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Purpose: Telemedicine use in healthcare is rising. However, infrastructural barriers may impede implementation in lower- and middle-income country settings. Patient perspectives regarding teleconsultation need to be explored. This study assesses the feasibility of teleconsultation among patients with cancer, patient satisfaction with its use, determinants of satisfaction, and its economic benefits. Methods: A cross-sectional telephonic interview-based study was conducted between February and September 2021 in a tertiary care cancer center in India. Adult patients with cancer or their caregivers who had availed of teleconsultation during the 6 months preceding the interview date were included. Teleconsultation was administered through email and telephone conversation. The research team developed an interview guide to elicit demographic details, satisfaction with teleconsultation, and the underlying reasons. Cost savings through teleconsultation were also recorded. Factors predicting subject satisfaction were identified by multivariable logistic regression. Results: During the study period, 195 subjects, including 84 patients (43.1%) and 111 caregivers (56.9%), were interviewed. The median patient age at diagnosis was 31 years. In our study, 147 (75.4%) patients/caregivers reported satisfaction with teleconsultations. The benefits cited included better access and follow-up (n = 173, 88.7%) and saving time and money (n = 164, 84.1%). In multivariable analysis, a higher patient age (more than 30 years) was the only factor predictive of less satisfaction with teleconsultation. The median cost savings were not a predictor of satisfaction. Conclusion: Teleconsultation is feasible and acceptable to most patients availing treatment in a tertiary oncology care setting in India. Patient and physician training for better communication may further improve the utility of this modality. [ABSTRACT FROM AUTHOR]

This small-scale qualitative study focuses on educational psychologists’ (EPs’) views on developing attuned interactions with service users during remote/online consultations. Data from 10 EPs in nine EP services in England were collected through semi-structured interviews and analysed using thematic analysis. The findings suggest that participants viewed it as possible to remain attuned during remote consultation. They also reported that online consultations can help to address the power imbalance between service users and professionals. Prior experience in Video Enhanced Reflective Practice (VERP) and training in Video Interactive Guidance (VIG) were viewed by some participants as supportive. However, some EPs considered skills in being attuned to others as being inherent to the role of psychologists. Further research on EP and service users’ online experiences and tentative implications for practice are suggested, including that EP services continue to include remote consultation within the range of services that they offer. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Telemedicine provides a means to deliver healthcare across distances, enhancing efficiency and accessibility, especially in low- and middle-income countries. The COVID-19 pandemic highlighted its importance by reducing the risk of virus transmission while maintaining healthcare delivery. This study evaluates the telemedicine program implemented at B.P. Koirala Institute of Health Sciences (BPKIHS), Nepal, which provided specialist services to remote districts via teleconsultation during the 2020 lockdown. The objectives were to identify the number of patients, the major complaints, and the follow-up departments during teleconsultation. Methods: A retrospective analysis was conducted on teleconsultation data from March 1 to August 31, 2020, across various outpatient departments at BPKIHS. Data from 10,901 patients were reviewed, with variables including age, gender, residence, and consultation medium. Descriptive statistics were calculated using SPSS (version 22). Results: Most of the patients (55.46%) were female, and the majority (30.84%) aged 21–30 years. Most consultations were from the Sunsari district (54.8%) and Koshi state (88.9%). Voice calls were the primary medium (39.62%), followed by WhatsApp video calls (30.08%). Obstetrics and gynecology had the highest consultation rate (16.15%), followed by dermatology (14.4%) and psychiatry (10.37%). Nearly half of the patients (45.0%) had follow-up consultations, primarily for dermatological issues (17.85%). Conclusion: The findings underscore telemedicine's role in facilitating healthcare access, particularly for women and residents of remote areas, by reducing travel and exposure risks. This study highlights the need for further integration of telehealth technologies to enhance healthcare delivery, suggesting that teleconsultation can efficiently meet healthcare demands in resource-limited settings during and beyond pandemics. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the relevance of the Rheumatoid Arthritis Impact of Disease (RAID) score as a disease activity marker of rheumatoid arthritis (RA) in a teleconsultation setting. Methods. A prospective, observational, 24-month, single-center study involving patients with RA who underwent teleconsultations was performed. The RAID score was sent to all patients by email and completed the day before the scheduled session. The RAID questionnaire was also completed just prior to the next scheduled face-to-face consultation. The same physician performed teleconsultation/in-person consultations and was unaware of the RAID results. Results. We included 70 patients (mean age 50 [SD 14] yrs, mean disease duration 10 [SD 9] yrs). The RAID score correlated with the following items: patient global assessment (r 0.55, P < 0.001), patient-reported swollen joint count (r 0.50, P < 0.001), and Disease Activity Score in 28 joints based on C-reactive protein (DAS28-CRP) calculated with patient self-reported tender/swollen joints (r 0.74, P < 0.001). The RAID score completed during the next face-to-face consultation for 45 patients also correlated with the DAS28-CRP performed by the clinician (r 0.65, P < 0.001). A RAID score > 2 was associated with the best combination of sensitivity (94%) and specificity (43%) for the indication of rapid in-person consultation because of insufficiently controlled disease activity, with an area under the curve of 0.74. All 23 patients with RAID < 2 had no intercurrent flares; overall physician global assessment was 1.6 of 10 (SD 1.4), DAS28-CRP 1.5 (SD 0.2), and CRP 1.8 (SD 1.4) mg/L. Conclusion. Our findings reinforce the RAID score as a valuable tool in teleconsultation, exhibiting a good correlation with disease activity variables. Using a RAID score threshold of 2 during teleconsultations could distinguish patients with good disease control and those with the potential need for an in-person visit. [ABSTRACT FROM AUTHOR]

Abstract Telehealth is defined as the provision of health care services over a distance. Major health systems, including outpatient clinics and check-ups alike, turned to telehealth and teleconsultation amid the COVID19 pandemic. There are many recognized advantages of telehealth and its increasing implementation, however, not much is known about the specific impact of remote consultation on the quality of non-consultant hospital doctors (NCHD) training experiences in medicine. This study aimed to gain rich descriptive insights into the specific impact of remote consultation on the quality of medical NCHD training experiences and their perceptions, through purposeful sampling. Data was collected via semi-structured virtual interviews of fifteen NCHD participants. The interviews were recorded, transcribed and analysed using thematic analysis. The collective transcripts were analysed using NVIVO data software for common themes. The themes identified suggested that there were both advantages and disadvantages to telehealth and its impact on training across a spectrum of entities including; doctor-patient relationships, peer relationships, service provision, work morale, working hours, clinical skills experience and general feedback as a trainee. NCHD perspectives expressed were mixed across all themes. Further research is recommended to advance understanding of the potential impact of telehealth on current and prospective doctors in training. With a greater understanding of general insights, future changes, including telehealth training programmes, could be implemented to build confidence and familiarity with telehealth utilization and potentiate its conceivable benefits.

