Background: There is a shift towards increased use of telemedicine applications for healthcare service provision and delivery.Thus, awareness among healthcare practitioners of telemedicine policies is critical for proper implementation and utilization of telemedicine technology.Objective: This study assesses the level of computer access and literacy, knowledge of telemedicine policies and technology, perceptions, and willingness to use telemedicine among healthcare practitioners working in ambulatory care clinics.Methods: An observational cross-sectional study was conducted at King Fahad Armed Forces Hospital in Jeddah.Data were collected between February and March 2021 using a self-completed online survey.Results: Of 136 healthcare practitioners surveyed, we found that over half had average to high knowledge about telemedicine technology, tools, guidelines, security, and privacy policies within the hospital.95% were willing to use telemedicine to consult with large centers in their medical or clinical specialty and support further implementation of telemedicine technology in the hospital.90% expressed a need for continuous training in the use of telemedicine. Conclusion:The current study shows that there is inadequate computer access and knowledge of telemedicine, but there were very positive perceptions and willingness related to telemedicine among healthcare practitioners working in the ambulatory care clinics.There is an urgent need for orientation and training programs that focus on the technology and applications of telemedicine, as well as current policies.
Introduction: COVID-19 pandemic shows the importance of teledentistry usage to cope with such conditions and to improved the patient access and quality of care. Since dental treatments are highly infectious procedures due to the close proximity to patients required and the extended exposure to aerosols (including water from high-and low-speed handpieces and patients' saliva and blood). Viruses such as COVID-19 could be transmitted through these aerosols. As a result dental treatments were limited to emergency only, according to the guidance of the Ministry of Health. This limitation increases the need for means of communication between dental practitioners and patients in order to follow up and provide consultation without direct contact. This could be provided by using telemedicine.Methods: However, the evidence assessing the effectiveness of this intervention is scars. Therefore, The aim of this study is to conduct mixed method research (quantitative and qualitative) to measure the effectiveness of teledentistry usage during the COVID-19 pandemic. To provide an in-depth understanding of the use of teledentistry in assessing urgent dental cases and providing consultations.Results: The sample size for the quantitative part of the study (questionnaire) will include Patients that contacts the virtual clinic and attended to their appointments between 28/4/20 and 30/6/20 (the total will be 125 patients), While the sample for the qualitative part will be dentists who used to work in the call center listed in the virtual clinic database.Conclusion: The outcome of the study is to provide an overview of the use of teledentistry in assessing urgent dental cases and providing consultations and patients satisfaction of the provided service.
Background: An IoT Big Data analysis platform should be able to dynamically manage IoT data and it should be appropriate the fundamental components, known as the 5V's of big data. Therefore, speed and accuracy are two important criteria to consider. In this context, there are no similar studies that prioritize speed and accuracy criteria in big health data. It is thought that this study and the experimental results obtained are a new approach in the field of healthcare, hence it will add novelty to the studies to be carried out. The main objective of this paper is to detect anomalies at the edge of IoT for the effective management of big health data. Methods: This study focuses on detecting anomalies on the data stream created with IoT sensors between the sensing and network layer. The classification success and data proces-sing speed of the random cut forest, logistic regression, Naive Bayes, and neural network algorithms used for anomaly detection are compared. In order to detect anomalies in a data stream consisting of temperature, age, gender, weight, height, and time data and compare algorithms. Results: The speed and accuracy performances of ML Algorithms were compared. The performance comparison shows that the LR algorithm will be more successful in IoT systems in terms of speed, although it is very close to the RCF in terms of accuracy. Conclusion: The experimental results show that using ML algorithms on IoT edges will help make effective and timely decisions in the healthcare domain. Thus, the big data generated by the IoT sensing layer in healthcare will be formed at a more manageable level. Also, thanks to this, service providers, users, and other interested sides will be minimally affected by the negative effects of anomalous data.
Phone or tablet-based healthcare applications, or "medical apps," play an important role in an evolving healthcare system. The effect of medical apps on consumers has been welldocumented; however, little attention has been paid to the impacts that apps have had on medical professionals, people whose best interests like in ensuring that medical apps positively impact patient outcomes. After a brief introduction, introducing the spectrum of problems surrounding medical apps, this paper will move its focus to issues of concern for medical practitioners who prescribe or use medical apps as a part of their approach to medical care. Given the current lack of regulatory oversight of medical apps and noting the potential for improper use of these mHealth technologies, the authors will argue that as qualified, well suited, and interested parties, medical professionals should help to shape this new regulatory and ethical landscape. Additionally, before concluding, the authors will provide concrete examples of ways that medical professionals have put these ideas into practice.
