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Occupational therapy services for adult neurological clients in Queensland and therapists’ use of telehealth to provide services

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Occupational therapy services for adult neurological clients in Queensland and therapists’ use of telehealth to provide services

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Alex Greger

Telehealth for occupational therapy is used to give people with limited access to rehabilitation and health services the opportunity to receive the care they need from therapists from afar. this study was done on 39 rural, critical access patients. The patients were equiped with the necessary technology to receive telehealth treatment and consultation within their home.

The equipment used included a web camera, computer, rehabilitative devices, and other home therapy equipment. Although effective, it did make for more cost to the patient and buying the therapeutic equipment, but the use of everyday tools in therapy was effective.

It was found that the telehealth services were effective. However, the access to these services are limited, but itt should be used as a potential option in the future to help patients in rural areas gain access to the care and rehabilitation they need.

Hoffmann, T., & Cantoni, N. (2008). Occupational therapy services for adult neurological clients in Queensland and therapists’ use of telehealth to provide services. Australian occupational therapy journal, 55(4), 239-248. Chicago

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Telehealth Implementation in a SkilledNursing Facility: Case Report forPhysical Therapist Practice inWashington

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Telehealth Implementation in a SkilledNursing Facility: Case Report forPhysical Therapist Practice inWashington

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Jacob Munger

In 2011, telehealth was allowed in the toolbelt of Physical Therapy in Washington State. The American Physical Therapy Association endorsed telehealth and stated the need of it in skilled nursing facilities. Skilled nursing facilities are often understaffed in relation to physical therapists. Residents at these facilities have the right and the need to be at the highest functional level, and a lack of physical therapists can greatly hinder residents. The purpose of the case study was to describe the development and implementation of telehealth in relation to physical therapy at skilled nursing facilities in Washington state and explore clinical factors of physical therapists in skilled nursing facilities.

Clinical outcomes, User satisfaction, and Cost savings were looked at to meet and describe the purposes. It was found that residents using telehealth scored as well as residents seen in person. Out of 25 individuals tested, 81% of them had positive feedback towards telehealth. Practitioners also stated that communication with other therapists increased with telehealth due to the ease of the communication. In terms of Cost savings, each telehealth visit saved approximately 20-30$ compared to in person.

Overall, the study found that telehealth implementation was a feasible alternative to in-person encounters. Clinical outcomes matched between telehealth and in-person visits, satisfaction was positive, and there were savings with the service. One thing that I found concerning with the article, though, was that it lacked limitations. While telehealth is a promising new utility, I feel as though there had to be some form of limitation. I would be very interested in seeing telehealth research expanded into various other Physical Therapy practices, such as home health.

Lee, A. W., & Billings, M. (2016). Telehealth Implementation in a Skilled Nursing Facility: Case Report for Physical Therapist Practice in Washington. Physical Therapy, 96(2), 252-259. doi:10.2522/ptj.20150079

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Telehealth Technologies for Heart Failure Disease Management in Rural Areas: An Integrative Research Review 

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Telehealth Technologies for Heart Failure Disease Management in Rural Areas: An Integrative Research Review 

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Ashley Fritz
In this article, they studied the effectiveness of telehealth technologies that helped improve the health outcomes of those with heart failure. Throughout the United States, there are 5.8 million Americans who suffer with congestive heart failure. Many patients that live in rural areas with heart failure find it challenging to gain access to health care. Some of the challenges are: geography, finances, and sociocultural issues. Telehealth has helped increase health outcomes and decrease costs.

Some of the risk factors that come with having heart failure are atrial fibrillation, sclerotic valvular heart disease, obesity, diabetes mellitus and renal dysfunction (Ford, Graves, & Mooney, 2013). Telehealth uses lots of health care providers to videoconference or internet-based applications to help prevent these risk factors. To see if telehealth is effective, they brought together different kinds of studies to answer their questions.

The results that came from the study showed improved health, better education which lead to better self-care behaviors, and it saved the patient money. Many believe that patients will struggle with the technology but the study also showed that it is easy to adapt to. Telehealth is very beneficial but I can also see there being some problems since it is no face to face. I believe telehealth will help many patients in the future.

Graves, B. A., Ford, C. D., & Mooney K. D. (2013). Telehealth Technologies for Heart Failure Disease Management in Rural Areas: An Integrative. Online Journal of Rural nursing and Health care, 13(2), 56-83.

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Telehealth Implementation in a SNF: Case Report for Physical Therapist Practice in Washington-Morgan Dodd

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Telehealth Implementation in a SNF: Case Report for Physical Therapist Practice in Washington-Morgan Dodd

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Telehealth has been creating many new options for many people, and have been making life much simpler for health care providers and their patents. In a case I found done in 2009, a rehab facility organized a pilot program to help find whether or not telehealth could be used to meet physical therapist supervision requirements. Telehealth was evaluated in a 51-person sample. In this, telehealth services were delivered to patients in a manner using audio and video.

