jmir medical informatics

Having patients develop a positive perception will make administering a telemedicine program more desirable. This is because of the high levels of competition in health care today, requiring facilities to consistently look for ways to reduce cost and increase quality. Hypertension is a chronic condition that occurs when blood is pumped through the arteries with excessive force [1]. Furthermore, it is shown to have decreased costs overall for providing care [13], despite the cost of the per-unit provision of care being the same [11]. All identical papers were analyzed and unified before the table was generated. Mileski, Clemens Scott Increased convenience/ease of the use of telemedicine in the treatment of hypertension was identified 4 times [4,13,15] (multiple occurrences per article: 12) (10%). During the course of the period chosen (2010-2016) for this systematic review, 112 authors published 14 works that specifically studied, analyzed, and discussed factors relating to the self-management of hypertension via telemedicine. Preventive intervention during hospitalization is an underexplored area that holds potential for reducing readmission risk. Telemedicine lacks oversight in the area of application production or effectiveness [14]. JMIR Medical Informatics 684 articles JMIR Public Health and Surveillance 623 articles JMIR Mental Health 561 articles JMIR Formative Research 398 articles Iproceedings 312 articles JMIR … An immediate medical breakthrough is needed. Show/hide abstract. The benefits of telemedicine are yet to be fully realized through research, and it could easily become a regulation to implement it as a tool, such as electronic health records or the International Classification of Diseases, Tenth Edition (ICD-10). Telemedicine has been shown to be effective, efficient, and affordable in reaching its target population [4]. What is the Impact Factor of JMIR mHealth and uHealth? However, virtual patient care can also limit the patient-provider relationship, quality of examination, efficiency of health care delivery, and overall quality of care. What is Impact Factor misuse? Hypertension is defined as having abnormally high blood pressure [8]. Telemedicine has incentives for health care facilities and the patients who would participate. Three theme areas were next tied with each other in incidence. 2010 Telemedicine: opportunities and developments in member states: report on the second global survey on eHealth Another concern among providers is the cost of using such technology [4,11,12], as it was mentioned in 3 papers (8%). Telemedicine broadens access to people unable to reach health services easily [4,18]. WHO. 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Rejection of using telemedicine is not solely derived from the users’ perceptions; it is heavily influenced by the organization deciding whether implementation is in its best interest. Self-management refers to taking responsibility for one’s own behavior and well-being. Catalani J, JMIR Research Protocols (ISSN 1929-0748) is a unique Pubmed- and (new!) Kruse CS, Telemedicine offers a method to be utilized in conjunction with face-to-face communication with providers. Telemedicine has made it more convenient for users to keep track of their health; it allows users to take measurements from home and immediacy of communication [2,4,5,14]. Telemedicine can be rapidly implemented and can easily negate some of the financial burdens in facilities throughout the United States by higher patient volumes and by more efficient use of patient-physician care time [1]. The use of telemedicine has expanded vastly to include a “variety of applications and services using two-way video, email, smartphones, wireless tools and other forms of telecommunications technology” [2]. With the ability of technology to inform the public, patient awareness on the management of their own health has made them a major stakeholder in health care. Telemedicine cardiovascular risk reduction in veterans. Background: Accurate data retrieval is an essential part of patient care in the intensive care unit (ICU). NIH. USA.gov. These themes were then divided into two affinity matrix tables for facilitators and barriers. Due to these inconsistencies, staff seem to be skeptical about the use of technology in this fashion [16], as the accuracy of the information provided [4] and the validity of the results are in question [14]. The electronic health record (EHR) is the primary method for data storage and data review. These numbers are growing at an alarming rate, with an estimated 1.56 billion adults to be afflicted with hypertension by 2025 [9]. Information for this review was collected through the use of two databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete via Elton B Stephens Company (EBSCOhost) and PubMed (which queries MEDLINE). JMIR Medical Informatics (JMI, ISSN 2291-9694; Impact Factor: 2.58) (Editor-in-chief: Christian Lovis MD MPH FACMI) is a PubMed/SCIE-indexed journal that focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. Oct-Dec, Michael Telemed J E Health 2012 Oct;18(8):613-620 [, Adopting Telemedicine for the Self-Management of Hypertension: Systematic Review, Vol 5, No Finding easier ways of managing this condition is key to successful treatment. Legislature is placing an increasing