Abstract Background Oral mucosa lesions are the third most prevalent oral pathology, following caries and periodontal diseases. Teledentistry offers an effective way to manage patients with these lesions. The accuracy of remote diagnoses and consultations relies heavily on the quality of the information and photos sent to remote specialists. This study aims to evaluate the usability and reliability of a teledentistry tool for the remote diagnosis of oral lesions. Methods The cross-sectional study included both usability evaluation and reliability assessment. The teledentistry platform, "OralMedTeledent", facilitated synchronous and asynchronous interactions, allowing for patient consultations, remote follow-ups, and doctor-to-doctor consultations. Usability was evaluated by 5 experts using the Nielsen heuristic checklist. Reliability was assessed from August 2022 to September 2023 with 109 patients, using Cohen's kappa coefficient to measure agreement between examiners and the gold standard in diagnosing oral lesions. Results The findings revealed 66 usability issues, most of which were related to helping users recognize, diagnose, and recover from errors, as well as issues with help and documentation. Among these, 11 issues were of minor severity. The reliability test, conducted with 109 participants (57.8% female, 42.2% male) showed that the web-based teleconsultation system performed significantly well. The system demonstrated significant substantial performance (0.81 ≤ κ 0.05). Conclusion Overall, the web-based teleconsultation system has proven to be reliable for the remote diagnosis of oral lesions, making it a valuable alternative during emergencies such as the COVID-19 pandemic. However, several usability issues have been identified and need to be addressed.

Abstract Background Quebec’s healthcare system faces significant challenges due to labour shortage, particularly in long-term care facilities (CHSLDs). The aging population and increasing demand for services compound this issue. Teleconsultation presents a promising solution to mitigate labour shortage, especially in small CHSLDs outside urban centers. This study aims to evaluate the cost and cost savings associated with teleconsultation in CHSLDs, utilizing the Time-Driven Activity-Based Costing (TDABC) model within the framework of Value-Based Healthcare (VBHC). Methods This study focuses on CHSLDs with fewer than 50 beds in remote regions of Quebec, where teleconsultation for nighttime nursing care was implemented. Time and cost data were collected from three CHSLDs over varying periods. The TDABC model, aligned with VBHC principles, was applied through five steps, including process mapping, estimating activity times, calculating resource costs, and determining total costs. Results Teleconsultation increased the cost per minute for nursing care compared to traditional care, attributed to additional tasks during remote consultations and potential technical challenges. However, cost savings were realized due to reduced need for onsite nursing staff during non-eventful nights. Overall, substantial savings were observed over the project duration, aligning with VBHC’s focus on delivering high-value healthcare. Conclusions This study contributes both theoretically and practically by demonstrating the application of TDABC within the VBHC framework in CHSLDs. The findings support the cost savings from the use of teleconsultation in small CHSLDs. Further research should explore the long-term sustainability and scalability of teleconsultation across different CHSLD sizes and settings within the VBHC context to ensure high-value healthcare delivery.

Background: Oral mucosa lesions are the third most prevalent oral pathology, following caries and periodontal diseases. Teledentistry offers an effective way to manage patients with these lesions. The accuracy of remote diagnoses and consultations relies heavily on the quality of the information and photos sent to remote specialists. This study aims to evaluate the usability and reliability of a teledentistry tool for the remote diagnosis of oral lesions. Methods: The cross-sectional study included both usability evaluation and reliability assessment. The teledentistry platform, "OralMedTeledent", facilitated synchronous and asynchronous interactions, allowing for patient consultations, remote follow-ups, and doctor-to-doctor consultations. Usability was evaluated by 5 experts using the Nielsen heuristic checklist. Reliability was assessed from August 2022 to September 2023 with 109 patients, using Cohen's kappa coefficient to measure agreement between examiners and the gold standard in diagnosing oral lesions. Results: The findings revealed 66 usability issues, most of which were related to helping users recognize, diagnose, and recover from errors, as well as issues with help and documentation. Among these, 11 issues were of minor severity. The reliability test, conducted with 109 participants (57.8% female, 42.2% male) showed that the web-based teleconsultation system performed significantly well. The system demonstrated significant substantial performance (0.81 ≤ κ < 1; P > 0.05). Conclusion: Overall, the web-based teleconsultation system has proven to be reliable for the remote diagnosis of oral lesions, making it a valuable alternative during emergencies such as the COVID-19 pandemic. However, several usability issues have been identified and need to be addressed. [ABSTRACT FROM AUTHOR]

Background: Quebec's healthcare system faces significant challenges due to labour shortage, particularly in long-term care facilities (CHSLDs). The aging population and increasing demand for services compound this issue. Teleconsultation presents a promising solution to mitigate labour shortage, especially in small CHSLDs outside urban centers. This study aims to evaluate the cost and cost savings associated with teleconsultation in CHSLDs, utilizing the Time-Driven Activity-Based Costing (TDABC) model within the framework of Value-Based Healthcare (VBHC). Methods: This study focuses on CHSLDs with fewer than 50 beds in remote regions of Quebec, where teleconsultation for nighttime nursing care was implemented. Time and cost data were collected from three CHSLDs over varying periods. The TDABC model, aligned with VBHC principles, was applied through five steps, including process mapping, estimating activity times, calculating resource costs, and determining total costs. Results: Teleconsultation increased the cost per minute for nursing care compared to traditional care, attributed to additional tasks during remote consultations and potential technical challenges. However, cost savings were realized due to reduced need for onsite nursing staff during non-eventful nights. Overall, substantial savings were observed over the project duration, aligning with VBHC's focus on delivering high-value healthcare. Conclusions: This study contributes both theoretically and practically by demonstrating the application of TDABC within the VBHC framework in CHSLDs. The findings support the cost savings from the use of teleconsultation in small CHSLDs. Further research should explore the long-term sustainability and scalability of teleconsultation across different CHSLD sizes and settings within the VBHC context to ensure high-value healthcare delivery. [ABSTRACT FROM AUTHOR]

