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Virtual Care

Impact of Pharmacist Involvement on Telehealth Transitional Care Management (TCM) for High Medication Risk Patients

December 01, 2019

Impact of Pharmacist Involvement on Telehealth Transitional Care Management (TCM) for High Medication Risk Patients

This pilot study sought to evaluate the impact of pharmacist involvement in the preexisting telehealth transitional care management (TCM) program at Atrium Health on the quality and safety of the medication discharge process for high medication risk patients. Eligible participants were those 18 years of age or older with moderate-to-high risk for hospital readmission who were contacted by a TCM Nurse, identified as high medication risk patients, and referred to the TCM Pharmacist from September 2018 through February 2019. The TCM Pharmacist contacted patients by phone, completed a comprehensive medication review, identified medication list discrepancies (MLDs) and medication-related problems (MRPs), and made interventions or recommendations to primary care providers. Primary endpoints included the number and types of MLDs identified, number and types of MRPs identified, and the rate of unplanned 30-day hospital readmissions. Seventy-six patients were enrolled, and 78 MLDs and 108 MRPs were identified. Of the identified MRPs, 74.1% were resolved. A relative risk reduction of 36.8% was achieved for 30-day hospital readmissions for those with high medication risk contacted by the TCM Pharmacist compared to those only contacted by the TCM Nurse. Overall, TCM Pharmacists identified and resolved 80 medication-related problems, improved access to medication therapy, provided comprehensive medication counseling, and bridged gaps in care following hospital discharge.

The full article can be downloaded below.  

Name: 
Anna

On-Demand Telemedicine as a Disruptive Health Technology: Qualitative Study Exploring Emerging Business Models and Strategies Among Early Adopter Organizations in the United States

November 24, 2019

On-Demand Telemedicine as a Disruptive Health Technology: Qualitative Study Exploring Emerging Business Models and Strategies Among Early Adopter Organizations in the United States

On-demand telemedicine is a potentially disruptive innovation currently in the early adopter stage of technology adoption and diffusion. On-demand telemedicine must cross into the early majority stage to truly be a positive disruption that will increase accessibility and affordability for health care consumers. Our findings provide guidance for adopter organizations as they seek to deploy viable business models and successful strategies to smooth the transition to early majority status. We present important insights for both early adopters and potential early majority organizations to better harness the disruptive potential of on-demand telemedicine.

The full article can be viewed at this link.   

Name: 
Anna

Artificial Intelligence Could Help Solve America's Impending Mental Health Crisis

November 22, 2019

Artificial Intelligence Could Help Solve America's Impending Mental Health Crisis

Five years from now, the U.S.’ already overburdened mental health system may be short as many as 15,600 psychiatrists as the growth in demand for their services outpaces supply, according to a 2017 report from the National Council for Behavioral Health. But some proponents say that, by then, an unlikely tool—artificial intelligence—may be ready to help mental health practitioners mitigate the impact of the deficit.

The full TIME article can be viewed at this link.  

Name: 
Anna

Prevalence and Factors Associated with Family Physicians Providing E-Visits

November 16, 2019

Prevalence and Factors Associated with Family Physicians Providing E-Visits

The use of telemedicine has grown in recent years. As a subset of telemedicine, e-visits typically involve the evaluation and management of a patient by a physician or other clinician through a Web-based or electronic communication system. The national prevalence of e-visits by primary care physicians is unclear as is what factors influence adoption. The purpose of this study was to examine the prevalence of family physicians providing e-visits and associated factors.

A national, cross-sectional practice demographic questionnaire for 7580 practicing family physicians was utilized. Bivariate statistics were calculated and logistic regression was conducted examining both physician level and practice level factors associated with offering e-visits.

The overall prevalence of offering e-visits was 9.3% (n 702). Compared with private practice physicians, other physicians were more likely to offer e-visits if their primary practice was an academic health center/faculty practice (odds ratio [OR], 1.73; 95% CI, 1.03 to 2.91), managed care/health maintenance organization (HMO) practice (OR, 9.79; 95% CI, 7.05 to 13.58), hospital-/health system– owned medical practice (not including managed care or HMO) (OR, 2.50; 95% CI, 1.83 to 3.41), workplace clinic (OR, 2.28; 95% CI, 1.43 to 3.63), or federal (military, Veterans Administration [VA]/Department of Defense) (OR, 4.49; 95% CI, 2.93 to 6.89). Physicians with no official ownership stake (OR, 0.44; 95% CI, 0.28 to 0.68) or other ownership arrangement (OR, 0.29; 95% CI, 0.12 to 0.71) had lower odds of offering e-visits compared with sole owners.

Fewer than 10% of family physicians provided e-visits. Physicians in HMO and VA settings (ie, capitated vs noncapitated models) were more likely to provide e-visits, which suggests that reimbursement may be a major barrier.

The full article can be downloaded below.  

Name: 
Anna

How Big-Box Retailers Can Revitalize Rural Health Care

November 12, 2019

How Big-Box Retailers Can Revitalize Rural Health Care

There's a surefire, and perhaps unlikely, way to bolster access to health care for underserved Americans—at the shopping mall.

Millions of Americans struggle to get affordable, timely medical care. Roughly one-quarter of rural Americans haven't been able to get needed care at some point in recent years, according to a May 2019 poll conducted by NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health.

The main reasons? Affordability. Trouble scheduling an appointment. Having to travel a long distance.

