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Vinadé Chagas ME, Cristina Jacovas V, de Campos Moreira T, Rodrigues Moleda Constant HM, Fernanda Rohden S, Stiehl Alves S, Santini F, Dall'Agnol S, König Klever E, Cezar Cabral F, da Silva Terres M. Are We Adequately Measuring Patient Satisfaction with Telemedicine? A Systematic Review with a Meta-Analysis. Telemed J E Health 2024. [PMID: 38436274 DOI: 10.1089/tmj.2023.0530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
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.
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Affiliation(s)
- Maria Eulália Vinadé Chagas
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | - Suelen Stiehl Alves
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Santini
- Universidade do Vale do Rio dos Sinos (Unisinos), Business School, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sara Dall'Agnol
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Emanuele König Klever
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Mellina da Silva Terres
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Zhang Z, Yan Y, Seop Kim B, Han W, Chen X, Lin L, Zhang Y, Chai G. iPhone 13 Pro Max photography for quantitative evaluation of fine facial wrinkles: Is it feasible? Skin Res Technol 2023; 29:e13360. [PMID: 37753675 PMCID: PMC10468579 DOI: 10.1111/srt.13360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 05/15/2023] [Indexed: 09/28/2023]
Affiliation(s)
- Ziwei Zhang
- Department of Plastic and Reconstructive SurgeryShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yingjie Yan
- Department of Plastic and Reconstructive SurgeryShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Byeong Seop Kim
- Department of Plastic and Reconstructive SurgeryShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Wenqing Han
- Department of Plastic and Reconstructive SurgeryShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Xiaojun Chen
- Department of Plastic and Reconstructive SurgeryShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Li Lin
- Department of Plastic and Reconstructive SurgeryShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yan Zhang
- Department of Plastic and Reconstructive SurgeryShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Gang Chai
- Department of Plastic and Reconstructive SurgeryShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
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Alromaihi D, Asheer S, Hasan M, Faqihi F, Almannaei N, Alkowari S, Janahi D, Hasan M, Abraham A, Verma S. Evaluation of Patients' Satisfaction with the Transition of Internal Medicine Outpatient Clinics to Teleconsultation During COVID-19 Pandemic. Telemed J E Health 2023; 29:270-277. [PMID: 35704029 DOI: 10.1089/tmj.2021.0517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: The utilization of telemedicine has been steadily rising and became more available during the coronavirus disease 2019 (COVID-19) pandemic to ensure the continuity of care and minimize the risk of exposure to the infection. The aim of this study was to evaluate patients' and caregivers' satisfaction to newly developed teleconsultation services at the internal medical outpatient clinics at a tertiary university hospital during the COVID-19 pandemic. Methods: A cross-sectional satisfaction evaluation was conducted between April 2020 and June 2020. Participants included patients or caregivers who were randomly selected to answer a multi-item questionnaire to measure satisfaction with the quality, effectiveness, and convenience of the service. Results: A total of 901 participants completed the satisfaction survey. Most of the patients were in the age group 45-64 years (43.7%). The main teleconsultation method was telephone call (99.2%) and 798 participants (88.6%) were satisfied with the quality of teleconsultation. There was no difference in satisfaction levels across the various specialty clinics or age groups. The service was viewed as convenient by 636 participants (70.5%) and 481 (56.6%) preferred to continue using telemedicine after the COVID-19 pandemic. Conclusion: The study revealed high level of satisfaction among patients and caregivers with the recently introduced teleconsultation services at internal medicine outpatient clinics during the COVID-19 pandemic, which is a relatively new concept in many countries. This opens the door to further utilize telemedicine as an integrated part to improve patient care beyond the pandemic.
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Affiliation(s)
- Dalal Alromaihi
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain.,Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Kingdom of Bahrain
| | - Shaikha Asheer
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Mariam Hasan
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Fatima Faqihi
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Noora Almannaei
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Shaikha Alkowari
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Duha Janahi
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Mona Hasan
- Quality and Patient Safety Directorate, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Aneena Abraham
- Quality and Patient Safety Directorate, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
| | - Seema Verma
- Quality and Patient Safety Directorate, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
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Trinh P, Yekrang K, Phung M, Pugliese S, Chang ALS, Bailey EE, Ko JM, Sarin KY. Partnering with a senior living community to optimise teledermatology via full body skin screening during the COVID-19 pandemic: A pilot programme. Skin Health Dis 2022; 2:e141. [PMID: 35941936 PMCID: PMC9349994 DOI: 10.1002/ski2.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/15/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Elderly patients in senior communities faced high barriers to care during the COVID-19 pandemic, including increased vulnerability to COVID-19, long quarantines for clinic visits, and difficulties with telemedicine adoption. OBJECTIVE To pilot a new model of dermatologic care to overcome barriers for senior living communities during the COVID-19 pandemic and assess patient satisfaction. METHODS From 16 November 2020 to 9 July 2021, this quality improvement programme combined in-residence full body imaging with real-time outlier lesion identification and virtual teledermatology. Residents from the Sequoias Portola Valley Senior Living Retirement Community (Portola Valley, California) voluntarily enroled in the Stanford Skin Scan Programme. Non-physician clinical staff with a recent negative COVID-19 test travelled on-site to obtain in-residence full body photographs using a mobile app-based system on an iPad called SkinIO that leverages deep learning to analyse patient images and suggest suspicious, outlier lesions for dermoscopic photos. A single dermatologist reviewed photographs with the patient and provided recommendations via a video visit. Objective measures included follow-up course and number of skin cancers detected. Subjective findings were obtained through patient experience surveys. RESULTS Twenty-seven individuals participated, three skin cancers were identified, with 11 individuals scheduled for a follow up in-person visit and four individuals starting home treatment. Overall, 88% of patients were satisfied with the Skin Scan programme, with 77% likely to recommend the programme to others. 92% of patients agreed that the Skin Scan photographs were representative of their skin. In the context of the COVID-19 pandemic, 100% of patients felt the process was safer or comparable to an in-person visit. Despite overall appreciation for the programme, 31% of patients reported that they would prefer to see dermatologist in-person after the pandemic. CONCLUSIONS This programme offers a framework for how a hybrid skin scan programme may provide high utility for individuals with barriers to accessing in-person clinics.