The main reason for conducting this test was because of the amount of physical therapists workforce shortages. In some SNF residents had medically complex conditions that required the PT’s and PTA’s to have extensive experience in treating them. Many of them didn’t have this extensive knowledge therefor making it hard for them to treat their patients and for them to get people with the necessary skills. Once the idea of telehealth was brought to everyone’s attention, everyone was on board with testing the new technology.

In 2014 the House of Delegates of the American Physical Therapy Association endorsed telehealth as an applicable source of delivery. In 2015 the Federation of State Boards of Physical Therapy released a recommendation for telehealth model for physical therapist practice. Positive feedback from use of telehealth was reported. Also, positive cost savings from the use of telehealth was estimated to be approximately $5,000.

Alan Chong W. Lee, Michale Billings (February 2016).  Telehealth Implementation in a skilled Nursing Facility: Case Report for Physical Therapist Practice in Washington. Volume 96

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Nick Augeson

The article about  telemedicine I choose to write about is about is about the benefits of using telemedicine for therapy purpose. The article is about the different benefits that telemedicine can have on the psychiatry field. It describes the current problems with psychiatry, one of the key problems being the lack of properly trained  professionals, and how telemedicine can help. The article then goes on to describe telepsychiatry as “  The delivery of healthcare and the exchange of healthcare information for the purposes of providing psychiatric services across distances”. This is important because it will allow psychiatrists to do more from their home and patients will also be able to be well without leaving the comfort of their own couch.

As I was reading this article I was imagining the many positive outcomes of individuals being able to communicant and visually see their psychiatrists from home.  I feel there would be an incline in people whom use therapists and countless other ways for them to help.  One of the ideas I thought about was the future of telepsychiarty. I feel with the mass improvements to the holographs and virtual reality technology the possibilities could be infinite of the things they could do to improve patient success.

Overall I feel the telepsychiatry felid is about to greatly grow with the ease and convinces technology has provided. Although the Telepsychiatry department is fairly new It continues to develop better and better with the latest technology. I agree with this article about there being downfalls to updating and upgrading with technology and the costs of constantly having to have the latest and greatest would also be a negative, but the positives in this situation I feel defiantly outweigh the negatives. There is so much potential with telepsychiatry, one can only imagine what the next few years have instore for the whole psychiatry field.

NORMAN, S. (2006). The use of telemedicine in psychiatry. Journal Of Psychiatric & Mental Health                                        Nursing, 13(6), 771-777. doi:10.1111/j.1365-2850.2006.01033.x

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Home videophones Improve Direct Observation in Tuberculosis Treatment: A Mixed Methods Evaluation

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Home videophones Improve Direct Observation in Tuberculosis Treatment: A Mixed Methods Evaluation

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~Kasey Hoek
This study took place in South Australia within a community nursing service. This was made to help patients not only cut down on prices, but also made it faster to be diagnosed. Tuberculosis is a multi-systemic infectious disease caused by mycobacterium tuberculosis, and is also the most common cause of an infectious disease. When having tuberculosis (TB) it requires one to take multiple antibiotics for the duration of at least six months. When taking your antibiotics it is very important that you not forget to take your pills every day; failure to do so can cause reoccurrence of TB, or it requires more medication that may be more expensive and is known to be less effective.

Telehealth has benefited so many patients over the past years not only do they not have to travel, but they also get to stay in the comfort of their own homes. By using telehealth patients have saved money and time. Like what the article says “clinical and direct observation takes time and money that the patients often lack, leaving them with a choice of receiving treatment or earning a living” (1). This option for healthcare now has made many improvements when it comes to testing and treating patients. Now with the baby boomers getting older in age there are bunch of elderly living at home, depending on their children to come in and take care of them, but with telehealth this makes it beneficial to the family, and less burdensome.

The study was based on the benefits and the differences between the drive-around service, and the telehealth video chat. This home video observation is a patient-centered, and the most resourceful way of trying to figure out what your diagnosis is. Not only is it cost sufficient, but it is also time sufficient as well. Telehealth video chats have increased the direct observation of TB and also used less staff time. In poorer countries they noticed that this was the better option when it came down to the cost of things. TB is something to take serious, and the sooner you catch it the sooner you can go back and live a healthy life. With video chatting and being able to catch TB and making sure that the patients are still taking their medication everyday has not only helped the patient, but has also helped the nursing staff in many ways as well.

