Guest Editorial: Compelling Issues in Telemedicine

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140280/1/tmj.2013.9998.pd

The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence

Introduction: Radiology was founded on a technological discovery by Wilhelm Roentgen in 1895. Teleradiology also had its roots in technology dating back to 1947 with the successful transmission of radiographic images through telephone lines. Diagnostic radiology has become the eye of medicine in terms of diagnosing and treating injury and disease. This article documents the empirical foundations of teleradiology. Methods: A selective review of the credible literature during the past decade (2005?2015) was conducted, using robust research design and adequate sample size as criteria for inclusion. Findings: The evidence regarding feasibility of teleradiology and related information technology applications has been well documented for several decades. The majority of studies focused on intermediate outcomes, as indicated by comparability between teleradiology and conventional radiology. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include reductions in patient transfer, rehospitalization, and length of stay.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140295/1/tmj.2016.0149.pd

The Empirical Evidence for Telemedicine Interventions in Mental Disorders

Problem and Objective: This research derives from the confluence of several factors, namely, the prevalence of a complex array of mental health issues across age, social, ethnic, and economic groups, an increasingly critical shortage of mental health professionals and the associated disability and productivity loss in the population, and the potential of telemental health (TMH) to ameliorate these problems. Definitive information regarding the true merit of telemedicine applications and intervention is now of paramount importance among policymakers, providers of care, researchers, payers, program developers, and the public at large. This is necessary for rational policymaking, prudent resource allocation decisions, and informed strategic planning. This article is aimed at assessing the state of scientific knowledge regarding the merit of telemedicine interventions in the treatment of mental disorders (TMH) in terms of feasibility/acceptance, effects on medication compliance, health outcomes, and cost. Materials and Methods: We started by casting a wide net to identify the relevant studies and to examine in detail the content of studies that met the eligibility criteria for inclusion. Only studies that met rigorous methodological criteria were included. Necessary details include the specific nature and content of the intervention, the research methodology, clinical focus, technological configuration, and the modality of the intervention. Results: The published scientific literature on TMH reveals strong and consistent evidence of the feasibility of this modality of care and its acceptance by its intended users, as well as uniform indication of improvement in symptomology and quality of life among patients across a broad range of demographic and diagnostic groups. Similarly, positive trends are shown in terms of cost savings. Conclusion: There is substantial empirical evidence for supporting the use of telemedicine interventions in patients with mental disorders.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140291/1/tmj.2015.0206.pd

Commentary on “Critical Appraisal of Published Systematic Reviews Assessing the Cost-Effectiveness of Telemedicine Studies”

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140283/1/tmj.2014.9980.pd

The Origins of Telemedicine and e-Health

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140285/1/tmj.2014.9996.pd

The U.S. Army Telemedicine and m-Health Program: Making a Difference at Home and Abroad

This article highlights the deployment of telemedicine by the U.S. Army through the various echelons of care and in overseas locations, including range and scope of health services provided by telemedicine in a challenging environment. This is followed by a discussion of technological developments advances in mobile communications likely to change the practice of telemedicine in the military from limited fixed-point access to a highly mobile individual with handheld communication devices.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140278/1/tmj.2012.0297.pd

Telemedicine Evaluation

This paper examines the context and status of evaluation research in telemedicine, and it proposes a two-pronged strategy for addressing the critical policy and programmatic concerns in this field. It explains the evolution of evaluation research in the United States, and it describes a comprehensive typology and requirements for valid evaluation. Major impediments for definitive evaluation are discussed, together with a summary of major trends in empirical studies. Two concurrent strategies are proposed for producing definitive findings and for assessing the available empirical evidence. These consist of large-scale experimental studies and theoretical and empirical triangulation for assessing the available empirical evidence.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63176/1/tmj.2005.11.296.pd

Chapter 8: Executive Summary

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63118/1/15305620252933437.pd

The Empirical Foundations of Telemedicine Interventions in Primary Care

Introduction: This article presents the scientific evidence for the merits of telemedicine interventions in primary care. Although there is no uniform and consistent definition of primary care, most agree that it occupies a central role in the healthcare system as first contact for patients seeking care, as well as gatekeeper and coordinator of care. It enables and supports patient-centered care, the medical home, managed care, accountable care, and population health. Increasing concerns about sustainability and the anticipated shortages of primary care physicians have sparked interest in exploring the potential of telemedicine in addressing many of the challenges facing primary care in the United States and the world. Materials and Methods: The findings are based on a systematic review of scientific studies published from 2005 through 2015. The initial search yielded 2,308 articles, with 86 meeting the inclusion criteria. Evidence is organized and evaluated according to feasibility/acceptance, intermediate outcomes, health outcomes, and cost. Results: The majority of studies support the feasibility/acceptance of telemedicine for use in primary care, although it varies significantly by demographic variables, such as gender, age, and socioeconomic status, and telemedicine has often been found more acceptable by patients than healthcare providers. Outcomes data are limited but overall suggest that telemedicine interventions are generally at least as effective as traditional care. Cost analyses vary, but telemedicine in primary care is increasingly demonstrated to be cost-effective. Conclusions: Telemedicine has significant potential to address many of the challenges facing primary care in today's healthcare environment. Challenges still remain in validating its impact on clinical outcomes with scientific rigor, as well as in standardizing methods to assess cost, but patient and provider acceptance is increasingly making telemedicine a viable and integral component of primary care around the world.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140293/1/tmj.2016.0045.pd