Do the benefits of participation in a hypertension self-management trial persist after patients resume usual care? This method is inefficient and time-consuming in the clinical setting. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. 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.   URL: Melnyk SD, Zullig LL, McCant F, Danus S, Oddone E, Bastian L, et al. They were placed on your computer when you launched this website. JMIR Medical Informatics is a journal respected by experts and researchers alike. Table 3 illustrates and rank orders the themes from the barriers based on their frequency of occurrence in the literature. Increased knowledge for the patients empowered them to make better decisions and have more control of their own care [6,17]. 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]. Abstract: Background The COVID-19 pandemic has not only changed the private lives of millions of people but has significantly affected the collaboration of medical specialists throughout health care systems worldwide. Cost is often an argument against telemedicine use in health facilities; however, studies show that implementation such as a Tailored Case Management for Diabetes and Hypertension (TEACH-DM) system allows for rapid implementation at low cost [1]. Our policy towards the use of cookies All Clarivate Analytics websites use cookies to improve your online experience. Linking ISSN (ISSN-L): 2291-9694. 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). 29066424 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. The Journal of Medical Internet Research (JMIR), now in its 21st year, is the pioneer open access eHealth journal and is the flagship journal of JMIR Publications. Editor-in-Chief: Christian Lovis, MD, MPH, FACMI, Division of Medical Information Sciences, University Hospitals of Geneva (HUG), University of Geneva (UNIGE), Switzerland Impact Factor 2.58, Christian Lovis, MD, MPH, FACMI, Division of Medical Information Sciences, University Hospitals of Geneva (HUG), University of Geneva (UNIGE), Switzerland.   URL: Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. 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. An advantage to the use of telemedicine identified was that it alleviates issues regarding interventions in the face-to-face method [10]. With facilities moving toward implementation of telemedicine models, it is likely for this uncertainty to be demolished [2,9]. 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]. Papers are listed in the order of publication, with the most recent papers at the top. Qualifications for organizations to implement telemedicine programs, at a minimum, are alignment with the mission of the organization and the strategic plan. These themes were identified 7 times each, out of 41 total occurrences (17% each). USA.gov. Utilizing nurses [16], portable [4], timely [15], and utilizing space [16] were all mentioned one time in the thematic review (2% each). 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). Organizational factors associated with readiness to implement and translate a primary care based telemedicine behavioral program to improve blood pressure control: the HTN-IMPROVE study. However, it is challenging to predict readmission risk at the early stage of hospitalization because few data are available. The complete bibliographic information, a link to the original publication on http://medinform.jmir.org/, as well as this copyright and license information must be included. 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. Furthermore, there was an overall increased access to care and telecommunication by the use of telemedicine [4]. 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]. [, Piette JD, Marinec N, Gallegos-Cabriales EC, Gutierrez-Valverde JM, Rodriguez-Saldaña J, Mendoz-Alevares M, et al. Racial differences in the effect of a telephone-delivered hypertension disease management program. 4 (2017): Edited by G Eysenbach; submitted 01.09.16; peer-reviewed by D Cianflone, A Subasinghe; comments to author 25.10.16; revised version received 18.11.16; accepted 01.07.17; published 24.10.17. A total of 13 facilitator theme categories and 11 barrier categories were identified. Since there is little proven evidence suggesting success in gaining a financial return in using telemedicine for long-term conditions, organizations hesitate on its adoption [2,11,12]. Telemedicine has been shown to be effective, efficient, and affordable in reaching its target population [4]. Screening patients for eligibility for clinical trials is labor intensive. The next two most identified themes were patient knowledge and involvement [4-6,17] (multiple occurrences per article: 18) and technology growth with remote monitoring [4,13,16,18] (multiple occurrences per article: 6,12). The extraordinarily vast number of uses for telemedicine made research difficult with regard to narrowing down the target population while still having enough data to conduct a systematic review. 