A Multipronged Digital Response to Increased Demand for Telehealth Support and Training During the COVID-19 Pandemic.

In response to the COVID-19 public health emergency, the University of Kansas Center for Telemedicine & Telehealth (KUCTT) adopted a multipronged, digital strategy to address COVID-induced, high-volume telehealth inquiries in Kansas and sought to quickly disseminate rapidly evolving federal policy updates and foundational telehealth implementation guidance. Retrospectively, KUCTT examined participant engagement in three educational approaches (e.g.

Maintaining Intervention Fidelity When Using Technology Delivery Across Studies.

The current standard in healthcare research is to maintain scientific fidelity of any intervention being tested. Fidelity is defined as the consistent delivery of interventions that ensures that all participants are provided the same information, guidance, and/or materials. Notably, the methods for ensuring fidelity of intervention delivery must also be consistent.

mHealth Clinic Appointment PC Tablet: Implementation, Challenges and Solutions.

Background: Patients requiring daily intravenous (IV) home parenteral nutrition (HPN) would benefit from in-home professional observation to improve self-care, to assess, detect and prevent serious complications.

Aims: The study aims are to assess the viability and utility of conducting mobile healthcare (mHealth) videoconference assessments with patients managing lifelong daily 12-hour IV nutrition infusions in their homes. The challenges and solutions to implementing mobile personal computer (PC) tablet based clinic appointments are described.

Comparative and cost effectiveness of telemedicine versus telephone counseling for smoking cessation.

Background: In rural America, cigarette smoking is prevalent and health care providers lack the time and resources to help smokers quit. Telephone quitlines are important avenues for cessation services in rural areas, but they are poorly integrated with local health care resources.

Objective: The intent of the study was to assess the comparative effectiveness and cost effectiveness of two models for delivering expert tobacco treatment at a distance: telemedicine counseling that was integrated into smokers' primary care clinics (Integrated Telemedicine-ITM) versus telephone counseling, similar to telephone quitline counseling, delivered to smokers in their homes (Phone).

Costs of multidisciplinary parenteral nutrition care provided at a distance via mobile tablets.

Background: Determining the costs of healthcare delivery is a key step for providing efficient nutrition-based care. This analysis tabulates the costs of delivering home parenteral nutrition (HPN) interventions and clinical assessments through encrypted mobile technologies to increase patients' access to healthcare providers, reduce their travel expenses, and allow early detection of infection and other complications.

Methods: A traditional cost-accounting method was used to tabulate all expenses related to mobile distance HPN clinic appointments, including (1) personnel time of multidisciplinary healthcare professionals, (2) supply of HPN intervention materials, and (3) equipment, connection, and delivery expenses.

Design and participant characteristics of a randomized-controlled trial of telemedicine for smoking cessation among rural smokers.

Introduction: In rural America cigarette smoking is prevalent, few cessation services are available, and healthcare providers lack the time and resources to help smokers quit. This paper describes the design and participant characteristics of Connect2Quit (C2Q), a randomized control trial (RCT) that tests the effectiveness and cost-effectiveness of integrated telemedicine counseling delivered by 2-way webcams mounted on desktop computers in participant's physician office examining rooms (ITM) versus quitline counseling delivered by telephone in participant's homes (Phone) for helping rural smokers quit.

Methods/design: C2Q was implemented in twenty primary care and safety net clinics.

Experience with telehealth for sleep monitoring and sleep laboratory management.

In 2009, we established a pilot telehealth service to a sleep laboratory in Garden City, Kansas, approximately 600 km from the Kansas University Medical Center. Videoconferencing was used for polysomnography (PSG) study follow-up, patient monitoring and sleep laboratory medical management. It allowed the sleep specialist to treat patients and collaborate with sleep laboratory personnel from a distance without extensive travel.

Vagal afferent innervation of the proximal gastrointestinal tract mucosa: chemoreceptor and mechanoreceptor architecture.

