Diabetes is an increasingly prevalent and costly chronic disease worldwide, and a large cause of unnecessary disease burden. To address the growing burden of diabetes, care models should support management of diabetes in primary care to reduce reliance on overstretched hospital-based specialists services. Virtual care presents an opportunity to provide diabetes care remotely, potentially enhancing the accessibility and efficiency of healthcare services. This review aimed to identify existing evidence on the effectiveness of virtual care on diabetes management, and the extent to which video components are included in the evidence base.

The protocol was registered in PROSPERO (CRD42022366125). Systematic search of the databases PubMed, Embase, Medline, Scopus, CINAHL and Cochrane CENTRAL, were conducted for studies on telemedicine, telehealth, or virtual interventions for type 2 diabetes management published between January 2011 to March 2022. The primary outcome was HbA1c, and secondary outcomes were blood glucose control, Body Mass Index (BMI), taking the prescribed medications, and self-management behaviour. The results were reported following the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Quality of each review was appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses.

From 10,708 articles, 63 underwent full-text review. Thirty systematic reviews were included. Overall quality of the included reviews was high. Among the 30 systematic reviews, there was significant overlap of the primary studies, with 48% of them appearing in multiple reviews. Of the 30 reviews, 28 reported that virtual care improved HbA1c compared to usual care. Meta-analysis of 16 reviews revealed a mean difference of -0.37% (-0.41% to -0.32%), I2 of 77.1%. Significant non-clinical impacts were noted for BMI and secondary outcomes. Most reviews (25/30) included some studies with video components, however these studies did not disaggregate the impact of video from other aspects of complex interventions such as web-based and telephone support.

This umbrella review strengthens the evidence that virtual care significantly improves clinical outcomes in people with type 2 diabetes, primarily affecting HbA1c. Fewer studies addressed other health outcomes such as BMI and taking medications. Effectiveness of virtual care varies by demographic and clinical characteristics, emphasising the need to tailor virtual care interventions to maximise impact. Future research could directly compare and identify the most effective virtual care strategies for different populations, including those with lower digital literacy.

Background: As the COVID-19 public health emergency (PHE) altered delivery of health care, alternate forms of health care delivery were adopted. The usage of telehealth expanded during the PHE to reduce exposure to COVID-19, which provides the opportunity to understand how expanded telehealth access affected costs of care. The objective of this work was to evaluate the association between telehealth adoption and health care-related costs during the COVID-19 PHE. Methods: We conducted a systematic review by searching PubMed, Embase, Cochrane Central Register of Controlled Trials, and CINAHL from database inception to May 26, 2023. In June 2023, we also searched Telehealth.HHS.gov and the Rural Health Research Gateway. We sought to identify studies across three main search domains: telehealth, COVID-19, and cost. We analyzed costs based on an economic perspective: patient, health care payer, and health care sector. Results: Out of 8,557 studies screened, 12 studies met the inclusion criteria. Studies had high heterogeneity in telehealth modality and cost perspectives. Included studies had, on average, a moderate risk of bias and lacked standardized outcomes that would have aided in across-study comparisons. We found that the COVID-19 PHE was associated with an increase in spending on telehealth services and decreased patient health care costs, which limited changes in monthly total health care spending. Results were variable, however, based on the telehealth application studied. Conclusions: Telehealth may be associated with cost savings from a patient perspective and from a broader health care sector perspective. Future research should focus on the role of integrated telehealth applications and long-term costs using the societal perspective.

To explore the core competencies needed on part of the medical and dental teachers to carry out effective digital teaching for their students.

It was a qualitative study which employed phenomenological approach. The data were collected from 12 teachers who were purposively selected for semi-structured interviews. They were all expert digital teachers. The data were transcribed verbatim, coded and analyzed thematically. Textural and structural description of the themes helped to develop a new competency framework.

The data yielded 47 selective codes with 15 sub-themes and five themes. The emergent themes included general digital competencies, specific digital teaching competencies, mastery of the subject matter, mastery of pedagogical strategies and proficiency in using innovative digital technologies for teaching. The themes 1, 2 and 5 relate to digital competencies only whereas the themes 3 and 4 are generic competencies which apply to both digital and non-digital teaching. These generic competencies form the basis of all kinds of teaching, hence equally important for digital teaching.

Medical teachers should possess diverse digital competencies. The competency framework that emerged in the current research encompasses the essential attributes that should be included in any future training program aiming at the digital capacity building of the teachers. This will keep them primed for effective digital teaching. Given its crucial importance, the digital teaching competency should be considered as a cross-cutting competency that applies to almost all of the famous eight roles of medical teacher.

Despite a recent rise in adoption, telemedicine consultations retention remains challenging, and aspects around the associated experiences and outcomes remain unclear. The need to further investigate these aspects was a motivating factor for conducting this scoping review.

