PURPOSE The need to rapidly implement telemedicine in primary care during the coronavirus disease 2019 (COVID-19) pandemic was addressed differently by various practices. Using qualitative data from semistructured interviews with primary care practice leaders, we aimed to report commonly shared experiences and unique perspectives regarding telemedicine implementation and evolution/maturation since March 2020. METHODS We administered a semistructured, 25-minute, virtual interview with 25 primary care practice leaders from 2 health systems in 2 states (New York and Florida) included in PCORnet, the Patient-Centered Outcomes Research Institute clinical research network. Questions were guided by 3 frameworks (health information technology evaluation, access to care, and health information technology life cycle) and involved practice leaders’ perspectives on the process of telemedicine implementation in their practice, with a specific focus on the process of maturation and facilitators/barriers. Two researchers conducted inductive coding of qualitative data open-ended questions to identify common themes. Transcripts were electronically generated by virtual platform software. RESULTS Twenty-five interviews were administered for practice leaders representing 87 primary care practices in 2 states. We identified the following 4 major themes: (1) the ease of telemedicine adoption depended on both patients’ and clinicians’ prior experience using virtual health platforms, (2) regulation of telemedicine varied across states and differentially affected the rollout processes, (3) visit triage rules were unclear, and (4) there were positive and negative effects of telemedicine on clinicians and patients. CONCLUSIONS Practice leaders identified several challenges to telemedicine implementation and highlighted 2 areas, including telemedicine visit triage guidelines and telemedicine-specific staffing and scheduling protocols, for improvement.

/pdf/the-telemedicine-experience-in-primary-care-practices-in-the-9kq07baf.pdf

The Telemedicine Experience in Primary Care Practices in the United States: Insights From Practice Leaders

Telehealth has received attention in recent years for improving access to healthcare and for supporting integrated care for chronic diseases. Considering that telehealth integration into clinical workflow can alter healthcare providers’ practice patterns, impacting efficiency, quality of care, and patient safety, it is timely to identify and account for system-level variables and considerations to improve the efficiency of telehealth integrations in healthcare settings. Despite the growth of telehealth, and isolated efforts to identify such considerations, a comprehensive conceptual framework for telehealth clinical integration is largely absent. To address this gap, this research effort applied a mixed methods approach to develop a sociotechnical framework to serve as a roadmap for clinics, hospitals, and other healthcare settings regarding the components that must be considered when developing and implementing a telehealth system. The developed framework, System Adoption and Integration of New Telehealth Systems (SAINTS), is grounded in literature and insights from three telehealth case studies in healthcare settings, is influenced by well-grounded sociotechnical models with application in complex healthcare systems, incorporates model-based systems engineering language for the development of structural models, and has been structured considering three temporal stages: system preparation, patient enrollment, and system implementation. 

A Sociotechnical Framework for Integration of Telehealth into Clinical Workflow

Ensuring equitable access to dental health services is a critical yet challenging endeavor, particularly for underserved populations in the United States. This abstract presents a comprehensive approach to address this issue by integrating business analytics and program management strategies. The proposed framework aims to leverage data-driven insights and effective management techniques to optimize resources and improve outcomes for vulnerable communities. The first component of the plan involves harnessing the power of business analytics to gather and analyze data pertaining to dental health disparities, demographic trends, and resource allocation. By utilizing advanced analytics tools and predictive modeling, healthcare providers can identify areas with the greatest need and allocate resources accordingly, ensuring efficient and targeted interventions. In conjunction with business analytics, effective program management strategies are essential for the successful implementation of initiatives aimed at improving dental health equity. This includes establishing partnerships with local communities and healthcare providers, designing culturally sensitive programs, and implementing streamlined workflows to maximize efficiency. The implementation plan outlines the steps required to set up infrastructure, train staff, pilot programs, and scale successful initiatives. Moreover, the abstract discusses potential challenges such as funding constraints, cultural barriers, and workforce shortages, along with proposed solutions to mitigate these obstacles. Ultimately, this integrated approach to optimizing dental health equity holds the potential to significantly reduce disparities and improve overall oral health outcomes for underserved populations in the United States. By continuously evaluating and refining strategies based on feedback and emerging data, stakeholders can work towards the shared goal of ensuring equitable access to dental care for all.