Crohn's disease and ulcerative colitis are the two most common subtypes of inflammatory bowel disease. Most studies show that this patient population is increasing in incidence. Patients with these diseases require lifelong care by experienced practitioners however the traditional medical model is not ideal for patients who require continuous close monitoring and whose symptoms may dramatically worsen between regularly scheduled visits. Patients with uncontrolled disease may experience abdominal pain, diarrhea, and rectal bleeding and such patients are at increased risk for complications that may necessitate hospitalization and emergency surgery. Traditional medical care can be supplemented by telemedicine, which is the delivery of health care through remote electronic communication, for example, through web-based computer or smartphone applications. Here we describe several studies that highlight the many ways in which telemedicine can augment and improve patient care through telemonitoring, telemanagement, televisit, and teleconsultation.
Background Numerous living labs have established a new approach for studying the health, independent living, and well-being of older adults with dementia. Living labs interact with a broad set of stakeholders, including students, academic institutions, private companies, health care organizations, and patient representative bodies and even with other living labs. Hence, it is crucial to identify the types of cocreations that should be attempted and how they can be facilitated through living labs. Objective This study aims to scope publications that examine all types of living lab activities, exploring the needs and expectations of older adults with dementia and seeking solutions, whether they live in the community or long-term health care facilities (LTHFs). Methods This scoping review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations for the extension of scoping reviews. We searched six bibliographic databases for publications up to March 2020, and a forward-backward citation chasing was performed. Additional searches were conducted using Google Scholar. The quality of the selected papers was assessed. Results Of the 5609 articles identified, we read 58 (1.03%) articles and retained 12 (0.21%) articles for inclusion and final analysis. All 12 articles presented an innovative product, developed in 4 main living labs, to assist older adults with cognitive disorders or dementia living in the community or LTHFs. The objectives of these studies were to optimize health, quality of life, independent living, home care, and safety of older adults with cognitive disorders or dementia, as well as to support professional and family caregivers or reduce their burdens. The overall methodological quality of the studies ranged from poor to moderate. Conclusions This scoping review identified several living labs playing a pivotal role in research aimed at older adults with dementia living in the community or LTHFs. However, it also revealed that living labs should conduct more better-quality interventional research to prove the effectiveness of their technological products or service solutions. International Registered Report Identifier (IRRID) RR2-10.2147/SHTT.S233130
Background: Obesity is recognized as the most widespread metabolic disease. The growing spread of modern technologies opens new perspectives in treating and caring for people suffering from obesity. The main objective of this paper is to analyze the use of modern technologies among Generation Y (age between 15 and 30) to chart the actual skills of obesity patients. Methods: The key method used in this paper is a quantitative survey research targeted on generation Y. The two groups "Y" and "non Y" are compared according to numerical and categorical variables. Possible dependences between body mass index and other numerical variables are also analyzed in pairs. Results: The two groups "Y" and "non Y" do not significantly differ in "hours of physical activities or sports per week" (p>0.33) and in the category of residence size (p>0.10) and they are significantly different in all other variables (p<0.0001). Besides the relatively higher size of sample, the relationships between BMI and three possible numerical variables are not confirmed (p>0.05). Among all respondents, most of them know some obesity-related applications and more than one third uses or used one of them in the past, but only 17.14% of respondents used these applications for active weight loss. Among Generation Y, 41.48% of respondents use an obesity-related application. Conclusion: Based on the findings of this research, the mobile applications and modern technologies should be considered as a tool with great potential for preventing obesity rather than its treatment.
