Bystander cardiopulmonary resuscitation (CPR) has been shown to be associated with increased rates of survival from non-traumatic out-of-hospital cardiac arrest (OHCA). GoodSAM is a platform integrated into the computer-assisted dispatch system. The software allows the telecommunicator to send a link to the caller’s smart phone. Once activated, the telecommunicator can see and hear the patient, and obtain breathing and heart rates using the camera and microphone on the caller’s phone. The telecommunicator can use the platform to identify cardiac arrest and provide real-time compression feedback. It was hypothesized that telecommunicator use of video telecommunication would be associated with increased rates of pre-arrival CPR.

This was a retrospective review of all cardiac arrest resuscitations performed from July 2021 through February 2022 in the San Antonio Fire Department (SAFD) Emergency Medical Services (EMS) system – the seventh largest city in the United States. Data source was the Office of the EMS Medical Director (OMD) Cardiac Arrest Registry. Inclusion criteria included cardiac arrests for which resuscitation was attempted. Exclusion criteria were cardiac arrest was witnessed by EMS personnel, or missing data. Dataset included: location of arrest, presumed etiology of the arrest, if dispatch CPR instructions were given; caller compliance; type of CPR performed; who witnessed the arrest; and who performed the CPR prior to EMS. Patients were dichotomized as to whether video telecommunication was used by the paramedic telecommunicator. A case was recorded as having received pre-arrival CPR if the initial CPR was performed by anyone other than the responding unit.

A total of 779 cases were included in the study. Primary outcome, in the cases where video telecommunication was utilized, 46/74 (62%) received pre-arrival CPR, versus 324/705 (46%) without the use of video telecommunication, with an overall difference of 16.2% (95% CI, 4.6% to 27.9%; P = .008). When using video telecommunication, a larger proportion of the persons performing pre-arrival CPR were family members when compared to the cases where video telecommunication was not used (35% versus 17%).

Using video telecommunication to perform paramedic clinical dispatch telemedicine was associated with an increased rate of pre-arrival CPR. Further research will be required to show outcome-related results to determine if dispatch video and audio telemedicine can be used to increase survival in patients suffering OHCA.

Access to quality healthcare is often limited in rural and underserved areas, leading to higher rates of preventable diseases, avoidable hospitalizations, and mortality. Virtual health clinics, utilizing telehealth and telemedicine technologies, offer a promising solution to bridge these gaps. This scoping review aimed to systematically identify and analyze the benefits, outcomes, and service range of virtual clinics in remote and underserved settings.

This scoping review was conducted following Arksey and O’Malley’s six-stage framework. Relevant literature was searched in PubMed, Web of Science, Scopus, Google, and Google Scholar. Data were extracted using a standardized charting form and thematically analyzed using Braun and Clarke’s method with MAXQDA software.

A total of 38 benefits of virtual clinics were identified, primarily related to improved access to health services, reduced costs, and decreased patient travel. In the domain of governance and leadership, enhanced governmental support and optimal resource allocation were reported. For human resources, improved communication and training were emphasized. Moreover, the use of local technologies, remote medication ordering, and digital record-keeping demonstrated a significant impact, particularly in middle- and high-income countries.

Virtual clinics can effectively enhance the quality and accessibility of health services in underserved areas and play an important role in reducing health inequities.

To evaluate the impact of telemedicine on the workload of primary care physicians (PCPs).

Telemedicine, including video visits, telephone visits, and digital correspondence, is increasingly offered by physicians, particularly since the COVID-19 pandemic. It is still unclear whether increasing the variety of services creates an increase in demand and therefore causes an increase in the workload of PCPs. In this study.

A population-based descriptive study, conducted during the 2020–2021 period, on a cohort of 464,119 patients, all members of Leumit Health Services and without a diagnosis of COVID-19. The patients were stratified into three distinct groups based on the nature of their healthcare visits: Patients who used only face-to-face (FTF) visits; Patients who used asynchronous visits with or without FTF visits but did not use synchronous telemedicine visit; and patients who used synchronous telemedicine visits with or without other types of visits. We performed a comparative analysis on Accumulated Annual Duration of Time (AADT) as an index for workload, across the different periods, using standard descriptive statistics methods.

