Redesigning telemedicine: preliminary findings from an innovative assisted telemedicine healthcare model.
Background: Telemedicine holds immense potential to revolutionise healthcare delivery, particularly in resource-limited settings and for patients with chronic diseases. Despite proven benefits and policy reforms, the use of telemedicine remains low due to several patient, technology, and system-leve...
| Publicado en: | BMC Primary Care Vol. 25; no. 1; pp. 1 - 12 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
10/23/2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180457767&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180457767 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 27314553 MZZU jtl: BMC Primary Care issn: 27314553 maglogo: N pubinfo: dt: 10/23/2024 vid: 25 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 180457767 180457767 180457767 10.1186/s12875-024-02631-x 180457767 ppf: 1 ppct: 11 formats: tig: atl: Redesigning telemedicine: preliminary findings from an innovative assisted telemedicine healthcare model. aug: au: Jose, Arun Pulikkottil Kaushik, Aprajita Tange, Huibert van der Weijden, Trudy Pandey, Nikki Sharma, Anshika Sheikh, Ruksar Ali, Nazneen Kushwaha, Savitesh Kondal, Dimple Chaturvedi, Abhishek Prabhakaran, Dorairaj affil: https://ror.org/02jqpaq24 BRIDGE Centre for Digital Health, Centre for Chronic Disease Control, New Delhi, India sug: subj: Telemedicine Utilization Chronic Disease Health Services Accessibility Diabetes Mellitus Hypertension Outcomes (Health Care) Models, Theoretical Program Implementation Human Male Female Adolescence Adult Middle Age Aged India Descriptive Statistics Nonexperimental Studies Interviews Confidence Intervals Decision Support Systems, Clinical Implementation Science Electronic Health Records Clinical Information Systems Blood Glucose Systolic Pressure Diastolic Pressure Digital Health Quality of Health Care Technology, Medical Guideline Adherence Healthcare Disparities Health Care Delivery, Integrated Funding Source Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Telemedicine holds immense potential to revolutionise healthcare delivery, particularly in resource-limited settings and for patients with chronic diseases. Despite proven benefits and policy reforms, the use of telemedicine remains low due to several patient, technology, and system-level barriers. Assisted telemedicine employs trained health professionals to connect patients with physicians, which can improve access and scope of telemedicine. The study aims to describe the design, service utilisation and chronic disease outcomes following the implementation of an assisted telemedicine initiative. Methods: This is an observational implementation study. Barriers and potential solutions to the implementation of telemedicine were identified through interviews with key stakeholders. The assisted telemedicine solution using an interoperable platform integrating electronic health records, point-of-care diagnostics, and electronic clinical decision support systems was designed and piloted at three telemedicine clinics in Tamil Nadu, India. Nurses were trained in platform use and facilitation of tele-consultations. Health records of all patients from March 2021 to June 2023 were included in the analysis. Data were analysed to assess the utilisation of clinic services and improvements in health outcomes in patients with diabetes mellitus and hypertension. Results: Over 2.4 years, 11,388 patients with a mean age of 45 (± 20) years and median age of 48 years, predominantly female (59.3%), accessed the clinics. The team completed 15,437 lab investigations and 26,998 consultations. Among 5542 (48.6%) patients that reported chronic conditions, diabetes mellitus (61%) and hypertension (45%) were the most frequent. In patients with diabetes mellitus and hypertension, 43% and 75.3% were newly diagnosed, respectively. Diabetes mellitus and hypertension patients had significant reductions in fasting blood sugar (-33.0 mg/dL (95% CI (-42.4, -23.7, P < 0.001)), and systolic (-9.6 mmHg (95% CI (-12.1, -7.0), P < 0.0001)) and diastolic blood pressure (-5.5 mmHg (95% CI (-7.0, -4.08), P < 0.0001)) at nine months from first visit, respectively. Conclusions: The 'Digisahayam' model demonstrated feasibility in enhancing healthcare accessibility and quality by bridging healthcare gaps, diagnosing chronic conditions, and improving patient outcomes. The model presents a scalable and sustainable approach to revolutionising patient care and achieving digital health equity, with the potential for adaptation in similar settings worldwide. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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