demand on health care organizations to increase the quality of care delivered to patients at a lower cost. JMIR medical informatics. It requires abstraction of data elements from multiple components of the longitudinal health record and matching them to inclusion and exclusion criteria for each trial. Facilities that have adopted models of telemedicine have shown better patient outcomes and satisfaction, higher patient volumes, and increased facility space to be used for other purposes. The concerns here were that the implementation of such technology would blur professional roles in the treatment milieu [13] and that a fear of a significantly increased workload via input exists among these same practitioners [6]. All the papers were related to using telemedicine to measure high blood pressure, but it was the target populations that varied. It also fosters care for those who might otherwise not go to the physician for treatment [11] and allows for different interventions outside the normal ones, which would come with usual care for hypertension [11]. The transfer of the peer-review reports may mean that the paper does not have to be re-reviewed. The electronic health record (EHR) is the primary method for data storage and data review. DHHS. The most prevalent barriers include lack of evidence, self-management difficult to maintain, no long-term results/more areas to address, and long-term added workload commitment. These same patients have a lack of comfortability with technology [4], and there are concerns regarding the safety of personal health data [4]. Additionally, it lacks Food and Drug Administration approval [14]. This helps to increase patient participation with their own health and modify behaviors that result in an unhealthy lifestyle [6,11]. June 2020, the journal received an impact factor of 2.58. Background: Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. 29066424 Resource information. The transfer of the peer-review reports may mean that the paper does not have to be re-reviewed. What is an Impact Factor? 5676030, Copyright © Owing to a shortage of geriatric teams and the vast number of older adults diagnosed with cancer each year, a web-based geriatric assessment may improve access to geriatric assessment for older adults. Which JMIR journals are indexed in Web of Science/SCIE and have an impact factor? Poor planning has been an extreme issue because of the alignment of goals and vision required throughout the organization to be successful in a telemedicine implementation process [13,14]. The editor-in-chief is Gunther Eysenbach.The publisher is JMIR Publications. Manual extraction is difficult and time-consuming, and there is not a lot of research on natural language processing extracting medical information from unstructured text from French corpora. There is evidence to show that there are differences in effectiveness between men and women [3] and that there are other inconsistencies between the programs (and the research surrounding them) [12]. Table 3 illustrates and rank orders the themes from the barriers based on their frequency of occurrence in the literature. Artificial intelligence (AI) systems have been developed to improve the efficiency and accuracy of this process. There was also a “value-added” component to the use of telemedicine, as there was additional information available regarding the diagnosis to patients, which otherwise might not have been readily available [6]. JMIR Medical Informatics is a journal respected by experts and researchers alike. [, Shaw RJ, Kaufman MA, Bosworth HB, Weiner BJ, Zullig LL, Lee SD, et al. Show/hide abstract. The last four facilitators were each mentioned once in the identified papers. Existing readmission reduction solutions tend to focus on complementing inpatient care with enhanced care transition and postdischarge interventions. Furthermore, communication is facilitated, as the use of telemedicine is able to create a positive organizational culture for patients and practitioners alike [16]. The search focused on self-management of hypertension through the use of telemedicine. Catalani, Tara May 13, 2021, Copyright © Racial differences in the effect of a telephone-delivered hypertension disease management program. aDenotes multiple occurrences in the same paper. The Journal of Medical Internet Research is a peer-reviewed open-access medical journal established in 1999 covering eHealth and "healthcare in the Internet age". Mileski M, Increases in health and quality facilitators were noted in areas that allowed practitioners to have increased oversight of their patients and an easing of the facilitation of care [14,16]. However, parallel to the emergence of the COVID-19 pandemic is the proliferation of information regarding the pandemic, which, if uncontrolled, cannot only mislead the public but also hinder the concerted efforts of relevant stakeholders in mitigating the effect of this pandemic. Patients are highly dependent on their physicians for information on their health. The Journal of Medical Internet Research is a peer-reviewed open-access medical journal established in 1999 covering eHealth and "healthcare in the Internet age". JMIR has a network of over 60.000 potential problem-solvers and idea generators: eHealth researchers and health experts, e-patients, leaders and innovators, including