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Affiliation(s)
- Pavin Trinh
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Kiana Yekrang
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Michelle Phung
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Silvina Pugliese
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Anne Lynn S. Chang
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Elizabeth E. Bailey
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Justin M. Ko
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Kavita Y. Sarin
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
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Reuland BD, Redman CT, Kneifati-Hayek JZ, Fernandes Y, Kosber R, Ortuno-Garcia C, Crossman DJ, Salmasian H, Chen AR, Barchi DJ, Applebaum JR, Green RA, Adelman JS. Observation and Patients' Perceptions of Incorporating Their Photograph Into the Electronic Health Record. J Patient Saf 2022; 18:377-381. [PMID: 35948287 DOI: 10.1097/pts.0000000000001024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Wrong-patient errors are common and have the potential to cause serious harm. The Office of the National Coordinator for Health Information Technology Patient Identification SAFER Guide recommends displaying patient photographs in electronic health record (EHR) systems to facilitate patient identification and reduce wrong-patient errors. A potential barrier to implementation is patient refusal; however, patients' perceptions about having their photograph captured during registration and integrated into the EHR are unknown. METHODS The study was conducted in an emergency department (ED) and primary care outpatient clinic within a large integrated health system in New York City. The study consisted of 2 components: (1) direct observation of the registration process to quantify the frequency of patient refusals and (2) semistructured interviews to elicit patients' feedback on perceived benefits and barriers to integrating their photograph into the EHR. RESULTS Of 172 registrations where patients were asked to take a photograph for patient identification, 0 refusals were observed (ED, 0 of 87; primary care outpatient clinic, 0 of 85). A convenience sample of 30 patients were interviewed (female, 70%; age ≥55 years, 43%; Hispanic/Latino, 67%; Black, 23%). Perceived benefits of integrating patient photographs into the EHR included improved security (40%), improved patient identification (23%), and ease of registration (17%). A small proportion of patients raised privacy concerns. CONCLUSIONS Patient refusal was not found to be a barrier to implementation of patient photographs in the EHR. Efforts to identify and address other potential barriers would help ensure that the highest proportion of patients has photographs in their medical record.
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Affiliation(s)
- Brian D Reuland
- From the Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Chelsea T Redman
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jerard Z Kneifati-Hayek
- From the Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Yelstin Fernandes
- From the Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Rashid Kosber
- Department of Urology, UCLA Health, Los Angeles, California
| | | | - Daniel J Crossman
- Division of Pediatric Oncology, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, Baltimore, Maryland
| | - Hojjat Salmasian
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Allen R Chen
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Daniel J Barchi
- Department of Information Technology, NewYork-Presbyterian Hospital, New York, New York
| | - Jo R Applebaum
- From the Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Robert A Green
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York
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Koh E, Maranga A, Yane T, Ndlovu K, Jereni B, Nwako-Mohamadi MK, Kovarik C, Forrestel A, Williams VL. Evaluation of WhatsApp as a Platform for Teledermatology in Botswana: Retrospective Review and Survey. JMIR Dermatol 2022. [DOI: 10.2196/35254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background
In emerging market countries in sub-Saharan Africa, access to specialty services such as dermatology is limited. Teledermatology is an innovative solution to address this issue; however, many initiatives have been tried without sustained success. Recently, WhatsApp has been used as a store-and-forward telemedicine communication platform for consultation and education in Botswana.
Objective
This study aims to describe the utilization of WhatsApp for teledermatology and the satisfaction levels of participating providers.
Methods
A 2-part pilot study was conducted. First, a retrospective review was performed of WhatsApp communications received by participating dermatologists in Gaborone, Botswana, from January 2016 to December 2019. Sender information, patient demographics and history, response time, diagnoses made, and follow-up recommendations were collected. Second, a 12-question cross-sectional survey was distributed to health care providers who utilized WhatsApp for teledermatology during this period. Descriptive statistics were then performed.
Results
There were 811 communication threads over the study period. The majority (503/811, 62%) of communications were consultations from providers inquiring about a specific patient, followed by multidisciplinary care coordination communications (90/811, 11%). Our in-depth analysis focused on the former. In 323 (64%) provider consultations, dermatologists responded within 1 hour. A diagnosis was made in 274 (55%) consultations. Dermatologists gave treatment recommendations remotely in 281 (56%) consultations and recommended an in-person dermatology visit in 163 (32%). Of the 150 health care providers surveyed, 23 (15%) responded. All respondents (100%) felt that there was a need for teledermatology and improved teledermatology education in Botswana. Moreover, 17 (74%) respondents strongly felt that the guidance received via WhatsApp was high quality, and 22 (96%) were satisfied with WhatsApp as a platform for teledermatology.
Conclusions
This retrospective review and survey demonstrated that WhatsApp is a quick, well-received, and sustainable method of communication between dermatologists and providers across Botswana. The app may offer a solution to the challenges providers face in accessing specialty referral systems, point-of-care education, and medical decision-making support for complex dermatologic cases in Botswana. The information gained from this pilot study can serve as the basis for future telemedicine studies to improve the implementation of teledermatology in Botswana and other resource-limited countries.
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Kheir DYME, Alshamsi RA, Alalwi ST, Alshammari RZ. "Webside" healthcare from medical interns' perspective: Telemedicine implementation and need for training. J Family Community Med 2022; 29:145-154. [PMID: 35754750 PMCID: PMC9221231 DOI: 10.4103/jfcm.jfcm_105_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/03/2022] [Accepted: 04/15/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND: Telemedicine involves the use of electronic communication and technology to remotely deliver clinical services to patients. With the increase in the adoption of telemedicine in healthcare delivery, “webside healthcare” is becoming the virtual analog of bedside care. The Ministry of Health in Saudi Arabia has recently established the use of telemedicine, including social media (SM) and medical applications (Apps) to enhance the quality and accessibility of healthcare services to patients and healthcare providers. In the present study, we evaluated medical interns' perception of the use of telemedicine, SM, and medical Apps in patient care, their awareness of related guidelines to find out if targeted training is needed. MATERIALS AND METHODS: A qualitative study recruited and interviewed, through semi-structured key informant (KI) interviews and focus group discussions (FGD), a total of 24 male and female medical interns. The Interns were purposefully sampled from all Saudi Arabia's 5 main geographical regions until data saturation was observed. The transcripts of five KI interviews and 6 FGDs done were thematically analyzed and are presented as themes and subthemes. RESULTS: Medical interns discussed the advantages and disadvantages related to telemedicine, SM, and medical Apps in healthcare services. Overall, interviewees appreciated the role telemedicine, SM, and medical Apps play in the healthcare and for such particular specialties as family medicine and (tele-) psychiatry. However, the interns believed that training on the technical operational aspects of different telemedicine modalities with an emphasis on targeted education for related ethical and legal regulating guidelines was vital. CONCLUSION: Most interviewed medical interns had a positive perception of telemedicine and were willing to use it in their daily clinical practice. However, there were some challenges to its successful implementation such as prompt training on its proper use and clear ethical and legal guidance.