The use of remote technology, via telephone and video, was rapidly introduced across health services at the outset of the COVID‐19 pandemic and is likely to future. This study investigated the experience and opinions of staff working in Specialist Intellectual Disability Community Teams, with the aim of clarifying the advantages and disadvantages of remote technology in this setting and helping to guide service development. Fourteen members of staff from seven different health disciplines across seven NHS Greater Glasgow and Clyde Community Intellectual Disability Teams were interviewed using a semi‐structured format. Thematic analysis identified three overarching themes: use of remote technology; efficiency and limitations. Participants reported clear efficiency advantages using remote technology but some challenges with communication and completing comprehensive patient assessments. There was support for the ongoing use of remote technology in the assessment and treatment of people with intellectual disability, particularly for multidisciplinary meetings. However, participants also described a need for face to face assessments, particularly for people with more severe intellectual disability, with complex care needs or when particular assessments are required (such as a new patient appointment or physical assessment). [ABSTRACT FROM AUTHOR]

Our study explores the efficacy and economic benefits of neurosurgical teleconsultations in managing intracerebral hemorrhage (ICH), focusing on reducing unnecessary patient transfers and associated costs. We conducted a cost-savings analysis at our institution of a previously published pilot study involving a cohort of patients with ICH who were potential candidates for airlift to our tertiary care center but instead received neurosurgical consultation via teleconsultation to avoid the transfer. Data on patient demographics, distances, and costs were collected and analyzed to assess the economic impact of teleconsultations. The cohort comprised 14 patients; we noted significant cost savings from avoiding interhospital transfers, ranging from $84,346.52 to $120,495.03 per patient. Teleconsultations facilitated immediate, collaborative decision-making between healthcare providers at community hospitals and a tertiary care center, reducing the need for expensive air transportation and unnecessary hospital transfers. Neurosurgical teleconsultations offer a cost-effective alternative to traditional patient transfer methods for ICH management, providing substantial economic benefits while maintaining high physician and patient-family satisfaction levels. This study underscores the potential of our teleneurosurgery program to significantly reduce costs by reducing unnecessary financial burdens on patients' families and healthcare systems. [ABSTRACT FROM AUTHOR]

Introduction:Teleconsultations for preoperative evaluation in anesthesiology proved to be feasible during the COVID-19 pandemic. However, widespread implementation of teleconsultations has not yet occurred. Besides time savings and economic benefits, teleconsultations in anesthesia may have the potential to reduce CO2 emissions. Methods:We conducted a life cycle assessment based on prospective surveys to assess the potential environmental benefits of preoperative anesthesia teleconsultations in comparison to the status-quo in-person consultations. Within 1 month, all patients presenting at the preoperative anesthesia clinic at RWTH Aachen University Hospital were asked about the distance traveled and mode of transportation to the hospital. The main outcome measure was the potential environmental benefit resulting from the implementation of teleconsultations. Results:In total, 821 out of 981 patients presenting at the anesthesia clinic participated in the survey. Most patients visited on an outpatient basis (62.9%) and traveled by car (81.7%). The median travel distance was 25 km [interquartile range 12–40]. If patients who came to the hospital solely for the anesthesia appointment had scheduled virtual appointments, the emissions of 3.03-ton CO2 equivalents (CO2-eq) could be avoided in the first month after implementation. The environmental impact associated with the production of teleconsultation equipment is outweighed by the reduction in patient travel. If all outpatient appointments were performed virtually, these savings would triple. Within 10 years, more than 1,300 tons CO2-eq could be avoided. Conclusion:Teleconsultations can mitigate the environmental impact of in-person anesthesia consultations. Further research is essential to leverage teleconsultations for preoperative evaluation also across other medical specialties. [ABSTRACT FROM AUTHOR]

Introduction: One of the challenges faced by the Colombian Health System is to improve access to health services for the dispersed and isolated rural population, particularly in the field of dermatology. This article examines the implementation of a teledermatology service using a PC and camera versus smartphone technology. Methods: A total of 542 teledermatology visits were conducted, involving 478 patients, in addition to 64 visits for clinical follow-up for patients as per the dermatologist's recommendation. Out of the 478 patients, 461 met the inclusion criteria and agreed to participate in the study. The data collection instrument from the general practitioner or referring provider covered three consultation moments: (1) sending an initial consultation, (2) providing a response to the patient, and (3) sending a follow-up consultation. Seven hundred forty-seven records were completed by the general practitioner for the three consultation moments. Furthermore, 372 consultations were documented by the dermatologist or referring provider for two moments: (1) response to the initial consultation by the dermatologist, and (2) response to the follow-up consultation by the dermatologist. After validating the information reported in the instruments, a descriptive analysis of the data was conducted, utilizing absolute frequencies and percentages for qualitative variables and measures of central tendency (mean, median, standard deviation, and interquartile range) for quantitative variables. The data were analyzed from 747 records of the referring provider instrument related to 461 patients, between 18 and 98 years of age, with a predominantly female representation. Results: The results indicated that for teleconsultations conducted using a mobile device, the average total duration of the teleconsultation was longer on the traditional platform compared with the mobile device (13.03 vs. 8.27 min). Additionally, it was observed that the time taken to store, send, and capture a single image (clinical or dermoscopic) using the mobile device was three times lower than that on the conventional platform (25 vs. 75 s). Similar findings were noted for teleconsultations carried out by the dermatologist, predominantly utilizing a mobile device. The average consultation time was shorter for the mobile device compared with the traditional platform (8.14 vs. 12 min). Conclusions: The cost reduction suggests that the operation of the service is more efficient with smartphone technology in comparison to the use of a PC and camera. Teledermatology with smartphones provides a streamlined, efficient, and technically sound process for obtaining clinical and dermoscopic images. [ABSTRACT FROM AUTHOR]

Background: Although immune checkpoint inhibitors (ICIs) show a more favorable toxicity profile than classical cytotoxic drugs, their mechanism of action is responsible for peculiar new toxicities. There is an urgent need for a multidisciplinary approach to advice on how to manage organ‐specific toxicities. Methods: Our project aims to integrate the practices of two different hospitals into a single Italian regional collaborative model to treat immune‐related adverse events (irAEs). The team structure is a multi‐professional and multidisciplinary cooperative network that consists of different medical specialists. The team referrer is the medical oncologist and an existing telematic platform is used for specialists' cooperation. The leading oncologist first evaluates patients' clinical condition, therefore team intervention and teleconsultation are planned to activate proper management. After a first phase structured for general setting, outcomes analysis, data collection, and identification of critical issues, it is planned to define appropriate key performance indicators (KPIs) in quality, structure, process, and outcome settings. Therefore, a second phase would serve to implement KPIs. In the third phase, the proposal for the enlargement of the network with the extension to more centers in the context of the Regional Health Service will be performed. Discussion: The multidisciplinary management of irAEs based on telemedicine fits into the debate on the renewal of healthcare systems and the push for change toward multidisciplinary with the rising use of telemedicine. To our knowledge, this is the first project reporting a multi‐institutional experience for change of service in irAEs management. [ABSTRACT FROM AUTHOR]

