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      Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA

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          Abstract

          A narrative review was conducted to examine the current state of the utilisation of telemedicine amid the current COVID-19 pandemic and to evaluate the benefits of continuing telemedicine usage in the future. A literature review was performed for articles related to telemedicine. Databases including PubMed, Google Scholar, Cochrane Library and Ovid MEDLINE were searched. Three reviewers independently performed article selection based on relevance to our topic. We included all articles between 1990 and 2020 related to telemedicine using the following keywords: ‘telemedicine’, ‘telehealth’, ‘policy’, ‘COVID-19’, ‘regulation’, ‘rural’, ‘physical examination’, ‘future’. A total of 60 articles were identified, and through careful selection we narrowed the final number of articles to 42 based on relevance to our topic. Telemedicine has been rapidly evolving over the past several decades. Issues with regulation and reimbursement have prevented its full immersion into the healthcare system. During the current pandemic, Centers for Medicare and Medicaid services have expanded access to telemedicine services. The advantages of telemedicine moving forward include its cost-effectiveness, ability to extend access to specialty services and its potential to help mitigate the looming physician shortage. Disadvantages include lack of available technological resources in certain parts of the country, issues with security of patient data, and challenges in performing the traditional patient examination. It is critically important that changes are made to fully immerse telemedicine services into the healthcare landscape in order to be prepared for future pandemics as well as to reap the benefits of this service in the future.

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          Virtually Perfect? Telemedicine for Covid-19

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            Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)

            The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare.
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              Covid-19 and Health Care’s Digital Revolution

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                Author and article information

                Journal
                Fam Med Community Health
                Fam Med Community Health
                fmch
                fmch
                Family Medicine and Community Health
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2305-6983
                2009-8774
                2020
                18 August 2020
                : 8
                : 3
                : e000530
                Affiliations
                [1 ]departmentInternal Medicine , Central Michigan University College of Medicine East Campus , Saginaw, Michigan, USA
                [2 ]departmentFamily Medicine , Samaritan Medical Center , Watertown, New York, USA
                [3 ]departmentMedicine , Geisinger Commonwealth School of Medicine , Scranton, Pennsylvania, USA
                [4 ]departmentInternal Medicine , Hurley Medical Center , Flint, Michigan, USA
                [5 ]departmentNephrology , Westchester Medical Center , Valhalla, New York, USA
                Author notes
                [Correspondence to ] Dr Michael Albosta; albos1ms@ 123456cmich.edu
                Author information
                http://orcid.org/0000-0003-4187-4911
                http://orcid.org/0000-0002-0085-8272
                Article
                fmch-2020-000530
                10.1136/fmch-2020-000530
                7437610
                32816942
                205bf357-5138-42f3-a850-73cf01bb34d6
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

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                rural health,health care costs,family medicine,general practice

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