Source:
Wade, V. A., Karnon, J., Eliott, J. A., & Hiller, J. E. (2012). Home Videophones Improve Direct Observation in Tuberculosis Treatment: A Mixed Methods Evaluation. PLoS ONE, 7(11).
doi:10.1371/journal.pone.0050155

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Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study. 

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Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study. 

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Madeline Bures
This study focused on Chronic Obstructive Pulmonary Disease (COPD) patients and their experiences with either a Telehealth-supported or a specialist nursing intervention following being discharged from the hospital after being admitted for an increase in the severity of COPD. COPD involves the worsening of lung capacity, so individuals begin to gain difficulty with breathing, resulting in recurrent hospital admissions and more severe disability. The article states, “The increasing prevalence and associated cost of treating COPD is unsustainable, and focus is needed on self-management and prevention of hospital admissions. Telehealth monitoring of patient’s vital signs allows clinicians to prioritize their workload and enables patients to take more responsibility for their health” (Fitzsimmons, Thompson, Bentley, Mountain, 2016). For this study, patients were given the choice to either participate in interviews or complete a questionnaire to gather information regarding the impact of Telehealth technology.

Nine patients were interviewed and seventeen patients filled out questionnaires, while three clinicians who delivered both interventions were also interviewed to gain a better understanding of their opinions and views on Telehealth services. For the interviews, five of the nine individuals completed the Telehealth Service and the remaining four received standard service. The interviews took place in the patients’ homes by the same individual, with audiotaping taking place to gain additional research. For the questionnaires, patients were asked for permission regarding their participation, and if a patient chose not to participate in the study or didn’t meet the necessary requirements, they received the standard service. The article states, “The questionnaire comprised of open and closed questions covering five aspects of the service: first thoughts on hearing of the service and seeing the equipment, equipment installation and training, use of the equipment, and availability of support and removal of the service” (Fitzsimmons, Thompson, Bentley, Mountain, 2016).

Telehealth provides individuals with long term conditions with many more opportunities and less challenges, as this form of technology takes away the aspect of having to be at a specific location when receiving health care services. Cost-effectiveness is also an additional benefit. As a result, patients who received both forms of service expressed feelings of safety from the service and how it was delivered to them. Patients who were provided with Telehealth service received 50% fewer home visits from clinicians than recipients of community-based nursing interventions, but were impressed about the service and viewed it as the best service they had ever received (Fitzsimmons, Thompson, Bentley, Mountain, 2016). This study ultimately concludes that Telehealth is a positive alternative compared to a home nursing visit when monitoring patients with COPD following their discharge from a hospital.

Fitzsimmons, D., Thompson, J., Bentley, C., Mountain, G. (2016). Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study. BMC Health Services Research, 1-12.
doi: 10.1186/s12913-016-1623-z

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Primary Care Telehealth Practice - Ciara Maciel

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Primary Care Telehealth Practice - Ciara Maciel

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The article focused on what it is like to work for a primary care teleheath practice. The first primary health care telehealth practice opened in 2002, which provided services to members of Libery County’s (TX) indigent health program and later expanded to several corporate sites. The corporation which Christine Booley works is Morningside Ministries in San Antonia, Texas. Dr. Booley explains the importance of the presenter being a registered nurse. The nurse is able to use experience and assessment skills to provide the clinician with further information, educate the patient, and suggest local recourses to the patient.

During Dr. Booley’s online appointments, she is able to address most primary care complaints. The handheld camera and attached light is so powerful and clear that it is just as effective as being there in person. The dermascope magnifies skin lesions so well that it is more effective than seeing them in person. One issue she does run into is determining skin tone when it is being transmitted through the camera, especially when the patient has darker skin tones or in a shadowed room. She proceeds to explain that a telehealth appointment is nearly the same as a face-to-face visit. Dr. Booley and her coworkers at Morningside average six to eight patients a day.

The five most common diagnoses diagnosed through telehealth patients at morninside were a llergic rhinitis, hypertension, diabetes mellitus, obesity, and depression. I think that there are millions of people that could benefit from telehealth. While there are things that should require a face to face doctors visit, there are so many diagnoses that can be made through telehealth. One of the most important parts of primary care is supporting and education the patients and this is one of the easiest things to do through on screen visits. I think Telehealth could be a big part of the future.

