Journal of telemedicine and telecare
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The purpose of this study was to understand the methods of current delivery of health care services to cerebral palsy (CP) patients in Queensland, Australia. The study also examines the current use of telehealth by clinicians and their perceptions about telehealth use. ⋯ Traditional methods of delivering services to CP patients do not meet their needs. Clinicians have found telehealth is a feasible and satisfactory delivery method. However, the use of telehealth is still limited.
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Randomized Controlled Trial
Telemedicine compared with standard care in type 2 diabetes mellitus: A randomized trial in an outpatient clinic.
Good metabolic control is important in type 2 diabetes mellitus to improve quality of life, work ability and life expectancy, and the use of telemedicine has proved efficient as an add-on to the usual treatment. However, few studies in type 2 diabetes patients have directly compared telemedicine with conventional outpatient treatment, and we wanted to evaluate whether telemedicine, compared with standard care, provides equivalent clinical outcomes. ⋯ In the direct comparison of home video consultations vs standard outpatient treatment in type 2 diabetes mellitus, telemedicine was a safe and available option with favourable outcomes after six months treatment.
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E-consultations are asynchronous, text-based consultations. The specialist e-consultant answers clinical questions in a similar way to a standard consultation but the questions and answers are sent electronically. The e-consultant has access to some or all of the medical record but does not have contact with the patient. Although e-consultations are meant to substitute for face-to-face (F2F) consultations, a significant proportion of e-consultations are converted to F2F consultations. ⋯ E-consultations convert to F2F consultations primarily at the request of the specialist. Diagnostic and treatment complexity appear to be the main reasons. We found little evidence that patients decided independently to get a F2F visit or that specialists needed a F2F visit to perform a physical examination. Although e-consultations might not be a complete substitute for F2F consultations, they may serve as an entry level consultation that could be supplemented by a video consultation as needed for cases with more diagnostic and treatment complexity.
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The Flinders University Telehealth in the Home (FTH) trial was an action research initiative that introduced and evaluated the impact of telehealth services on palliative care patients living in the community, home-based rehabilitation services for the elderly, and services to the elderly in residential aged care. The aim of this study was to understand the issues encountered during the provision of technology services that supported this trial. ⋯ In the setting described, an iterative approach to the development of telehealth services to the home using consumer technologies was needed. The efficient management of consumer devices in multiple settings will become critical as telehealth services grow in scale. Effective collaboration between clinical and technical stakeholders and further workforce education in telehealth can be key enablers for the transition of face-to-face care to a telehealth mode of delivery.
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Randomized Controlled Trial
E-virtual reality exposure therapy in acrophobia: A pilot study.
Virtual reality therapy is already used for anxiety disorders as an alternative to in vivo and in imagino exposure. To our knowledge, however, no one has yet proposed using remote virtual reality (e-virtual reality). The aim of the present study was to assess e-virtual reality in an acrophobic population. ⋯ None of the sessions were cancelled or interrupted because of software incidents. Measures (anxiety, presence, therapeutic alliance) were comparable across the two conditions. e-Virtual reality can therefore be used to treat acrophobic disorders. However, control studies are needed to assess online feasibility, therapeutic effects and the mechanisms behind online presence.