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]. JMIR Dermatology (JDerm) is a new sister journal of JMIR (the leading open-access journal in health informatics), focusing on technologies, medical devices, apps, engineering, informatics applications for patient education in dermatology, including preventative interventions (e.g. Furthermore, communication is facilitated, as the use of telemedicine is able to create a positive organizational culture for patients and practitioners alike [16]. Regarding increased access, authors have noted facilitators where patients found themselves with access to care that they might otherwise not receive [13] and that technology could easily be adapted to use for medically underserved populations [13]. 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]. EndNote Styles - JMIR Medical Informatics. 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]. These facilitators need to be kept in mind when determining a route to abide by PPACA guidelines. What is an Impact Factor? Having patients develop a positive perception will make administering a telemedicine program more desirable. Mileski, Clemens Scott 10.2196/medinform.6603 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]. Beyond resource availability, insufficient guidance on how to address key aspects of implementation, such as contextual factors, may also limit the application of CDS best practices. Background: Nursing homes (NHs) are increasingly implementing electronic health records (EHRs); however, little information is available on EHR use in NH settings. The last four facilitators were each mentioned once in the identified papers. Objective: This study aimed to provide an integrative and personalized model of DED by making an explanatory model of DED using as many factors as possible from the Korea National Health and Nutrition Examination Survey … Medical informatics Keywords Catalani J, JMIR Publications, JMIR Rehabilitation and Assistive Technologies. For this type of study, formal consent is not required. Haderer T Adopting Telemedicine for the Self-Management of Hypertension: Systematic Review JMIR Med Inform 2017;5(4):e41 doi: Existing readmission reduction solutions tend to focus on complementing inpatient care with enhanced care transition and postdischarge interventions. JMIR Medical Informatics, Volume 9; doi:10.2196/25183 . Popul Health Manag 2013 Jun;16(3):169-177. Objective: A solution to reduce visits to physicians for chronic conditions is to utilize telemedicine. 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. Currently, the health care system relies on face-to-face communication to deliver care. skin cancer prevention) and clinical care for people with dermatological conditions. 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. JMIR Publications, Canada Manuscripts accepted in English LCC subjects Look up the Library of Congress Classification Outline Medicine: Medicine (General): Computer applications to medicine. Lack of evidence was an area that showed many possible concerns. JMIR medical informatics. Identifiers. JMIR Medical Informatics is a journal respected by experts and researchers alike. The findings of this review will be useful to health administrators, physicians, nurses, and other stakeholders in facilities that are weighing the potential benefits and barriers of adopting a telemedicine policy into their organization. The telemedicine intervention was also noted to be sustainable [12] and could target treatment outcomes remotely [15], which allowed for increased effectiveness in treatment, a gain of adjusted life years, and improved patient outcomes [3,15,16]. This barrier surrounds the ability of patients to support themselves using the technology. By increasing the quality and patient satisfaction, higher reimbursement can be realized through federally funded programs. These results are further verified in reduced overall costs for the care of patients with the use of telemedicine technologies, despite their increased front-end cost overall [4,11]. A total of 24 themes were noted between the two categories. In the United States, 1 in 3 adults has hypertension, and about half of the hypertensive population is adequately controlled. 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. 2013 A global brief on hypertension: silent killer, global public health crisis Simple technical challenges [5] and the perception that there will be little collaboration among clinical teams in the use of the technology [18] are also major concerns. With cost-effectiveness and rapid implementation models such as TEACH-DM being available, the only barrier is uncertainty. Cost plays a key role in conducting a cost-benefit analysis. Br J Gen Pract 2012 Feb;62(595):e135-e142 [. The members of the research team reevaluated the papers and determined facilitators and barriers in the self-management of hypertension via telemedicine. Also of note is that blood pressure readings in the home environment are more natural [6] and are not plagued by the stress of the medical office or “white coat syndrome.” These more natural readings, which are facilitated because of the use of telemedicine, show patients to have decreased blood pressure readings versus normal in office care [13], which in turn assists in long-term blood pressure control [12]. Incentives for cost cutting and improved outcomes exist through PPACA and Medicare reimbursement policies. All decisions are associated with costs and benefits; research indicates that the effectiveness of adopting telemedicine programs is growing, as time unveils the positive outcomes that result from the establishment of these programs. Telemed J E Health 2012 Oct;18(8):613-620 [, Adopting Telemedicine for