Christine A. Boodley, RN, PhD, FNP, School Of Nursing, University of Texas Medical Branch, 301 University Boulevard, Galveston

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Effects of physical therapy delivery via home video telerehabilitation onfunctional and health-related quality of life outcomes - Taylor Knecht 

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Effects of physical therapy delivery via home video telerehabilitation onfunctional and health-related quality of life outcomes - Taylor Knecht 

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This study investigated outcomes and satisfaction for a group of Veterans receiving telerehabilitation. In order to meet the mission of the Veterans Health Administration, which is to deliver quality care to all Veterans no matter what the economic, geography, or distance barriers are, the Department of Veteran Affairs (VA) require telerehabilitation. The VA currently serves 3.3 million individuals living in rural locations, representing 41% of all Veterans enrolled. In 2011, they invested $163 million in telerehabilitation, but when considering that some Veterans need therapy three to five times a week, this is a necessity to invest in. According to Levy (2015), “Telerehabilitation refers to the clinical application of consultative, preventative, diagnostic, and therapeutic services via two-way interactive telecommunication technologies” (p. 362).

The results from this study indicate clear evidence of improvements in physical function, cognitive function, functional independence, and high-rated quality of life from telerehabilitation. Additionally, satisfaction measurements were rated very high. This may be because of patient motivation and compliance with prescribed treatment regimens, but nevertheless, patient satisfaction is important when considering the future of telerehabilitation. It should also be noted that telerehabilitation minimized time, expense, and the inconvenience of travel for the Veterans on top of the increased function and satisfaction rates. All of the results prove that in-home video telerehabilitation is promising when finding alternatives to standard face-to-face care.

The future for telerehabilitation is bright. There are many other studies proving that outcomes for patients receiving telerehab is just as sufficient as face-to-face care and that the satisfaction is equal too due to the fact that it accommodates to the individual’s needs. Furthermore, with an increase of access to those in rural communities, this can decrease cost and waiting times for clinics nationwide. While some may be hesitant to try telerehab, it will soon be a main alternative because of the vast attention and approval it has already acquired. Telerehab will be one of many benefits to telehealth, if it is not considered that already.

Levy, C. E., Silverman, E., Huanguang, J., Geiss, M., & Omura, D. (2015). Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes. Journal Of Rehabilitation Research & Development, 52(3), 361-369. doi:10.1682/JRRD.2014.10.0239

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Improved Virologic Suppression With HIV Subspecialty Care in a Large Prison System Using Telemedicine

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Improved Virologic Suppression With HIV Subspecialty Care in a Large Prison System Using Telemedicine

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Carmelita Shouldis

In this study, telehealth was used to see if it could help lower the high prevalence in prisons with individuals that had human immunodeficiency virus (HIV), since prisons have a lack of access to subspecialty care. The virologic suppression and Cluster of Differentiation 4 (CD4) T-lymphocyte counts with incarcerated individuals with HIV were recorded to determine which was a better treatment strategy. CD4 count is a test that measures the immune systems strength, in this case, measuring the T-lymphocyte counts. This study included a 514 pretelemedicine group, who were administered by on-site correctional physicians and a 687 telemedicine group, who were administered by a University-based, multidisciplinary subspecialty team through telemedicine clinics. The focus result of interest was virologic suppression to identify appropriate antiretrovial therapy (ART).
The baseline mean for CD4 showed no difference in the first laboratory draw between the two groups. The telemedicine group showed higher results with subjects who had complete virologic suppression during the first six visits. All clinic visits were recorded in a logistic regression analysis. The telemedicine group also had a lower mean of community HIV viral load (CVL) during those first six visits and a lower mean in-care HIV load at the final visit. The overall mean CD4 was significantly higher with the subspecialty telemedicine clinic. With the elevated burden that nation has with HIV and its population in prisons, it is suggested through this study that telemedicine can positively affect the patients results and lessen the transmission of HIV in the communities after individuals are released.
I really enjoyed this study and learning about prison HIV rates, the tests that were used, and how telemedicine was used in a different setting. When thinking about telemedicine, I had not paid enough attention to prisons with patients who are suffering from HIV. Instead I thought of patients in rural areas. Considering this was the first study of their particular interest, I think it opened more opportunities for research. The population focus was interesting because of the rate of transmission upon release from prison and how telemedicine can lower those rates.

Young, J. D., Patel, M., Badowski, M., Mackesy-Amiti, M. E., Vaughn, P., Shicker, L., & ... Ouellet, L. J. (2014). Improved Virologic Suppression With HIV Subspecialty Care in a Large Prison System Using Telemedicine: An Observational Study With Historical Controls. Clinical Infectious Diseases, 59(1), 123-126.