The traditional model of health services imposes limitations, especially in resource-limited countries like Nepal. Introduction to information technology can mitigate various challenges like geographic complexity, urban-rural disparity, poor accessibility, shortage of healthcare professionals, inadequate health facilities, higher cost, and time. Nepal is a resource-limited country with diverse geographic features making it hard to have proper access to healthcare facilities. Telemedicine service has the potential to improve service quality and accessibility of the disadvantaged and underserved population by overcoming the existing challenges. The objective of this review was to explore the roles of telemedicine in vanquishing existing challenges. Seven data sources (namely CINAHL, PubMed, POPLINE, Web of Science, Scopus, DOAJ and Summon) were consulted using five keywords (telemedicine, telehealth, eHealth, mHealth and Nepal to find the literature using the Boolean operator AND) to obtain the relevant materials. The narrative synthesis method was used to review papers and to analyze the findings. This review selected 27 papers for further analysis by scrutinizing 1161 initial search results. The most common features of telemedicine services so far, implemented or piloted in Nepal, were addressing geographic remoteness (21%), a shortage of in healthcare service providers (11%), saving time (11%), addressing challenges of extreme conditions (10%), cost saving (9%), service quality (9%) and real-time services (8%). Some other features of telemedicine were communication, transportation, referral, collaboration, addressing challenges in proper diagnosis and the shortage of health professionals. In a nutshell, the review findings suggested improved service quality, increased collaboration and accessibility and decreased the disparity in comparison with traditional health service models. Although it cannot be said that telemedicine in Nepal has been mainstreamed, yet the appeal is increasing due to its positive impact, especially in rural and hard-to-reach areas where with a lack of healthcare set-up and professionals.
Parkinson's disease (PD) is a progressive neurological disorder that primarily affects older adults. The number of patients who receive specialty care continues to be limited, even though the benefits of seeing a movement disorder specialist for management of PD have been well established. Telemedicine has been suggested as a useful tool in addressing the problem of access to specialty care. As evidenced by the literature, it has been suggested that using telemedicine to treat PD is feasible and economically advantageous for both patients and providers. A high level of interest exists on both sides, and a high level of patient and provider satisfaction has been reported. The quality of care provided to patients with PD via telemedicine is comparable to in-person care based on objective measures. Additionally, telemedicine can increase access to care for certain patient populations. The current shortcomings of telemedicine that limit widespread use of the technology include technological barriers, limitations of the virtual exam, limited patient access to technology, weaknesses of current research, ongoing difficulties negotiating reimbursement for virtual visits, and licensing difficulties. We propose an ideal telemedicine system for PD set up as a remote clinic to ensure consistency across patient encounters. This clinic would have adequate support staff to conduct the physical exam, organize patient scheduling and discharge instructions, and coordinate ancillary services for patients including physical therapy, occupational therapy, psychological services, speech and language therapy, and social services. The future of telemedicine for the treatment of PD is promising, but broader research is needed to understand the challenges of patients living with PD. New portable technologies for monitoring symptoms and delivering treatment will continue to change the landscape, but it will still be some time before these technologies can be streamlined into virtual care without the need for in-person assessments and adjustments.
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The revolution in digital technology has transformed our lives, and electronic advances are expected to expand. At the same time, personal attitudes toward technology developments and digital health care are also changing positively. Younger generations and older adults have started to enjoy the outcomes of the recent technology progresses. Soon, smart gadgets are expected to play an important role in health care and day-to-day management of the patients, and hence will be able to renovate medical services and facilitate real improvement in the patients' self-management. The challenge is how to make most of these technical advances patient friendly, and explore ways to avoid the risks, particularly in regard to privacy. This article discusses the growing role of telehealth in standard health care, the facility and impact of using digital technology in day-to-day patients' management and the best evidence available from those using digital technology on the front line.
Technological advancements have revolutionized modern medicine and smartphones are now ubiquitous among health care professionals. The ability to look up information promptly is invaluable to doctors and medical students alike, but there is an additional contiguous benefit to patients. Queries can be answered more accurately through fingertip access to evidence-based medicine, and physicians have instant access to emergency care protocols. However, is consideration always extended to the patient's perception of the use of smartphones by doctors? Do patients know why we use smartphones to assist us in their care? What do they think when they see a doctor using a smartphone?An independent question, conducted within a wider service evaluation (ethical approval not required, full verbal and written electronic consent provided by all patients) at St. Mary's Hospital, London, indicated that although the majority (91.0%) of patients owned a smartphone, many (61.6%) did not agree that the use of smartphones at work by doctors is professional. This highlights the potential for damage to the doctor-patient relationship. There is a risk that these patients will disconnect with care services with possible detriment to their health. Additionally, it is notable that a larger proportion of those patients aged >70 years found the use of smartphones by doctors at work unprofessional, compared with patients aged <70 years.Adequate communication between the doctor and patient is critical in ensuring that doctors can make use of modern technology to provide the best possible care and that patients are comfortable with this and do not feel isolated or consider the doctor ignorant. It is suggested that moves are made to educate patients of the importance of the use of technology by doctors and to ensure that patients are aware of the reasons for which doctors use smartphones at work.