https://frontiersrj.com/journals/ijflsr/sites/default/files/IJFLSR-2024-0031.pdf

Optimizing dental health equity: Integrating business analytics and program management for underserved populations in the U.S

Older age is a potentially confounding variable in models of telehealth utilization. We compared unified and stratified logistic regression models using data from the 2021 National Health Interview Survey. A total of 27,626 patients were identified, of whom 38.9% had utilized telehealth. Unified and stratified modeling showed a number of important differences in their quantitative estimates, especially for gender, Hispanic ethnicity, heart disease, COPD, food allergies, high cholesterol, weak or failing kidneys, liver conditions, difficulty with self-care, the use of mobility equipment, health problems that limit the ability to work, problems paying bills, and filling a recent prescription. Telehealth utilization odds ratios differ meaningfully between younger and older patients in stratified modeling. Traditional statistical adjustments in logistic regression may not sufficiently account for the confounding influence of older age in models of telehealth utilization. Stratified modeling by age may be more effective in obtaining clinical inferences.

pdf/the-confounding-influence-of-older-age-in-statistical-models-14ujfogkrc.pdf

The Confounding Influence of Older Age in Statistical Models of Telehealth Utilization

In this technique, it has been proposed to agree the session keys that have been generated through dual artificial neural networks based on the Telecare Health COVID-19 domain. Electronic health enables secure and protected communication between the patients and physicians, especially during this COVID-19 pandemic. Telecare was the main component which served the remote and non-invasive patients in the crisis period of COVID-19. Neural cryptographic engineering support in terms of data security and privacy is the main theme for Tree Parity Machine (TPM) synchronization in this paper. The session key has been generated on different key lengths and key validation done on the proposed set of robust session keys. A neural TPM network receives a vector designed through same random seed and producing a single output bit. Duo neural TPM networks’ intermediate keys would be partially shared between the patient and doctor for the purpose neural synchronization. Higher magnitude of co-existence has been observed at the duo neural networks at the Telecare Health Systems in COVID-19. This proposed technique has been highly protective against several data attacks in the public networks. Partial transmission of the session key disables the intruders to guess the exact pattern, and highly randomized through different tests. The average p-values of different session key lengths of 40 bits, 60 bits, 160 bits, and 256 bits were observed to be 221.9, 259.3, 242, and 262.8 (taken under multiplicative of 1000) respectively. 

/pdf/concurring-of-neural-machines-for-robust-session-key-1djq3w4l.pdf

Concurring of Neural Machines for Robust Session Key Generation and Validation in Telecare Health System During COVID-19 Pandemic

Telehealth drastically reduces the time burden of appointments and increases access to care for homebound patients. During the COVID-19 pandemic, many outpatient practices closed, requiring an expansion of telemedicine capabilities. However, a significant number of patients remain unconnected to telehealth-capable patient portals. Currently, no literature exists on the success of and barriers to remote enrollment in telehealth patient portals. From March 26 to May 8, 2020, a total of 324 patients were discharged from Mount Sinai Beth Israel (MSBI), a teaching hospital in New York City. Study volunteers attempted to contact and enroll patients in the MyChart patient portal to allow the completion of a post-discharge video visit. If patients were unable to enroll, barriers were documented and coded for themes. Of the 324 patients discharged from MSBI during the study period, 277 (85%) were not yet enrolled in MyChart. Volunteers successfully contacted 136 patients (49% of those eligible), and 39 (14%) were successfully enrolled. Inability to contact patients was the most significant barrier. For those successfully contacted but not enrolled, the most frequent barrier was becoming lost to follow-up (29% of those contacted), followed by lack of interest in remote appointments (21%) and patient technological limitations (9%). Male patients, and those aged 40–59, were significantly less likely to successfully enroll compared to other patients. Telehealth is critical for healthcare delivery. Remote enrollment in a telemedicine-capable patient portal is feasible, yet underperforms compared to reported in-person enrollment rates. Health systems can improve telehealth infrastructure by incorporating patient portal enrollment into in-person workflows, educating on the importance of telehealth, and devising workarounds for technological barriers.

Remote enrollment into a telehealth-delivering patient portal: Barriers faced in an urban population during the COVID-19 pandemic

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Danielle L. Tepper

Author Tools

Chat about Author

Papers

Remote enrollment into a telehealth-delivering patient portal: Barriers faced in an urban population during the COVID-19 pandemic