Development and Operation of a Video Teleconsultation System Using Integrated Medical Equipment Gateway: a National Project for Workers in Underserved Areas

Clinical applications of telemedicine services using a regional telemedicine platform for cancer treatment: a cross-sectional study

BACKGROUND

Telemedicine is beneficial for improving treatment efficiency and reducing medical expenses of cancer patients. This study focuses on cancer patients participating in teleconsultations through a regional telemedicine platform in China, analyzes the consultation process, and provides references for the clinical application of telemedicine.

METHODS

We collected information on teleconsultations of cancer patients conducted from 2015 to 2022 through the regional telemedicine platform. Utilizing SPSS 23.0 software, we conducted descriptive analysis to summarize the distribution of patient gender, age, region, and disease types. The ordinal logistic regression analysis was adopted to analyze the factors influencing the waiting time and consultation duration for teleconsultations.

RESULTS

From 2015 to 2022, a total of 23,060 teleconsultations were conducted for cancer patients via regional telemedicine platform, with an average growth rate of 11.09%. The main types of consultations were for lung cancer, liver cancer, and breast cancer, accounting for 18.14%, 10.49%, and 9.46% respectively. 57.05% of teleconsultations had a waiting time of less than 24 h, while patient age, consultation expert level, and disease type were the main factors influencing the waiting time. 50.06% of teleconsultations had a duration of more than 20 min, and the inviting hospital level and the title of invited consultant were the main factors influencing the consultation duration.

CONCLUSIONS

In China, telemedicine has been widely employed in the clinical diagnosis and treatment of cancers, covering various types of oncological diseases. However, the waiting time for teleconsultations was generally more than 12 h, indicating the need to enhance consultation scheduling and allocate more expert resources to further optimize the efficiency of teleconsultations. Additionally, further exploration is required for remote health management of outpatients with cancers outside the hospital.

Are We Adequately Measuring Patient Satisfaction with Telemedicine? A Systematic Review with a Meta-Analysis

Introduction: Telemedicine has gained significant attention as an effective means of providing health care remotely, particularly during the COVID-19 pandemic. Patient satisfaction is a critical aspect of implementing telemedicine, but we have no comprehensive understanding of satisfaction levels and the associated factors. The aim of this systematic review and meta-analysis was to assess patient satisfaction related to telemedicine consultations and to identify key factors influencing satisfaction levels. Results: The search yielded a total of 147 cross-sectional studies, of which 107 met the criteria for inclusion in the meta-analysis. Overall, patient satisfaction with teleconsultations was found to be high, with satisfaction levels ranging from 38 to 100 on a scale of 0 to 100. Only a small percentage (2.72%) of the studies reported satisfaction levels below 75%. Surprisingly, most studies used nonvalidated satisfaction questionnaires, which highlight the need for the development of standardized measurement instruments. Conclusions: This systematic review and meta-analysis provide evidence that patients generally exhibit high levels of satisfaction with telemedicine consultations. The use of nonvalidated satisfaction questionnaires in many studies, however, suggests a need for more standardized assessment tools. Factors such as the time interval between the consultation and the assessment were found to influence satisfaction levels. Understanding these factors can help health care providers improve telemedicine services and patient-provider relationships and optimize health care delivery in the context of telemedicine. Further research is warranted to develop validated satisfaction measurement instruments and explore any additional factors that influence patient satisfaction with telemedicine.

Dentists' Intention to Use Teleconsultation for the Treatment of Patients With Osteoporosis: An Online Survey Study

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.

Use of video-based telehealth services using a mobile app for workers in underserved areas during the COVID-19 pandemic: A prospective observational study

BACKGROUND

The COVID-19 pandemic has limited face-to-face treatment, triggering a change in the structure of existing healthcare services. Unlike other groups, workers in underserved areas have relatively poor access to healthcare.

OBJECTIVE

This study aimed to investigate the effects of video-based telehealth services using a mobile personal health record (PHR) app for vulnerable workers with metabolic risk factors.

