Thehealthcare sector substantially has developed over the years thanks to the conveniencebrought by the current technologies advancements. Nevertheless, there are stillmany difficulties that the industry has to deal with, especially when it comesto accessibility, provision and convenience of services both for the patientsand the medical providers.One ofthe answers the medical profession and the health sector have brought up to dealwith these issues is telemedicine. What is telemedicine? It is the remotediagnosis and treatment of patients by means of telecommunications technology. Besidesfrom bringing patients and medical providers together via various modes ofcommunication, telemedicine also supplies a way for health care professionalsto consult with other physicians.
Earlier on, telemedicine was commonly usedto provide a connection to doctors working with a patient in one location tospecialists elsewhere. This was of great advantage to rural or hard to reach placeswhere specialists aren’t easily and readily accessible. Throughout the nextseveral decades, the equipment necessary to conduct remote visits remainedexpensive and complex, so the use of the approach, while growing, was limited.The increased use of the internet broughtwith it significant changes for the telemedicine practices. The risen use ofsmart devices into the global market, capable of high-quality video. More so, consequentiallythe growth of today’s telemedicine is the rising mobile (smartphones) health field.With the various mobile health applications, new mobile medical devices thatare user-friendly and patients are starting to use technology to observe andtrack their health. Basic home-use medical devices that can take signs andsymptoms, and diagnose ear infections, monitor glucose levels, or measure bloodpressure, lets patients gather needed medical information for use by the doctorto perform diagnosis, without booking a doctor’s appointment.
And again, asmore patients get signup to using technology to help manage their health status,they also will be more open to alternative ways to get attention – throughtelemedicine. CHAPTER 2: METHODOLOGYHavingexplored the nature and purpose of qualitative research, this article exploresdata collection techniques used in qualitative research. There are a variety ofmethods of data collection in qualitative research, i.e. observations, textualor visual analysis (e.g. from books or videos) and interviews (individual orgroup).
However, the most common methods used, particularly in healthcareresearch, are interviews and focus groups.Qualitative research interviewsThereare three fundamental types of research interviews: structured, semi-structuredand unstructured. Structured interviews are, verbally administeredquestionnaires, in which a list of predetermined questions are asked, withlittle or no variation and with no scope for follow-up questions to responsesthat warrant further elaboration.
Conversely,unstructured interviews do not reflect any preconceived theories or ideas andare performed with little or no organisation. Such an interview may simplystart with an opening question and will then progress based, primarily, uponthe initial response. Semi-structuredinterviews consist of several key questions that help to define the areas to beexplored, but also allows the interviewer or interviewee to diverge in order topursue an idea or response in more detail. This interview format is used mostfrequently in healthcare, as it provides participants with some guidance onwhat to talk about, which many find helpful. Thepurpose of research interviewsThe aimof the research interview is to explore the views from various individuals onspecific matters. Qualitative methods, such as interviews, are believed to enlightenus on social phenomena than would be obtained from purely quantitative methods,such as questionnaires. Interviews are, therefore, most appropriate wherelittle is already known about the study phenomenon or where detailed insightsare required from individual participants.
They are also particularlyappropriate for exploring sensitive topics, where participants may not want totalk about such issues in a group environment.TheinterviewWhendesigning an interview schedule it is imperative to ask questions that arelikely to yield as much information about the study phenomenon as possible andalso be able to address the aims and objectives of the research. In aqualitative interview, good questions should be open-ended (i.e., require morethan a yes/no answer), neutral, sensitive and understandable. It is usuallybest to start with questions that participants can answer easily and thenproceed to more difficult or sensitive topics. This can help put respondents atease, build up confidence and rapport and often generates rich data thatsubsequently develops the interview further.Thelength of interviews varies depending on the topic, researcher and participant.
However, on average, healthcare interviews last 20-60 minutes. Interviews canbe performed on a one-off or, if change over time is of interest, repeatedbasis, for example exploring the psychosocial impact of oral trauma on participantsand their subsequent experiences of cosmetic dental surgery.Focus groupsFocusgroups share many common features with less structured interviews, but there ismore to them than merely collecting similar data from many participants atonce. A focus group is a group discussion on a particular topic organized forresearch purposes. This discussion is guided, monitored and recorded by aresearcher (sometimes called a moderator or facilitator).When focus groups are usedFocusgroups are used for generating information on collective views, and themeanings that lie behind those views.
They are also useful in generating a richunderstanding of participants’ experiences and beliefs. Suggested criteria forusing focus groups include:· As a standalone method, for research relating togroup norms, meanings and processes· In a multi-method design, to explore a topic orcollect group language or narratives to be used in later stages· To clarify, extend, qualify or challenge data collectedthrough other methods· To feedback results to research participants.Preparing an interview scheduleLikeresearch interviews, the interview schedule for focus groups is often no morestructured than a loose schedule of topics to be discussed.