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Affiliation(s)
- Dalia Y M El Kheir
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Razan A Alshamsi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Sukainah T Alalwi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Razan Z Alshammari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
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Yadav D, Bhatia S, Ramam M, Singh V, Khanna N, Khandpur S, Gupta V. Patient perception and satisfaction with a smartphone-based teledermatology service initiated during the COVID-19 pandemic at a tertiary care hospital in North India. Indian J Dermatol Venereol Leprol 2022; 88:623-632. [PMID: 35389031 DOI: 10.25259/ijdvl_608_2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/01/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Telemedicine is being increasingly used to provide healthcare to patients, particularly during the COVID-19 pandemic. AIMS The study aimed to study patient perception and satisfaction with a smartphone-based hybrid teledermatology service initiated during the COVID-19 pandemic. METHODS This was a cross-sectional telephonic survey including patients ≥18 years of age who had received a teledermatology consultation. After noting the demographic, clinical and teleconsultation details, patients were administered the Telemedicine Satisfaction Questionnaire and an additional 6-item questionnaire. Patients were also asked to give qualitative feedback and suggestions for improvement using a semi-structured interview guide. RESULTS We interviewed 201 subjects. The most common diagnoses were pemphigus (27, 13.4%), superficial fungal infections (24, 11.8%), psoriasis (22, 10.9%) and dermatitis (21, 10.4%). The overall mean Telemedicine Satisfaction Questionnaire score was 4.20± 0.71. One hundred seventy-one (85.1%) patients responded that they would use teledermatology services again, while 168 (83.6%) reported satisfaction with the quality of services. A majority of the patients were largely satisfied with the various components involved, though some concerns were raised about the care perceived as not at par with physical consultations, difficulty in procuring medicines, lack of confidence in photographic diagnoses and the lack of a personal touch. Patients with urticaria (P=0.020), those who were advised a change in treatment (P=0.029) and those with improvement in their skin disease (P=0.026) were more likely to be satisfied. LIMITATIONS Our study was conducted during the COVID-19 pandemic when patient acceptability was likely to be higher. Only follow-up patients were included in the study. CONCLUSION Patient satisfaction levels were generally high with teledermatology. Addressing lacunae that negatively impact patient perception and satisfaction will help in greater acceptance of teledermatology services.
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Affiliation(s)
- Deepika Yadav
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Bhatia
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - M Ramam
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwajeet Singh
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Sujay Khandpur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Alodhayani AA, Hassounah MM, Qadri FR, Abouammoh NA, Ahmed Z, Aldahmash AM. Culture-Specific Observations in a Saudi Arabian Digital Home Health Care Program: Focus Group Discussions With Patients and Their Caregivers. J Med Internet Res 2021; 23:e26002. [PMID: 34889740 PMCID: PMC8701718 DOI: 10.2196/26002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/09/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022] Open
Abstract
Background There is growing evidence of the need to consider cultural factors in the design and implementation of digital health interventions. However, there is still inadequate knowledge pertaining to the aspects of the Saudi Arabian culture that need to be considered in the design and implementation of digital health programs, especially in the context of home health care services for patients who are chronically and terminally ill. Objective This study aims to explore the specific cultural factors related to patients and their caregivers from the perspective of physicians, nurses, and trainers that have influenced the pilot implementation of Remotely Accessible Healthcare At Home, a connected health program in the Home Health Care department at King Saud University Medical City, Riyadh, Saudi Arabia. Methods A qualitative study design was adopted to conduct a focus group discussion in July 2019 using a semistructured interview guide with 3 female and 4 male participants working as nurses, family physicians, and information technologists. Qualitative data obtained were analyzed using a thematic framework analysis. Results A total of 2 categories emerged from the focus group discussion that influenced the experiences of digital health program intervention: first, culture-related factors including language and communication, cultural views on using cameras during consultation, nonadherence to web-based consultations, and family role and commitment and second, caregiver characteristics in telemedicine that includes their skills and education and electronic literacy. Participants of this study revealed that indirect contact with patients and their family members may work as a barrier to proper communication through the Remotely Accessible Healthcare At Home program. Conclusions We recommend exploring the use of interpreters in digital health, creating awareness among the local population regarding privacy in digital health, and actively involving direct family members with the health care providers.
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Affiliation(s)
- Abdulaziz A Alodhayani
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Marwah Mazen Hassounah
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fatima R Qadri
- Prince Naif Bin Abdulaziz Health Research Center, King Saud University, Riyadh, Saudi Arabia.,Medical Researches Company, iResearch, Riyadh, Saudi Arabia
| | - Noura A Abouammoh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Zakiuddin Ahmed
- Prince Naif Bin Abdulaziz Health Research Center, King Saud University, Riyadh, Saudi Arabia.,Riphah Institute of Healthcare Improvement & Safety, Riphah International University, Islamabad, Pakistan
| | - Abdullah M Aldahmash
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,College of Medicine, Vision Colleges, Riyadh, Saudi Arabia
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11
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Balay-Odao EM, Alquwez N, Alsolami F, Tork HMM, Al Otaibi K, Al Thobaity A. COVID-19 crisis: Influence of eHealth literacy on mental health promotion among Saudi nursing students. J Taibah Univ Med Sci 2021; 16:906-913. [PMID: 34803568 PMCID: PMC8591548 DOI: 10.1016/j.jtumed.2021.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/08/2021] [Accepted: 07/15/2021] [Indexed: 12/02/2022] Open
Abstract
Objective This study aims to determine the influence of eHealth literacy on mental health promotion among Saudi nursing students. Method This cross-sectional study was conducted from 19 April to 21 May 2020. A total of 468 nursing students responded to the self-administered online survey. Two instruments, namely, the eHealth Literacy Scale and the Positive Mental Health Scale, were used. Statistical tools such as frequency, percentage, mean, and standard deviation were used for the descriptive analysis. Multiple regression analysis was employed to analyse the relationship between eHealth literacy, health promotion, and its predictors. Results The results showed that 30.3% of nursing students were dissatisfied with their general health. Students perceived high self-assessed eHealth literacy and positive mental health. Students in the 4th year had lower scores than those of students in the 2nd year. Nursing students perceived that the quarantine and public social distancing lowered their mental health scores. Finally, the eHealth literacy mean scores resulted in a 0.21-point increase in the positive mental health scores. Conclusion The finding of the study shows that the eHealth literacy positively influnce the mental health status of Saudi Nursing students.