the Self-Management of Hypertension: Systematic Review, Vol 5, No 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]. Increased use also will lead to increased options in information technology infrastructure and support [16] and increased tools to use to promote health in patients [4]. Another focus is on how to train health professionals to use digital tools. Vol 5, No Telemedicine is relatively new to assist with self-management of chronic conditions, and there is limited research on the subject. Telemedicine lacks oversight in the area of application production or effectiveness [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 benefits will not be evident immediately [13]. These incentives include increased access to rural areas, increased involvement of nurses, decreased involvement of doctors in menial tasks, potential cost-effectiveness, interactive behavior change, high patient satisfaction, and positive long-term health outcomes [1-5]. Users’ perceptions pose a great level of concern for facilities thinking of adopting a telemedicine program. It remains unclear how care workers perceive its safety, quality, and efficiency, and whether EHR use might ease the burden of documentation, thereby reducing its implicit rationing. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 24.10.2017. All the papers were related to using telemedicine to measure high blood pressure, but it was the target populations that varied. This paper does not contain any studies with human participants or animals performed by any of the authors. Oct-Dec, School of Health Administration, Texas State University, San Marcos, TX, United States. Significant concerns were raised over added workload to already overburdened or time-strapped staff [10], increased educational efforts being required [18], and unclear time commitments to roll out and keep telemedicine programs implemented [10]. Tailored case management for diabetes and hypertension (TEACH-DM) in a community population: study design and baseline sample characteristics. Executing a telemedicine program may help alleviate the burden of the PPACA demands and may benefit the health of the population currently living with hypertension. These themes were then divided into two affinity matrix tables for facilitators and barriers. Patients are highly dependent on their physicians for information on their health. Hypertension is defined as having abnormally high blood pressure [8]. ©Michael Mileski, Clemens Scott Kruse, Justin Catalani, Tara Haderer. Facilitates communication [10,16] (multiple occurrences per article: 13), natural readings [3,6,12], and personalized care [10,11] (multiple occurrences per article: 17) were all identified 3 times (7% each). Other variant title: JMI. 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 … This review is also useful to patients. There is also a perception that the use of telemedicine will result in a long-term added workload commitment [11,16,18] (multiple occurrences per article: 11,16), as it was identified 5 times (12%). The authors of this review compared and grouped the facilitators and barriers into common themes. Although telemedicine offers numerous benefits, the benefits are not fully recognized at the beginning of implementation. Practices may realize the benefits of using telemedicine in the self-management of hypertension after conducting a cost-benefit analysis. 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%). 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]. Preventive intervention during hospitalization is an underexplored area that holds potential for reducing readmission risk. JMIR Research Protocols (ISSN 1929-0748) is a unique Pubmed- and (new!) 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 - Furthermore, inconsistencies also question the outcomes generated by the apps and the efficiency of the use of telemedicine to monitor hypertension [11]. Finding easier ways of managing this condition is key to successful treatment. 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]. 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. Kruse, Justin 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]. However, virtual patient care can also limit the patient-provider relationship, quality of examination, efficiency of health care delivery, and overall quality of care. Technology growth was also an important theme identified; the more this technology is used, the greater the applications that will be identified [13]. The Patient Protection and Affordable Care Act of 2010 (PPACA) has put a burden on health care facilities, forcing them to cut costs and focus on quality. Using telemedicine to attend to the management of patients’ health will vastly reduce problems occurring in face-to-face care [17]. 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. 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. aDenotes multiple occurrences in the same paper. JMIR Diabetes (JD, Editor-in-Chief: Caroline Richardson) is a Pubmed journal of JMIR the leading open-access journal in health informatics. However, both studies [11,12] were specific to the Veterans Administration population, and findings could be specific to this particular population. Am Heart J 2012 Jun;163(6):980-986. 