Telemedicine journal and e-health : the official journal of the American Telemedicine Association
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Multicenter Study
A Multicenter Case-Historical Control Study on Short-Term Outcomes of Tele-Intensive Care Unit.
Aims: This study aimed to determine the impact of tele-intensive care unit (ICU) on ICU mortality rate (%), and to quantify association of the tele-ICU intervention with ICU length of stay (LOS, days), readmission rates (%), reintubation rates (%), hospital-acquired pressure ulcer (HAPU) rate (%), and discharge against medical advice (DAMA) rate (%) in five hospitals. Methods: A multicenter case-historical control study was conducted on short-term outcomes of tele-ICU program in five private hospitals within Arabian Gulf Region. Critically ill adult patients admitted into ICU without tele-ICU were recorded as control group (pre-tele-ICU), whereas those admitted to tele-ICU were grouped as treatment group (post-tele-ICU). ⋯ Independent t-test showed that there is significant different in LOS (t = 43.63, p < 0.001) between pre-tele-ICU (mean = 6.72 days) and post-tele-ICU (mean = 5.79 days). Odds ratio showed that critically ill adult patients who admitted to post-tele-ICU have 19% less reduction in mortality rate, 23% less reduction in readmission rate, 43% less reduction in HAPU rate, and 11% less reduction in DAMA rate as compared with those admitted to pre-tele-ICU. Conclusion: Tele-ICU as a step to improve the quality of health care project has shown statistically significant improvement in the adult ICU patients' outcomes, which lead to lesser mortality rate, readmission rate, HAPU rate, DAMA rate, and shorter LOS.
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Randomized Controlled Trial Multicenter Study
Proof of Concept of a Mobile Health Short Message Service Text Message Intervention That Promotes Adherence to Oral Anticancer Agent Medications: A Randomized Controlled Trial.
This multisite, randomized controlled trial assigned 75 adult cancer patients prescribed an oral anticancer agent to either an experimental group that received daily text messages for adherence for 21 days plus usual care or a control group that received usual care. ⋯ Proof of concept and preliminary efficacy of a mobile health intervention using text messages to promote adherence for patients prescribed oral anticancer agents were demonstrated. Patients accepted and had high satisfaction with the intervention, and adherence improved after the intervention. Text messages show promise. Additional research is needed prior to use in practice.
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Multicenter Study
The educational impact of the Specialty Care Access Network-Extension of Community Healthcare Outcomes program.
With the aging hepatitis C cohort and increasing prevalence of fatty liver disease, the burden on primary care providers (PCPs) to care for patients with liver disease is growing. In response, the Veterans Administration implemented initiatives for primary care-specialty referral to increase PCP competency in complex disease management. The Specialty Care Access Network-Extension of Community Healthcare Outcomes (SCAN-ECHO) program initiative was designed to transfer subspecialty knowledge to PCPs through case-based distance learning combined with real-time consultation. There is limited information regarding the initiative's ability to engage PCPs to learn and influence their practice. ⋯ This study shows that the SCAN-ECHO videoconferencing program between PCPs and specialists can educate providers in the delivery of specialty care from a distance and potentially improve healthcare delivery.
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Multicenter Study
The potential for health-related uses of mobile phones and internet with homeless veterans: results from a multisite survey.
Addressing the health needs of homeless veterans is a priority in the United States, and, although information technologies can potentially improve access to and engagement in care, little is known about this population's use of information technologies or their willingness to use technologies to communicate with healthcare providers and systems. ⋯ These findings suggest new avenues for communication and health interventions for hard-to-reach homeless veterans.
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Multicenter Study
Development of a service delivery protocol used for remote wheelchair consultation via telerehabilitation.
The purpose of this paper is to explain the development, methodology, and implementation of an assistive technology (AT) service delivery protocol using a telerehabilitation consultation model for evaluation of remote wheelchair prescriptions. The provision of wheeled mobility and seating interventions can be complex when considering people with intricate seating and positioning needs, environmental factors, and wide array of product interventions. The availability of qualified practitioners with specialty expertise in this area is limited, especially outside of urban areas. ⋯ The live interaction has enabled remote therapists the ability to exchange personal and health information to experts in the field from an urban facility. The impact of this service delivery protocol will be augmented as it is to be launched and replicated in three additional sites. Telerehabilitation is a new field that can only be measured by its long-term impact; however, its success can be looked at by its development and implementation into everyday clinical service delivery.