However, inpreparing an interview schedule for focus groups, two general principlessuggested by Stewart and Shamdasani are used:1. Questions should move from general to morespecific questions2. Question order should be relative to importanceof issues in the research agenda.
Therecan, however, be some conflict between these two principles, and tradeoffs areoften needed, although often discussions will take on a life of their own,which will influence or determine the order in which issues are covered. Usually,less than a dozen predetermined questions are needed and, as with researchinterviews, the researcher will also probe and expand on issues according tothe discussion.ModeratingModeratinga focus group looks easy when done well, but requires a complex set of skills. Themoderator should facilitate group discussion, keeping it focused withoutleading it. They should also be able to prevent the discussion being dominatedby one member, ensure that all participants have ample opportunity tocontribute, allow differences of opinions to be discussed fairly and, ifrequired, encourage reticent participants.ConclusionInterviewsand focus groups remain the most common methods of data collection inqualitative research, and are now being used with increasing frequency indental research, particularly to access areas not amendable to quantitativemethods and/or where depth, insight and understanding of particular phenomenaare required. The examples of dental studies that have employed these methodsalso help to demonstrate the range of research contexts to which interview andfocus group research.
CHAPTER 3: LITERATURE REVIEWMD.comTelemedicine.Book doctor appointments 24/7 and see adoctor on your smartphone or tablet from the privacy of your home or officewith MD.com Telemedicine!Skip crowded waiting rooms (and theirgerms), request appointments anytime, and prevent the costs of missed appointmentswith automated email/SMS reminders — get started now to enjoy privacy,convenience and access to doctors at your fingertips.AdvaitTelemedicineAdvait telemedicine is an app whichallows patients to have access to their doctors 24/7 365 days.
This app links a patient with hisdoctor and the patient can send voice messages, text messages take picturesfrom the camera and send those pictures using the app to the doctor. The doctorcan also reply to the voice messages and text and view those pictures sent bytheir patients.The app is a 2 way communication toolsfor the patients and their doctor.ChironHealthIs a website that promotes telemedicineto patients has never been easier. It promotes video visits to your patientswith personalized campaigns. Custom web pages and automated email notificationsallow you to announce your new service and keep patients informed abouttelemedicine in in your practice.
It has the following key products:HIPAA-Compliant: Secure video overpeer-to-peer connection and a signed BAA for each client; Co-Pay Collection: Accurate paymentdetermination is processed through our insurance Rules Engine and depositedinto your account; Patient Notifications: Once an appointment is scheduled,patients automatically receive an email to set up account and join appointment;Clinical Protocols: Customized telemedicine formula specific to your practice –Know exactly when and how to use telemedicine; Custom Patient Marketing: Easilymarket to patients about telemedicine with custom in-office and onlinematerials; Streamlined Patient Workflow: Automated appointment reminder emailsand an experience that mimics the in-office workflow with a virtual waitingroomCHAPTER 4: FINDINGS AND OBSERVATIONHow isTelemedicine impacting patients and providers?Afast-growing field in the healthcare industry, telemedicine holds a lot ofpromise in solving various challenges that health professionals and patientsare facing today. Providing a range of benefits for both patients and medicalproviders, it offers:Pros of TelemedicineAdoptingthe latest telemedicine initiatives can help your practice achieve numerousbenefits. You can lower healthcare costs, drive up practice efficiency andrevenue, provide your patients better access to healthcare services, andultimately get happier, healthier patients who stay in your practice.1. More Convenient and Accessible Patient CareAccordingto a recent Cisco global survey, 74% of patients prefer easy access tohealthcare services over in-person interactions with providers.2. Healthcare Cost SavingsRemoteanalysis and monitoring services and electronic data storage significantlyreduce healthcare service costs, saving money for you, your patients, andinsurance companies. Telemedicine also reduces unnecessary non-urgent ER visitsand eliminates transportation expenses for regular checkups.
Recently, theAmerican Hospital Association reported on a telemedicine program that saved 11%in costs and more than tripled ROI for investors. Beyond these generalcost-savings, telehealth can help boost doctors’ revenue by turning on-callhours into billable time, attracting new patients, reducing no-shows, and evenreducing overhead for physicians who decide to switch to a flexiblework-from-home model for part of the week.3. Extended Specialist and Referring PhysicianAccessWithtelehealth, patients in rural or remote areas benefit from quicker and moreconvenient specialist access. In the U.S., for every 100,000 rural patients,there are only 43 specialists available. These patients endure longerappointment commutes and have trouble accessing lifesaving consultations forspecific diseases or chronic care plans.
4. Increased Patient EngagementWhenpatients are committed to their own healthcare goals, it leads to lower costsand improved health. Ernst & Young Senior Advisory Services Manager JanOldenburg told Healthcare IT News that the high cost of disengaged consumersaffects everybody.”Engagingyour patients through telemedicine can help them maintain appointments and careschedules. Increased engagement initiatives can also curb obesity rates andtobacco use by helping you to encourage your patients’ healthy lifestylechoices.