With a focus on synchronous telemedicine consultations between patients with nonmalignant chronic illnesses and health care professionals (HCPs), this scoping review aimed to gain insights into (1) the available evidence on telemedicine consultations to improve health outcomes for patients, (2) the associated behaviors and attitudes of patients and HCPs, and (3) how supplemental technology can assist in remote consultations.

PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guided the scoping review process. Inclusion criteria were (1) involving adults with nonmalignant, noncommunicable chronic conditions as the study population; (2) focusing on health outcomes and experiences of and attitudes toward synchronous telemedicine consultations between patients and HCPs; and (3) conducting empirical research. A search strategy was applied to PubMed (including MEDLINE), CINAHL Complete, APA PsycNet, Web of Science, IEEE, and ACM Digital. Screening of articles and data extraction from included articles were performed in parallel and independently by 2 researchers, who corroborated their findings and resolved any conflicts.

Overall, 4167 unique articles were identified from the databases searched. Following multilayer filtration, 19 (0.46%) studies fulfilled the inclusion criteria for data extraction. They investigated 6 nonmalignant chronic conditions, namely chronic obstructive pulmonary disease, diabetes, chronic kidney disease, ulcerative colitis, hypertension, and congestive heart failure, and the telemedicine consultation modality varied in each case. Most observed positive health outcomes for patients with chronic conditions using telemedicine consultations. Patients generally favored the modality's convenience, but concerns were highlighted around cost, practical logistics, and thoroughness of clinical examinations. The majority of HCPs were also in favor of the technology, but a minority experienced reduced job satisfaction. Supplemental technological assistance was identified in relation to technical considerations, improved remote workflow, and training in remote care use.

For patients with noncommunicable chronic conditions, telemedicine consultations are generally associated with positive health outcomes that are either directly or indirectly related to their ailment, but sustained improvements remain unclear. These modalities also indicate the potential to empower such patients to better manage their condition. HCPs and patients tend to be satisfied with remote care experience, and most are receptive to the modality as an option. Assistance from supplemental technologies mostly resides in addressing technical issues, and additional modules could be integrated to address challenges relevant to patients and HCPs. However, positive outcomes and attitudes toward the modality might not apply to all cases, indicating that telemedicine consultations are more appropriate as options rather than replacements of in-person visits.

The occurrence of the COVID-19 pandemic demanded fast changes in the delivery of health care. As a result, significant growth in the use of telemedicine services occurred. Research, especially from nationally representative German samples, is needed to better understand determinants of telemedicine use.

The purpose of this study was to identify determinants of telemedicine service use among middle-aged and older adults during the COVID-19 pandemic in Germany.

Cross-sectional, nationally representative data were taken from the German sample of the Survey of Health, Ageing and Retirement in Europe (SHARE). The German Corona Survey 2 (n=2039), which was conducted between June and August 2021, was used for this study. Reporting experience with remote medical consultations during the COVID-19 pandemic served as the outcome measure. Associations with socioeconomic, psychological, social, health-related, and COVID-19-related determinants were examined using multiple Firth logistic regressions.

Psychological factors including feeling nervous, anxious, or on edge (odds ratio [OR] 1.61, 95% CI 1.04-2.50; P=.03), feeling sad or depressed (OR 1.62, 95% CI 1.05-2.51; P=.03) and feelings of loneliness (OR 1.66, 95% CI 1.07-2.58; P=.02) were positively associated with telemedicine use. Moreover, forgoing medical treatment because of being afraid of being infected by SARS-CoV-2 (OR 1.81, 95% CI 1.10-2.97; P=.02) and describing limitations because of a health problem as severe were positively associated with the outcome (OR 2.11, 95% CI 1.12-4.00; P=.02). Socioeconomic and social factors were not significantly associated with telemedicine use in our sample.

Middle-aged and older individuals in Germany seem to use telemedicine services according to psychological needs and health limitations. Especially when psychological symptoms are experienced, telemedicine seems to be a promising service option in this age group. Future research is needed to confirm these initial findings in postpandemic circumstances.

The call to scale up telemedicine services globally as part of the digital health transformation lacks an agreed-upon set of constructs to guide the implementation process. A lack of guidance hinders the development, consolidation, sustainability and optimisation of telemedicine services. The study aims to reach consensus among telemedicine experts on a set of implementation constructs to be developed into an evidence-based support tool.

A modified Delphi study was conducted to evaluate a set of evidence-informed telemedicine implementation constructs comprising cores, domains and items. The study evaluated the constructs consisting of five cores: Assessment of the Current Situation, Development of a Telemedicine Strategy, Development of Organisational Changes, Development of a Telemedicine Service, and Monitoring, Evaluation and Optimisation of Telemedicine Implementation; seven domains: Individual Readiness, Organisational Readiness, Clinical, Economic, Technological and Infrastructure, Regulation, and Monitoring, Evaluation and Optimisation; divided into 53 items. Global telemedicine specialists (n = 247) were invited to participate and evaluate 58 questions. Consensus was set at ≥70%.