Telemedicine use was higher in older persons, females, those of higher socioeconomic status, and patients with comorbidities. The greater the number of telemedicine visits, the greater the time the PCP spent on visits during the year. The largest increase in AADT (56.1%) was observed in patients who had only FTF meetings in 2020 but in 2021 made all types of visits. Overall, there was an increase of 2.5% in time invested in 2021 and a 5.8% increase in the number of patients making digital visits.

Policymakers encouraging telemedicine should consider the additional load on PCPs associated with telemedicine use and plan resources accordingly.

Test educational interventions to increase the quality of care in telemedicine.

Telemedicine (TM) has become an essential tool to practise medicine around the world. However, education to address clinical skills in TM remains an area of need globally across the health professions. We aim to evaluate the impact of a pilot online learning platform (OLP) and standardized coaching programme on the quality of medical student TM clinical skills.

A randomized pilot study was conducted with fourth-year medical students (n = 12). All participants engaged in video-recorded standardized patient (SP) simulated encounters to assess TM clinical skills before and after the intervention. Participants were randomized to either the OLP or OLP + Virtual Coaching Institute (VCI) intervention cohort. Quantitative and qualitative data were collected to address self-reported skills, attitudes, and self-efficacy before the 1st SP encounter and after the 2nd SP encounter. SP encounter recordings were scored by two blinded non-investigator raters based on a standardized rubric to measure the change in TM care delivered pre- and post-intervention. Statistical analysis of quantitative data included descriptive statistics and mixed effects ANOVA.

Recruitment and retention of participants exceeded expectations, pointing to significant enthusiasm for this educational opportunity. Self-reported skills and scored simulation skills demonstrated significant improvements for all participants receiving the interventions. Both OLP and VCI interventions were well received, feasible, and demonstrated statistically significant efficacy in improving TM clinical skills. Participants who received coaching described more improvements in self-efficacy, confidence, and overall virtual clinical skills. This study provides evidence that virtualized clinical learning environments can positively impact the development of TM clinical skills among medical students. As TM continues to evolve, the implementation of innovative training approaches will be crucial in preparing the next generation of healthcare professionals for the demands of modern healthcare delivery.

The COVID-19 pandemic presented unique challenges to global healthcare. Face-to-face outpatient care was dramatically reduced. This study implemented a remote consultation service via a mobile app (Pexip) to monitor patients with major CHD.

Study design was quasi-experimental and prospective.

Remote consultations were carried out at a tertiary paediatric cardiology centre in Northern Ireland.

Children with major CHD aged 0–16years in Northern Ireland.

The intervention was a Pexip-enabled remote consultation.

Primary outcome measures included the number of attendances to hospital both initiated and avoided via remote consultation. Remote consultations were conducted by doctor and/or cardiac specialist nurse or by specialist nurse alone (52% vs. 48%).

In the study, 32 patients enrolled; three were non-responders and a further two excluded. There were 201 remote consultations delivered (mean = 7.4). There were 12 admissions to hospital resulting from the remote consultation; the commonest indication was abnormal oxygen saturations (42%). There were 38 hospital attendances avoided, predominantly related to infant feeding and medication advice (both 42%).

A significant number of unnecessary hospital attendances were avoided (n = 38). Remote consultation technology proved a user-friendly and valuable adjunct to the provision of ongoing specialist patient care in challenging circumstances. There was a reduction in parental anxiety, and both parents and clinicians found this initiative beneficial to patient care. There was prompt identification of unwell children on remote consultations.

In order to minimise physical interaction during the COVID-19 pandemic, telepsychiatry became a key part of clinical practice for many psychiatrists.

This study involved an exploratory, cross-sectional, opt-in online survey circulated to non-consultant doctors in psychiatry working in Ireland. It assessed experience and attitudes in relation to telepsychiatry use.

The response rate was 11.6% (n = 61). Forty-eight individuals (78.6%) had delivered clinical care using telepsychiatry. Fifty-nine individuals (96.7%) were unfamiliar with telepsychiatry prior to the pandemic. Most respondents had not received specific training around use of a telepsychiatry platform (86.9%, n = 63) and were unaware of published guidelines around its optimal use (54.1%, n = 33). Respondents’ concerns included issues around connectivity, medico-legal uncertainty and clinical effectiveness.