the top scientists in the fields of informatics, behavioral sciences, mental health, serious games, mHealth, ubiquitous computing, human factors, bioinformatics and biotechnology (sign up here). Objective: A solution to reduce visits to physicians for chronic conditions is to utilize telemedicine. Furthermore, practitioners are concerned over the cost of the delivery of such services possibly outstripping reimbursement [11] and that there might simply be no economic gain to providing services in such a fashion as via telemedicine [12]. Even with research that supports expanding the use of telemedicine, some clinical trials show no economic gains [12]; this poses a challenge for pushing the expansion of telemedicine in organizations. Other variant title: JMI. This review highlights the facilitators and barriers to implementing telemedicine techniques into health care facilities to identify the benefits that can be realized if adopted [2-4,6,11,12]. By enabling the users to track and record their health status, they feel that they have an increase in knowledge with regard to understanding their health condition [5,6,13]. JMIR Medical Education (JME) is an open access, Pubmed-indexed, peer-reviewed journal with focus on technology, innovation and openess in medical education. There are concerns over the perception that the technology is labor intensive and is only available in affluent countries [18]. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. An electronic health record that integrates appointment scheduling and patient web-based access to medical records creates an opportunity for patient self-scheduling. Thomson Reuters’ Impact Factors for 2008 (which are a well-recognised reflection of the relative importance of journals in their field) have recently been published, and for medical informatics journals provide much food for thought. The telehealth revolution in response to COVID-19 has increased essential health care access during an unprecedented public health crisis. Research is limited on the effects of utilizing telemedicine in health care facilities. ISSN : 2291-9694. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 24.10.2017. Although there are clear advantages and evidence showing that telemedicine improves outcomes of hypertension and other chronic illness not only in the short term but also in the long term, studies show that health care facilities and medical staff are skeptical regarding the adoption of telemedicine models because of the shift of responsibility to the provider to check up on the patient [6]. Nurses were able to provide more timely care and intervention than would normally happen in the office environment [15,16]. JMIR Diabetes focuses on technologies, medical devices, apps, engineering, informatics and patient education for diabetes prevention, self-management, care, and cure, to help people with diabetes. The editor-in-chief is Gunther Eysenbach.The publisher is JMIR Publications. Compared with severe acute respiratory syndrome and Middle East Respiratory Syndrome, COVID-19 spreads more rapidly owing to increased globalization, a longer incubation period, and unobvious symptoms. These journals include e.g. The members of the research team had full agreement on all papers included in this systematic review. Background: Accurate data retrieval is an essential part of patient care in the intensive care unit (ICU). These, in turn, were grouped into larger recurring themes: either key determinants or impediments to success. With the obesity rate in America at an all-time high, along with hypertension diagnoses on the rise, it is important to recognize the benefits that telemedicine offers to consumers. There are also issues identified regarding patients adhering to rules and guidelines surrounding the use of the technology [10] and keeping up with these patients from the provider perspective [6]. Limited consideration of clinical decision support (CDS) design best practices, such as a user-centered design, is often cited as a key barrier to CDS adoption and effectiveness. Haderer, http://www.who.int/goe/publications/goe_telemedicine_2010.pdf, http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf, Add this article to your Mendeley library, Clinical Communication, Electronic Consultation and Telehealth (122), Hypertension Prevention and Treatment (102), Limited oversight, regulation, and guidelines, Mobile phones can become electrocardiographs (EKG) or other diagnostic machines, Blurring of professional role of practitioners, Increased access to care that patients otherwise may not receive, Potential for increased liability for practitioners, Large application to medically underserved areas, Need for identification for ways to mitigate risk, Ease in scheduling, communication, monitoring, and management for patients and practitioners, Apps attached to practitioners have increased oversight of patients and ease of facilitation of care, Many available apps for mobile phones do not have a practitioner involved with them, Apps available are not documented as valid ways to measure blood pressure, No oversight to app production or effectiveness, Lack of Food and Drug Administration approval, Differences in results compared with other studies, Reduced blood pressure compared with usual care, Not many other studies to exhibit consistency, No