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Using Telehealth to Provide Diabetes Care to Patients in Rural Montana -- Jamie Bryan 

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Using Telehealth to Provide Diabetes Care to Patients in Rural Montana -- Jamie Bryan 

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This study was performed to determine the effectiveness of telehealth for patients with diabetes in rural areas and to compare the outcomes of it with face-to-face visits. To conduct this 3-year study, 206 patients were used. 118 of those received telehealth services and 88 were in face-to-face environments. The patients in the study had to have definitive type 2 diabetes, have at least one uncontrolled vascular risk factor, and be at least 21 years of age. In order to access the telehealth services for this study, the 118 patients involved had to travel to their local primary care clinics. Additionally, due to the limited number of rural clinics, patients, and providers, the study funders were not able to form rural control groups.

Following this study, there were no significant results of differences in increases for the telehealth and face-to-face patients for any of the measures (self-management, knowledge about diabetes, satisfaction, communication, self-efficacy, or self-reported symptoms). Both groups had immense satisfaction rates with the study (191% increase for telehealth and 131% for face-to-face). Patients reported that they felt comfortable learning about the health information using the technology and understood it as if they were face-to-face. 99% of the patients thought the picture and audio of the technology was clear which was helpful. According to results though, telehealth visits for diabetes care may be as effective as traditional office visits.

Although results show that telehealth visits in rural areas are effective, it is not clear on whether all diabetes patients would be able to benefit from this. Certainly there are some things that telehealth will not be able to accomplish for patients, but it is definitely becoming a useful resource for patients. The implementation of telehealth technology in rural areas will increase the access for much needed diabetes services and decrease unnecessary health care utilization . I think that telehealth is headed in the right direction for the future and will only continue to improve over time.

Ciemins, E., Coon, P., Peck, R.,  Holloway, B., & Min, S. J. (2011). Using telehealth to provide diabetes care to patients in rural Montana: findings from the promoting realistic individual self-management program. Telemedicine Journal and E-Health, 17(8), 596-602.
http://doi.org/10.1089/tmj.2011.0028

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Telehealth and the Deaf: A Comparison Study-Victoria Hagg

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Telehealth and the Deaf: A Comparison Study-Victoria Hagg

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For this assignment, I read and analyzed the article titled ‘Telehealth and the Deaf: A Comparison Study’.  In this article, it was brought to my attention how inaccessible that mental health education is for people who struggle with hearing problems or who are completely deaf. Health care professionals and the loved ones of people with a hearing disability are concerned that the deaf population is underserved. 92% of deaf individuals feel that they do not have enough mental health services, and would welcome to advancement of telehealth services that would be able to aid and inform them regarding their health (Wilson & Wells, 2009). Mental health services are the most requested but the least available.

Some ideas that were portrayed in the article to help alleviate the need for mental health care among people who suffer from hearing loss involved telehealth. The writers define telehealth as ‘the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision, education, and information across distance’ (Wilson & Wells, 2009). A system where mental healthcare professionals can live chat clients or where a vast amount of questions could be answered directly would be a benefit to many. The main component in improving the mental healthcare of patients would be live or patient specific conversations with physicians. This kind of personal interaction could be designed to orientate to the patient’s specific needs rather than the alternative of, for example, looking up symptoms and a diagnosis through a universal online website. The use of telehealth would be able to address health issues more quickly and efficiently.

Because it is a form of technology, there is always a chance that there could be glitches or other technological issues. In my opinion, it would be a risk worth taking to be able to aid so many people in a short amount of time. I think that telehealth in the future will be very beneficial for everyone. Patients will be able to interact with physicians without having to go to a healthcare facility. The cost of using telehealth would be cheaper than seeing a physician. Physicians would be able to communicate information, ideas, and patient charts among one another. The benefits are endless.

Wilson, J., & Wells, G. (2009). Telehealth and the deaf: a comparison study. In Deaf studies and

deaf education (Vol. 14).

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Nurse Practitioners in Telehealth:Bridging the Gaps in Healthcare Delivery

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Nurse Practitioners in Telehealth:Bridging the Gaps in Healthcare Delivery

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Haley Baker
In recent years there has been several advances in technology, specifically in the healthcare setting. These advances have greatly improved patient access to healthcare. In the past those who lived in a rural area somewhat struggle with receiving high quality care in emergency situations due to how far away the nearest emergency room was. In some rural areas, the closest, fully staffed emergency room was 40 miles , and some rural emergency rooms were staffed with physicians or nurse practitioners with little or no formal emergency medical training. (Henderson, Davis, Smith, & King, 2014) In order to compensate for the physicians and NPs lack of training in that department, patients would be transferred to other facilities. Unfortunately, not all patients would make it.

Telehealth is currently being used to avoid situations such as the one explained in the paragraph above. Telehealth is a broad term that includes video- conferencing, exchange of medical information via electronic communications, remote patient monitoring, population health management, and mobile health technologies. (Henderson et al., 2014) NPs are now going through a program to get trained in Telehealth. Once they have gone through the 3-6 month training, the NP may use telemedicine equipment within the rural hospital emergency department to audio conference or video conference, for collaboration with physician at the academic medical center to treat a patient. Not only does this benefit the patient by getting an accurate diagnosis, but it also lowers the medical cost that one has to may to go somewhere else and see a physician.

