Assessing the Role of Digital Literacy in Accessing and Utilising Virtual Healthcare Services: A Systematic Review Protocol

HumanInsight Assessing the Role of Digital Literacy in Accessing and Utilising Virtual Healthcare Services: A Systematic Review Protocol

J Eval Clin Pract. 2025 Feb;31(1):e14245. doi: 10.1111/jep.14245.

ABSTRACT

RATIONALE: Emerging digital technologies are accelerating the transition of healthcare services from traditional in-person settings to virtual platforms. As a result, digital literacy is becoming essential for individuals to effectively engage with these services. However, inadequate digital literacy poses a significant barrier to both accessing and utilising virtual healthcare, potentially widening existing health disparities.

AIMS AND OBJECTIVES: This protocol outlines the approach for systematically reviewing and synthesising the existing literature on the influence of digital literacy on accessing and utilising virtual healthcare services.

METHODS: A comprehensive literature search will be conducted across five databases: Web of Science, Medline, Scopus, CINAHL and IEEE Xplore, covering publications from 2014 to 2024. The review will include all age cohorts and demographics, focusing on studies that examine digital literacy and measures of access to and utilisation of virtual healthcare services. Two independent reviewers will screen studies using pre-determined search strategies for inclusion.

CONCLUSION: Findings from this study will provide valuable insights into the challenges and facilitators of digital literacy in engaging with virtual healthcare services. This review will also offer evidence-based recommendations to optimise digital health interventions and promote inclusive, equitable healthcare delivery.

PMID:39564975 | DOI:10.1111/jep.14245

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Designing and Implementing the Psychiatrist-led Personalized Mentorship Programs: The Role and Impact of Live Consultation-driven Training Methods

HumanInsight Designing and Implementing the Psychiatrist-led Personalized Mentorship Programs: The Role and Impact of Live Consultation-driven Training Methods

Indian J Psychol Med. 2024 Oct 19:02537176241286033. doi: 10.1177/02537176241286033. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical training in traditional medical education often needs more translational value, especially for in-service MBBS doctors working in primary health centers (PHCs), who provide first-line treatment for psychiatric disorders. To address this gap, a psychiatrist-led personalized mentorship program incorporating three live consultation-driven training (CDT) methods was developed to integrate psychiatric care into PHCs.

METHODS: The authors designed and implemented a personalized mentorship program using three CDT methods tailored for in-service MBBS doctors. The CDT methods were applied through live consultations to facilitate real-time, real-life learning and integration of psychiatric care into primary health settings. Data from published articles and manuals on CDT methods were collected, focusing on their descriptions, effectiveness, principles, and advantages over traditional classroom training.

RESULTS: Data indicate the effectiveness of the CDT methods to translate to real-life skills (translational quotient). The personalized mentorship program showed promising results in enhancing the confidence and competence of MBBS doctors in managing psychiatric disorders in PHCs. The CDT methods were found to be superior to traditional classroom training in terms of practical applicability and real-time learning.

CONCLUSION: The psychiatrist-led personalized mentorship program with CDT methods demonstrates the potential for significant improvements in the training of in-service MBBS doctors, facilitating the integration of psychiatric care into PHCs. These methods offer a practical and effective approach to bridging the gap in clinical training and can be replicated among medical students and residents across various medical and surgical specialties. Further research and longitudinal studies are recommended to validate these preliminary findings and explore the program's broader applicability.

PMID:39564304 | PMC:PMC11572698 | DOI:10.1177/02537176241286033

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Telemedicine and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis

HumanInsight Telemedicine and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis

Cureus. 2024 Oct 20;16(10):e71907. doi: 10.7759/cureus.71907. eCollection 2024 Oct.

