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Telemedicine refers to the delivery of healthcare services remotely through the means of technology, i.e., phone calls and video calls. In most cases, telemedicine is used to overcome the physical distance between the patient and the care provider or assist patients who have difficulty leaving their house, like the elderly or patients with disabilities. There are, in general, three types of telemedicine:

1)Interactive Medicine allows for real-time communication between the patient and the physician. It is basically like going to the doctor’s office — but through your computer.

2)Store and Forward permits a third-party organization to collect the patient’s information and send it to a physician in another location for evaluation. This one is more like communicating with your doctor through email.

3)Remote Patient Monitoring enables care providers to monitor a patient’s conditions, like blood sugar and pressure, remotely using mobile devices.

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The development of telemedicine in the world

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The development of telemedicine in the world

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Long‐term physical conditions affect 10% to 12% of children and adolescents worldwide; these individuals are at greater risk of developing psychological problems, particularly anxiety and depression. Access to face‐to‐face treatment for such problems is often limited, and available interventions usually have not been tested with this population. As technology improves, e‐health interventions (delivered via digital means, such as computers and smart phones and ranging from simple text‐based programmes through to multimedia and interactive programmes, serious games, virtual reality and biofeedback programmes) offer a potential solution to address the psychological needs of this group of young people.

Objectives: To assess the effectiveness of e‐health interventions in comparison with attention placebos, psychological placebos, treatment as usual, waiting‐list controls, or non‐psychological treatments for treating anxiety and depression in children and adolescents with long‐term physical conditions.

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Healthcare app development played a pivotal role in making telemedicine accessible to a broader audience.

1. Accessibility and Convenience: With a smartphone and a healthcare app, patients can connect with a healthcare provider from the comfort of their homes.This convenience is especially crucial for individuals with mobility issues, those in rural areas with limited access to healthcare facilities, or anyone seeking medical advice outside of regular office hours. Healthcare software development has made it possible for doctors to offer consultations at times that suit their patients’ schedules.

2. Expanded Reach: Telemedicine has broken down geographical barriers. Patients can consult with specialists located in different cities, states, or even countries, all thanks to healthcare app development. This expanded reach means patients can access the best care and expertise without the constraints of distance.

3. Reduced Healthcare Costs: Telemedicine has the potential to lower healthcare costs significantly. Healthcare software development has enabled healthcare providers to streamline their operations, reduce overhead costs associated with physical facilities, and optimize resource allocation.They save money on transportation, parking, and, in some cases, accommodation when seeking medical care far from home. Additionally, telemedicine often leads to quicker diagnoses and treatments, preventing the progression of illnesses and further reducing healthcare expenses.

4. Enhanced Patient Engagement: Effective doctor-patient communication is essential for quality healthcare.Patients can easily access their medical records, test results, and treatment plans through these apps.Healthcare app development has enabled the integration of features like appointment reminders and medication tracking. These features help patients stay on top of their health management, leading to better treatment adherence and improved health outcomes.

5. Improved Health Monitoring: Mobile apps have made it possible for healthcare providers to remotely monitor patients’ health conditions. Patients can use connected devices to measure vital signs like blood pressure, glucose levels, or heart rate and share this data with their healthcare providers through the app.This real-time data enables doctors to make informed decisions about a patient’s treatment plan, adjust medications, or recommend lifestyle changes promptly. It also allows for early intervention in case of deteriorating health, reducing the risk of complications.

6. Privacy and Security

Patient data privacy and security are paramount in healthcare. Healthcare software development ensures that these apps are designed with robust security measures in place. Data encryption, secure user authentication, and compliance with healthcare regulations such as HIPAA (Health Insurance Portability and Accountability Act) are standard practices in healthcare app development.

Patients can have confidence that their sensitive medical information is protected when using telemedicine apps, fostering trust between them and their healthcare providers.

7. Continuity of Care

Healthcare is an ongoing process, and continuity of care is crucial for managing chronic conditions or following up on treatments.Patients can easily schedule follow-up appointments, ask questions, and provide updates on their health status.This continuous connection ensures that patients receive consistent care and support, leading to better long-term outcomes.

8 Reduced Disease Transmission

9. Integration with Electronic Health Records (EHR)

This integration ensures that doctors have access to a patient’s complete medical history and can make informed decisions based on a comprehensive understanding of the patient’s health.Moreover, EHR integration eliminates the need for patients to repeatedly provide their medical history, medications, and allergies, streamlining the consultation process and reducing the risk of errors.