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Affiliation(s)
- Ejercito M Balay-Odao
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Al Dawadmi, KSA
| | - Nahed Alquwez
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Al Dawadmi, KSA
| | | | | | - Khalaf Al Otaibi
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Al Dawadmi, KSA
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Joshi TP, Ren V. Teledermatology in the Control of Skin Neglected Tropical Diseases: A Systematic Review. Dermatol Pract Concept 2021; 11:e2021130. [PMID: 34631272 DOI: 10.5826/dpc.1104a130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 10/31/2022] Open
Abstract
Introduction Neglected tropical diseases (NTDs) include a group of about 20 illnesses that have garnered relatively little attention, despite their ability to inflict significant suffering and disability. Skin neglected tropical diseases (sNTDs) are a subset of NTDs that present with cutaneous manifestations and are well known for their ability to generate stigma and promote poverty. Teledermatology (TD) represents a potential method to control sNTDs. Objective We sought to analyze the potential for TD to ease the burden of sNTDs. Methods We performed a systematic literature search using the Texas Medical Center Library One Search, which scans 167 databases, including Embase, PubMed, and Scopus. We included all original investigations published after 2011 that assessed the impact of TD intervention in the control of one or more sNTDs. We excluded studies not written in English and studies that did not perform any outcome analyses. Results Twenty studies met our search criteria, and 18 expressed positive attitudes towards TD. Overall, we found that TD may be a sustainable, cost-effective strategy for expanding access to care for individuals afflicted with sNTDs. However, poor image quality, lack of access to further diagnostic tests, and ethical, legal, and cultural issues pose as barriers to TD utilization. Conclusion TD may be helpful in achieving control of sNTDs but has its limitations. An integrated approach, which employs TD in conjunction with other strategies, represents a realistic path for alleviating sNTDs.
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Affiliation(s)
| | - Vicky Ren
- Department of Dermatology, Baylor College of Medicine
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Abstract
OBJECTIVES The COVID-19 pandemic has led to an increased use of telemedicine. The primary objective of the study was to evaluate attitudes and behaviors of licensed physicians in the region to telemedicine. METHODOLOGY A cross-sectional design using an electronic survey as the primary tool was done. The questionnaire had a demographic component of the respondent (first part), covering age, specialty, and experience with telemedicine during the COVID pandemic, and a second part, which was in the form of a Likert scale, covering perceptions related to telemedicine. The Likert scale itself had two main areas: (1) attitudes toward telemedicine and (2) perceived barriers. RESULTS There were 392 valid responses of which 228 (58.1%) had used some form of telemedicine (other than standard phone calls) during the COVID-19 pandemic. The most common platforms used for telemedicine include WhatsApp® (211, 53.8%), Zoom® (131, 33.4%), Microsoft Teams® (27, 6.2%), Sehha App (65, 16.5%), Email (84, 21.4%). There was a strong agreement on the following statements: "Telemedicine can reduce unnecessary outpatient visits" (87.5%), "Effectiveness of telemedicine depends on the specialty" (89.5%), and "Telemedicine can be used to monitor chronic patients from home" (88.3%). Concerning the barriers to telemedicine, the ones having the most concordance were technological limitations (66.6%) and concerns of diagnostic reliability (66.1%). CONCLUSIONS The responses from our study seem to suggest that while the attitudes toward telemedicine are positive, practicing physicians are concerned about a perceived lack of clarity regarding related legal frameworks and barriers such as technological issues, cultural factors, and diagnostic concordance.
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Affiliation(s)
| | | | - Ali Al Ameer
- Dermatology, King Fahad General Hospital, Hofuf, SAU
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Dovigi E, Kwok EYL, English JC. A Framework-Driven Systematic Review of the Barriers and Facilitators to Teledermatology Implementation. Curr Dermatol Rep 2020; 9:353-361. [PMID: 33200042 PMCID: PMC7658914 DOI: 10.1007/s13671-020-00323-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 01/07/2023]
Abstract
Purpose of Review Telemedicine use in dermatology, termed “teledermatology”, offers a cost-effective model to improve healthcare efficiency and access. Only a minority of dermatology practices has integrated teledermatology into their practice prior to COVID-19. A thorough understanding of the barriers and facilitators may promote teledermatology adoption. Implementation science frameworks offer theoretically driven ways to assess factors affecting teledermatology implementation. This review uses a comprehensive implementation science framework to summarize barriers and facilitators of teledermatology implementation and appraises the quality of existing research. Recent Findings Technological characteristics of teledermatology (e.g., user-friendliness) and factors within the outer setting (e.g., reimbursement and legal considerations) were the most commonly reported barriers. No existing studies use a comprehensive implementation framework to identify factors influencing teledermatology implementation. Many included studies have a risk of bias in at least two of the five study quality indices evaluated. Summary This systematic review is the first study to summarize the existing teledermatology implementation literature into well-defined constructs from a comprehensive implementation science framework. Findings suggest future studies would benefit from the use of an implementation framework to reduce study bias, improve result comprehensiveness, facilitate comparisons across studies, and produce evidence-based resolutions to implementation barriers. Tools, resources, and recommendations to facilitate the use of an implementation framework in future studies are provided. Supplementary Information The online version contains supplementary material available at 10.1007/s13671-020-00323-0.
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Affiliation(s)
- Edwin Dovigi
- Rush University Medical Center, 1620 W Harrison St, Chicago, IL 60612 USA
| | | | - Joseph C. English
- Department of Dermatology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA USA
- Center for Teledermatology, UPMC North Hills Dermatology, 9000, Brooktree Rd Suite 200, Wexford, PA 15044 USA
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Ridard E, Secember H, Carvalho-lallement P, Schuers M. Indicateurs en télédermatologie : une revue de la littérature. Ann Dermatol Venereol 2020; 147:602-17. [DOI: 10.1016/j.annder.2020.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/25/2019] [Accepted: 01/31/2020] [Indexed: 11/24/2022]
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Aldebasi B, Alhassan AI, Al-Nasser S, Abolfotouh MA. Level of awareness of Saudi medical students of the internet-based health-related information seeking and developing to support health services. BMC Med Inform Decis Mak 2020; 20:209. [PMID: 32883284 PMCID: PMC7469907 DOI: 10.1186/s12911-020-01233-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 08/26/2020] [Indexed: 11/10/2022] Open
Abstract
Background Many studies are available in the literature about e-health in Saudi Arabia, however, data is limited to a few organizations and does not necessarily reflect the current and potential use of e-health for health care organizations in the country. This study aimed to determine the level of awareness of Saudi medical students of the internet-based health-related information seeking and developing to support health services and significant predictors of their practice. Methods A cross-sectional survey of 440 medical students in Riyadh, Saudi Arabia, was conducted, during October/November 2019, using a previously validated questionnaire, to assess: (1) knowledge in three domains; e-health definition (13 statements), fields of application of e-health (8 statements), methods of using e-health (7 statements), (2) attitude toward using e-health (8 statements) and (3) reported practice of e-health in medical training (5 statements). A scoring system was used to calculate the total and percentage score of knowledge, attitude, and practice for each student. Multiple regression analysis was applied to identify predictors of e-health practice. Significance was considered at p < 0.05. Results Of 440 medical students, the majority were females (55.7%) and from families whose monthly income was more than 10,000SR (82.8%). Overall knowledge about e-health was unsatisfactory (percentage mean score, PMS = 71.6%), with only 43.6% of students reporting a satisfactory level. However, this level was satisfactory for fields of application (Percentage mean score-PMS = 76.6%) and unsatisfactory for the definition of e-health (PMS = 70.7%) and methods of its use (PMS = 65.7%) domains. The overall attitude towards e-health use was positive (PMS = 82.3%), with nearly three-quarters of students (73.4%) reporting a positive attitude. Generally, a good level of practice of e-health was reported by students (PMS = 84.3%), with more than three-quarters of students (78.4%) reporting good practice. Adjusting for age, gender, stream, educational grade, and family monthly income, good practice was significantly predicted with higher knowledge (t = 2.22, p = 0.03) and attitude (t = 2.11, p = 0.04) scores. Conclusion This study provides basic information regarding medical students’ level of awareness of internet-based health-related information seeking and developing to support health services. More resources should be directed to elevate medical students’ knowledge and to motivate them to practice e-health using the available tools.