Overall I believe that Telehealth is an amazing aspect of healthcare. This form of medicine eliminates the the barriers of gaining access to healthcare while still being cost effective and giving an accurate diagnosis. The only concerns I would have with this form of healthcare is how confidential is it? Will this new form of technology make the visit/consultation less personable by not being face to face but rather it be over a phone or computer? I suppose we will have to wait and see what the future holds when it comes to finding the answers to these questions.

Henderson, K., Davis, T. C., Smith, M., & King, M. (2014). Nurse Practitioners in Telehealth: Bridging the Gaps in Healthcare Delivery. The Journal for Nurse Practitioners, 10(10), 845-850. doi:10.1016/j.nurpra.2014.09.003

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Cyndal Sathe- Evaluation of TeleMOVE: A Telehealth Weight Reduction Intervention for Veterans with Obesity

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Cyndal Sathe- Evaluation of TeleMOVE: A Telehealth Weight Reduction Intervention for Veterans with Obesity

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There has been a prevailing problem with being overweight and obese among the population and veterans in the United States. The article, “Evaluation of TeleMOVE: A Telehealth Weight Reducation Intervention for Veterans with Obesity” goes over the results of the of the new telehealth program, Veterans Affairs (VA) has designed, called TeleMOVE. TeleMOVE was designed to helped veterans lose weight. The program took place in the veterans own home through a telehealth monitor connected to a phone line. The VA initiated the TeleMOVE program in hospitals beginning in 2009, but this study took place from October 2010 and August 2012. (Skoyen, Rutledge, Wiese, & Woods, 2015)

When the TeleMOVE program happened there was 171 patients. Out of the 171 there was 37 women and 134 men. There were two cycles the participants could have been in, but didn’t have to do both. In the first 90-day cycle of TeleMOVE the results were associated with significant weight loss and those who participated in the second cycle, as well as the first, lost significantly more weight overall. According to Skoyen et al. (2015), “those who enrolled in the first cycle lost on average 5.55 lb (SD=8.23), whereas those who enrolled in two cycles lost on average 11.68 lb (12.53)” (p.631). The TeleMOVE program delivered the promise to help veterans lose weight. (Skoyan et al., 2015)

I think that the TeleMOVE is a great example of ways to improve the healthcare system in the future. Having the access at home makes it easier for the patient. Each patient gets a telehealth monitor, a digital scale, pedometer, and a booklet to use. Also everyone gets assigned a care coordinator that can help keep them on track. It is important that the patient gets a care coordinator so the personal aspects and one on one care isn’t lost. It hasn’t been around long, but I think it is going to be a good addition to the healthcare system.

Skoyen, J. A., Rutledge, T., Wiese, J. A., & Woods, G. N. (2015). Evaluation of teleMOVE: a telehealth weight reduction intervention for veterans with obesity. Annals Of Behavioral Medicine, 49(4), 628-633. doi:10.1007/s12160-015-9690-7

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Robot-Assisted Ultrasound Imaging: Overview and Development of a Parallel Telerobotic System

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Robot-Assisted Ultrasound Imaging: Overview and Development of a Parallel Telerobotic System

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Blair Altman
Ultrasound imaging is becoming more common for diagnosing in medical centers. This resource is less expensive and invading than other technology resources. The images that are produced with this technology are done by sonographers. Rural communities may not have the availability to have experienced sonographers which can cause difficulty and delays in diagnosing patients. Monfaredi et al. (2015) researched if having a robotic-assisted US imaging would benefit these communities that may be struggling and also assist with the physical load of sonographers.

The robot-assisted systems would be extremely helpful for medical professionals. The robot-assisted systems may get more accurate results of images which can help diagnose a patient much more efficiently. Having an experienced sonographer watching or connected into the appointment can also help diagnose the patient more efficiently. There will be less chances of errors and misinterpretations occurring with having this system taking images. I think this would be a huge advancement into the medical field for sonographers especially rural communities who don’t have the opportunity to have advanced sonographers.

On the other hand, the outcomes of this study show some concerns that I thought about. The results of the study show that these robotic- assisted systems can be a great resource because of their accurate imaging, but they also have a huge cost accompanied with them. Many communities may not have the money or want to spend the money on new technology that does that same thing as a sonographer would do. This robotic- assisted system would also require a sonographer to set up the equipment and be present in the examination. I believe this system is in the right direction for sonographers and helping advancing their field. I also think that this robot-assisted system has some issues that will need to be resolved before more communities will be using it.

