· Finding Peer-Reviewed Articles in Google Scholar - blogger.com: Gloria Dikeogu · Introduction. In December , an infection caused by a bat-origin novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was detected in Wuhan, China (1). Within less than 3 months, coronavirus disease (COVID), the disease caused by SARS-CoV-2, had spread across China and blogger.com by: 4 Explore the latest full-text research PDFs, articles, conference papers, preprints and more on PEER-REVIEWED JOURNALS. Find methods information, sources, references or conduct a literature review Estimated Reading Time: 10 mins
Peer Reviewed: The Influence of Telehealth for Better Health Across Communities
Try out PMC Labs and tell us what you think. Learn More. Rapid spread of coronavirus disease COVID forced an abrupt shift in the traditional US health care delivery model to meet the needs of patients, staff, and communities. Through federal policy changes on telehealth, patient care shifted from in-person to telephone or video visits, and health care providers reached out to patients most at risk for exacerbation of chronic disease symptoms.
ECHO Extension for Community Healthcare Outcomesa videoconferencing peer learning application, engaged health care providers across Missouri in the treatment and management of complex COVID—positive patients. Re-envisioning health care in the digital age includes robust utilization of telehealth to enhance care for all.
The COVID pandemic has forced many health care institutions to reconsider health care delivery mechanisms. Because of reimbursement restrictions, telehealth has been underutilized. Capitalizing on existing infrastructure that supports digital connectivity through uptake of telehealth was vital to successfully reimagine safe health care delivery. Removing a critical barrier, reimbursement, supported telehealth.
Technologic advancements and policy changes can alter health care delivery and have the potential to reduce disparities in access to care and improve outcomes among the most vulnerable populations. In Decemberan infection caused by a bat-origin novel coronavirus, severe acute respiratory syndrome coronavirus 2 SARS-CoV-2was detected in Wuhan, China 1.
Within less than 3 months, coronavirus disease COVIDthe disease caused by SARS-CoV-2, had spread across China and worldwide. The World Health Organization declared COVID a pandemic on March 11, 2. As of May 30,more than 1 million infections had been laboratory-confirmed in the United States with more thancase fatalities 3, google peer reviewed articles.
Hospitalization rates were highest among adults aged 65 years or older, people with multiple chronic conditions, and men 3. Among younger patients 18—49 yobesity, underlying chronic lung disease primarily asthmaand diabetes were the most prevalent chronic disorders 3.
Because COVID is a pandemic, the virus is expected to cause multiple waves of infection in future months and to persist to cause seasonal outbreaks 2. Rural populations in the United States face significant challenges in accessing health care and have poorer health outcomes than urban or suburban populations, including higher rates of chronic disease, higher death rates, and delayed diagnoses for cancers and other diseases 5 — 7. These challenges are likely due to less accessible care related to lower rates of insurance; maldistribution of the health care workforce, particularly specialists; an older population; a greater proportion of patients with multiple comorbidities; and higher levels of socioeconomic need 8.
Missouri is a predominantly rural state. These comorbid conditions among rural Missouri residents put them most at risk of fatal complications from COVID, in particular those with predisposing conditions, such as diabetes, chronic pulmonary disease, and hypertension 3, google peer reviewed articles.
As cases of COVID increased exponentially once the pandemic reached the United States, clinicians and researchers became particularly concerned about its impact on the most vulnerable rural and underserved people with chronic conditions. Our objective is to describe the multipronged approach used in Missouri to provide quick response to the COVID pandemic along with preliminary trend data, including disruptive technology applications that created an environment for widespread adoption of telemedicine.
Taking advantage of the experiences of US coastal cities where the COVID pandemic hit hard and fast, an incident command team was created on March 9,at a tertiary referral hospital system, google peer reviewed articles, Google peer reviewed articles of Missouri Health Care MU Health Careserving a county, predominantly rural, catchment area.
In this commentary, google peer reviewed articles, we use telehealth as an umbrella term referring to telemedicine and other health-related virtual activities, such as distance continuing medical education, training, and patient portals. Telemedicine will refer to providing medical care at a distance, which includes audio—video care or audio care only.
The MU Health Care system had to reconsider the delivery of care, not only for the expected deluge of COVID—positive patients but also the routinely sick patients. With these policies and behavior changes, a significant shift in nursing work duties and the way nurses provided care occurred, often in areas outside normal clinical specialty areas. During this same time period, some redeployed nurses served as ambulatory care coordinators and identified patients most at risk for exacerbation of chronic disease symptoms.
This repositioning of nurses to care for vulnerable populations was based on strong evidence-based research in which nurse-led interventions in primary care have been shown to improve health outcomes This also harkened back to an era in which patients stayed at home and the health care provider traveled to the patient. In this case, the traveling was virtual.