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Affiliation(s)
- Bader Aldebasi
- King Abdullah International Medical Research Center, King Saud bin-Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia
| | - Abdulaziz I Alhassan
- Department of Medical Education, College of Medicine, King Saud bin-Abdulaziz University, Riyadh, Saudi Arabia, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia
| | - Sami Al-Nasser
- Department of Medical Education, College of Medicine, King Saud bin-Abdulaziz University, Riyadh, Saudi Arabia, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia
| | - Mostafa A Abolfotouh
- King Abdullah International Medical Research Center, King Saud bin-Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia.
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Hadeler E, Gitlow H, Nouri K. Definitions, survey methods, and findings of patient satisfaction studies in teledermatology: a systematic review. Arch Dermatol Res 2020; 313:205-215. [PMID: 32725501 PMCID: PMC7385477 DOI: 10.1007/s00403-020-02110-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/18/2020] [Indexed: 02/06/2023]
Abstract
Remote consultations likely will grow in importance if the COVID-19 pandemic continues. This review analyzes which methods of teledermatology patients prefer by categorizing how recent studies have defined satisfaction, conducted surveys and concluded patients respond to the different modalities of teledermatology. Using PubMed and Cochrane databases, we reviewed studies from April 5th, 2010 to April 5th, 2020 that included the search terms patient satisfaction and teledermatology. All studies that included patient satisfaction as an outcome were included, but studies not published in English were excluded. We examined domains of satisfaction, survey method, study characteristics (including patient population, country, age, study design and evidence score), findings and statistical comparisons. We thoroughly reviewed 23 studies. Definitions of satisfaction varied, but all concluded patients were satisfied with the live-interactive and store-and-forward modalities. The studies reveal that store-and-forward is appropriate for clinicians with established patients who require regular follow-up. Verified areas of care include treatment of chronic conditions, topical skin cancer therapy, wound monitoring, and post-procedural follow-up. Only four studies conducted statistical analyses. One of those studies compared patient preference for each modality of teledermatology with face-to-face dermatology. While this study reported high satisfaction with each mode of teledermatology, patients still preferred face-to-face. Favorable responses to remote diagnostic capabilities suggest that these offerings improve preference for teledermatology. With only one study evaluating preference between each modality and face-to-face dermatology, more studies should address the discrepancy. Surveys that cover all domains of satisfaction may improve assessments and identify where gaps in preference exist.
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Affiliation(s)
- Edward Hadeler
- Miller School of Medicine Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA.
| | - Howard Gitlow
- Herbert Business School, University of Miami, Coral Gables, FL, USA
| | - Keyvan Nouri
- Miller School of Medicine Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA
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Alameddine M, Tamim H, Hadid D, Cheaito MA, Makki M, Maatouk H, Hitti E. Patient Attitudes Toward Mobile Device Use by Health Care Providers in the Emergency Department: Cross-Sectional Survey. JMIR Mhealth Uhealth 2020; 8:e16917. [PMID: 32229474 PMCID: PMC7157496 DOI: 10.2196/16917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/04/2019] [Accepted: 02/06/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Health care provider usage of mobile devices is increasing globally; however, there is little understanding of patient perceptions on this behavior in a health care setting. OBJECTIVE The aim of this study was to assess patients' attitudes toward mobile device usage by health care providers in the emergency department and to identify predictors of these attitudes. METHODS The study was carried out at the emergency department of a large academic tertiary care medical center in Lebanon. A cross-sectional survey design was adopted by administering a questionnaire to medically stable adult patients who presented to the emergency department with an emergency severity index of 3, 4, or 5 between January 2017 and March 2018. The questionnaire collected relevant patient demographic information and included questions related to their mobile device usage along with those evaluating attitudes for the use of mobile devices by health care providers with respect to six major domains: role in health care, distraction potential, impact on communication, empathy, privacy, and professionalism. The attitude toward mobile device usage by health care providers in the emergency department was the main outcome variable. A stepwise logistic regression model was used to assess the association between the outcome variable and the demographic and attitude-related independent variables. RESULTS Among the 438 eligible patients, 338 patients responded to the questionnaire for a response rate of 70.0%. Overall, 313/338 (92.6%) respondents agreed that mobile devices improve health care delivery, whereas 132/338 (39.1%) respondents were opposed to their usage by health care providers in the emergency department (95% CI: 34.0-44.4). The majority (240/338, 71.0%) of patients agreed that mobile devices are a source of distraction to health care providers in the workplace. Females (odds ratio [OR]=1.67, 95% CI: 1.00-2.78) as well as all patients (OR=2.54, 95% CI 1.36-4.76) who believed that mobile devices were a source of distraction, reflecting a lack of professionalism (OR=2.77, 95% CI 1.59-4.82) and impacting the provider's ability to relate to the patient (OR=2.93, 95% CI 1.72-4.99), were more likely to agree that mobile devices should not be used in the emergency department. CONCLUSIONS Patients' negative attitude toward mobile device use in the emergency department is largely driven by patient gender (females), patient perception of the distraction potential of the devices, and their negative impact on the health care provider's empathy and professionalism. The findings of this study shed light on the importance of encouraging stakeholders to impose a digital professionalism code of conduct for providers working in acute health care settings.