Background: Online consultation systems (OCSs) allow patients to contact their healthcare teams online. Since 2020 they have been rapidly rolled out in primary care following policy initiatives and the COVID-19 pandemic. In-depth research of patients' experiences using OCSs is lacking. Aim: Explore patients' experiences of using an OCS. Design and setting: Qualitative study in English GP practices using the Patchs OCS (www.Patchs.ai) from March 2020 to July 2022. Method: Thematic analysis of 25 patient interviews and 21 467 written comments from 11 851 patients who used the OCS from nine and 240 GP practices, respectively. Results: Patients cited benefits of using the OCS as speed, flexibility, and efficiency. Nevertheless, some patients desired a return to traditional consultation methods. GP practices often did not clearly advertise the OCS or use it as patients expected, which caused frustration. Patients reported advantages of having a written record of consultations and the opportunity to communicate detailed queries in free text. Views differed on how the OCS influenced clinical safety and discussions of sensitive topics. Patients who struggled to communicate in traditional consultations often preferred using the OCS, and male patients reported being more likely to use it. Conclusion: Globally, this is the largest in-depth study of patient experiences of an OCS. It contributes new knowledge that the patient experience of using OCSs can be influenced by previously unreported patient characteristics and the conditions they consult about. Further, it contributes recommendations on the design and implementation of the OCS in practice. [ABSTRACT FROM AUTHOR]

Background: We report the impact of capacity building and teleconsultation on change in the thrombolysis rates and one-year mortality in patients with STEMI using a hub and the spoke model of STEMI care. Methods: Twenty secondary care public hospitals were linked with a teaching hospital as a hub centre and the impact of the intervention on change in ischemic time, thrombolysis rates and all-cause in-hospital and one-year mortality was compared. Results: 29 patients with STEMI were treated during pre-intervention from April 2020 to June 2020 and 255 patients during the post-intervention period from July 2020 to Oct 2021 in spoke centres. 245 patients were reported to a hub centre during the study period. The thrombolysis rate was significantly higher in the spoke centres after intervention (65.5%vs. 27.5 % p

Telehealth is a rapidly developing field of veterinary medicine, particularly during and after the coronavirus 2019 (COVID-19) pandemic. The world and animal owners' expectations are changing to the point where veterinary practice will need to adapt due to information technology advancements. This narrative review describes the status, benefits, technology basics, applications, limitations and legal aspects of veterinary telemedicine over the globe. Veterinary telemedicine is a service alongside other veterinary services that meets client needs, delivers quality medicine and improves animal welfare. The most frequently utilized veterinary telemedicine applications include; teleradiology, telesonography, teledentistry, telecardiology, telerehabilitation, anesthesia teleconsultation, telehospice and telepalliative care, telecytology, tele-endoscpy, teledermatology, tele-ophthalmology, tele-behavior therapy as well as veterinary education and training. Veterinary telemedicine has a bright near future and will impact veterinary medicine and animal welfare due to its numerous advantages. These advantages include; its low cost, availability, involvement in veterinary health care, online payment, and effectiveness in many clinical situations like follow-up after an in-person examination, inspection of surgical sites or mobility. Nevertheless, veterinary telemedicine should receive more attention by veterinary professional regulatory bodies in all countries. Moreover, it is necessary to conduct more studies to evaluate how telehealth is beginning to improve veterinary care, particularly for underserved regions. [Open Vet J 2024; 14(4.000): 952-961]

Introduction: Fewer than a quarter of people considered to have factors associated with HIV acquisition are prescribed pre-exposure prophylaxis (PrEP) in the United States. Prior studies demonstrate disparities in provider comfort and knowledge regarding PrEP, suggesting a need for provider capacity building to support widespread PrEP availability. This study examined real-world PrEP clinical questions/cases from providers to a teleconsultation service to identify knowledge gaps and improve PrEP-related training materials and clinical guidelines. Methods: The National Clinician Consultation Center (NCCC) PrEPline provides educational teleconsultation services on clinical decision-making related to PrEP for U.S. health care providers. The NCCC PrEP consultation data collected between 2017 and 2020 were reviewed and systematically categorized by clinical topics, subtopics, and complexity levels (low, moderate, and high). Results: Within the study period, the PrEPline provided 1,754 teleconsultations. More than three quarters came from advanced practice nurses and physicians. The topics of questions commonly focused on medication-based HIV prevention strategies (22.7%), PrEP laboratory ordering/monitoring (17.4%), and side effects and contraindications (14.6%). The majority of teleconsultations (57.9%) involved sharing information that was directly available/addressed in the Centers for Disease Control and Prevention (CDC) 2017 PrEP Guidelines (i.e., low complexity). Discussion: The low frequency of consultations from nonphysician and non-nurse practitioner providers may suggest a need for increased training and collaborative opportunities for other types of providers. The high percentage of low-complexity inquiries may reveal a desire for capacity-building materials specifically designed for practicing providers (e.g., abridged versions of guidelines). This study may inform future research, best clinical practices, and aid in the development of training materials to increase providers' HIV prevention comfort and knowledge.

Introduction: Childcare center closures during COVID-19 impacted education for approximately 40 million children nationwide. Unfortunately, COVID-19 restrictions significantly limited the extent that outside personnel could provide in-person support to educators, resulting in the need for innovative approaches to meet childcare centers' needs. A virtual robotic telepresence approach was applied to early childhood consultation models to promote child resilience while mitigating COVID-19 risks. The goal of this study was to examine how training influenced consultants' and childcare staff uptake of the virtual robotic telepresence consultation approach and their acceptance of this technology. Methods: Ten early childhood consultants received multimedia/simulation training and weekly communities of practice related to virtual telepresence robotic consultation. Telepresence robotic consultation equipment was deployed to 16 childcare centers in a diverse multilingual metropolitan area as a part of a larger randomized controlled trial. Consultants trained childcare staff (14 center directors and 58 teachers) on how to receive virtual telepresence robotic consultation. Demographic information and measures of technology acceptability and uptake were collected from childcare staff and consultants. A mixed methods approach was used including multilevel modeling and focus groups to examine consultation uptake, acceptability, barriers, and facilitators of virtual telepresence robotic consultation implementation. Results: Consultants and childcare staff generally perceived the virtual telepresence consultation approach to be useful and easy to use. Consultant perceptions of the acceptability of technology did not change over time. Childcare staff, center, and consultant factors impacted the uptake of the virtual robotic telepresence consultation approach and childcare staff acceptance of the technology. Focus groups revealed that consultants believed that additional hands-on training with childcare staff would have benefited implementation and expressed a desire for a hybrid approach for consultation. Discussion: Perceptions of telepresence robotic consultation acceptability are discussed, including future recommendations for training. [ABSTRACT FROM AUTHOR]