Retailers can help overcome these barriers. In many rural communities, the local Walmart or CVS is not just an economic anchor but a civic institution. It's a gathering place for far-flung residents. And it may be the most convenient place for historically underserved populations to seek health care.

Adding telehealth capabilities to our existing retail infrastructure could significantly expand access to top-notch care—and reduce costs for patients and the healthcare system.

The full Forbes article can be viewed at this link.  

 

Name: 
Anna

Reaching People With Disabilities in Underserved Areas Through Digital Interventions: Systematic Review

November 03, 2019

Reaching People With Disabilities in Underserved Areas Through Digital Interventions: Systematic Review

People with disabilities need rehabilitation interventions to improve their physical functioning, mental status, and quality of life. Many rehabilitation interventions can be delivered digitally via telehealth systems. For people with disabilities in underserved areas, digitally delivered rehabilitation interventions may be the only feasible service available for them.

The objective of this study was to evaluate the current status of digital intervention for people with disabilities in remote and underserved areas.

A systematic review was conducted on this topic. Keyword searches in multiple databases (PubMed, CINAHL, and Inspec) were performed to collect articles published in this field. The obtained articles were selected based on our selection criteria. Of the 198 identified articles, 16 duplicates were removed. After a review of the titles and abstracts of the remaining articles, 165 were determined to be irrelevant to this study and were therefore removed. The full texts of the remaining 17 articles were reviewed, and 6 of these articles were removed as being irrelevant to this study. The 11 articles remaining were discussed and summarized by 2 reviewers.

These 11 studies cover a few types of disabilities, such as developmental disabilities and mobility impairments as well as several types of disability-causing disorders such as stroke, multiple sclerosis, traumatic brain injury, and facio-scapulo-humeral muscular dystrophy. Most of these studies were small-scale case studies and relatively larger-scale cohort studies; the project evaluation methods were mainly pre-post comparison, questionnaires, and interviews. A few studies also performed objective assessment of functional improvement. The intervention technology was mainly videoconferencing. Moreover, 10 of these studies were for people with disabilities in rural areas and 1 was for people in urban communities.

A small number of small-scale studies have been conducted on digital interventions for people with disabilities in underserved areas. Although the results reported in these studies were mostly positive, they are not sufficient to prove the effectiveness of telehealth-based digital intervention in improving the situation among people with disabilities because of the small sample sizes and lack of randomized controlled trials.

The full article can be downloaded below.  

Name: 
Anna

Urbanization Leaves Rural America In A Health Care Crisis

October 26, 2019

Urbanization Leaves Rural America In A Health Care Crisis

Declining birth rates and an aging population have impacted American migration patterns for decades. But according to the USDA’s Economic Research Service, between 2010 and 2017, almost 1,000 rural counties in the U.S. recorded more deaths than births. Add in migration patterns of people moving from rural areas of the country to more urban and suburban regions, and we find that in 2019 only 20% of Americans live in rural areas - which accounts for a surprising 97% of U.S. land mass.

But the implications of these population shifts greatly exceed the economic and housing needs of the region. Population change also means significant changes in health care need, demand and access. According to the National Institute for Health Care Management (NIHCM), “As urbanization increases, an older, sicker and poorer population remains in rural America.” What this really means is that those Americans living in rural areas of the country have much greater health issues, and far fewer health resources.

The full Forbes article can be found at this link.  

Name: 
Anna

The Use of Telehealth in School-Based Health Centers

October 26, 2019

The Use of Telehealth in School-Based Health Centers

Telehealth is a growing model of delivering health care. School-based health centers (SBHCs) provide access to health care for youth in schools and increasingly use telehealth in care delivery. This article examines the recent growth of telehealth use in SBHCs, and characteristics of SBHCs using telehealth, including provider types, operational characteristics, and schools and students served. The percentage of SBHCs using telehealth grew from 7% in 2007-2008 to 19% in 2016-2017. Over 1 million students in over 1800 public schools have access to an SBHC using telehealth, which represents 2% of students and nearly 2% of public schools in the United States. These SBHCs are primarily in rural communities and sponsored by hospitals. This growing model presents an opportunity to expand health care access to youth, particularly in underserved areas in the United States and globally. Further research is needed to fully describe how telehealth programs are implemented in school settings and their potential impacts.

The full article can be downloaded below.  

Name: 
Anna

Virtual Visits: Telehealth and Older Adults

October 18, 2019

Virtual Visits: Telehealth and Older Adults

Telehealth allows patients to have visits with health care providers remotely using video technology. Such visits are increasingly available and have the potential to make health care more accessible and convenient for patients. In May 2019, the University of Michigan National Poll on Healthy Aging asked a national sample of adults age 50–80 about their experiences with and opinions of telehealth.

The full report can be downloaded below.  

Name: 
Anna

Doctors turn to thumbs for diagnosis and treatment by text

October 09, 2019

Doctors turn to thumbs for diagnosis and treatment by text

Dr. Anna Nguyen spoke with none of the five patients she treated on a recent weekday morning. She didn’t even leave her dining room.

The emergency physician nevertheless helped a pregnant Ohio woman handle hip pain, examined a Michigan man’s sore throat and texted a mom whose son became sick during a family trip to Mexico.

Welcome to the latest wrinkle in health care convenience: the chat diagnosis.

The full article from the Associated Press can be viewed at this link

Name: 
Anna