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Affiliation(s)
- Mohamad Alameddine
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Dima Hadid
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohamad-Ali Cheaito
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Maha Makki
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Hadi Maatouk
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Eveline Hitti
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
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Nicholson P, Macedo C, Fuller C, Thomas L. Patient satisfaction with a new skin cancer teledermatology service. Clin Exp Dermatol 2020; 45:691-698. [DOI: 10.1111/ced.14191] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/18/2020] [Accepted: 02/04/2020] [Indexed: 12/24/2022]
Affiliation(s)
- P. Nicholson
- Dermatology Department Chelsea and Westminster Hospital NHS Foundation Trust London UK
| | - C. Macedo
- Dermatology Department Chelsea and Westminster Hospital NHS Foundation Trust London UK
| | - C. Fuller
- Dermatology Department Chelsea and Westminster Hospital NHS Foundation Trust London UK
| | - L. Thomas
- Dermatology Department Chelsea and Westminster Hospital NHS Foundation Trust London UK
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Arafa A, Anzengruber F, Mostafa A, Navarini A. Perspectives of online surveys in dermatology. J Eur Acad Dermatol Venereol 2018; 33:511-520. [DOI: 10.1111/jdv.15283] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/27/2018] [Indexed: 11/30/2022]
Affiliation(s)
- A.E. Arafa
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Department of Public Health Faculty of Medicine Beni‐Suef University Beni‐Suef Egypt
| | - F. Anzengruber
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - A.M. Mostafa
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University of Zurich Zurich Switzerland
| | - A.A. Navarini
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University of Zurich Zurich Switzerland
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Clark AK, Bosanac S, Ho B, Sivamani RK. Systematic review of mobile phone-based teledermatology. Arch Dermatol Res 2018; 310:675-689. [DOI: 10.1007/s00403-018-1862-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 05/30/2017] [Accepted: 08/27/2018] [Indexed: 12/17/2022]
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Kohara EK, Abdala CG, Novaes TF, Braga MM, Haddad AE, Mendes FM. Is it feasible to use smartphone images to perform telediagnosis of different stages of occlusal caries lesions? PLoS One 2018; 13:e0202116. [PMID: 30188900 DOI: 10.1371/journal.pone.0202116] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/20/2018] [Indexed: 12/02/2022] Open
Abstract
The purpose of this study was to compare the performance of two different models of smartphone and a conventional camera with that of direct clinical examination in detecting caries lesions at different stages of progression in deciduous molars. The photographic equipment consisted of two smartphones (iPhone and Nexus 4) and a conventional macro camera setup. First, in the laboratory phase of the study, we compared the images of 20 exfoliated primary teeth having caries lesions at different stages. Then, in the clinical phase of the study, the images of 119 primary molars from fifteen children (3 to 6 years old) were used. All of the photographic images were taken using the previously described devices. In both groups, two examiners, blinded to the photographic equipment used, assessed the images independently on a computer screen, and classified them according to the International Caries Detection and Assessment System (ICDAS). The teeth were then examined directly by two other experienced examiners, and the consensus reached was considered the reference standard. Parameters of validity, such as percentage of correct answers, agreement with the reference standard, sensitivity, specificity and inter-examiner agreement (using the weighted kappa test) were calculated. The examiners performed similarly in both in vitro and in vivo studies. Inter-examiner reliability was approximately 0.7 for all the devices in the laboratory setting, and for the macro camera photography system in the clinical setting, but it was approximately 0.9 for the iPhone and Nexus images taken in vivo. With regard to the percentage of correct answers, the highest values were observed for sound and extensive caries lesions in both laboratory and clinical settings. The percentage of correct answers for initial and moderate lesions was particularly low in the clinical evaluation, irrespective of the camera devices used. Therefore, we concluded that photographic diagnosis using smartphone images is feasible and accurate for distinguishing sound tooth surfaces from extensive caries lesions; however, photographic images are not a good method for accurately detecting initial and moderate caries lesions.
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Augustin M, Wimmer J, Biedermann T, Blaga R, Dierks C, Djamei V, Elmer A, Elsner P, Enk A, Gass S, Henningsen M, Hofman-Wellenhof R, von Kiedrowski R, Kunz HD, Liebram C, Navarini A, Otten M, Reusch M, Schüller C, Zink A, Strömer K. Praxis der Teledermatologie. J Dtsch Dermatol Ges 2018; 16 Suppl 5:6-57. [DOI: 10.1111/ddg.13512] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP); Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Johannes Wimmer
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP); Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Tilo Biedermann
- Hautklinik Campus Biederstein; Technische Universität München, München
| | - Rolf Blaga
- Psoriasis Selbsthilfe Arbeitsgemeinschaft e. V.; Berlin
| | | | | | - Arno Elmer
- Hochschule für Ökonomie und Management Berlin, Berlin
| | - Peter Elsner
- Klinik für Hautkrankheiten; Universitätsklinikum Jena, Jena
| | - Alexander Enk
- Hautklinik; Universitätsklinikum Heidelberg, Heidelberg
| | | | - Maike Henningsen
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP); Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | | | | | | | | | | | - Marina Otten
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP); Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | | | | | - Alexander Zink
- Dermatologischen Universitätsklinik; Technischen Universität München, München
| | - Klaus Strömer
- Gemeinschaftspraxis für Dermatologie und Allergologie; Mönchengladbach
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Nimkar S, Gilles EE. Improving Global Health With Smartphone Technology. International Journal of E-Health and Medical Communications 2018. [DOI: 10.4018/ijehmc.2018070101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The widespread use of smartphones makes them a popular platform for healthcare applications. This article reveals the global trends and overarching goals of mHealth initiatives that seek to enhance healthcare quality, increase access to health services, and improve global health communication. Three main themes emerged from this study: a) the impact of mHealth on international public health, b) overcoming mhealth barriers, and c) emerging mHealth technologies. The costs of developing mHealth apps and handling related data security concerns are the key barriers which need to be addressed to successfully implement global mHealth campaigns. Future directions of mHealth research are discussed, including the integration of new technologies, development of innovative healthcare systems, and overall improvement of global healthcare.
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Sáenz JP, Novoa MP, Correal D, Eapen BR. On Using a Mobile Application to Support Teledermatology: A Case Study in an Underprivileged Area in Colombia. Int J Telemed Appl 2018; 2018:1496941. [PMID: 29785181 DOI: 10.1155/2018/1496941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/08/2018] [Indexed: 12/03/2022] Open
Abstract
Background The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no specialty training. Moreover, ontologies—sets of concepts that represent knowledge in a given domain—are increasingly being used to support medical diagnosis. A specific case is ONTODerm: an ontology to aid dermatological diagnosis. However, there is little information on the combined use of mobile applications and ontologies as support solutions in dermatology. Objective Assessing the reliability of ONTODerm as a tool to support remote dermatological diagnosis when used together with a mobile dermatological application in underprivileged areas. Methods A mobile application that allows characterization of skin lesions was developed, and the information about the lesions was sent to ONTODerm. An exploratory study was conducted in a remote area without access to a dermatologist. A total of 64 dermatological queries were recorded in the application and consulted with ONTODerm. Later, an experienced dermatologist evaluated the characterization and diagnosis of each query to determine the accuracy of the system. Results The results showed that the probability of obtaining a correct diagnosis was between 64.4% and 85.6% with a confidence interval of 95%. A higher accuracy rate was obtained when the skin lesion occurred on the face or when its border was categorized as poorly demarcated. Conclusions This study demonstrates the implementation of a teledermatology strategy based on mobile applications and domain ontology-driven knowledge base to provide timely assistance to healthcare professionals. This approach was found to be pertinent in the Colombian rural context, particularly in forest regions, where dermatology specialists are not available. The results of this article do not represent a final validation of the proposed approach; they suggest how the ontology can be improved to effectively support medical staff in marginalized regions.