ABSTRACT

Hyperglycemia known as gestational diabetes mellitus (GDM) can happen during pregnancy and poses a risk to the developing baby as well as the mother. Glycemic control, patient involvement, and diabetes management might all be improved via telemedicine (TM). Therefore, this study aimed to compare TM versus standard care for GDM in terms of maternal and fetal outcomes. The authors searched for randomized controlled trials (RCTs) contrasting TM with conventional care among gestational diabetes women across various databases including PubMed, the Cochrane Central Register of Controlled Studies, and Google Scholar from April 2010 to December 2023. This meta-analysis included a total of 2,192 pregnant women from 12 RCT studies and was analyzed by RevMan (version 5.4; Cochrane, London). Applying fixed and random effects was based on heterogeneity. There was a statistically significant difference in the effect on the control of blood glucose levels two-hour postprandial (MD = -0.45, 95%CI = (-0.84, -0.06), P = 0.02) and on the cesarean section effect (RR = 0.74, 95%CI = (0.63, 0.87), P < 0.001) when TM was compared to standard care for GDM. However, there was no statistically significant difference in the effect on other maternal or fetal outcomes such as HBA1c, fasting blood glucose, preterm birth, fetal macrosomia, or hypoglycemia. TM interventions are more successful than standard therapy in lowering the rate of cesarean section and decreasing the two-hour postprandial glucose level of GDM patients, which is essential for improving glycemic control and reducing cardiovascular disease.

PMID:39564055 | PMC:PMC11574696 | DOI:10.7759/cureus.71907

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Real-time Technical Support Using a Remote Technology During Cardiac Implantable Electronic Device Follow-up: A Preliminary Multicenter Experience in Clinical Practice

HumanInsight Real-time Technical Support Using a Remote Technology During Cardiac Implantable Electronic Device Follow-up: A Preliminary Multicenter Experience in Clinical Practice

J Innov Card Rhythm Manag. 2024 Nov 15;15(11):6070-6078. doi: 10.19102/icrm.2024.15114. eCollection 2024 Nov.

ABSTRACT

Industry-employed allied professionals (IEAPs) provide technical assistance to physicians during cardiac implantable electronic device (CIED) implantation, programming, troubleshooting, and follow-up. The Heart Connect™ application (Boston Scientific Inc., Marlborough, MA, USA) is a data-sharing system that enables remote access and display sharing of the CIED Programmer. This report aims to describe the preliminary experience of remote IEAP support through the application during CIED follow-up in clinical practice. The application was downloaded on the programmer, and network connections were established and tested at six Italian centers. Staff members were trained and online meetings were scheduled with IEAPs during consecutive CIED follow-up visits. Data and user feedback were collected. A total of 20 operators received training, and online meetings were conducted during 208 patient visits. Of these, 202 (97%) visits were successfully completed with remote support, without the need for additional medical or technical assistance. The connection quality, audio, and video were rated as good or excellent in ≥95% of sessions. The average duration of online meetings ranged from 6-16 min, depending on the supported session type. Comprehensive CIED checks and tests were performed during the visits, leading to the identification of relevant conditions or programming changes in 29% of visits. All operators found the application to be user-friendly and effective. Overall, satisfaction with the remote support service was rated high in 80% of responses, particularly for managing unscheduled CIED follow-up visits. In conclusion, remote support during CIED follow-up appears to be feasible, effective, and well accepted. It offers a viable alternative to traditional on-site IEAP support for both scheduled and unscheduled follow-up visits.

PMID:39563992 | PMC:PMC11573302 | DOI:10.19102/icrm.2024.15114

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Factors Influencing Telehealth Adoption in Managing Healthcare in Saudi Arabia: A Systematic Review

HumanInsight Factors Influencing Telehealth Adoption in Managing Healthcare in Saudi Arabia: A Systematic Review

J Multidiscip Healthc. 2024 Nov 14;17:5225-5235. doi: 10.2147/JMDH.S498125. eCollection 2024.

ABSTRACT

BACKGROUND: The utilization of telehealth as an effective means to provide quality services is steadily rising across different tiers of the health system. However, advancing telehealth utilization relies on the current healthcare systems' infrastructure, policies, cultural factors, and utilization requirements can influence the utilization of telehealth within Saudi Arabia's healthcare system.

PURPOSE: This study seeks to systematically review the literature related to examining the factors influencing telehealth adoption and identifying the barriers and determinants of the use of telehealth in Saudi's healthcare system.

METHODS: A systematic review methodology was utilized in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodology included an exploratory and narrative design, a dual-phase search strategy, eligibility criteria, and analysis. The Joanna Briggs Institute (JBI) tool was employed to assess the quality of the chosen papers.

