Search results

Physical activity is an important component of treatment for people living with mental illness, and exercise practitioners are well placed to deliver these interventions. In response to the COVID-19 pandemic and associated lock-down regulations, exercise professionals have rapidly adapted to the online delivery of services to continue care for their clients. To date, the research surrounding the delivery of exercise sessions via telehealth for this population has been scarce. Therefore, this study aims to explore how exercise professionals working in mental health have adapted to telehealth, the barriers and facilitators they have experienced and the implications for the future.

A qualitative study using semi-structure interviews was conducted. Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis.

Nine exercise physiologists working in mental health settings in Australia participated in the interviews. Two main themes were explored. The first related to the implementation of telehealth and was divided into four sub-themes: service delivery, accessibility and suitability, technology barriers and facilitators, adaptations to exercise prescription. The second theme related to attitudes and was categorised into two sub-themes: attitudes towards telehealth and future recommendations.

Telehealth appears to be a feasible and well accepted platform to deliver exercise sessions for people with mental illness, and this study provides guidance for clinicians including service and training recommendations.

To the best of the authors’ knowledge, this is the first study to examine the experiences of exercise physiologists working in mental health and using telehealth.

Taking a business lens of telehealth, this article aims to review and provide a state-of-the-art overview of telehealth research.

This research conducts a systematic literature review using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) protocol and a collection of bibliometric analytical techniques (i.e. performance analysis, keyword co-occurrence, keyword clustering and content analysis).

Using performance analysis, this article unpacks the publication trend and the top contributing journals, authors, institutions and regions of telehealth research. Using keyword co-occurrence and keyword clustering, this article reveals 10 major themes underpinning the intellectual structure of telehealth research: design and development of personal health record systems, health information technology (HIT) for public health management, perceived service quality among mobile health (m-health) users, paradoxes of virtual care versus in-person visits, Internet of things (IoT) in healthcare, guidelines for e-health practices and services, telemonitoring of life-threatening diseases, change management strategy for telehealth adoption, knowledge management of innovations in telehealth and technology management of telemedicine services. The article proposes directions for future research that can enrich our understanding of telehealth services.

This article offers a seminal state-of-the-art overview of the performance and intellectual structure of telehealth research from a business perspective.

The purpose of this paper is to report on a small telehealth pilot in local authority sheltered housing in NE England. This explored the training and capacity building needed to develop a workforce/older person, telehealth partnership and service that is integrated within existing health, social care and housing services.

A qualitative case study approach on the implementation and deployment of a pilot telehealth service, supporting sheltered housing tenants with Chronic obstructive pulmonary disease (n=4).

Telehealth training and capacity building, needs to develop from within the workforce/older person partnership, if a usable and acceptable telehealth service is to be developed and integrated within existing health, care and housing services. To be adaptable to changing circumstances and individual need, flexible monitoring is also required.

Service users and workforces, need to work together to provide flexible telehealth monitoring, that in the longer term, may improve service user, quality of life.

The pilot explored a workforce/older person partnership to consider how to add and implement telehealth services, into existing health and housing services.

The COVID-19 pandemic transformed the delivery of occupational therapy (OT) community mental health services nationally, resulting in the rapid expansion and delivery of services through telehealth. While telehealth technology and its use are not new, widespread adoption was precipitated by the cessation of face-to-face services due to the COVID-19 pandemic. Research in this field has been conducted previously; however, it is not specific to OT in the Irish context. This study aims to explore service users’ experience of telehealth OT interventions in adult mental health services during the COVID-19 pandemic.

A descriptive qualitative approach was used to explore service users’ experience of mental health telehealth OT services. Five service users were recruited to participate in a focus group to explore their experience of OT via telehealth. The themes identified from this focus group were then further explored via individual interviews. Four of the service users who participated in the focus group chose to complete in-depth interviews. Reflexive thematic analysis was then completed.