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Marchell R, Locatis C, Burgess G, Maisiak R, Liu WL, Ackerman M. Patient and Provider Satisfaction with Teledermatology. Telemed J E Health 2017; 23:684-690. [PMID: 28375822 PMCID: PMC5564023 DOI: 10.1089/tmj.2016.0192] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is little research comparing dermatologist and patient satisfaction with in-person, store-and-forward, and live interactive examinations. OBJECTIVE To compare satisfaction with in-person examinations to store-and-forward and live interactive consultations having two types of video. METHODS A controlled study was conducted where patients referred for dermatology consultations were examined in-person, by video, and by store-and-forward methods. Video changed between compressed and uncompressed on alternate clinics. Patients and dermatologists rated encounters after each examination. Dermatologists doing store-and-forward evaluations rated the quality of information provided. After experiencing all methods patients ranked their preferences. Dermatologists ranked their preferences at the end of the study. RESULTS In-person examinations were preferred by both patients and dermatologists. Overall, satisfaction with teledermatology was still high. Patients were evenly divided in preferring store-and-forward workups or live interactive video. Dermatologists were also divided on store-and-forward and uncompressed video, but tended toward the latter. Compressed video was the least preferred method among dermatologists. LIMITATIONS Dermatology residents took store-and-forward photos and their quality was likely superior to those normally taken in practice. CONCLUSIONS Patients and dermatologists prefer in-person examinations and diverge on preferring store-and-forward and live interactive when video is not compressed. The amount of video compression that can be applied without noticeable image degradation is a question for future research.
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Affiliation(s)
- Richard Marchell
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Craig Locatis
- National Library of Medicine, National Institutes of Health, Bethesda, Maryland
| | - Gene Burgess
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | | | - Wei-Li Liu
- National Library of Medicine, National Institutes of Health, Bethesda, Maryland
| | - Michael Ackerman
- National Library of Medicine, National Institutes of Health, Bethesda, Maryland
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Trettel A, Eissing L, Augustin M. Telemedicine in dermatology: findings and experiences worldwide - a systematic literature review. J Eur Acad Dermatol Venereol 2017; 32:215-224. [PMID: 28516492 DOI: 10.1111/jdv.14341] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/29/2017] [Indexed: 01/28/2023]
Abstract
Telemedicine has become an important element of health care in many countries and profited from the technological progress of the last two decades. Due to the visual character of the dermatological specialty, teledermatology in particular participated in that development and is becoming a major tool in dermatological consultation. The objective of this article was to identify the use of teledermatology across the world based on published original articles. A systematic literature search of the MEDLINE and Embase databases for eligible publications (predefined inclusion and exclusion criteria) and a cross-validation search were conducted. Search results were reviewed systematically. The search resulted in 204 publications meeting the inclusion criteria for analysis. The highest number of published studies on teledermatology was performed in the United States, followed by the United Kingdom, Spain, the Netherlands, Italy and Austria. The majority of dermatological indications for telemedical consultations were not specified or included various kinds of skin diseases, followed by skin cancer and wounds. Research questions predominantly focused on concordance, effectiveness and cost-effectiveness to determine the value. Teledermatology proved to be a reliable consultation tool in the majority of studies. If specified, telemedicine was used in daily dermatological routine for patient management purposes, to consult patients in peripheral locations, or for medical support in nursing homes or home care settings. The application of teledermatology worldwide is highest in North American and European countries, while countries with poor geographical distribution of physicians seem to be under-represented in teledermatological use, as concluded from publication output. Regarding indications, comparison with classic consultation and area of application, most studies were of general nature. For precise determination of the value, systematic studies would be needed. However, teledermatology is already accepted as a valid tool.
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Affiliation(s)
- A Trettel
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - L Eissing
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Mounessa JS, Chapman S, Braunberger T, Qin R, Lipoff JB, Dellavalle RP, Dunnick CA. A systematic review of satisfaction with teledermatology. J Telemed Telecare 2017; 24:263-270. [PMID: 28350281 DOI: 10.1177/1357633x17696587] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The two most commonly used modalities of teledermatology (TD) are store-and-forward (SF) and live-interactive (LI) TD. Existing studies have not compared these tools with respect to patient and provider satisfaction. Objective To systematically review all published studies of patient and provider satisfaction with SF and LI TD. Methods PubMed, EMBASE, and Cochrane databases were systematically searched for studies on provider or patient satisfaction with SF or LI TD between January 2000 and June 2016. Results Forty eligible studies were identified: 32 with SF TD, 10 with LI TD, and 2 evaluating both. With SF TD, 96% of studies assessing patient satisfaction and 82% of studies assessing provider satisfaction demonstrated satisfaction ( n = 24 and 17, respectively). With LI TD, 89% of studies assessing patient satisfaction and all studies assessing provider satisfaction revealed satisfaction (n = 9 and 6, respectively). Conclusion Patients and providers are satisfied with both SF and LI TD. Studies assessing satisfaction with LI have not been conducted in recent years, and have only been conducted in limited geographic patient populations. Further research assessing satisfaction with TD will help address any dissatisfaction with its uses and allow for increased support and funding of future programmes.
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Affiliation(s)
- Jessica S Mounessa
- 1 Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stephanie Chapman
- 2 Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | | | - Rosie Qin
- 4 Duke University School of Medicine, Durham, NC, USA
| | - Jules B Lipoff
- 5 Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Robert P Dellavalle
- 1 Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,6 Dermatology Service, Eastern Colorado Health Care System, US; Department of Veteran Affairs, Denver, CO, USA.,7 Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
| | - Cory A Dunnick
- 1 Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,6 Dermatology Service, Eastern Colorado Health Care System, US; Department of Veteran Affairs, Denver, CO, USA
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McKoy K, Antoniotti NM, Armstrong A, Bashshur R, Bernard J, Bernstein D, Burdick A, Edison K, Goldyne M, Kovarik C, Krupinski EA, Kvedar J, Larkey J, Lee-Keltner I, Lipoff JB, Oh DH, Pak H, Seraly MP, Siegel D, Tejasvi T, Whited J. Practice Guidelines for Teledermatology. Telemed J E Health 2016; 22:981-990. [PMID: 27690203 DOI: 10.1089/tmj.2016.0137] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Previous American Telemedicine Association (ATA) Teledermatology Practice Guidelines were issued in 2007. This updated version reflects new knowledge in the field, new technologies, and the need to incorporate teledermatology practice in a variety of settings, including hospitals, urgent care centers, Federally Qualified Health Centers, school-based clinics, public health facilities, and patient homes.