To readily support virtual traveling within the US health care system, the federal government allowed a more robust use of telehealth services during google peer reviewed articles national emergency. Specifically, the Centers for Medicare and Medicaid Services CMS made a limited-time change for allowable reimbursement for medical visits by expanding their definition to include telemedicine visits. The change was initially released on March 17,and made retroactive to March 6, CMS also relaxed the Health Insurance Portability and Accountability Act HIPAA requirements for secure exchange sites by allowing the use of nonpublic-facing video applications such as Skype or Zoom and text-based applications such as WhatsApp, iMessage The ability of a large health care system to make this happen nearly overnight was breathtaking and a reminder of our potential to respond to an imminent challenge or threat.
With this change, health care providers took care of both new and established patients in their homes by telephone and video visits ie, telemedicine visits throughout the county catchment area. In our MU Health Care system of selected specialties — family and community medicine, internal medicine, cardiology, and specialty medicine — no telehealth visits happened before March Figure, google peer reviewed articles.
In reviewing the appointment data, May had a higher volume of appointments than February through April. An opposite pattern for the same time period was observed in ; May had the lowest volume of appointments. This leads us to conclude that the appointment trends we are observing are not associated with seasonality. We attribute a lower number of appointments in May and higher number of cancellations to the continued public health response to the COVID pandemic.
Unfortunately, appointment cancellation data were not collected on type of visit so we do not have insight into whether telehealth versus in-person visits were more likely to be cancelled. Percentage of ambulatory patients who had in-person clinical, cancelled, and telehealth visits for family medicine, internal medicine, cardiology, and medical specialty, google peer reviewed articles, February—May, The denominator for in-person visits and telehealth visits is in-person plus telehealth visits.
The denominator for cancelled appointments is all visits plus cancelled visits. For connectivity, another rapid change was CMS aligning audio-only with audio—video telemedicine google peer reviewed articles on April 30,retroactive to March 6, Originally audio-only visits were reimbursed at about one-third the rate of audio—video visits For patients who experienced poor connectivity, this disparity in reimbursement had the potential to affect care and widen the gap in medical care for vulnerable populations.
Missouri is ranked fortieth among states on the digital divide index; this score is google peer reviewed articles by using both broadband access and broadband adoption as well as socioeconomic factors The literature on the telehealth divide between rural and urban areas shows that the quality of broadband access affects the use of telehealth 1819google peer reviewed articles, although some disparities are narrowing Besides connectivity, other factors influence the ability to use telehealth.
In preliminary data using family medicine encounters over a 1-month period March 17—Apr 16,telemedicine services with audio—video visits were markedly less likely to be among older, black, Medicaid-insured, google peer reviewed articles, or self-pay patients. Going forward, re-envisioning health care in the digital age in which health care providers are reimbursed for time spent with the patient virtually shifts the driver from insurance companies to patients and health care providers to determine what a health care visit looks like and to document access disparities, such as connectivity, privacy, and digital literacy.
Therefore, more immediate and urgent action is needed to address these disparities for equitable health care in the adoption of telehealth. The Show-Me ECHO uses disruptive innovation technologies, such as videoconferencing applications, and is different from traditional telehealth, google peer reviewed articles.
It is centered on case-based learning, health care provider development and retention, and efficiency. Although successfully adopted in acute care medicine and nonmedical applications, this model is primarily used to increase capacity of health care providers to care for patients with chronic diseases and targets rural, isolated, and underserved communities Since its inception in Missouri, over 27, google peer reviewed articles, learners medical doctors, doctors of osteopathy, nurse practitioners, physician assistants, health educators, and others have attended sessions representing almost every county in Missouri.
The existing infrastructure of this provider-facing technology was immediately expanded to create 2 new ECHOs: COVID ECHO and Telemedicine ECHO. COVID ECHO, launched on March 23,supports health care professionals, especially those practicing in rural and isolated areas, with weekly meetings of didactic presentations focused on testing, triage, and other State updates, google peer reviewed articles more than 2, attendees as of May 26, De-identified case presentations were used for learning through a guided practice model, focusing specifically on patients with chronic conditions and COVID infection or risk of infection.
In addition to these weekly sessions, COVID—related topics were incorporated into other regular ECHO sessions, such as asthma, kidney disease, autism, and oral health, thereby substantially expanding the learning and networking opportunities among health care providers. A benefit of ECHO learning is the development of a network of professional colleagues that encourages informal communication outside of regular sessions.
The spread of COVID has caused fear and uncertainty among the public and concerns among health care professionals about their responsibilities to practice medicine while balancing their need to protect their families.
The ECHO virtual collaborative network provides an ideal environment for reducing a sense of isolation among rural health care providers. To support a growing number of novice health care providers using telemedicine and in response to popular demand, Telemedicine ECHO was initiated on April 14, Telemedicine ECHO is a collaboration of the University of Missouri, Missouri Telehealth Network, and the Heartland Telehealth Resource Center serving Missouri, Kansas, and Oklahoma.