With the rapid advances in the capabilities of telehealth devices and their increasing connection to the Internet, security is becoming an issue of major concern. Therefore, the perceptions of the health care professionals regarding security are of interest, as the patients trust them to make informed decisions on issues concerning their privacy, data, and health. Eight health care professionals were interviewed to determine their perceptions and knowledge of security in health care. The research further examines one specific aspect of security which is considered of significant concern: the authenticity of a device being from the actual manufacturer and not a counterfeit. This research proposes device registration together with digital signatures and one-time passwords to address the issue of counterfeit remote patient-monitoring devices and identify and authenticate the user of the device.
Although the concepts are broad, telemedicine and mobile health (mHealth) can be defined as a methodology to provide health care remotely and improve health services and outcomes using telecommunication tools. The widespread adoption of these technologies and current health care challenges, such as the aging population and increasing costs, has encouraged interest in the development of new strategies involving telemedicine. Overall, there is a lack of evidence rigorously assessing the impact of telemedicine and mHealth. Therefore, proper randomized controlled trials, with cost-effectiveness and impact on quality-of-life analysis, are urgently needed. They should also focus on specific populations and their comorbidities, since customizing telemedicine approaches is paramount to ensure success. Obstructive sleep apnea is a highly prevalent chronic condition and the most common of sleep-breathing disorders, and telemedicine and mHealth could play a pivotal role in the different phases of its management. In the future, using new devices capable of signal acquisition and analysis will refine obstructive sleep apnea diagnosis; even smartphones' built-in sensors could offer improved comfort and the possibility of home sleep monitoring. Continuous positive airway pressure titration could be performed with wireless devices, whose parameters can be changed remotely from sleep centers. Finally, the follow-up phase could be specially improved by telemedicine by using remote continuous positive airway-pressure data, self-management platforms, and mobile applications for patient feedback. Incorporating new procedures with novel technologies and sensors will probably change the process. Instead of replicating traditional visits, mHealth may provide shorter and more frequent assessments; alarm systems on the patients' devices could alert physicians or mobile applications with simple questionnaires may help on follow-up. With telemedicine, patients will not be treated in the same way.
Purpose: The purpose of this study was to update the current status on accuracy, reliability, and clinical outcomes and establish barriers and perspectives of teledermatology strategies. Methods: MEDLINE was searched to identify relevant studies published until April 2017, supplemented by references from the selected articles. Study search and selection were performed by independent reviewers. Quality assessment was performed. Results: Of the 2,525 articles retrieved, 45 manuscripts (44 studies, 7,033 patients) were included in the review, 42 of them in developed countries. The studies were organized in three groups, according to their content: clinical outcomes (n=16), diagnostic accuracy (n=9), and diagnostic reliability (n=19). Teledermatology diagnosis is accurate, with sensitivity and specificity ranging from 73% to 97% and 73% to 83%, respectively, when compared to face-to-face (FTF) diagnosis and/or histopathological results. The diagnostic agreement between teledermatologists and FTF dermatologists showed high variability, from fair (kappa 0.35) to almost perfect (kappa 0.91), but in most of the studies the agreement was almost perfect. Studies that used educational teledermatology strategies showed benefits in improvement of severity of skin conditions, adherence to therapy, and higher quality-of-life score; and anxiety reduction in patients with psoriasis, when compared to usual care. Overall, interventions focused on clinical outcomes showed at least similar results when compared to usual care. Interventions connecting patients to specialists or health care practitioners to specialists did not show statistical difference in the rate of healing, severity, and/or clinical evolution of skin conditions when compared to usual care, except for one study with methodological issues. Conclusion: Overall, teledermatology demonstrated good performance in comparison to conventional consultations for diagnostic agreement and diagnostic accuracy. The evidence suggests there is no difference in clinical outcomes with teledermatology in most cases, but adequately powered studies for subgroups of skin conditions are needed.
