Telehealth and Medicine Today https://telehealthandmedicinetoday.com/index.php/journal Telehealth and Medicine Today (TMT) is a leading international peer review journal where multidisciplinary thought leaders, practitioners, and stakeholders converge to address strategic, medical, technical, economic, legal, regulatory and societal aspects of this growing health technology sector. The journal assists building knowledge and consensus to deploy and scale delivery services to achieve sustainable outcomes for affordable, accessible, and quality care for health consumers around the globe, Partners in Digital Health en-US Telehealth and Medicine Today 2471-6960 <p>Authors retain copyright of their work, with first publication rights granted to&nbsp; <em>Telehealth and Medicine Today (TMT).</em></p> <p>&nbsp;</p> Avera eCARE: Medical Student Education in Telemedicine https://telehealthandmedicinetoday.com/index.php/journal/article/view/179 <p><strong>Purpose:&nbsp;</strong>The purpose of this research study is to explore medical student knowledge of and interest in telemedicine services in urban and rural communities. In the past, medical students have reported feeling unprepared to use telemedicine and uninformed about laws regarding telemedicine usage following graduation. However, they also reported that telemedicine training is relevant and important for their future work.</p> <p><strong>Methods:&nbsp;</strong>Study participants included medical students taking part in a two day telemedicine education program in 2018 and 2019. The first day includes a faculty seminar where students are introduced to telemedicine by experts in telemedicine innovations. The second day is a simulation day (SIM) where medical students complete a rotation at the Avera eCARE virtual hospital hub. A survey was given prior to the faculty seminar and re-administered following the SIM day. Questions asked about telemedicine knowledge, curriculum, and willingness to practice via telemedicine.</p> <p><strong>Results:&nbsp;</strong>A Chi-square analysis was used to look for associations’ pre/post by year. Both years show an increase in favorable responses for questions to telemedicine training and education. For analyses by topic area, we created clusters of questions to build scores. T-tests were used to look for associations’ pre/post by year. The analysis resulted in three topic areas to build scores. Both years show a significant increase in both Rating of Overall Knowledge and Interest in Curriculum and Utilization. There is no significant difference in Willingness to Practice.</p> <p><strong>Conclusions:&nbsp;</strong>Results show notable differences in how students perceive and understand telemedicine after structured exposure to telemedicine services. Further, this study demonstrates students' need for and interest in more telemedicine training opportunities in their curriculum. Results demonstrate no significant difference in the willingness to practice in rural settings. Future studies may focus on how telemedicine training is perceived by those more willing to work in rural communities.</p> Kelly Rhone Jennifer Lindgren Luke J. Mack Morgan E. Nelson Lindsay Spencer Susan M. Anderson ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-04-30 2020-04-30 10.30953/tmt.v5.179 Telemedicine step-wise consultation of a patient with multiple gunshot fractures of the long bones in recovery treatment system https://telehealthandmedicinetoday.com/index.php/journal/article/view/184 <p>Due to the armed conflict in the East of Ukraine, it is relevant to investigate factors that affect patient outcomes with the use of telemedicine. This applies especially to patients with multiple gunshot fractures, which is the most severe category at increased risk for complications and unsatisfactory results. A case study is reported here.</p> O. A. Burianov Y. O. Yarmolyuk T. M. Omelchenko V.M. Lyanskorunsky M.V. Vakulych ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-04-30 2020-04-30 10.30953/tmt.v5.184 Predictive Modeling for Telemedicine Service Demand https://telehealthandmedicinetoday.com/index.php/journal/article/view/186 <p><strong><em>Introduction:</em></strong> Emergency teleneurology care has grown in magnitude, impact, and validation. Stroke is a leading cause of death in the US and the timely treatment of stroke results in better outcomes for patients. Teleneurology provides evidence-based care to patients even when a board-certified neurologist is not physically on site. Determining staffing demand for telemedicine consultation for a specific period of time is an integral part of the decision-making activities of providers of acute care telemedicine services. This study aims to build a forecasting model to predict consultation demand to optimize telemedicine provider staffing. Such forecasting models acquire added importance in emergency situations such as the current COVID-19 pandemic.</p> <p><strong><em>Materials and Methods</em></strong>: This study trained consultation data of SOC Telemed, a private telemedicine provider, from 411 hospitals nationwide and involving 97,593 incidents of consultations. The forecasting model analyzes characteristics including hospital size (number of beds), annual volume, patient demographics, time of consultation, and reason for consultation.</p> <p><strong><em>Results:</em></strong> Several regression techniques were used to demonstrate a strong correlation between these features and weekly demand with r<sup>2 </sup>= 0.7821. Reason for consult in the past week was the strongest predictor for the demand in the next week with r<sup>2 </sup>= 0.7899.