Telemedicine ECHO has provided didactic presentations on numerous topics, such as legal and regulatory issues, policy changes, billing and reimbursement, privacy, and security. Google peer reviewed articles program has had more than attendees as of May 26, Case presentations of patients with acute and chronic conditions included best practices for treatment and care management using telemedicine.
Although many institutions, nudged by the COVID pandemic, have adopted this technology, there is still an art to this type of encounter. As Telemedicine ECHO demonstrated, practicing health care professionals benefited from expert google peer reviewed articles support. It is likely that medical schools and residency programs will supplement their google peer reviewed articles on patient encounters to include telehealth visits, if it is not already included.
As telemedicine becomes more commonly used, this platform can be extended to monitor those with influenza-like illness and COVID—like symptoms as well as assist in the management of multiple chronic diseases, as demonstrated by our Italian colleagues One comment made by leadership on the COVID response team was the unwavering willingness of nurses and other health care workers to go where they were needed.
This especially epitomized the dedication and professionalism of nurses and health care professionals. As the COVID first wave passes, the health care workforce, including nurses, can continue using telehealth successfully, and its use has been extended to departments and specialties that had never implemented telehealth before google peer reviewed articles pandemic.
One of our gynecologic oncologists began using telemedicine after COVID policies were enacted. He remarked that he plans on google peer reviewed articles telemedicine encounters for enhanced patient-centered care and that telemedicine provided more comprehensive family engagement.
All family members participated in a telemedicine visit, asked questions, heard his responses, and understood the treatment plan and prognosis. The pattern of delivering health care continues to adapt to medical, economic, and cultural changes, google peer reviewed articles.
Before the middle of the twentieth century, few hospitals existed, and the health system enterprise, including health insurance, was nonexistent Pivotal advances in scientific medical knowledge dramatically google peer reviewed articles the landscape of medicine.
The evolution from health care providers as generalists who provided all care for their patients to health care providers who refer their patients to specialists is complicated, but most consider that the tipping point in this change began in the post-World War II era In the initial response to the COVID pandemic, limited referrals for specialty care as well as appointment cancellations by health care providers for established patients and patients opting to not seek routine care were the norm, leaving a group of patients temporarily adrift Figure.
Similarly, just as technology, such as the invention of the telephone and automobiles, shaped health care by reversing the traveler — the patient coming to see the physician rather than physician going to the patient — disruptive technology in the COVID era with focused attention to addressing disparities faced by some can reshape health care, especially for rural patients and patients with multiple comorbidities.
The fourth aim is often cited as finding joy in work or elevating health equity These aims may be achieved through a more robust inclusion of telehealth. However, a critical factor for success requires thoughtful supportive interventions to ameliorate reported disparities in telehealth adoption. In the COVID era, informal conversations with health care providers about telemedicine, from primary google peer reviewed articles to oncology to endocrinology, suggest mixed reactions to virtual visits through telemedicine.
Some providers have reverted back to the old ways whereas others have embraced this change. As google peer reviewed articles as the CMS policy change for reimbursement remains, a telemedicine visit can be an option between patient and health care provider, and therefore by default create an environment of patient-centered care. For telehealth, many of the restrictions have been lifted, google peer reviewed articles, namely HIPAA compliance, licensing restrictions, and reimbursement differences by type of visit, with the hope that these will be permanently lifted.
Although telemedicine has been integrated into daily clinical practice in responding to the public health emergency, barriers to telemedicine and issues surrounding associated health disparities should not be neglected. Telehealth alone is not a panacea for better health care, and it behooves researchers, providers, and educators to explore creative solutions for optimal health care for all, particularly among vulnerable populations.
Undoubtedly, a concerted effort google peer reviewed articles government agencies, organizations, and community volunteers will be needed to ensure effective access to improved health care, both for high-technology and low-technology solutions.
How to use Google Scholar to find journal articles - Essay Tips
, time: 6:34Is there a way to use Google to find peer reviewed articles? – blogger.com
Explore the latest full-text research PDFs, articles, conference papers, preprints and more on PEER-REVIEWED JOURNALS. Find methods information, sources, references or conduct a literature review Estimated Reading Time: 10 mins · Peer review articles are scholarly and academic sources which: Are written by and for faculty, researchers or scholars (chemists, historians, doctors, artists, etc.) Use scholarly or technical language; Articles tend to be long and detailed, about research in a particular academic discipline; Include full citations for sources; Are often refereed or peer-reviewed; Include Use Google Scholar to Find Peer-Reviewed Articles Google Scholar can be a powerful source of scholarly information, It's very easy to use, looking and feeling just like Google. But the results you will get are very different. Here's some of what you may find: 1. Peer-reviewed journal articles 2. Other previously published journal articles 3. Unpublished scholarly articles blogger.com Size: KB
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