Medical Imaging, Medline, Methods, Mhealth, Mobile, Mobile Health, Mobile Phone, Mobile Teledermatology, Monitoring, Patient, Patients, Photography, Plastic Surgery, Privacy, Publications, Pubmed, Purpose, Radiology, Results, Review, Reviews, Science, Smartphone, Smartphone, Specialty, Storage, Study Design, Surgery, System, Techniques, Technology, Telemedicine, Validation, Volume, Web, Web Of Science, Web Of Science Databases