</p> <p><strong><em>Conclusion</em></strong>: A predictive model for demand forecasting can optimize telemedicine resources to improve patient care and help telemedicine providers decide how many physicians to staff. The goal of the forecasting model is to improve patient care and outcomes by providing physicians timely and efficiently to meet consultation demand. The ability to predict demand and calculate expected volume allow telemedicine providers to schedule physicians in advance. This mitigates the clinical risk of excess patient demand.and long waiting time, as well as the financial risk of surplus of physicians.</p> Agni Kumar Nancy Hung Yuhan Wu Robyn Baek Amar Gupta ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-04-30 2020-04-30 10.30953/tmt.v5.186 Interstate Telehealth Policy and Provider Incentives: Recommendations to Combat Historically Low Physician Acceptance of Medicaid Patients https://telehealthandmedicinetoday.com/index.php/journal/article/view/182 <p><strong>Methods: </strong>A holistic, mixed-methods approach is used to investigate the research goal. Primary source telehealth reimbursement data obtained from the Medicaid offices of Florida and Nebraska, extensive literature review on Medicaid and telehealth policy, as well as secondary source data from online databases and previously published research were used to highlight the improvements needed to better implement telehealth programs across the country, as well as identifying precedential cases of policy changes regarding telemedicine.</p> <p><strong>Results: </strong>The primary and secondary source data analyzed in this article demonstrate the need for policy changes to address historically low physician acceptance of new patients through state Medicaid. Data obtained from Florida and Nebraska in Table 1 corroborate with the data in</p> <p>Table 2 – both demonstrating how Florida reimburses at a much lower rate (0.79 to national Medicaid average) as compared to Nebraska (1.14 to national Medicaid average). Table 3 exhibits how national averages for Medicaid reimbursement, as well as Florida’s and Nebraska’s averages, fall below the national averages for Medicare reimbursement in all categories except obstetric care, showing that Medicaid services are reimbursed at a lower rate than Medicare in most circumstances.</p> <p><strong>Conclusions: </strong>Nationally, Medicaid reimbursement rates are among the lowest reimbursement rates of any insurer. Additionally, new Medicaid patients witness the lowest rates of acceptance by physicians, in large part due to low reimbursement rates. Medicaid policies and reimbursement rates vary across each state, making it difficult to enact any broad-sweeping policies to improve the access to care for Medicaid beneficiaries in the United States. However, by drawing reference to several policy changes involving Medicare, Medicaid, and telehealth, this paper presents recommendations for an incentivized cross-state telehealth policy aimed toward increasing Medicaid beneficiaries’ access to care. With nation-wide policy changes like those during the COVID-19 pandemic, there are historical examples and precedence to support policies focused on decreasing the limitations and barriers needed to practice telemedicine across state lines. This paper offers a potential, but limited framework for states to consider implementing in their Medicaid programs after conducting further research on the state-by-state level.</p> Sophia S. Albanese Emily A. Yin Sarah J. Timmons ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-07-09 2020-07-09 10.30953/tmt.v5.182 Space Medicine: The Ultimate in Remote Healthcare https://telehealthandmedicinetoday.com/index.php/journal/article/view/178 <p>The term “Remote Health Care” (RHC) more clearly defines what is implied by Telehealth or Telemedicine. The latter terms clearly indicate delivering health care at a distance using Information and Communication Technology. Distance today has become meaningless–at least on earth ! Geography has indeed become History. The ultimate in providing RHC would be to continuously monitor in almost real time, various health parameters of those in outer space, staying in Low Earth Orbit at present. Eventually this would extend to &nbsp;the lunar surface, deep space and one day perhaps even on the red planet Mars. This overview discusses some of these challenges.</p> K. Ganapathy ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-04-30 2020-04-30 10.30953/tmt.v5.178 Role of telemedicine in healthcare during COVID-19 pandemic in developing countries https://telehealthandmedicinetoday.com/index.php/journal/article/view/187 <p><strong><em>Abstract:</em></strong> COVID-19 is a public health emergency of international concern. Ensuring primary healthcare during this pandemic appeared to be a great challenge. Primary healthcare services are being disrupted due to lockdown, lack of protective gears and hospital facilities, risk of infection spread to non-COVID patients and health professionals. People with acute and chronic ailments including diabetes, pregnancy, obesity, chronic respiratory diseases, cardiovascular disease, cancer, mental health conditions are in trouble. In this article, the challenges in primary healthcare in developing countries during COVID-19 pandemic have been analyzed and the role of telemedicine in addressing these challenges has been discussed. Telemedicine can play an important role in this pandemic by minimizing virus spread, utilizing the time of healthcare professionals effectively and in alleviating mental health issues.</p> Muhammad Abdul Kadir ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-04-30 2020-04-30 10.30953/tmt.v5.187