significant difference between intervention and control group, Information technology unlikely to lead to improved outcomes alone, Information technology infrastructure and support, Utilization of existing equipment and space, Technological tools lead to improved patient health, Medicare’s efforts to extend reimbursement to self-management training, Effective, efficient, and affordable ways to reach and support minorities, Patient Care Alignment Teams; stresses non-face-to-face interactions, Patients adherence to the guidelines/rules, Facilitates individualized personal interaction, Remedies face-to-face intervention problems, Increased access to health information between visits, Interactive voice response call completion rate declined, Labor intensive and rarely available in low- and middle-income countries, Cloud computing can make mobile health (mHealth) services more accessible, Lacks the resources to launch and maintain an mHealth service, Relatively little collaborative work with patients’ clinical teams, Hypertension is a common reason for men to go to the doctor, Substantial time costs accumulated for nurses to prepare, Different telephone interventions added with usual care, No long-term difference in results compared with usual care, Costs may not significantly differ from that of usual care, Hypertension Intervention Nurse Telemedicine Study (HINTS) intervention was costly and time-consuming to deliver, Unknown whether intervention generates other patient-centered outcomes or efficiencies in other aspects of medical care, Participants valued additional information, Self-management hard to be maintained by participants, Home blood pressure readings more natural, Needs significant input from general practitioner, No long-term results and more areas to address, Significant input by general practitioner needed. 24.10.2017 Currently, the health care system relies on face-to-face communication to deliver care. Practices may realize the benefits of using telemedicine in the self-management of hypertension after conducting a cost-benefit analysis. 2021 Another focus is on how to train health professionals to use digital tools. skin cancer prevention) and clinical care for people with dermatological conditions. Initial concerns that the cost for the use of the technology might be wasted also exist, as one study showed similar probabilities for inpatient admission in those who used technology versus those who did not [12]. Access is noted to increase with the use of telemedicine by reaching a broader population that may not have easy access to health care resources and transportation, and individuals who require more care such as the elderly. JMIR Publications, Canada Manuscripts accepted in English LCC subjects Look up the Library of Congress Classification Outline Medicine: Medicine (General): Computer applications to medicine. Linking ISSN (ISSN-L): 2291-9694. Using telemedicine to attend to the management of patients’ health will vastly reduce problems occurring in face-to-face care [17]. A common theme throughout the facilitators was an increase in patient health and the quality of care provided. This costs the nation US $46 billion each year in health care services and medications required for treatment and missed workdays. The organization needs to align a telemedicine program in accordance with its mission, vision, and values. The use of the technology also allowed for care to be delivered over long distances, which increased not only access to care but also access to health information [5,18]. Finally, there exists concern over low health literacy levels [4], lack of comfort with technology [4], and security of data [4]. 10.2196/medinform.6603 PMID: Our policy towards the use of cookies All Clarivate Analytics websites use cookies to improve your online experience. Contemp Clin Trials 2013 Sep;36(1):298-306 [, Flodgren G, Rachas A, Farmer AJ, Inzitari M, Shepperd S. Interactive telemedicine: effects on professional practice and health care outcomes. Do the benefits of participation in a hypertension self-management trial persist after patients resume usual care? They were placed on your computer when you launched this website. The lack of long-term studies on this topic has shown a difficulty in the fashioning of responsive clinical processes [15] and a lack of data to show comparison with normal management of hypertension [11]. Users’ perceptions pose a great level of concern for facilities thinking of adopting a telemedicine program. The authors of this review compared and grouped the facilitators and barriers into common themes. Utilizing nurses [16], portable [4], timely [15], and utilizing space [16] were all mentioned one time in the thematic review (2% each). Am Heart J 2013 Apr;165(4):501-508 [, Wang V, Smith VA, Bosworth HB, Oddone EZ, Olsen MK, McCant F, et al. Neighboring cities in Hubei Province followed suit with the government enforcing social distancing measures to restrict the spread of the disease throughout the province. An existing practice can additionally expand its reach and patient base, as the implementation of technology will not take more space resources, and it can utilize existing equipment in most cases [16]. Monitoring critically ill patients in intensive care units (ICUs) in real time is vitally important. Results: Results