RESULTS: The search yielded 3197 articles to which eligibility criteria were applied. Thirteen articles were deemed eligible, screened, and utilized for comprehensive analysis in the present study. Numerous articles indicated that the utilization of telehealth has risen in Saudi Arabia, particularly during the COVID-19 pandemic. The investment strategies have aligned with the demand for telehealth systems. The primary challenges were resource limitations and the absence of cultural frameworks conducive to the utilization of telehealth in the country.

CONCLUSION: Telehealth represents a major technological breakthrough in the healthcare industry. However, there are some drawbacks to its adoption. The limited availability of Telehealth technologies poses a significant challenge. Secondly, relying solely on privatization might not adequately address the issue at hand. Third, there is a lack of knowledge and awareness regarding its associated benefits among healthcare staff. The establishment of telemedicine and telehealth infrastructure necessitates significant financial investment, which serves as a major factor and obstacle to the widespread adoption of telehealth.

PMID:39563833 | PMC:PMC11573687 | DOI:10.2147/JMDH.S498125

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Fetal heart rate and amniotic fluid volume measurements with a home ultrasound device

HumanInsight Fetal heart rate and amniotic fluid volume measurements with a home ultrasound device

Am J Perinatol. 2024 Nov 19. doi: 10.1055/a-2469-0887. Online ahead of print.

ABSTRACT

OBJECTIVE: Pulsenmore ES is a self-scanning ultrasound system for remote fetal assessment. It is composed of a hand-held transducer that serves as a smartphone cradle coupled with an application and clinician's web-viewer dashboard. Recently, a novel capability was added to the system allowing for offline fetal heart rate (FHR) and maximal vertical pocket (MVP) measurements. The aim of this study was to evaluate these tools for usability and accuracy.

STUDY DESIGN: A prospective, non-randomized, non-blinded clinical study design was used. Pulsenmore ES scans were obtained by non-professional laypersons in app-guided (AG) mode (user follows video tutorials in the application) or clinician-guided (CG) mode (user is guided by a health-care professional in a real-time telemedicine visit). The scans were stored on a cloud for later interpretation by a health-care professional. Each self-scan was immediately followed by a standard ultrasound scan performed by a clinician. The asynchronous FHR and MVP measurements made on the AG and CG scans through the designated dashboard were analyzed and compared with the real-time, in-clinic, measurements.

RESULTS: The cohort included 28 women. Rates of successful utilization of the Pulsenmore tool for measurement of FHR were 84.7±11.24% of scans made in AG mode and 96.3±6.35% of scans made in CG mode. Corresponding values for MVP were 91.7±2.31% and 95.0±1.73%. FHR accuracy (difference from in-clinic values) was 10.8±7.5 bpm (7.2%) in AG mode and 5.8±5.1 bpm (4%) in CG mode; MVP accuracy was 1.3±1.4cm (22%) and 0.9±0.8cm (14%), respectively. Sensitivity (87.5% and 100%, in AG and CG modes respectively) and specificity (95% and 95.5%, in AG and CG modes, respectively) were established for MVP.

CONCLUSION: FHR and MVP measurements obtained from scans captured by the self-operated Pulsenmore ES ultrasound platform are highly accurate and reliable for clinical use relative to standard in-clinic measurements.

PMID:39561972 | DOI:10.1055/a-2469-0887

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Analysis of skills and perceptions regarding mHealth in the management of chronic patients by primary care professionals

HumanInsight Analysis of skills and perceptions regarding mHealth in the management of chronic patients by primary care professionals

Aten Primaria. 2024 Nov 18;57(2):103142. doi: 10.1016/j.aprim.2024.103142. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the perceptions of primary care professionals regarding the integration and effectiveness of mHealth in managing patients with chronic conditions, as well as their digital skills.

DESIGN: Descriptive cross-sectional observational study conducted from April to November 2023.

SETTING: Primary care services in the Health Department of Denia, Alicante, Spain.

PARTICIPANTS: Professionals in nursing, medicine, and physiotherapy.

MEASUREMENTS: Participants completed an anonymized ad hoc questionnaire divided into two sections: sociodemographic data and questions regarding the use of mobile health technologies and the internet.

RESULTS: A total of 181 professionals participated, showing high proficiency in managing mobile applications (median score of 8 out of 10; IQR=2), with higher proficiency observed among younger professionals (P<.001). 56.35% had prescribed official or scientifically endorsed digital information. The primary advantage identified for mHealth was the enhancement of patient self-monitoring and self-control (86.74%). However, 88.95% noted the difficulty of using mobile technologies depending on patient type as a disadvantage. 64.64% believed mHealth should be targeted towards patients or caregivers dealing with cardiometabolic or respiratory chronic conditions.