Two key themes emerged from the data. The theme of positive telehealth experiences included subthemes of gratitude for the option of telehealth and accessibility. The second theme of learning from experience, included subthemes of human connection, preferred platforms of telehealth methods and future considerations for telehealth interventions.

These findings provide a unique insight into the importance of continuing OT services via telehealth, from the service users’ perspective.

Despite substantial investment over recent years in telehealth there appears to be little consensus regarding what a successful implementation should achieve. However, defining success is often controversial and complex due to differing views from the large number of stakeholders involved, the local environment where telehealth is deployed and the scope, or size, of any planned initiative. Nevertheless, a number of generic measures are proposed in this paper which then provides a framework for the measurement of success. The local context can then be applied to determine the exact emphasis on specific measures, but it is proposed that all of the measures should be included in the holistic measurement of success. Having considered what constitutes success, attention is then given to how success should be quantified. Robust evaluation is fundamental and there is much debate as to whether the ‘gold standard’ randomised control trial (RCT) is the most appropriate methodology for telehealth. If the intervention, technology and system, can be maintained in a stable state then the RCT may well provide the most authoritative evidence for decision‐makers. However, ensuring such stability, in what is still a novel combination of technology and service, is difficult and consequently other approaches may be more appropriate when stability is unlikely to be maintained.

Telehealth consultations are likely to continue while living with COVID-19 and the risk of other pandemics. Greater understanding of patient perceptions is important in order to inform future integrated care models involving telehealth.

An interpretative qualitative study. Fifteen, in-depth qualitative interviews were conducted with diverse range of community dwelling patients who attended outpatient clinics at The John Hunter Hospital, Newcastle. Data were analysed using an inductive thematic approach.

Key themes were identified: (1) telehealth is valuable in a pandemic; (2) telehealth accessibility can be challenging; (3) there are variations in care experiences, especially when visual feedback is lacking; (4) telehealth for acute and complex care needs may lead to gaps and (5) considerations towards the future of telehealth, beyond a pandemic.

There is a shortfall in evidence of the patient experience of integrated care within a telehealth framework. The results provided practical insights into how telehealth services can play a greater role in integrated care.

Apart from the need for affordable access to high-speed data for basic Internet access, the author posit the need for patient and clinician training towards promoting communication that is underpinned by choice, trust and shared decision-making.

Telehealth is important towards keeping patients safe during COVID-19. Key findings extend knowledge of the practical implications need to promote integrated telehealth systems. While there is a benefit in extending telehealth to more preventative activities, there is also a need for greater service coordination and sharing of information between treating clinicians. Overall the results highlight telehealth consultations to be an effective means of treating well-known conditions and for follow-up rather than for acute conditions.

This study aims to determine elements of telehealth that have the potential to increase costs for the health system in the short to medium term.

A search of PubMed, EMBASE and Scopus databases was performed in May 2018 using broad terms for telehealth and economics. Articles were included if they identified and explained reasons for an increase in cost for telehealth services. Studies were categorised by economic analysis type for data extraction and descriptive synthesis.

Fourteen studies met inclusion criteria and were included in the review. These studies identified that increased health system costs were due to implementation costs (e.g. for equipment, software or staff training), increased use of other healthcare services (e.g. pharmaceutical services) and ongoing service costs (including staff salaries) resulting from telehealth being additive to traditional service (e.g. increased frequency of contact).

Telehealth is often assumed to be a cost-effective method of delivering healthcare, even to the point where direct cost savings are expected by decision makers as a result of implementation. However, this investigation suggests it does not routinely reduce costs for the health system and can actually increase costs at both implementation and ongoing service delivery stages. Health services considering implementing telehealth should be motivated by benefits other than cost reduction such as improved accessibility, greater patient centricity and societal cost–benefit.

The purpose of this paper is to explore the benefits of the internet of things (IoT) technology on geriatric telehealth.