Monfaredi, R., Wilson, E., Azizi koutenaei, B., Labrecque, B., Leroy, k., Goldie, J., & ... Cleary, K. (2015). Robot-assisted ultrasound imaging: Overview and development of a parallel telerobotic system. Minimally Invasive Therapy & Allied Technologies, 24(1), 54-62. doi:10.3109/13645706.2014.992908

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Sydney Schad- Telehealth regarding cancer support groups in American Indian/ Alaskan Native populations

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Sydney Schad- Telehealth regarding cancer support groups in American Indian/ Alaskan Native populations

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There is a peace of mind knowing telehealth is benefitting American Indian and Alaskan Native populations.  The article “Satisfaction with Telehealth for Cancer Support Groups in Rural American Indian and Alaska Native Communities” was conducted to assess the need and information of AI/AN cancer survivors, along with their acceptance of telehealth support group services for cancer survivors in rural communities.  (Doorenbos, Eaton, Haozous, Towle, Revels, & Buchwald, (2010).  This study was particularly important as it gave cancer survivors more access to support groups and to further determine information needed to improve support groups in the future.  Geographically, many American Indian/ Alaskan Native people do not have access to care.  Cancer is very prevalent in AI/AN populations.  It is the second-leading cause of death for AI/ANs over the age of 45 (U.S. Department of Health and Human Services, Indian Health Services, 2010).  The methods suggested in the article were support group sites and support group content meetings.  These meetings were held at different locations and conducted for two hours a month, for twelve months straight.  People who would be in attendance at the meetings would vary from people who are currently battling cancer to people who have lost a loved one from cancer.  When people could not attend due to travel issues, there were arrangements provided by telehealth operations.

There were limitations to this study as well.  All of the participants in the study were women.  This could be related to the fact that women are more open to showing emotions regarding life-threatening diseases.  There is also the society norm of men being macho and not wanting to participate in studies regarding these topics.  Another limitation would be that the study was only done within two states and was narrowed to a small group of 50.  Previous research has shown that people who are willing to participate in studies pertaining to support groups, tend to be more positive.  This is a factor that could heavily affect the study.

I think this study is a step in the right direction.  This is a simple way to improve the health care needs of American Indian/ Alaskan native people who do not have access to post-surgery care.  Telehealth will be very beneficial to reach patients who want or need support, but cannot drive to it.  I grew up on the Cheyenne River Indian Reservation.  My grandpa was diagnosed with brain cancer in 2010 and made numerous trips to Rapid City for services at the beginning of his treatment, but when he was finished, we had a personal experience with telehealth.  Our experience with telehealth was very positive.  The video chatting was very personable but without the three-hour drive to it.  His doctor would suggest dietary plans and every day activities to help bring back motor skills.  Telehealth positively impacted my family and I think it will soon impact numerous families with similar situations.

Doorenbos, A. Z., Eaton, L. H., Haozous, E., Towle, C., Revels, L., & Buchwald, D. (2010). Satisfaction With Telehealth for Cancer Support Groups in Rural American Indian and Alaska Native Communities. Clinical Journal of Oncology Nursing, 14(6), 765–770. http://doi.org/10.1188/10.CJON.765-770

U.S. Department of Health and Human Services, Indian Health Services. Alaska area: Division of planning, evaluation and health statistics. Author; Anchorage, AK: 2010

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Effects of physical therapy delivery via home video telerehabilitation onfunctional and health-related quality of life outcomes

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Effects of physical therapy delivery via home video telerehabilitation onfunctional and health-related quality of life outcomes

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Noah Kottke
This article describes a study done that examined the functional outcomes, health related quality of life, and satisfaction in a group of veterans who received physical therapy through a  in-home video telerehabilitation program. Veterans have many health care barriers such as  distance, high travel related expenses, reduced numbers of healthcare providers within rural areas, transportation barriers, and caregiver burden. Currently the VA serves 3.3 million veterans that live in rural community's, making up 41 percent of all veterans enrolled in the VHA.  The decreased access to health care for veterans causes an increase in morbidity and morality, increased cost of treatment, and inappropriate use of emergency services. The goal through telehealth is to make it easier for veterans to get quality physical therapy through telehealth while reducing the cost and time needed for both the veterans and the VA.
The study included 26 veterans, all of whom qualified for telerehabilitation, meaning that they didn't need hands on care,such as joint mobilization. The major medical diagnosis for 80% of the study was muscoskeletal injuries, therefore the physical therapy treatment was mostly strengthening and stabilization programs. Also 60% of the participants lived in a rural area, making it harder to access health care facilities. The results of the study were very good, resulting in lower costs and time spent for the veterans. According to the study, the program saved them an average of 2774 driving miles and 46 driving hours, resulting in the VHA saving an average of $1151 per veteran on travel reimbursement costs.
Not only did it save time and money, the results also showed significant improvements in physical function, cognitive function, and functional independence.  Also out of the 26 patients 25 were either "satisfied" or "very satisfied" with their telehealth experience. I believe that telerehabilitation can be a new promising alternative to face-to-face care. The minimizing of time, costs, and inconvenience of receiving rehabilitating care for both parties is enough to encourage therapists to adopt this new way of giving care into their daily schedules.