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Affiliation(s)
- Karen McKoy
- 1 Department of Dermatology, Lahey Hospital and Medical Center , Burlington, Massachusetts
- 2 Harvard Medical School , Boston, Massachusetts
| | | | - April Armstrong
- 4 Southern California Clinical and Translational Science Institute (SC CTSI) , Los Angeles, California
- 5 Department of Dermatology, Keck School of Medicine, University of Southern California , Los Angeles, California
| | - Rashid Bashshur
- 6 University of Michigan Health System , Ann Arbor, Michigan
| | | | | | - Anne Burdick
- 9 University of Miami Miller School of Medicine , Miami, Florida
| | - Karen Edison
- 10 Department of Dermatology, University of Missouri School of Medicine , Colombia , Missouri
- 11 Missouri Telehealth Network, University of Missouri School of Medicine , Colombia , Missouri
- 12 Center for Health Policy, University of Missouri School of Medicine , Colombia , Missouri
| | - Mark Goldyne
- 13 Department of Dermatology, University of California San Francisco , San Francisco, California
- 16 Dermatology Service, San Francisco VA Healthcare System , San Francisco, California
| | - Carrie Kovarik
- 14 Department of Dermatology, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Elizabeth A Krupinski
- 15 Department of Radiology and Imaging Sciences, Emory University , Atlanta, Georgia
| | - Joseph Kvedar
- 17 Connected Health, Partners HealthCare , Boston, Massachusetts
| | - Jim Larkey
- 19 Canfield Scientific , Parsippany, New Jersey
| | - Ivy Lee-Keltner
- 21 Department of Dermatology, University of California Los Angeles-Olive View , Los Angeles, California
| | - Jules B Lipoff
- 14 Department of Dermatology, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Dennis H Oh
- 13 Department of Dermatology, University of California San Francisco , San Francisco, California
- 16 Dermatology Service, San Francisco VA Healthcare System , San Francisco, California
| | - Hon Pak
- 18 Department of Dermatology, The George Washington University , Washington, DC
| | - Mark P Seraly
- 25 Department of Dermatology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Daniel Siegel
- 20 State University of New York Health Sciences Center at Brooklyn , Brooklyn, New York
| | - Trilokraj Tejasvi
- 22 Department of Dermatology, University of Michigan , Ann Arbor, Michigan
| | - John Whited
- 23 Research and Development, Durham VA Medical Center , Durham, North Carolina
- 24 Department of Medicine, Duke University School of Medicine , Durham, North Carolina
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Bashshur RL, Shannon GW, Tejasvi T, Kvedar JC, Gates M. The Empirical Foundations of Teledermatology: A Review of the Research Evidence. Telemed J E Health 2015; 21:953-79. [PMID: 26394022 PMCID: PMC4776540 DOI: 10.1089/tmj.2015.0146] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/20/2015] [Accepted: 08/21/2015] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION This article presents the scientific evidence for the merit of telemedicine interventions in the diagnosis and management of skin disorders (teledermatology) in the published literature. The impetus for this work derives from the high prevalence of skin disorders, the high cost, the limited availability of dermatologists in certain areas, and the promise of teledermatology to address unmet needs in this area. MATERIALS AND METHODS The findings are based on a targeted review of scientific studies published from January 2005 through April 2015. The initial search yielded some 5,020 articles in Google Scholar and 428 in PubMed. A review of the abstracts yielded 71 publications that met the inclusion criteria for this analysis. Evidence is organized according to the following: feasibility and acceptance; intermediate outcomes (use of service, compliance, and diagnostic and treatment concordance and accuracy); outcomes (health improvement and problem resolution); and cost savings. A special section is devoted to studies conducted at the Veterans Health Administration. RESULTS Definitions of teledermatology varied across a wide spectrum of skin disorders, technologies, diagnostic tools, provider types, settings, and patient populations. Outcome measures included diagnostic concordance, treatment plans, and health. CONCLUSIONS Despite these complexities, sufficient evidence was observed consistently supporting the effectiveness of teledermatology in improving accessibility to specialty care, diagnostic and treatment concordance, and skin care provided by primary care physicians, while also reducing cost. One study reported suboptimal clinical results from teledermatology for patients with pigmented skin lesions. On the other hand, confocal microscopy and advanced dermoscopy improved diagnostic accuracy, especially when rendered by experienced teledermatologists.
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Affiliation(s)
- Rashid L. Bashshur
- eHealth Center, University of Michigan Health System, Ann Arbor, Michigan
| | - Gary W. Shannon
- Department of Geography, University of Kentucky, Lexington, Kentucky
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan
| | - Joseph C. Kvedar
- Center for Connected Health, Partners HealthCare, Boston, Massachusetts
| | - Michael Gates
- eHealth Center, University of Michigan Health System, Ann Arbor, Michigan
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Abstract
This article provides an overview of teledermatology with an emphasis on the evidence most relevant to referring clinicians, who are often primary care clinicians. Discussion includes the different modalities used for teledermatology and their diagnostic reliability, diagnostic accuracy, impact on in-person dermatology visits, clinical outcomes, and user satisfaction.
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Affiliation(s)
- John D Whited
- Research and Development, Durham Veterans Affairs Medical Center, Research and Development (151), 508 Fulton Street, Durham, NC 27705, USA; Division of General Internal Medicine, Duke University School of Medicine, 411 West Chapel Hill Street, Suite 500, Durham, NC 27701, USA.
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Abstract
The smartphone is one of the biggest revolutions in the era of information technology. Its built in camera offers several advantages. Dermatologists, who handle a specialty that is inherently visual, are most benefited by this handy technology. Here in this article, we attempt to provide an overview of smartphone photography in clinical dermatology in order to help the dermatologist to get the best out of the available camera for clinical imaging and storage.
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Affiliation(s)
- K T Ashique
- Department of Dermatology, KIMS ALSHIFA Super Speciality Hospital, Perinthalmanna, Malappuram Dt., Kerala, India
| | - Feroze Kaliyadan
- Department of Dermatology, Faculty of Dermatology, College of Medicine, King Faisal University, Al Ahsa 31982, Saudi Arabia
| | - Sanjeev J Aurangabadkar
- Department of Dermatology, Skin and Laser Clinic, Brij Tarang, Green Lands, Begumpet, Hyderabad, India
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Coates SJ, Kvedar J, Granstein RD. Teledermatology: From historical perspective to emerging techniques of the modern era. J Am Acad Dermatol 2015; 72:577-86. [DOI: 10.1016/j.jaad.2014.08.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/21/2014] [Accepted: 08/07/2014] [Indexed: 11/22/2022]
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