METHODS

A prospective observational study was conducted with 117 participants and 27 healthcare professionals for 16 weeks. Participants visited the research institution three times (at weeks 1, 8, and 16) and underwent health check-ups and used various features of the mobile PHR app. Healthcare professionals observed the participants's data using the monitoring system and performed appropriate interventions. The primary outcome measures were to evaluate the effects of services on changes in the participants' metabolic risk factors, and secondary outcome measures were to analyze changes in the participants' lifestyle and service satisfaction, and to observe service use through usage logs. One-way repeated measures ANOVA and Scheffé's test were performed to observe changes in participants' health status and lifestyle, and a paired t-test was performed to analyze changes in service satisfaction. Finally, in-depth interviews with healthcare professionals were performed using semi-structured questionnaires to understand service providers' perspectives after the end of the study.

RESULTS

Systolic blood pressure (F = 7.32, P <.001), diastolic blood pressure (F = 11.30, P <.001), body weight (F = 29.53, P <.001), BMI (F = 17.31, P <.001), waist circumference (F = 17.33, P <.001), fasting blood glucose (F = 5.11, P =.007), and triglycerides (F = 4.66, P =.01) showed significant improvements with time points, whereas high-density lipoprotein cholesterol (F = 3.35, P =.067) did not. The dietary score (F = 3.26, P =.04) showed a significant improvement with time points, whereas physical activity (F = 1.06, P =.34) did not. In terms of service satisfaction, only lifestyle improvement (P <.001) showed a significant difference. COVID-19 has affected the performance of healthcare professionals, thereby changing the perspectives toward healthcare technology services.

CONCLUSIONS

We evaluated the effectiveness of video-based telehealth services supporting workers' health status and lifestyle interventions using healthcare technologies such as the mobile PHR app, tele-monitoring, and video teleconsultation. Our results indicate that as a complementary means, its utility can be expanded in the field of occupational safety and health to overcome the limitations of face-to-face treatment due to COVID-19 in the future.

A Worker-Centered Personal Health Record App for Workplace Health Promotion Using National Health Care Data Sets: Design and Development Study

Background

Personal health record (PHR) technology can be used to support workplace health promotion, and prevent social and economic losses related to workers’ health management. PHR services can not only ensure interoperability, security, privacy, and data quality, but also consider the user’s perspective in their design.

Objective

Using Fast Healthcare Interoperability Resources (FHIR) and national health care data sets, this study aimed to design and develop an app for providing worker-centered, interconnected PHR services.

Methods

This study considered the user’s perspective, using the human-centered design (HCD) methodology, to develop a PHR app suitable for occupational health. We developed a prototype after analyzing quantitative and qualitative data collected from workers and a health care professional group, after which we performed a usability evaluation. We structured workers’ PHR items based on the analyzed data, and ensured structural and semantic interoperability using FHIR, Systematized Nomenclature of Medicine–Clinical Terms (SNOMED-CT), and Logical Observation Identifiers Names and Codes (LOINC). This study integrated workers’ health information scattered across different Korean institutions through an interface method, and workers’ PHRs were managed through a cloud server, using Azure API for FHIR.

Results

In total, 562 workers from industrial parks participated in the quantitative study. The preferred data items for PHR were medication, number of steps walked, diet, blood pressure, weight, and blood glucose. The preferred features were ability to access medical checkup results, health information content provision, consultation record inquiry, and teleconsultation. The worker-centered PHR app collected data on, among others, life logs, vital signs, and medical checkup results; offered health care services such as reservation and teleconsultation; and provided occupational safety and health information through material safety data sheet search and health questionnaires. The app reflected improvements in user convenience and app usability proposed by 19 participants (7 health care professionals and 12 end users) in the usability evaluation. The After-Scenario Questionnaire (ASQ) was evaluated with a mean score of 5.90 (SD 0.34) out of 7, and the System Usability Scale (SUS) was evaluated a mean score of 88.7 (SD 4.83) out of 100.

Conclusions

The worker-centered PHR app integrates workers’ health information from different institutions and provides a variety of health care services from linked institutions through workers’ shared PHR. This app is expected to increase workers’ autonomy over their health information and support medical personnel’s decision making regarding workers’ health in the workplace. Particularly, the app will provide solutions for current major PHR challenges, and its design, which considers the user’s perspective, satisfies the prerequisites for its utilization in occupational health.