CONCLUSIONS: The study underscores a generally positive perception of mHealth among primary care professionals, highlighting their technological competence. It also emphasizes the potential of mHealth to improve patient self-management and enhance electronic documentation of patient follow-up. Addressing the digital divide is critical to ensuring equitable access to mHealth and thereby improving health care and outcomes.

PMID:39561676 | DOI:10.1016/j.aprim.2024.103142

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Predicting Pain Response to a Remote Musculoskeletal Care Program for Low Back Pain Management: Development of a Prediction Tool

HumanInsight Predicting Pain Response to a Remote Musculoskeletal Care Program for Low Back Pain Management: Development of a Prediction Tool

JMIR Med Inform. 2024 Nov 19;12:e64806. doi: 10.2196/64806.

ABSTRACT

BACKGROUND: Low back pain (LBP) presents with diverse manifestations, necessitating personalized treatment approaches that recognize various phenotypes within the same diagnosis, which could be achieved through precision medicine. Although prediction strategies have been explored, including those employing artificial intelligence (AI), they still lack scalability and real-time capabilities. Digital care programs (DCPs) facilitate seamless data collection through the Internet of Things and cloud storage, creating an ideal environment for developing and implementing an AI predictive tool to assist clinicians in dynamically optimizing treatment.

OBJECTIVE: This study aims to develop an AI tool that continuously assists physical therapists in predicting an individual's potential for achieving clinically significant pain relief by the end of the program. A secondary aim was to identify predictors of pain nonresponse to guide treatment adjustments.

METHODS: Data collected actively (eg, demographic and clinical information) and passively in real-time (eg, range of motion, exercise performance, and socioeconomic data from public data sources) from 6125 patients enrolled in a remote digital musculoskeletal intervention program were stored in the cloud. Two machine learning techniques, recurrent neural networks (RNNs) and light gradient boosting machine (LightGBM), continuously analyzed session updates up to session 7 to predict the likelihood of achieving significant pain relief at the program end. Model performance was assessed using the area under the receiver operating characteristic curve (ROC-AUC), precision-recall curves, specificity, and sensitivity. Model explainability was assessed using SHapley Additive exPlanations values.

RESULTS: At each session, the model provided a prediction about the potential of being a pain responder, with performance improving over time (P<.001). By session 7, the RNN achieved an ROC-AUC of 0.70 (95% CI 0.65-0.71), and the LightGBM achieved an ROC-AUC of 0.71 (95% CI 0.67-0.72). Both models demonstrated high specificity in scenarios prioritizing high precision. The key predictive features were pain-associated domains, exercise performance, motivation, and compliance, informing continuous treatment adjustments to maximize response rates.

CONCLUSIONS: This study underscores the potential of an AI predictive tool within a DCP to enhance the management of LBP, supporting physical therapists in redirecting care pathways early and throughout the treatment course. This approach is particularly important for addressing the heterogeneous phenotypes observed in LBP.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04092946; https://clinicaltrials.gov/ct2/show/NCT04092946 and NCT05417685; https://clinicaltrials.gov/ct2/show/NCT05417685.

PMID:39561359 | DOI:10.2196/64806

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Delphi definition of general practice/family medicine specialty for a post-COVID world: in-person and remote care delivery

HumanInsight Delphi definition of general practice/family medicine specialty for a post-COVID world: in-person and remote care delivery

Fam Pract. 2024 Nov 19:cmae061. doi: 10.1093/fampra/cmae061. Online ahead of print.

ABSTRACT

INTRODUCTION: The evolving landscape of general practice (GP)/family medicine (FM) in the post-COVID-19 era, focussing on integrating telemedicine and remote consultations requires a new definition for this specialty. Hence, a broader consensus-based definition of post-COVID-19 GP/FM is warranted.

METHODS: This study involved a modified electronic Delphi technique involving 27 specialists working in primary care recruited via convenient and snowball sampling. The Delphi survey was conducted online between August 2022 and April 2023, utilizing the Google Forms platform. Descriptive statistics were employed to analyse consensus across Delphi rounds.