Purpose There is an acute shortage of neurosurgeons and spine surgeons especially in rural areas of low- and middle-income countries including India. Patients of spine surgery need to travel long distances for follow-up at tertiary care hospitals. This study was done to evaluate role and success rate of telemedicine in follow-up after spine surgery based on patients' diagnosis and demographic features and to identify barriers to successful telemedicine consultations. Materials and Methods All patients undergoing spine surgeries including craniovertebral junction (CVJ) surgeries from January 2021 to June 2022 were included in the study. Success rate of telemedicine was calculated using a simple formula: Success rate of telemedicine = successful telemedicine consultations / total number of telemedicine consultation × 100. Success rate was evaluated with respect to demographic features and underlying disease-related factors. Results Eighty-four patients formed the study group in which a total of 181 video teleconsultations were done. Overall success rate of telemedicine was 82.87%. Higher socioeconomic and educational statuses were related to higher success rates of tele-consultations (p < 0.05). Difficulty in assessing neurological condition using video call in follow-up cases of CVJ and issues related to Internet communication network leading to inability to video call and share image/videos were major causes of failures. Conclusion Telemedicine may prove an effective option for following up patients undergoing spine surgeries except CVJ, which is likely to improve further with improvements in Internet connectivity. [ABSTRACT FROM AUTHOR]

Background:In December 2021, the Region 1 Disaster Health Response System, the state of Vermont, and the National Emergency Tele-Critical Care Network partnered to provide statewide access to disaster teleconsultations during COVID-19 surge conditions. In this case report, we describe how a disaster teleconsultation system was implemented in Vermont to provide access to temporary tele-critical care consultations during the Omicron COVID-19 surge. Methods:We measured the time from request of service to implementation and calculated descriptive statistics. Results:Seven of Vermont's 14 hospitals requested the service. Despite a technology solution capable of providing services within hours, mean time to service implementation was 27 days (interquartile range 20–41 days). Conclusions:Integration of disaster teleconsultation systems into state and local emergency management plans are needed to bring administrative start-up times in line with technical readiness. [ABSTRACT FROM AUTHOR]

This document is a letter to the editor of the Annals of the Academy of Medicine, Singapore, discussing a study comparing the effectiveness, safety, and cost of teleconsultation versus face-to-face models of pharmacist-led anticoagulation clinics. The study found that there were no significant differences in clinical outcomes or safety outcomes between the two models. However, the teleconsultation model had a higher direct patient cost due to more consultations and the use of more test strips. The study provides valuable insights into the use of teleconsultation in anticoagulation clinics and its potential benefits and drawbacks. [Extracted from the article]

Existe un interés creciente en el potencial de la telemedicina (TM) como un medio alternativo a la consulta física. Aunque numerosos estudios prueban los beneficios de la TM en reumatología, no existen recomendaciones sobre su implementación en España. El objetivo de este estudio fue analizar la aplicación de la TM en consultas de reumatología en España. Estudio cualitativo, transversal, multicéntrico con metodología Delphi en 2 rondas de consultas. Se diseñó un cuestionario ad hoc estructurado que incluía enunciados sobre teleconsulta, teleconsulta de enfermería, teleasistencia, telerrehabilitación, telerradiología, teleeducación sanitaria, principales barreras, ventajas e inconvenientes de la teleeducación sanitaria y TM en artritis reumatoide. Los participantes fueron especialistas en reumatología que ejercían su labor asistencial en España. Los reumatólogos participantes (N = 80) tenían una edad media de 42,4 (± 9,0) años, con 12,6 (± 8,4) años de experiencia. Algunos de los aspectos de la TM que obtuvieron un mayor consenso fueron: La TM es útil para el seguimiento de algunos pacientes, ayudar a determinar si es necesaria una consulta presencial, o asistir a pacientes con artritis reumatoide si presentan baja actividad o en remisión; ciertos pacientes, como aquellos en su primera consulta o aquellos que presentan barreras digitales o deterioro cognitivo, deben ser atendidos presencialmente; la TM presenta algunas barreras técnicas y de acceso de los pacientes; la TM puede ser útil en enfermería y en la formación médica continuada. La TM puede ser beneficiosa para el tratamiento y seguimiento de los pacientes con enfermedades reumáticas, así como para aliviar la carga asistencial presencial en reumatología. There is growing interest in the potential of telemedicine (TM) as an alternative to physical consultation. Although numerous studies prove the benefits of TM in rheumatology, there are no recommendations on its implementation in Spain. The aim of this study was to analyze the application of TM in rheumatology consultations in Spain. Qualitative, cross-sectional, multicenter study with Delphi methodology in 2 rounds of queries. A structured ad hoc questionnaire was designed that included statements on teleconsultation, nursing teleconsultation, telecare, telerehabilitation, teleradiology, telehealth tele-education, main barriers, advantages and disadvantages of telehealth tele-education and TM in rheumatoid arthritis. The participants were rheumatology specialists practicing in Spain. The participating rheumatologists (N = 80) had a mean age of 42.4 (± 9.0) years, with 12.6 (± 8.4) years of experience. Some of the aspects of TM that obtained the greatest consensus were: TM is useful for follow-up of some patients, to help determine if a face-to-face consultation is necessary, or to assist patients with rheumatoid arthritis if they present low activity or in remission; certain patients, such as those in their first consultation or those who present digital barriers or cognitive deterioration, should be seen face-to-face; TM presents some technical and patient access barriers; TM can be useful in nursing and in continued medical education. TM can be beneficial for the treatment and follow-up of patients with rheumatic diseases, as well as for alleviating the face-to-face care burden in rheumatology. [ABSTRACT FROM AUTHOR]

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Telehealth is a rapidly developing field of veterinary medicine, particularly during and after the coronavirus 2019 (COVID-19) pandemic. The world and animal owners' expectations are changing to the point where veterinary practice will need to adapt due to information technology advancements. This narrative review describes the status, benefits, technology basics, applications, limitations, and legal aspects of veterinary telemedicine over the globe. Veterinary telemedicine is a service alongside other veterinary services that meets client needs, delivers quality medicine, and improves animal welfare. The most frequently utilized veterinary telemedicine applications include teleradiology, telesonography, teledentistry, telecardiology, telerehabilitation, anesthesia teleconsultation, telehospice and telepalliative care, telecytology, tele-endoscpy, teledermatology, tele-ophthalmology, tele-behavior therapy, and veterinary education and training. Veterinary telemedicine has a bright near future and will impact veterinary medicine and animal welfare due to its numerous advantages. These advantages include its low cost, availability, involvement in veterinary health care, online payment, and effectiveness in many clinical situations such as follow-up after an in-person examination, inspection of surgical sites, or mobility. Nevertheless, veterinary telemedicine should receive more attention from veterinary professional regulatory bodies in all countries. Moreover, it is necessary to conduct more studies to evaluate how telehealth is beginning to improve veterinary care, particularly for underserved regions. [ABSTRACT FROM AUTHOR]