Challenges and Considerations

While the benefits of telemedicine and healthcare app development are undeniable, there are some challenges and considerations to keep in mind:

Digital Divide: Not all patients have access to smartphones or reliable internet connections, which can create disparities in healthcare access. Efforts should be made to bridge this digital divide and ensure equitable healthcare.

Regulatory Compliance: Telemedicine apps must adhere to healthcare regulations and data protection laws. Compliance with regulations like HIPAA is essential to protect patient data and privacy.

User Training: Both healthcare providers and patients need training to use telemedicine apps effectively. User-friendly interfaces and educational resources can help overcome this challenge.

Security: Constant vigilance is required to maintain the security of patient data. Regular security audits and updates are crucial to protect against data breaches.

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INTERVENTION: Experimental Other,Placebo Comparator Other Tele‐education CPR training group,Conventional CPR training group Tele‐education participants studied CPR training lecture and manikin demonstration study through a live broadcast (Zoom videoconference),Conventional participants studied CPR training lecture and manikin demonstration study in the classroom.

CONDITION: Healthy volunteer to participate in Tele‐CPR training ; Tele‐education, Lay rescuers, Out‐of‐hospital cardiac arrest, Basic life support 2020 Tele‐education, Lay rescuers, Out‐of‐hospital cardiac arrest, Basic life support 2020

PRIMARY OUTCOME: CPR knowledge Single day Multiple choice questions ,CPR skill Single day Standardized checklist

SECONDARY OUTCOME: CPR skillset Single day Standardized checklist

INCLUSION CRITERIA: Healthy volunteer

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Types of teleconferences and server. Participation in online and offline teleconferences

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Types of teleconferences and server. Participation in online and offline teleconferences

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A teleconference is a live audio or audiovisual meeting with two or more participants. With the ability to teleconference, remote teams in an organization can collaborate and communicate, even when geographically dispersed. The process involves technology more sophisticated than a simple two-way phone connection.

Types of teleconferencing

Teams in an organization have the option to conduct teleconferencing through multiple means, including the following:

Audio teleconferencing. These voice-only calls are conducted similar to normal telephone calls but can support up to 100 participants.

Video teleconferencing. This form of teleconferencing combines live visual and audio mediums. Depending on the vendor, video conferencing can support over 100 participants. Users in the meeting can use features such as screen sharing or file sharing.

Web teleconferencing. A web teleconference is an umbrella term that describes teleconference services or mediums provided online, which includes web meetings, webinars and webcasts. A video conference is, therefore, a type of teleconference

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The purpose of conducting and participating in the teleconference

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The purpose of conducting and participating in the teleconference

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Introduction Multiple sclerosis (MS) is an immune‐mediated disease of the central nervous system. It is considered a major cause of non‐traumatic disability in young adults. One of the most common and disabling symptoms of MS is fatigue. MS fatigue can impact all aspects of quality of life, including physical, mental and social function. Fortunately, fatigue self‐management interventions, such as 'Managing Fatigue: A 6 week energy conservation course', can decrease the impact of fatigue and improve health‐related quality of life. The purpose of this study is to compare three modes of delivering the Managing Fatigue intervention ‐two remote delivery formats (teleconference and internet) and one in‐person format ‐on perceptions of fatigue and its impact on physical, mental and social function. Methods and analysis A non‐inferiority randomised clinical trial is being conducted to compare the three delivery formats (1:1:1 allocation ratio) among 582 participants with MS living in the Midwestern and Northeastern United States. The hypothesis is that teleconference and internet versions of the intervention are non‐inferior to the traditional mode of clinical service delivery (ie, one to one, in person) in terms of the primary outcome of self‐reported fatigue impact (ie, Fatigue Impact Scale) and the secondary outcome of health‐related quality of life (ie, Multiple Sclerosis Impact Scale). Outcomes are being measured at baseline, 2 months, 3 months and 6 months. The primary analysis tool will be linear mixed effects model. The prespecified inferiority margin for the primary outcome is 10 points. We will also examine whether baseline characteristics (eg, sociodemographic) moderate outcomes of the Managing Fatigue intervention and whether changes in self‐efficacy and fatigue self‐management behaviours mediate changes in outcomes. Ethics and dissemination The protocol is approved centrally by the institutional review board at Case Western Reserve University. Eligible participants give consent before being enrolled and randomised into the study. The study results will be disseminated through relevant advocacy organisations, newsletters to participants, publication in peer‐reviewed journals and presentations at scientific conferences. Trial registration number NCT03550170; Pre‐results.

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