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

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          Abstract

          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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          Education and training to support the use of clinical telehealth: A review of the literature.

          Introduction Despite a growing literature base, substantial investment, and policy changes within governments, the integration of telehealth into routine clinical care has been limited. The availability of appropriate systematic education and training for practitioners has been highlighted as necessary for strong adoption. However, the availability and nature of telehealth-related education and training for practitioners is not understood. By reviewing the literature, we aimed to describe the delivery of education and training in telehealth, with particular focus on content, modes of delivery, types of institutions, and target clinician groups. Methods We performed searches using PubMed, Scopus, Embase, Web of Science, PsycINFO, the Cochrane Library, and ERIC. We included studies that were focused on the delivery of telehealth-related academic or vocational education and training. We extracted information pertaining to country, programs and their participants, and tabulated the results. Results Altogether 388 articles were identified, of which nine studies were selected for final review. Programs from five countries were represented and articles were spread across telemedicine and clinically oriented journals. Education and training in telehealth has been provided as both university level and vocational courses using conventional classroom based delivery methods and e-learning. Reported curriculum items included terminology, clinical applications, the evidence-base, and technological aspects. Conclusions Published evidence in peer-reviewed literature on telehealth education and training is limited. According to this review, a number of topics relating to telehealth have been covered by existing education programs both within tertiary and professional development levels.
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            Telehealth interventions for reducing waiting lists and waiting times for specialist outpatient services: A scoping review.

            We undertook a scoping review of the published literature to identify and summarise key findings on the telehealth interventions that influence waiting times or waiting lists for specialist outpatient services. Searches were conducted to identify relevant articles. Articles were included if the telehealth intervention restructured or made the referral process more efficient. We excluded studies that simply increased capacity. Two categories of interventions were identified - electronic consultations and image-based triage. Electronic consultations are asynchronous, text-based provider-to-provider consultations. Electronic consultations have been reported to obviate the need for face-to-face appointments between the patient and the specialist in between 34-92% of cases. However, it is often reported that electronic consultations are appropriate in less than 10% of referrals for outpatient care. Image-based triage has been used successfully to reduce unnecessary or inappropriate referrals and was used most often in dermatology, ophthalmology and otolaryngology (ENT). Reported reduction rates for face-to-face appointments by specialty were: dermatology 38-88%, ophthalmology 16-48% and ENT 89%. Image-based triage can be twice as effective as non-image based triage in reducing unnecessary appointments. Telehealth interventions can effectively be used to reduce waiting lists and improve the coordination of specialist services, and should be considered in conjunction with clinical requirements.
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              Clinicians' Knowledge and Perception of Telemedicine Technology.

              Telemedicine is an application of information and communication technology in the healthcare environment. This study aimed to compare knowledge and perceptions of telemedicine technology among different groups of clinicians.
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                Author and article information

                Journal
                J Telemed Telecare
                J Telemed Telecare
                JTT
                spjtt
                Journal of Telemedicine and Telecare
                SAGE Publications (Sage UK: London, England )
                1357-633X
                1758-1109
                20 March 2020
                : 1357633X20916567
                Affiliations
                [1 ]Centre for Online Health, The University of Queensland, Australia
                [2 ]Hans Christian Andersen Children’s Hospital, Denmark
                [3 ]Centre for Innovative Medical Technology, University of Southern Denmark, Denmark
                [4 ]Centre for Health Services Research, The University of Queensland, Australia
                [5 ]Department of Health Care Policy, Harvard Medical School, USA
                Author notes
                [*]Anthony C Smith, Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Level, Building 33, Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia. Email: asmith@ 123456uq.edu.au
                Author information
                https://orcid.org/0000-0002-7756-5136
                https://orcid.org/0000-0001-8415-0521
                https://orcid.org/0000-0002-4298-9369
                https://orcid.org/0000-0001-9880-9358
                https://orcid.org/0000-0003-2223-1582
                https://orcid.org/0000-0003-1899-7534
                Article
                10.1177_1357633X20916567
                10.1177/1357633X20916567
                7140977
                32196391
                a51e84f3-70a2-40ac-b82f-01866a5e48ab
                © The Author(s) 2020

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 8 March 2020
                : 12 March 2020
                Categories
                LEADER: Focus
                Custom metadata
                corrected-proof
                ts2

                Medicine
                telehealth,telemedicine,pandemic,emergency,disaster management,sustainability, coronavirus, covid-19

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