Introduction:To properly combine osteoporosis treatment with dental treatment and to prevent medication-related osteonecrosis of the jaw (MRONJI), a system of communication between health providers can be smoothly made within a short time is required. With the recent increase in the possibility of telemedicine being introduced in Korea, it is expected that the introduction of teleconsultation between health providers treating osteoporosis will reduce the discomfort of patients and health providers and improve satisfaction. In this study, a survey was conducted on the knowledge and experience of MRONJ to find out the willingness of dentists treating osteoporosis patients for teleconsultation. Methods:An online questionnaire-based survey was conducted to investigate the intention for teleconsultation for MRONJ with a total of 516 dentists between September and October 2021. Results:Two-thirds of the respondents had experience of requesting consultation other dentists or doctors for the osteoporosis or MRONJ patients. They answered that the referral letter was the most used consultation request method and that it took a long time to get a reply. As for the intention of teleconsultation, 70% of the respondents answered that they were willing. The more experienced or the higher the educational level, the higher the intention for teleconsultation. Although the intention of dentists for teleconsultation was high, satisfaction with the cost of teleconsultation was low. Discussion:Although dentists' intention to use teleconsultation was high, satisfaction with the cost of medical care for teleconsultation was low, so it seems that this should be coordinated. [ABSTRACT FROM AUTHOR]

Background: Mobile health applications are a relatively new phenomenon in the healthcare industry, but their use is expanding rapidly for both general health and specific medical needs. Objective: To compare the utilization of the health apps among patients visiting pharmacies and health stores hospital and it awareness among people. Materials and Methods: A cross-sectional descriptive study was conducted with the general population who were using mobile health apps in the state between January 2023 to June 2023. The participants in the study were recruited from retail pharmacies and health stores located in different areas in the cities. Clients visiting the pharmacies and health stores were approached and invited to participate in the study, and those who agreed were interviewed. The inclusion criteria included smartphone owners who were using healthrelated apps, of age = 18 years old, and those who could speak the English language. Results: Out of 270 individuals, 52% of the sample were male and 48% were female, and the mean age (SD) of participants was 29.74 (11.74). In this study, 31% of the participants reported using their health apps on a daily basis, 40% at least once weekly, and 25% monthly. The main benefits of mobile health apps were tracking of health status (49%), followed by motivation (24%) and gaining knowledge about health and fitness (20%). The main issues reported by the participants included inaccuracy of the app (12.5%), inconvenience (5%), and not being user-friendly (8%). Conclusion: These apps inspired the participants to keep up their wellbeing and exercise while assisting them in tracking and better managing their health. To ensure evidence-based and efficient app use to achieve the desired health outcomes, further opportunities for improvement have been found. [ABSTRACT FROM AUTHOR]

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: The use of teleconsultation platforms enabling health professionals to provide advice especially in the new normal post COVID-19 situation has increased in both developing and developed countries. This teleconsultation has also expanded beyond that of post COVID-19 application to other purposes such as in the treatment of musculoskeletal pain. OBJECTIVE: The purpose of this commentary is to focus on presenting a feasible guide related to physical as well as psychological aspects in relation to computer based workers that could be taught to the computer-based workers using teleconsultation platforms. METHODS: A multi-criteria search was performed among available guidelines and approaches related to the physical and psychological aspects used for computer-based workers. RESULTS: A continuation of musculoskeletal pain creates a feedforward loop of pain and distress. Several conventional methods exist to manage musculoskeletal pain, however, the new normal situation following COVID-19 has rendered many of these moot, especially in computer based workers and with the increased reliance on teleconsultation platforms. CONCLUSIONS: During the COVID-19 pandemic, individuals were required to stay home due to varying levels of lockdown protocols and provide their usual services using online platforms both increasing sedentary behaviour in computer based workers and limiting the tools available to health professionals. Following in what is now the worldwide new normal post COVID-19 situation, individuals have adapted and accepted that they receive much of their necessary health advice using teleconsultation platforms as well. [ABSTRACT FROM AUTHOR]

Abstract Background Although immune checkpoint inhibitors (ICIs) show a more favorable toxicity profile than classical cytotoxic drugs, their mechanism of action is responsible for peculiar new toxicities. There is an urgent need for a multidisciplinary approach to advice on how to manage organ‐specific toxicities. Methods Our project aims to integrate the practices of two different hospitals into a single Italian regional collaborative model to treat immune‐related adverse events (irAEs). The team structure is a multi‐professional and multidisciplinary cooperative network that consists of different medical specialists. The team referrer is the medical oncologist and an existing telematic platform is used for specialists' cooperation. The leading oncologist first evaluates patients' clinical condition, therefore team intervention and teleconsultation are planned to activate proper management. After a first phase structured for general setting, outcomes analysis, data collection, and identification of critical issues, it is planned to define appropriate key performance indicators (KPIs) in quality, structure, process, and outcome settings. Therefore, a second phase would serve to implement KPIs. In the third phase, the proposal for the enlargement of the network with the extension to more centers in the context of the Regional Health Service will be performed. Discussion The multidisciplinary management of irAEs based on telemedicine fits into the debate on the renewal of healthcare systems and the push for change toward multidisciplinary with the rising use of telemedicine. To our knowledge, this is the first project reporting a multi‐institutional experience for change of service in irAEs management.