An exploratory case study approach is used to understand the applicability of the internet of medical things in geriatric telehealth. Data was collected from several managers who analyzed rates of re-hospitalizations for patients using telehealth services compared to those not using telehealth services and observations of patient satisfaction rates with telehealth services.

Benefits from the use of IoT included significant reductions in re-hospitalization rates for older adults and patients became more engaged in maintaining their health and wellness goals while becoming more tech-savvy, empowered and satisfied with the telehealth experience.

The present manuscript is among the few reports on the benefits of IoT on geriatric health care.

Telehealth and telecare innovations have the potential to improve quality of life, reduce unnecessary hospital and care home admissions, and support care integration by providing care and disease management from multi‐disciplinary care teams linked remotely to users. About 1.7 million people benefit from telecare services in the UK, but telehealth services have only around 5000 users, many of whom receive services through the Department of Health's Whole System Demonstrator (WSD) Pilot Programme. There is an identifiable chasm between early adopters and wider uptake of telehealth and telecare solutions. Key barriers include lack of robust evidence on cost‐effectiveness, of a consumer market and of interoperability of the technology between service sectors, and the implications for professionals and organisations of changing their established methods of practice. Telehealth and telecare could be combined to provide a common platform to integrate care for people requiring both health and social care support, but relatively few people are judged suitable for joint care. This is related both to the nature of the technology and the profile of those people who can use it, and to the different ways in which health and social care systems assess who is most 'at risk', which makes it difficult to assess which individuals might best benefit from an integrated response to their care needs. While there is considerable interest and policy momentum behind the adoption and diffusion of telehealth and telecare in England, more understanding of their benefits is required to convince commissioners and providers of its potential.

The rise of telehealth is evident worldwide, especially now with the COVID-19 pandemic situation, and is providing extensive opportunities for health-care organisations to create added value for different stakeholders. However, even in this extreme situation, the progress of telehealth is quite slow and insufficient. In this context, it is necessary to consider how the application of telehealth services allows co-creating additional value for different stakeholders. Consequently, the purpose of this paper is to explore telehealth services and the added value that they co-create for various stakeholders across publicly and privately oriented health-care ecosystems.

This paper adopted a qualitative research design based on an explorative and comparative approach to study the perceived added value that is co-created during telehealth encounters. The authors deployed a semi-structured interview research design. Interviews were carried out in two settings that have different health-care systems: Lithuania (publicly oriented health care) and the California Bay Area, USA, (privately oriented health care). The research covers telehealth services from the point of view of different stakeholders in the health-care ecosystem.

The paper emphasises that value-in-use is essential in the case of telehealth; however, value-in-exchange is relevant to describe the relationships between public and private insurers and health-care providers. The findings point out that despite the type of health-care system, telehealth added value-in-use was perceived quite similar in both research settings, and differences could be distinguished mainly at the sub-dimensional level. The added value-in-use for patients comprises economic, functional and emotional value; physicians potentially get functional added value-in-use. The authors also highlight that patients and physicians get relational functional and social value-in-use. The added value-in-use for health-care providers consists of economic (in both research settings) and functional value (in Lithuania). The research findings show that there is still an evident lack of health insurance companies ready to recognise telehealth as a valuable service and to reimburse similarly to in cases of in-person visits. Thus, the added value-in-exchange is hardly created and this impedes co-creation of the added value-in-use.

This paper contributes to the field mainly by transferring the business research applied concept of value co-creation into the social-purpose driven health-care industry. The findings are beneficial for the health-care management stream of the literature, which considers health care as a value-based industry. To the best of the authors’ knowledge, this is the first attempt to structure the perceived telehealth added value from the perspectives of different stakeholders and two different health-care ecosystems. This paper also gives a clearer understanding of the role of the value-in-exchange in such complex ecosystems as health care and gives reasons when it could be created in synergy with co-creation of the value-in-use. In this sense, the findings are beneficial from both marketing and innovation theoretical perspectives, as they give a special attention to value creation and co-creation phenomena analysis.