The vagus nerve supplies low-threshold chemo- and mechanosensitive afferents to the mucosa of the proximal gastrointestinal (GI) tract. The absence of a full characterization of the morphology and distributions of these projections has hampered comprehensive functional analyses. In the present experiment, dextran (10K) conjugated with tetramethylrhodamine and biotin was injected into the nodose ganglion and used to label the terminal arbors of individual vagal afferents of both rats and mice.

Urban telepsychiatry: uncommon service for a common need.

Psychiatry is a particularly good specialty to provide by telemedicine. The psychiatric interaction translates very well to the interactive video medium and typically does not require any peripheral medical devices for the consultation compared with other specialties. Although telemedicine is most often thought of as strictly a rural health tool for solving health care shortages, it has sometimes been used to improve access to many health specialists in urban areas of the United States.

Cost savings of telemedicine utilization for child psychiatry in a rural Kansas community.

The costs of pediatric telemedicine services remain underreported and understudied; however, there is evidence that telepediatric services can be cost competitive with traditional ones. For 15 years, the University of Kansas Center for Telemedicine and Telehealth has been providing telemental health outreach from the University of Kansas Medical Center (KUMC). One service site is located in Crawford County, Kansas, which provides telepsychiatry services to children and adolescents.

Implementation and evaluation of telehealth tools and technologies.

In June 2009, the National Center for Research Resources (NCRR), National Institutes of Health (NIH), convened a conference of experts to discuss future directions for research in addressing healthcare disparities through the use of telehealth technologies. As part of this conference, a panel was convened to review the status of current efforts to assess, implement, and evaluate telehealth technologies, and to recommend future directions for research. The panel members provided a series of practical recommendations to those who are contemplating establishing a telehealth service, as well as recommendations to the NIH on future funding for telehealth research.

Feasibility of using videoconferencing to provide diabetes education: a pilot study.

We conducted a pilot study of the effectiveness of individual counselling sessions provided by a dietician through telemedicine for patients with diabetes. All participants received a single group education session via videoconference. Those who were randomized to the intervention also received two additional follow-up sessions, four and eight weeks later.

A comparison of telehealth and face-to-face presentation for school professionals supporting students with chronic illness.

We compared the perceptions of school professionals who received education about students with chronic illness by videoconference (VC) or by face-to-face (FTF) presentation. Forty-five different one-hour presentations were provided by a paediatric educator to a total of 1389 subjects - 919 viewed FTF presentations and 417 viewed VC presentations. Subjects completed a 10-item survey to assess satisfaction and other perceptions, such as access and convenience of the sessions, on a 5-point Likert scale.

Defining the needs of a telemedicine service.

While telemedicine programme objectives, technologies and even philosophies will differ, certain common factors that enhance programme success can be identified. For example, a programme design which is driven by technological imperatives is likely to fail. It must also be recognized that telemedicine programmes cannot force remote sites to use their services.

Diffusion theory and telemedicine adoption by Kansas health-care providers: critical factors in telemedicine adoption for improved patient access.

Twenty counties in Kansas were randomly selected from those designated as rural on the basis of their populations. A sample of 356 physicians and physicians' assistants in these counties was chosen. A postal survey was sent to the identified providers up to three times.

Adapting the Roter interaction analysis system for telemedicine: lessons from four specialty clinics.

Four specialists (a child psychiatrist, an oncologist, a cardiologist and a rheumatologist) conducted telemedicine clinics using videoconferencing at a bandwidth of 128-384 kbit/s. The consultations were videorecorded. The coded interactions from the first two patients recruited from each of the four telemedicine clinics were analysed.

A cost analysis of a tele-oncology practice in the United States.

Oncology services have been provided by telemedicine from the University of Kansas Medical Center (KUMC) for almost 10 years. We have analysed the costs associated with providing tele-oncology clinics to a rural Kansas town for two fiscal years, 1995 and 2000. The aim was to compare recent tele-oncology costs with those of the first year of tele-oncology practice.