Telehealth transformation: COVID-19 and the rise of virtual care.

Recurrent BRAF mutations in Langerhans cell histiocytosis

Background
Sepsis poses a global threat to millions of lives. The Surviving Sepsis Campaign (SSC) guidelines provide evidence-based recommendations on the recognition and management of sepsis and its complications.
Methods
We formed a panel of 60 experts from 22 countries and 11 members of the public. The panel prioritized questions that are relevant to the recognition and management of sepsis and septic shock in adults. New questions and sections were addressed, relative to the previous guidelines. These questions were grouped under 6 subgroups (screening and early treatment, infection, hemodynamics, ventilation, additional therapies, and long-term outcomes and goals of care). With input from the panel and methodologists, professional medical librarians performed the search strategy tailored to either specific questions or a group of relevant questions. A dedicated systematic review team performed screening and data abstraction when indicated. For each question, the methodologists, with input from panel members, summarized the evidence assessed and graded the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The panel generated recommendations using the evidence-to-decision framework. Recommendations were either strong or weak, or in the form of best practice statements. When evidence was insufficient to support a recommendation, the panel was surveyed to generate “in our practice” statements.
Results
The SSC panel issued 93 statements: 15 best practice statements, 15 strong recommendations, and 54 weak recommendations and no recommendation was provided for 9 questions. The recommendations address several important clinical areas related to screening tools, acute resuscitation strategies, management of fluids and vasoactive agents, antimicrobials and diagnostic tests and the use of additional therapies, ventilation management, goals of care, and post sepsis care.
Conclusion
The SSC panel issued evidence-based recommendations to help support key stakeholders caring for adults with sepsis or septic shock and their families.

/pdf/surviving-sepsis-campaign-international-guidelines-for-1trp1tl9am.pdf

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.

https://zenodo.org/record/1009492/files/StrategiesforaddressingvaccinehesitancyAsystematicreview.pdf

Strategies for addressing vaccine hesitancy – A systematic review☆

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.

Background: One area where telemedicine may prove to be highly effective is in providing medical care to the geriatric population, an age group predicted to account for 20% of the population in the near future. However, even though telemedicine has certain advantages, the usability of these systems with this population merits investigation. Materials and Methods: This article reviews the literature published from 2000 to 2016 with the goal of analyzing the characteristics of usability-related studies conducted using geriatric participants and the subsequent usability challenges identified. Articles were found using Web of Knowledge and PubMed citation indexing portals using the keywords (1) Telemedicine* AND Geriatrics* (2) Telemedicine* AND Usability* (3) Telemedicine* AND Usability* AND Older Adults*. Results: A total of 297 articles were obtained from the initial search. After further detailed screening, 16 articles were selected for review based on the inclusion criteria. Of these, 60% of the...

Designing Telemedicine Systems for Geriatric Patients: A Review of the Usability Studies

Lessons learned from the usability assessment of home-based telemedicine systems.

Direct-to-consumer (DTC) telemedicine providers has the potential to change the traditional patient-physician relationship. Professional medical organizations recommend that telemedicine exist within the medical home. This study aims to understand patients’ preferences and desires for DTC telemedicine. We conducted a nationwide survey of 4345 survey respondents demographically balanced to represent the United States adult population. The survey consisted of questions assessing the respondents’ attributes and their willingness and comfortability using telemedicine as well as the importance and desired attributes of a provider providing care via telemedicine. Relatively few respondents (3.5%) had ever had an online video visit with their care provider. Respondents were more willing to see their own provider via telemedicine than unwilling (52% vs. 25%). Additionally, respondents were less willing to use telemedicine to see a different provider from the same healthcare organization (35%) and were least willing to see a different provider from a different organization (19%). Forty-one percent of respondents felt it was unimportant that their current provider offer telemedicine, and only 15% would consider leaving their current provider to a new provider who offers telemedicine as an option. More than half (56%) of respondents felt it was important to have an established relationship with a provider they’re having a telemedicine visit with. Nearly two-thirds of respondents (60%) felt it was important for a telemedicine provider to have access to their health records. Patients prefer to use telemedicine with their own doctor with whom they have an established relationship.

/pdf/patient-preferences-for-direct-to-consumer-telemedicine-209uwxeaa3.pdf

Patient preferences for direct-to-consumer telemedicine services: a nationwide survey.

Where You Live Matters: The Impact of Place of Residence on Severe Sepsis Incidence and Mortality

Background: Telemedicine systems are gaining attention nationwide as a means for providing care in remote areas and allowing a small number of providers to impact a large geographic region. We systematically reviewed the literature to identify the efficacy and implementation challenges of telemedicine systems in ambulances. Methods: A search for published studies on Web of Science and PubMed was completed. Studies were selected if they included at least a pilot study and they focused on feasibility or implementation of telemedicine systems in ambulances. Results: A total of 864 articles were used for title and abstract screening. Full text screening was completed for 102 articles, with 23 being selected for final review. Sixty-one percent of the studies included in the review focused on general emergency care, while 26% focused on stroke care and 13% focused on myocardial infarction care. The reviewed studies found that telemedicine is feasible and effective in decreasing treatment times, report ...

James T. McElligott

Papers

Designing Telemedicine Systems for Geriatric Patients: A Review of the Usability Studies

Lessons learned from the usability assessment of home-based telemedicine systems.

Patient preferences for direct-to-consumer telemedicine services: a nationwide survey.

Where You Live Matters: The Impact of Place of Residence on Severe Sepsis Incidence and Mortality

A Systematic Review of the Implementation Challenges of Telemedicine Systems in Ambulances.