5. Better Patient Care QualityTelemedicineoffers patient-centered approaches, such as improved timeliness of care. Thisis critical to quality patient care. Patients can address healthcare issuesquickly with real-time urgent care consultations and learn about treatmentoptions within minutes. A new study shows that telemedicine patients scorelower for depression, anxiety, and stress, and have 38% fewer hospitaladmissions. Cons of TelemedicineWhiletelemedicine promises to grow rapidly over the next decade and has clearbenefits, it still poses some technical and practical problems for healthcareproviders.
1. Technical Training and EquipmentRestructuringIT staff responsibilities and purchasing equipment takes time and costs money.Training is crucial to building an effective telemedicine program.
Physicians,practice managers, and other medical staff need to be trained on the newsystems to ensure a solid ROI. In addition, your staffing requirements maydecrease. For instance, a nurse in a rural Alaska facility can monitor up to 33patients at once from a single location using telemedicine services.2. Reduced Care ContinuityIn caseswhere patients are using on-demand telemedicine services that connect them witha random healthcare provider, care continuity suffers.
A patient’s primary careprovider may not have access to records from those other visits and end up withan incomplete history for the patient. Service provider shuffling increases therisk that a doctor won’t know a patient’s history or have notes about careroutines.3. Fewer In-Person ConsultationsWorriedabout technology’s limitations? You’re not alone. Many doctors worry abouttechnical problems associated with telemedicine. Senior Healthcare GroupConsultant Arun Ravi told Becker’s Hospital Review that poor broadbandconnections could lead to “possible patient mismanagement.
” Manyphysicians and patients alike still like a “personal touch,” and not allprocedures – even simple checkups – can be performed digitally. However, incases where patients just can’t get in to see their doctors’ in-person, and formany cases that don’t require a physical exam, telehealth can be a goodalternative.4. Tricky Policies and Reimbursement RulesHealthcarelaws, reimbursement policies, and privacy protection rules struggle to keep upwith this fast-growing industry. As a healthcare provider, you want to promotebest practices when approaching telemedicine. While major developments havebeen made to telehealth reimbursement over the past couple years, it stillremains a common stumbling block for providers interested in telemedicine. It’s best to do a little research into thereimbursement policy landscape in your state before you get started.
CHAPTER 5: RECOMMENDATIONSImprovingpatient assessment and reviewAllsites chose to improve the process for assessing and reviewing telehealth usersto ensure efficient use of resources. This included collecting additionalinformation from referring clinicians at assessment to identify goals for useand specify a date for review.Improvingservice deliveryThreesites aimed to improve the processes for monitoring and triage of telehealthpatients. Each site had previously completed some standardization, andtherefore targeted specific elements of their service that were not workingefficiently, or where practice was variable. Case study findings helped toidentify which processes needing improvement.
Improvingdata sharing and accessThreesites worked on improving data sharing and access. Acknowledging that solutionsto address the interoperability problems between monitoring software andelectronic patient record systems were not readily available, participantsconsidered other ways to reduce the additional workload associated with havingto access two, and sometimes three, different systems. Other work focused onhow to ensure that patient records were updated with monitoring information sothat other clinicians involved in the care of a patient could access thisinformation.
Raisingawareness of telehealthAllsites were keen to raise awareness of telehealth and ideas for action includedtraining sessions for nursing teams who were reluctant to use telehealth;working more closely with new clinical commissioning groups; and hosting eventsto promote telehealth to other clinical providers. Because of competingpriorities, this work was difficult to achieve and in two sites was discontinuedafter the first cycle. Improvingevaluation of telemedicineAllsites agreed that better evaluation was required to understand more about telemedicineoutcomes. However, only two sites chose to work on this activity. Dividedopinions about the rationale for investment in telehealth created uncertaintiesabout which outcomes to measure and consequently, while participants agreedthat this work was important, they could not agree on how to take it forward. Securingfinancial investment for telemedicineTheshort-term funding of telehealth was identified as a barrier to implementation.To secure future investment, participants focused on establishing relationshipswith technology providers and local decision-makers; scoping out the potentialof new technologies that were available; and identifying the needs of users andclinicians that could be addressed with telehealth.
Only one site was able tosecure financial investment during the study timeframe, and in two sites therewere real concerns about the future of telehealth.REFERENCESinfinithealthcare.comhttps://www.infinithealthcare.com/resource-center/telemedicine-and-its-impact-to-the-healthcare-indu…en.oxforddictionaries.comhttps://en.oxforddictionaries.com/definition/telemedicinechironhealth.comhttps://chironhealth.com/telemedicine/what-is-telemedicine/evisit.comhttps://evisit.com/what-is-telemedicine/slideshare.nethttps://www.slideshare.net/raihan_btc/data-collection-techniques-54205314