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]. J Gen Intern Med 2012 Dec;27(12):1682-1689 [, Piette JD, Datwani H, Gaudioso S, Foster SM, Westphal J, Perry W, et al. There is a large amount of support necessary for patients to be able to use and maintain a telemedicine program on their own [13]. However, existing model-based nICP estimation methods may be too slow or require data that are not easily obtained. EndNote Styles - JMIR Medical Informatics. Spanish-speaking patients' engagement in interactive voice response (IVR) support calls for chronic disease self-management: data from three countries. The global onset of COVID-19 has resulted in substantial public health and socioeconomic impacts. The long-term effects of increases in the health and quality of services that will facilitate financial benefits in the near future should override the initial start-up costs. It is a critical and important task to take thorough efforts to prevent and control the pandemic. Are telehealth technologies for hypertension care and self-management effective or simply risky and costly? Title proper: JMIR medical informatics. 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. Medical informatics journals impact factors; JMIR now no. Published on 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. Table 2 illustrates and rank orders the themes from the facilitators based on their frequency of occurrence in the literature. 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ISSN : 2291-9694. Costs may pose an issue if organizations lack proper strategic planning initiatives and fail to adequately address the purpose for adopting telemedicine into their practice. [, Kaambwa B, Bryan S, Jowett S, Mant J, Bray EP, Hobbs FD, et al. Telemedicine broadens access to people unable to reach health services easily [4,18]. This will aid organizations in determining whether the venture is worth adoption. JMIR Medical Informatics (JMI, ISSN 2291-9694) is a top-rated, tier A journal which focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. What is the Impact Factor of JMIR mHealth and uHealth? The search focused on self-management of hypertension through the use of telemedicine. By extending these findings to the public, increased awareness of the positive outcomes to the adoption of telemedicine might be the push to implementation that the health care facilities need. The long-term use of this as an intervention is where most cost savings are seen [3]. JMIR Research Protocols (ISSN 1929-0748) is a unique Pubmed- and (new!) Results: Results identify facilitators and barriers corresponding to the implementation of self-management of hypertension using telemedicine. 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 … JMIR Medical Informatics | Read 738 articles with impact on ResearchGate, the professional network for scientists. These journals include e.g. The application of CDS best practices is resource intensive; thus, institutions often rely on commercially available CDS tools that are created to meet the generalized needs of many institutions and are not user centered. Several other barriers were found in the literature, which show concern for implementation on many levels. The findings were summarized into the facilitators and barriers table after the members of the research team chose papers to construct the systematic literature review. However, this study can be used by facilities to raise awareness of the cost-saving potential that could result from the implementation of a telemedicine system. Research databases were queried from PubMed and CINAHL using search terms of (“telehealth” OR “Telemedicine” OR “eHealth” OR “mHealth” OR “information technology”) AND (“self-management” OR “self management”) AND (“hypertension” OR “high blood pressure” OR “elevated blood pressure”). 1. Telemedicine offers a method to be utilized in conjunction with face-to-face communication with providers. 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]. 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]. Background: Accurate data retrieval is an essential part of patient care in the intensive care unit (ICU). Each table documents the themes, their citation occurrence, their frequency sum, and their frequency percentage. The organization needs to align a telemedicine program in accordance with its mission, vision, and values. 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. This costs the nation US $46 billion each year in health care services and medications required for treatment and missed workdays. 2021 Conclusions: This review guides health care professionals in incorporating new practices and identifying the best methods to introduce telemedicine into their practices. An implementation science (IS) framework could provide needed guidance and increase the reproducibility of CDS implementations. Time is required for facilities to gather data information on the effectiveness of using telemedicine for this purpose, and this study was limited to papers published only within the past 5 years. Payers for services (such as Medicare) have made little efforts to pay for services provided via telemedicine [4], and this is slowing implementation. What is Impact Factor misuse? J Hypertens 2014 Jan;32(1):3-15. Few studies have examined the emotional attitudes of citizens as expressed on social media toward the imposed social distancing measures and the factors that affected their emotions.
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