RESULTS: Twenty-six international experts participated in the survey. The retention rate through the second and third Delphi rounds was 96.2% (n = 25). The broader consensus definition emphasizes person-centred care, collaborative patient-physician partnerships, and a holistic approach to health, including managing acute and chronic conditions through in-person or remote access based on patient preferences, medical needs, and local health system organization.

CONCLUSION: The study highlights the importance of continuity of care, prevention, and coordination with other healthcare professionals as core values of primary care. It also reflects the role of GP/FM in addressing new challenges post-pandemic, such as healthcare delivery beyond standard face-to-face care (e.g. remote consultations) and an increasingly important role in the prevention of infectious diseases. This underscores the need for ongoing research and patient involvement to continually refine and improve primary healthcare delivery in response to changing healthcare landscapes.

PMID:39561247 | DOI:10.1093/fampra/cmae061

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Adverse events associated with the delivery of telerehabilitation across rehabilitation populations: A scoping review

HumanInsight Adverse events associated with the delivery of telerehabilitation across rehabilitation populations: A scoping review

PLoS One. 2024 Nov 19;19(11):e0313440. doi: 10.1371/journal.pone.0313440. eCollection 2024.

ABSTRACT

OBJECTIVE: This scoping review aimed to map existing research on adverse events encountered during telerehabilitation delivery, across rehabilitation populations. This includes identifying characteristics of adverse events (frequency/physical/non-physical, relatedness, severity) and examining adverse events by different modes of telerehabilitation delivery and disease states.

INTRODUCTION: Telerehabilitation, a subset of telemedicine, has gained traction during the COVID-19 pandemic for remote service delivery. However, no prior scoping review, systematic review, or meta-analysis has identified and summarized the current primary research on adverse events in telerehabilitation. Understanding adverse events, such as falls during physiotherapy or aspiration pneumonia during speech therapy, is crucial for identifying limitations and optimizing delivery through risk mitigation and quality indicators. This understanding could also help to improve the uptake of telerehabilitation among clinicians and patients. This review addresses this gap by summarizing published literature on adverse events during telerehabilitation.

METHODS: The review followed the Joanna Briggs Institute framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The review protocol was registered and published on Open Science Framework. A comprehensive search across multiple databases (MEDLINE ALL/EMBASE/APA PsycINFO/CENTRAL/CINAHL) was conducted. Screening, extraction, and synthesis were performed in duplicate and independently. Data extraction followed the Template for Intervention Description and Replication framework and also involved extraction on authors, publication year (pre- or post-COVID), population, sample size, and modes of telerehabilitation delivery (asynchronous, synchronous, hybrid). For synthesis, data were summarized quantitatively using numerical counts and qualitatively via content analysis. The data were grouped by intervention type and by type of adverse event.

INCLUSION CRITERIA: This scoping review included qualitative and quantitative studies published between 2013-2023, written in English, and conducted in any geographic area. All modes of telerehabilitation delivery were included. Systematic reviews, meta-analyses, commentaries, protocols, opinion pieces, conference abstracts, and case series with fewer than five participants were excluded.

RESULTS: The search identified 11,863 references, and 81 studies were included in this review with a total of 3,057 participants (mean age:59.3 years; females:44.6%). Modes of telerehabilitation delivery (whether asynchronous, synchronous or hybrid) used in the studies included videoconferencing (52), phone calls (25), text messaging (4), email (6), mobile apps (10), and internet-based virtual reality systems (3). A total of 295 adverse events occurred during 84,534 sessions (0.3%), with the majority being physical (e.g., falls or musculoskeletal pain), non-serious/non-severe/mild, and unrelated to (i.e., not caused by) to the telerehabilitation provided.

CONCLUSIONS: From the 81 included studies, telerehabilitation was delivered with related adverse events being rare, and mostly characterized as mild/non-severe. A comparable occurrence of adverse events (~30%) was found between asynchronous and synchronous telerehabilitation studies. When categorized by disease type, cardiac telerehabilitation studies had the most frequent adverse events. Detailed reporting of telerehabilitation interventions and adverse event characteristics is recommended for future studies (i.e., use of TIDieR reporting guidelines). Telerehabilitation has the potential to make rehabilitation services more accessible to patients; however, more evidence on the safety of telerehabilitation is needed.

PMID:39561143 | DOI:10.1371/journal.pone.0313440

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