Conclusions drawn are limited by the potential for selection bias in this study. Nonetheless the paper has highlighted important issues including the need for more research assessing telepsychiatry clinical and curricular experience. Additional curricular interventions during training could build skillset and confidence in telepsychiatry.

Digital health technologies have been enhancing the capacity of healthcare providers and, thereby, the delivery of targeted health services. The Southeast Asia Region (SEAR) has invested in strengthening digital public health. Many digital health interventions have been implemented in public health settings but are rarely assessed using the holistic health technology assessment (HTA) approach.

A systematic literature review was performed to provide an overview of evaluations of digital public health interventions in the World Health Organization (WHO) SEAR. Searches were conducted on four electronic databases. Screening title abstracts and full texts was independently conducted by two reviewers, followed by data extraction. Dimensions of HTA were analyzed against the EUnetHTA Core Model 3.0. Quality assessment of included articles was conducted using the JBI Checklist for Economic Evaluation and Consolidated Health Economic Evaluation Reporting Standards 2022 checklist to assess the reporting quality. The findings are presented using systematic evidence tables and bar charts.

Of the forty-three studies screened at the full-text stage, thirteen studies conducted across six countries were included in the analysis. Telemedicine and m-health interventions were assessed in ten studies. Nine studies conducted cost-effectiveness analysis, and five assessments were conducted from a societal perspective. Four studies utilized more than one perspective for the assessment. Health problem definition and current use of technology, description and technical characteristics of the technology, clinical effectiveness, costs, economic evaluation, and organizational aspects were assessed by all the studies, whereas legal aspects were least assessed.

The lack of HTAs on digital public health interventions in the region highlights the need for capacity-building efforts.

In recent years, the importance of telemedicine has increased significantly. Especially in the field of echocardiography, virtual reality glasses offer the possibility of real-time data transmission without restrictions in the examination process. In particular, the care of critically ill newborns with suspected CHD might be improved by allowing a specialized paediatric cardiologist to remotely guide an echocardiographic examination. The current study aims to prove whether novices, under Google Glass guidance by a paediatric cardiologist, can perform an appropriate neonatal echocardiography.

The current study is a prospective monocentric single-blinded pilot study. Participants were supposed to perform two test runs: The first test run was “unguided” and the second test run was instructed via Google Glass. A validated training simulator for neonatal echocardiography “EchocomNeo, Echocom GmbH” was used. The study took place at the Leipzig Heart Center, Department of Pediatric Cardiology from April 2022 to November 2022.

A total of 21 medical students were enrolled. In total 252 views (126 views in each test run) were recorded. The overall performance was significantly higher in the Google Glass guided test run compared to “unguided” (structure score: 77.6% vs. 63.2%. p < 0.001 and quality score: 58.7% vs. 47.2%, p < 0.001). Also, the time was significantly lower in the Google Glass guided test run than in the unguided test run, p = 0.014.

Google Glass guidance by a paediatric cardiologist could optimize the performance of novices in echocardiography using a standardized neonatal echo-simulator with structural normal cardiac anatomy.

Since COVID-19, Indonesia has legalized telemedicine in medical services, including Return to Work (RTW). RTW programs help occupational injury-disabled workers return to work. This research examines how telemedicine supports RTW for employees with occupational injuries.

The study used Interrupted Time Series Analysis (ITSA) to find patterns and trends in RTW program telemedicine case numbers and claim settlements over time. A total of 1 314 data were obtained from the Indonesian National Social Security Agency on Employment (BPJS Ketenagakerjaan) from July 1, 2015, to December 2022.

Telemedicine reduces the frequency of recurrent occupational injuries in persons with impairments (Relative Risk [RR] = 0.59). In addition, the integration of telemedicine into health care practices exhibits promising prospects in terms of mitigating the financial burden on social security programs. This is supported by a robust RR (0.6).

Telemedicine reduced the number of repeat cases and optimized medical claims cost in the RTW program during the COVID-19 pandemic. The results will contribute to policy and assist health care professionals and employers in improving RTW outcomes for disabled people.