Resumen: Objetivos: valorar la repercusión de la alteración de la continuidad asistencial en los pacientes diabéticos de nuestro departamento de salud durante el confinamiento. Comprobar si el confinamiento supuso o no una alteración del grado de control de nuestros pacientes diabéticos tipo 2. Saber si nuestros pacientes diabéticos se encontraban adecuadamente controlados antes de iniciarse la pandemia. Saber si la pandemia ha supuesto un deterioro de su grado de control. Material y método: estudio retrospectivo entre los años 2019 y 2020 de los pacientes diabéticos tipo 2 de nuestra área de salud. A través de la aplicación «Alumbra» se obtuvo una muestra aleatorizada de nuestros pacientes diagnosticados de diabéticos tipo 2 mayores de 18 hasta los 100 años. Se informó al paciente si quería entrar en el estudio, y tras el consentimiento expreso, se le preguntó sobre sus hábitos de vida, se realizó una revisión de la historia clínica con los datos consignados antes del inicio del confinamiento (año 2019) y durante los meses del confinamiento del 2020. Resultados: se dispuso de 882 pacientes (88,28%) con determinaciones de HbA1c en 2019 con una media de 7,08. Se dispuso de 800 pacientes (88,98%) con determinaciones de HbA1c en 2020 con una media de 7,02. Se produjo una reducción en los hábitos de consumo de alcohol, tabaco y refrescos, pero también se produjo una reducción en el ejercicio físico (33% vs. 22%) y en la realización de una dieta diabética (34% vs. 24%). En la muestra analizada se produjo una reducción en el consumo de alcohol de los datos obtenidos en 2019 a los obtenidos en 2020 (22% vs. 13%). Se produjo un incremento de la obesidad que pasa de 77,7% a 90,4% en el 2020. Se observó que no se producen cambios en los porcentajes en enfermedades como la dislipidemia, fibrilación auricular, artrosis o accidente cerebrovascular. Conclusión: las consecuencias asociadas a la pandemia en la salud son preocupantes, la disminución de consultas de agudos, las actividades preventivas y el retraso de los controles de pacientes crónicos tendrán un profundo impacto en el bienestar psicológico y socioeconómico de la población. Cobra especial importancia la mirada holística de la atención primaria (AP) y la necesidad de reforzar y repensar el sistema para aumentar su eficiencia. Abstract: Objective: To assess the impact of the alterations of continuity of care on diabetic patients in our health department during the confinement that caused the pandemic. Check whether or not confinement mean tan alteration in the degree of control of our type 2 diabetic patients. Know whether our diabetic patients were adequately coontrolled before the pandemic began. Know if the pandemic has led to a deterioration in its degree of control. Subject and method: Retrospective study between the years 2019 and 2020 of type 2 diabetic patients in our health area. Through the “Alumbra” application of our health area, a random sample of our patients diagnosed with type 2 diabetes from 18 to 100 years of age was obtained. The patients was informed if they wanted to enter the study and after the patient´s express consent, the patient was asked about their lifestyle, habits and a review of the medical history was carried out with the data recorded before the confinement (year 2019) and during the months of confinement of 2020. Results: There were 882 patients (88.28%) with HbA1c determinations in 2019 with a mean of 7,08. There were 800 patients (88.98%) with HbA1c deteminations in 2020 with a mean of 7,02. There was a reduction in alcohol, tobacco and soft drink consumption habits, but there was also a reduction in physical exercise (33% to 22%) and is following a diabetic diet (34% to 24%). In the sample analyzed, there was a reduction in a alcohol consumption from the data obtained in 2019 to those obtained in 2020 (22% to 13%). There was an increase in obesity, which goes from 77,7% to 90,4%. It is observed that there is no change in the percentages in pathologies such as dislipemia, atrial fibrilation, osteoarthritis, and stroke. Conclussion: The consequences associated with the pandemic on health are worrying, the decrease in acute consultation, preventive activities and the delay in controls for chronic patients will have a profound impact on the psychological and socioeconomic well being of populations. The holistic view of the Primary Care and the need to strengthen and rethink the system to increase its effciency are of particular importance.

Introduction: This study evaluates feasibility of telemedicine to deliver diabetic care among different regions of the country. Materials and Methods: Medical interns affiliated with Rotaract Club of Medicrew (RCM) organized a Free Diabetes Screening Camp called “Diab-at-ease” at multiple sites across the country. Of all beneficiaries of the camp >18 years of age, patients previously diagnosed with diabetes and undiagnosed patients with a random blood sugar level of more than 200 mg/dL were interviewed regarding their knowledge, attitude, and practice regarding diabetes care and preparedness and vigilance to receiving care through telemedicine. Random blood sugar, height, weight, and waist circumference were also documented. Results: About 51.1% (N = 223) of female patients aged 57.57 ± 13.84 years (>18 years) with body mass index (BMI) =26.11 ± 4.63 were the beneficiaries of the health camps. About 75.3% (n = 168) of them were on oral hypoglycemic agents (OHAs), 15.7% (n = 35) were on insulin preparations, and 59.6% (n = 156) and 88.5% (n = 31) of which were highly compliant with treatment, respectively. About 35% (n = 78) and 43.9% (n = 98) of them were unaware of their frequency of hypoglycemic and hyperglycemic episodes, respectively. About 64.6% (n = 144) of the patients were equipped for receiving teleconsultation. Glucometer was only possessed by 51.6% (115) of which only 46.95% (n = 54) can operate it independently. Only 80 patients (35.9%) were aware of the correct value of blood glucose levels. Conclusion: While a majority of the population is compliant with treatment and aware about diabetes self-care, they lack adequate knowledge and resource equipment for the same leading to very limited utilization.

To address high rates of mental health and developmental concerns facing young children ages 0–6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state‐funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma‐informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18‐month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers. [ABSTRACT FROM AUTHOR]

Introduction: This study evaluates feasibility of telemedicine to deliver diabetic care among different regions of the country. Materials and Methods: Medical interns affiliated with Rotaract Club of Medicrew (RCM) organized a Free Diabetes Screening Camp called "Diab-at-ease" at multiple sites across the country. Of all beneficiaries of the camp >18 years of age, patients previously diagnosed with diabetes and undiagnosed patients with a random blood sugar level of more than 200 mg/dL were interviewed regarding their knowledge, attitude, and practice regarding diabetes care and preparedness and vigilance to receiving care through telemedicine. Random blood sugar, height, weight, and waist circumference were also documented. Results: About 51.1% (N = 223) of female patients aged 57.57 ± 13.84 years (>18 years) with body mass index (BMI) =26.11 ± 4.63 were the beneficiaries of the health camps. About 75.3% (n = 168) of them were on oral hypoglycemic agents (OHAs), 15.7% (n = 35) were on insulin preparations, and 59.6% (n = 156) and 88.5% (n = 31) of which were highly compliant with treatment, respectively. About 35% (n = 78) and 43.9% (n = 98) of them were unaware of their frequency of hypoglycemic and hyperglycemic episodes, respectively. About 64.6% (n = 144) of the patients were equipped for receiving teleconsultation. Glucometer was only possessed by 51.6% (115) of which only 46.95% (n = 54) can operate it independently. Only 80 patients (35.9%) were aware of the correct value of blood glucose levels. Conclusion: While a majority of the population is compliant with treatment and aware about diabetes self-care, they lack adequate knowledge and resource equipment for the same leading to very limited utilization. [ABSTRACT FROM AUTHOR]