: The global pandemic of obesity requires an urgent response. Obesity results in increased risk of type 2 diabetes, cardiovascular disease and cancer. The need to provide cost-effective treatment to the millions affected is evident but traditional repeated individual face-to-face management would clearly exhaust available health care services. It is for this reason that the use of mobile health (mHealth) to improve population health, diet, and physical activity has become an active area of research. The aim of this review is to give a perspective of where this field of research currently stands using examples from the published literature. Smartphones provide a medium for the delivery of health information, personal coaching, monitoring of eating and physical activity behaviors and to integrate outputs from other sensors. Health and computer researchers have been developing and evaluating mHealth for the management of obesity but their efforts are relatively small. Text messaging, applications (apps) and a number of multicomponent mHealth programs utilizing a variety of Smartphone functions indicate some success in weight management but the results are mixed. Apart from the ubiquitous nature of Smartphones and devices, the real-time delivery of output data provides the potential for continuous adjustment of interventions according to the changes an individual is making after each message they receive from the mHealth program. This ability to optimize interventions for individual weight management in a timely fashion is the big challenge for researchers. Person-alized heath advice is the preferred option of individuals, and cooperation between computer scientists, behavioral scientists, dietitians, exercise physiologists and medical practitioners will be needed to meaningfully integrate data and responses from automated systems. In summary, mHealth shows potential, but we are still in the early stages of being able to harness its full capabilities for making a meaningful contribution to combatting obesity.
Demographic aging of the world population contributes to an increase in the number of persons diagnosed with dementia (PWD), with corresponding increases in health care expenditures. In addition, fewer family members are available to care for these individuals. Most care for PWD occurs in the home, and family members caring for PWD frequently suffer negative outcomes related to the stress and burden of observing their loved one’s progressive memory and functional decline. Decreases in cognition and self-care also necessitate that the caregiver takes on new roles and responsibilities in care provision. Smart technologies are being developed to support family caregivers of PWD in a variety of ways, including provision of information and support resources online, wayfinding technology to support independent mobility of the PWD, monitoring systems to alert caregivers to changes in the PWD and their environment, navigation devices to track PWD experiencing wandering, and telemedicine and e-health services linking caregivers and PWD with health care providers. This paper will review current uses of these advancing technologies to support care of PWD. Challenges unique to widespread acceptance of technology will be addressed and future directions explored.
Cardiac rehabilitation (CR) has, for many years, been a highly recommended approach to secondary prevention for patients recovering after a heart attack or heart surgery. These programs are traditionally delivered from a hospital outpatient center. Despite demonstrated benefits and guideline recommendations, CR utilization has been poor, particularly in women, older patients, and ethnic minority groups. To overcome some of the barriers to the traditional delivery of CR, different delivery platforms and approaches have been developed in recent years. In general, Telehealth solutions which have been used to address the delivery of CR services remotely include: 1) patient-provider contact delivered by telephone systems; 2) the Internet, with the majority of patient-provider contact for risk factor management taking place online; and 3) interventions using Smartphones as tools to deliver CR through ( independently or in combination with) short message service messaging, journaling applications, connected measurement devices, and remote coaching. These solutions have been shown to overcome some of the barriers in CR participation and show potential as alternative or complementary options for individuals that find traditional center-based CR programs difficult to commit to. The major benefits of remote platforms for CR delivery are the ability to deliver these interventions without ongoing face-to-face contact, which provides an opportunity to reach large numbers of people, and the convenience of selecting the timing of cardiovascular disease management sessions. Furthermore, technologies have the potential to deliver long-term follow-up, which programs delivered by health professionals cannot afford to do due to staff shortages and budget restrictions. However, change in the existing CR services is not without challenges. There is a need to identify development issues that can hamper the implementation of the interventions outside controlled trial settings systems, which may require new computing infrastructures, specific clinical responsibilities, time for training, and development and openness to new ways of doing things.
Telemedicine has been used successfully in monitoring patients with a variety of chronic illnesses. Studies in the field of gastroenterology have shown that telemedicine is a feasible and well accepted method of patient monitoring. Several inflammatory bowel disease (IBD) centers have developed telemedicine systems to improve the management of these com- plex diseases. Implementation of these systems is feasible, and telemedicine is well received by patients. Telemedicine has been shown to improve disease activity, quality of life, adherence with short-term treatment, and to shorten relapses. Telemedicine has also been shown to decrease health care utilization; however, use of telemedicine systems is also associated with increased "non-billable" encounters (phone calls and electronic messages). Telemedicine has also been shown to be an effective mechanism to provide remote care in areas without access to IBD spe- cialty care. It is likely that telemedicine will be increasingly utilized in the future as an adjunct to traditional monitoring, especially for patients at high risk for nonadherence, and for those with limited access to IBD centers of excellence, to improve patient self-management, and as a mechanism to provide education, health maintenance, and medication reminders to patients.
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