identify facilitators and barriers corresponding to the implementation of self-management of hypertension using telemedicine. i-JMR, JMIR Research Protocols, JMIR mHealth and uHealth, JMIR Medical Informatics, JMIR Human Factors, JMIR Mental Health, JMIR Public Health and Surveillance, JMIR Cancer, Medicine 2.0 and others. Cost of self-management was shown to be higher overall in some cases, but as it was associated with an increase in quality of life for patients with a decrease in cardiovascular events, a net savings was noted [3]. Web-booking of flights, hotels, and sports events has become commonplace in the travel and entertainment industry, but self-scheduling of health care appointments on the web is not yet widely used. Am Heart J 2012 Jun;163(6):980-986. For this type of study, formal consent is not required. Circ Cardiovasc Qual Outcomes 2014 Mar;7(2):269-275 [, McKoy J, Fitzner K, Margetts M, Heckinger E, Specker J, Roth L, et al. Lack of evidence was an area that showed many possible concerns. Social question-and-answer communities play an increasingly important role in the dissemination of health information. Oct-Dec, School of Health Administration, Texas State University, San Marcos, TX, United States. JMIR Publications, JMIR Rehabilitation and Assistive Technologies. Facilitators mentioned most often in the literature were increased access [4,5,13,18] (multiple occurrences per article: 6,12,14) and increase in health and quality [3,4,12,14-16] (multiple occurrences per article: 10). The technology that is required is portable and can be carried with the patients anywhere they go [4], which allows for increased ability to give timely care [15]. There is a large amount of support necessary for patients to be able to use and maintain a telemedicine program on their own [13]. Although recent studies have not shown a direct short-term relationship to cost savings, they recognize that in the long-term, cost-effectiveness will be realized [5,10,11]. JMIR Medical Informatics 684 articles JMIR Public Health and Surveillance 623 articles JMIR Mental Health 561 articles JMIR Formative Research 398 articles Iproceedings 312 articles JMIR … The next most-cited barrier was self-management difficult to maintain [5,6,10,13] (multiple occurrences per article: 13,18), which was identified 7 times (18%). This paper does not contain any studies with human participants or animals performed by any of the authors. Background: Dry eye disease (DED) is a complex disease of the ocular surface, and its associated factors are important for understanding and effectively treating DED. J Gen Intern Med 2012 Dec;27(12):1682-1689 [, Piette JD, Datwani H, Gaudioso S, Foster SM, Westphal J, Perry W, et al. JMIR Medical Informatics adheres to rigorous quality standards, involving a rapid and thorough peer-review process, professional copyediting, professional production of PDF, XHTML, and XML proofs (ready for deposit in PubMed Central/PubMed). There is no distinction between the terms “telemedicine” and “telehealth,” and they are considered interchangeable to encompass a variety of remote health care options [7]. Economic evaluation of telephone self-management interventions for blood pressure control. Educating not only improves the individual’s knowledge of the condition but also allows for early detection of health problems and enables the individual to correctly self-titrate medications and allows for timely interventions [2,8]. Vol 5, No About 17% more facilitators to implementation were noted than barriers (48:40). May 22, 2021, March 18, 2021 Many practitioner issues with liability and the mitigation of risk have been raised with the use of telemedicine and its use in the self-management of hypertension [13], with potential for information technology issues causing the technology to not be reliable [15]. A shortfall of this study is that all the papers focused on serving different populations with telemedicine. JMIR mHealth and uHealth; Interactive Journal of Medical Research; JMIR Medical Informatics; JMIR Public Health and Surveillance; JMIR Mental Health; JMIR Human Factors; JMIR Serious Games; Medicine 2.0; JMIR Medical Education; JMIR Cancer; Iproceedings; JMIR Rehabilitation and Assistive Technologies; JMIR Diabetes; JMIR Preprints; JMIR Challenges This review presented a myriad of facilitating factors and barriers through a meta-analysis and systematic review of up-to-date papers from two academic databases. Clinical practice guidelines for the management of hypertension in the community a statement by the American society of hypertension and the international society of hypertension. The information presented is helpful in understanding the benefits of telemedicine and its function in an organization. Please review our privacy policy. Technology challenges are also a significant barrier [5,18] (multiple occurrences per article: 16), as they are mentioned 3 times (8%). An advantage to the use of telemedicine identified was that it alleviates issues regarding interventions in the face-to-face method [10]. in PMCID: Understanding the facilitators and barriers to implementation is important, as is understanding how these factors will impact a successful implementation of telemedicine in the area of self-management of hypertension.

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