Levy, C. E., Silverman, E., Huanguang, J., Geiss, M., & Omura, D. (2015). Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes. Journal Of Rehabilitation Research & Development, 52(3), 361-369. doi:10.1682/JRRD.2014.10.0239

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Jessica Johnson- Telehealth with Autism Spectrum Disorder and Anxiety

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Jessica Johnson- Telehealth with Autism Spectrum Disorder and Anxiety

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There are many obstacles that impact access to evidence-based mental health supports for youth with Autism Spectrum Disorder. (Hepburn, Smith, Wolff, & Reaven, 2016). One of the main focuses throughout this study were to overcome these obstacles, by using telehealth, specifically clinic-to-home videoconferencing, which allows for the patient to receive care through web cameras and personal computers. The article, “Telehealth delivery of cognitive-behavioral intervention to youth with autism spectrum disorder and anxiety: A pilot study” goes over a case study, published in 2016, at the University of Colorado Anschutz Medical Campus and the University of Denver. The test was conducted to determine if telehealth was able to directly intervene with youth who were diagnosed with Autism Spectrum Disorders. To conduct the test, they took a total of 17 males and females that were between the ages of 7 and 19. The youth had to have a current clinical diagnosis of Autism Spectrum Disorder within the past 5 years, by a reliable administrator.

The first six sessions were focused on recognizing that these patients all had different fears and worries that impacted how the body felt and what brain activities were going on. The second six sessions were built off the first six by promoting the development and implementation of youth-specific anxiety reduction strategies and goals of coping with the stress. The telehealth intervention part of this study was individualized to fit the different needs of each patient and their family to make it as “real-life” as possible. Throughout these sessions it was very important that the videoconferencing program was affordable and commercially available for home use. In order to measure the parent and youth satisfaction of this study, the families independently completed a web-based satisfaction measure during sessions 4-9. The results concluded that 92.9% of parents and 88.8% of youth were very satisfied with the intervention content, delivery method, and alliance with the therapist. Even though there was not a certain conclusion as to if telehealth was more impactful then face-to-face treatment among Autism patients, it did report that the telehealth version of treatment has the potential to impact anxiety and excessive fears in youth with Autism Spectrum Disorder.

I believe this study was a great example of new ways telehealth could be successful within the medical field. There were a few bumps in the road with some connection loss or audibility was cutting in and out, but it allowed the youth to stay relaxed in a familiar space such as their home. Having the ability, as a parent, to keep your child calm and still receive the treatment they need is a huge benefit when caring for a child with ASD. In some circumstances I do think we are losing the personal aspect of health care when using telehealth, but in situations such as this, they could be extremely impactful. Overall, I believe that telehealth is going to become the next big thing in health care. It is going to make access and delivery a lot easier for patients especially like the ones in this study who are not readily accessible to treatments and live in rural areas.

Hepburn, S. L., Blakeley-Smith, A., Wolff, B., & Reaven, J. A. (2016). Telehealth delivery of cognitive-behavioral intervention to youth with autism spectrum disorder and anxiety: A pilot study. Autism : The International Journal of Research and Practice, 20(2), 207–218. http://doi.org/10.1177/1362361315575164

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Review one scholarly, peer-reviewed journal article about the efficacy of telehealth. Summarize the article and write your thoughts regarding how this might impact health care delivery in the future. Post at least three full paragraphs by Sunday at 11:59 p.m. (A paragraph must be at least 5 sentences). Be sure to include your reference in APA style at the bottom of your initial post. We will discuss these posts in class This assignment is worth 10 points. See the grading rubric for more specific instructions. 

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Review one scholarly, peer-reviewed journal article about the efficacy of telehealth. Summarize the article and write your thoughts regarding how this might impact health care delivery in the future. Post at least three full paragraphs by Sunday at 11:59 p.m. (A paragraph must be at least 5 sentences). Be sure to include your reference in APA style at the bottom of your initial post. We will discuss these posts in class This assignment is worth 10 points. See the grading rubric for more specific instructions. 