Forty-five experts completed the survey. Consensus was reached on 78% of the constructs evaluated. Regarding the core constructs, Monitoring, Evaluation and Optimisation of Telemedicine Implementation was determined to be the most important one, and Development of a Telemedicine Strategy the least. As for the domains, the Clinical one had the highest level of consensus, and the Economic one had the lowest.

This research advances the field of telemedicine, providing expert consensus on a set of implementation constructs. The findings also highlight considerable divergence in expert opinion on the constructs of reimbursement and incentive mechanisms, resistance to change, and telemedicine champions. The lack of agreement on these constructs warrants attention and may partly explain the barriers that telemedicine services continue to face in the implementation process.

Based on personal experience over several years, we carried out a comparative analysis of two different European health systems, in Portugal and France, from a perspective comparing occupational medicine and use of telemedicine in a postpandemic context. This analysis addressed four aspects: Health System; Occupational Medicine; Telemedicine/Telework; and Future and Suggestions. The study employed searches and review of recent articles, guidelines, and recommendations from the authorities responsible for regulation (Medical Doctors Order, Labor Legislation, and Medical Collegiate Recommendations) and analysis of some statistical indicators from recent studies. Three tables on Occupational Health and Medicine present some relevant data and facilitate comparisons. Despite the difficulties of comparison, given the basic differences between these two systems (Beveridge vs. Bismark), it can be concluded that there is a greater acceptance of judicious use of teleconsultation in France (from 15 to 35%). This includes its use by occupational nurses, in the context of the "Visite de Information et Prevention", with good acceptance among employers and employees. There are still some difficulties to be resolved concerning security, conducting biometrics, and objective examinations. We expect that these issues will be overcome with improved biosensing, adequate training, and proper regulation. Given the shortage of occupational physicians and the customary overrunning of legal deadlines, we believe that these possibilities and suggestions should be explored and adopted by the specialty's Collegiates. Certain recommendations to this effect are made.

The Indian government launched national teleconsultation services (eSanjeevani OPD) to provide safe doctor-to-patient consultations. This study aimed to determine the awareness and willingness to seek services from eSanjeevani OPDs.

This is a cross-sectional descriptive study conducted in Nandigudi village, Karnataka. The total sample size was 273, and participants were recruited using a systematic sampling technique.

The prevalence of awareness about teleconsultations was 2.2% (n = 6, 95% CI: 0.8-4.7%). None of the participants utilized eSanjeevani services in the last year. Approximately 56.0% (n = 153, 95% CI: 49.9-62.0%) were willing to use eSanjeevani OPD. "Not being familiar" (n = 99, 82.5%) with eSanjeevani OPD was the major reason for unwillingness to use teleconsultation, and 73.8% (n = 113) preferred video calls as the mode of communication.

The majority of the participants were not aware of and were unwilling to use eSanjeevani OPD. Therefore, healthcare professionals should focus more on creating awareness of teleconsultations.

Several recent studies examined patient use and satisfaction with synchronous telemental health services in response to the widespread implementation during the COVID-19 pandemic. However, a systematic review of recent literature on the determinants of these outcomes is missing.

The aim of this systematic review was to give an extensive overview of the literature on and highlight the influential determinants of patient use and satisfaction with synchronous telemental health services during the COVID-19 pandemic.

This review satisfied the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered in PROSPERO. Peer-reviewed, quantitative studies that observed the determinants of patient use or satisfaction with synchronous telemental health services during the COVID-19 pandemic were included. PubMed, PsycInfo, and Web of Science database searches were conducted in August 2022 for English and German language studies published from 2020 onward. Key steps were performed by 2 reviewers. Determinants were synthesized into major categories informed by the dimensions of the widely used and established Unified Theory of Acceptance and Use of Technology.

Of the 20 included studies, 10 studies examined determinants of patient use, 7 examined determinants of patient satisfaction, and 3 observed both outcomes. The quality of the studies was mainly good or fair. There was substantial heterogeneity in the study designs, methods, and findings. Sociodemographic characteristics and health-related determinants were mostly considered. Some of the major dimensions of the Unified Theory of Acceptance and Use of Technology were neglected in recent studies. Although most findings were mixed or nonsignificant, some indications for potential relationships were found (eg, for sex, age, and symptom severity).

The findings revealed potential target groups (eg, female and young patients with mild symptoms) for future postpandemic telemental health interventions. However, they also identified patient groups that were harder to reach (eg, older patients with severe symptoms); efforts may be beneficial to address such groups. Future quantitative and qualitative research is needed to secure and expand on recent findings, which could help improve services.

PROSPERO CRD42022351576; https://tinyurl.com/yr6zrva5.