Introduction: teleconsultation is a useful healthcare tool in the multidisciplinary management of patients with indications of home enteral nutrition (HEN). The use of different teleconsultation platforms, as it happens in the Andalusian Health System (SAS), results in heterogeneous referral processes between Primary Care and hospital services in the same region. Objectives: to establish a consensus on patient profiles and the minimum data set necessary to guarantee an adequate referral to NED teleconsultation regardless of the existing platform. These agreed aspects in Andalusia can serve as a reference in other regions. Methods: three consecutive steps were followed: a) non-systematic review of the indexed literature on teleconsultation in clinical nutrition in Spain; b) survey to know the implementation and unmet needs of teleconsultation platforms in Andalusian public hospitals; and c) working meetings and consensus of 14 health professionals of Primary Care (n = 4) and endocrinology and hospital clinical nutrition (n = 10). Results: three referral forms were agreed in which three patient profiles were defined, with the corresponding minimum set of data necessary to request NED teleconsultation. The Primary Care team should provide this set of data to the clinical nutrition specialist via a teleconsultation platform, implemented in the SAS. Conclusions: three agreed forms between healthcare professionals involved in the referral process serve to standardize the request for teleconsultation of NED between healthcare teams based on patient profiles. [ABSTRACT FROM AUTHOR]

Background Telehealth technologies are playing an increasing role in healthcare. This study aimed to review the literature relating to the use of telehealth technologies in care homes with a focus on teledentistry. Methods Khangura et al.'s (Evidence summaries: the evolution of a rapid review approach. Syst Rev 2012; 1 :10) rapid review method included an electronic database search on Embase, PubMed, Web of Science and OpenGrey. Out of 1525 papers, 1108 titles and abstracts were screened, and 75 full texts assessed for eligibility. Risk of bias was assessed using the Mixed Methods Assessment Tool 2018. Results Forty-seven papers (40 studies) from 10 countries, published 1997–2021, were included in the review, four studies related to teledentistry. Whilst some preferred in-person consultations, perceived benefits by stakeholders included reduced hospitalization rates (n  = 14), cost-savings (n  = 8) and high diagnostic accuracy (n  = 7). Studies investigating teledentistry using intra-oral cameras reported that teleconsultations were feasible with potentially high diagnostic accuracy (n  = 2), cost-savings (n  = 1) and patient acceptability (n  = 1). Conclusion There is limited published research on teledentistry, but wider telehealth research is applicable to teledentistry, with findings suggesting that telehealth technologies play a role in care homes consultations that are acceptable, cost-saving and with potential diagnostic accuracy. Further research is needed on the mode, utility and acceptability of teledentistry in care homes. [ABSTRACT FROM AUTHOR]

Background: This research paper presents a comprehensive review of the existing literature about the adoption and utilization of mobile healthcare applications, as well as their implications for the healthcare sector. The study delves into the advantages and obstacles linked to teleconsultation. Methodology: To conduct this study, the methodology outlined was followed. This included developing a research question, setting criteria, coming up with a search strategy, looking through relevant databases, registering a protocol, manually searching for relevant material, extracting data, assessing quality, verifying and double-checking data, and writing a manuscript. Result: The empirical results presented in this study show how effective teleconsultation is at both addressing people's healthcare needs and lowering their risk of contracting infectious diseases and other viral infections. Conclusion: The previously described issue has emerged as a significant obstacle in the field of teleconsultation, leading the study to put up several suggestions that require serious thought. [ABSTRACT FROM AUTHOR]

Purpose: Teleconsultation services can be used to overcome the barriers imposed by the Covid-19 pandemic in providing basic orthopaedic rehabilitation services. Aim of the study is to compare the effectiveness of rehabilitation provided via outpatient and teleconsultation in patients with mechanical low backache (LBA) and early osteoarthritis (OA) of the knee joint utilizing Patient-Reported Outcome Measures. The satisfaction level of patients receiving teleconsultation will also be assessed. Methodology: This study was a hospital-based prospective observational study. The study's participants were divided into two groups (Outpatient and Teleconsultation, respectively), and each group was further divided into two subgroups of 100 participants each (Knee-pain subgroup 1; LBA subgroup 2). SF-12 questionnaire, visual analogue scale (VAS) score for pain, and functional outcome scores (KOOS score for knee pain and the modified Oswestry Disability Index-MODI for LBA) were assessed at initial presentation and 6 months follow-up. Participants' satisfaction for teleconsultation service was assessed at final follow-up by 5 points Likert scale (5, very satisfied; 1, very dissatisfied). Results: Mean consultation time was significantly longer in the outpatient group (p < 0.001). No statistically significant difference in the VAS score, KOOS score (58.0 ± 7.6 vs. 57.8 ± 9.2; p = 0.893), and MODI Score (24.7 ± 13.3 vs. 27.4 ± 12.4; p = 0.128) between the corresponding subgroups of the two groups at final follow-up. Eighty-seven percentage of the participants were satisfied (Likert score ≥ 4) with the teleconsultation services. Conclusion: Teleconsultation is equally effective to that as face-to-face outpatient consultation in the rehabilitation of patients with early OA knee and mechanical LBA. Level of study: Level 2, Prospective comparative study. [ABSTRACT FROM AUTHOR]

Telemedicine is utilized to deliver health care services remotely. TM gained popularity as a result of pandemics, it can help the patients to get required medical care while sitting in the comfortable environment of their homes. In the future, it will continue to be used as a convenient, cost-effective patient care modality. This cross-sectional study was conducted in a tertiary care hospital, the objectives were to identify challenges faced by physicians during teleconsultations, recognize the opportunities and strengths of this modality during pandemic in a lower-income country. The self-made questionnaire was filled through an online medium and responses were recorded on a five-point Likert scale. A total of 83 participants were enrolled in this study. Most of them were Associate professors (29.8%), Assistant professors (26.2%), the ratio of the females was (52.4%) greater than males (47.6%). 46 (54.8%) lie between the age group 30–40 years. Pediatricians and senior instructors faced more difficulty in using telemedicine. The ones having clinical experience of less than 15 years or categorized in the age of 50–60 years faced challenges while using this modality. During the current pandemic, situation telemedicine is the only glimmer of light to provide better quality health care. Telemedicine is an innovative strategy and it is important to understand the perception of physicians about it. Incomplete and inadequate infrastructure and attitude of the physicians are the main obstacles toward successful implementation of telemedicine. Successful installation and deployment of this technology require a complete grasp of the process among physicians. [ABSTRACT FROM AUTHOR]