When communities were forced into lockdown due to the COVID-19 pandemic, governments across different countries globally also started to impose new social restrictions. In order to comply with these new rules and to meet the demands of an emerging disease, health facilities modified the structures and processes of health care services. 1 Teleconsultations—or medical consultations wherein patients and health care practitioners are away from each other, connected only by telecommunication devices —took the place of the traditional face-toface (FTF) consultations, especially in the outpatient clinics. The provision of remote clinical services or telemedicine—which frequently involves teleconsultations—has been practiced since the early 1960’s, 2 but its utilization has grown exponentially ever since this pandemic started. 3-5 A few studies have demonstrated a significant reduction, from to 60 to 80%, in in-person outpatient visits and a four-fold increase in telehealth outpatient visits in the United States during the early days of the pandemic. 6 7 Similarly, across Asia-Pacific countries, there has been a surge of activity in telemedicine platforms since the identification of the COVID-19 virus in January 2020. 8 In the Philippines, for example, a subscription-based teleconsultation service called KonsultaMD registered a 450% increase in the number of teleconsultations in April 2020. 9 Medgate, one of the country’s leading international telemedicine providers, reported a 170% increase in teleconsultations in 2020. 10 11 The aim of this article is to recommend policies for the delivery and reporting of outpatient care using telemedicine in a tertiary hospital.
Remote Consultation ; COVID-19

To realize the remote operation of the slit lamp microscope for department of ophthalmology consultation, and visual display the real-time status of remote slit lamp microscope, a remote slit lamp microscope consultation system based on B/S structure is designed and implemented. Through framing the slit lamp microscope on the website system, the realtime acquisition and transmission of remote control and image data is realized. The three dimensional model of the slit lamp microscope is established and rendered on the web by using WebGL technology. The practical application results can well show the real-time interactive of the remote consultation system.
Internet ; Ophthalmology ; methods ; Remote Consultation ; Slit Lamp ; Technology

That the multicast technology is fit for telemedical consultation application has been developed on the basis of the features analysis of medical consultation action. A scheme of the telemedical consultation application based on the multicast technology has been designed. The features of this scheme are: unrestrained joining in and quitting, simultaneous control over the transport information of doctor and patient, extending, and simulating consultation scene. And the implementation of this scheme is discussed.
Computer Communication Networks ; Remote Consultation ; methods ; Software ; Systems Analysis

Introduction: The coronavirus disease 2019 (COVID-19) pandemic prompted a shift from standard in-person consultation to non-patient contact methods such as telemedicine. To our knowledge, there was no published a priori evaluation of the telemedicine readiness and acceptance among the medical staff of the Philippine General Hospital (PGH) before implementing the institution’s telemedicine program. The lack of this vital pre-implementation step is understandable given the unprecedented crisis. However, if telemedicine programs will continue in the post-quarantine period, it is crucial to determine the facilitators and barriers to the use of telemedicine. Objective: This study determined the level of readiness and acceptance for telemedicine as an alternative method for patient consultation during the COVID-19 pandemic and post-enhanced community quarantine period among PGH medical staff (consultants, residents, fellows). Methods: The cross-sectional study was conducted from October 2020 to July 2021. Medical staff from the 16 clinical departments of the PGH were selected by systematic random sampling. Inclusion criteria included appointment as medical staff in PGH or University of the Philippines College of Medicine (UPCM), voluntary informed consent, internet access, and technical capacity to access e-mail and SurveyMonkey™. The online survey consisted of two questionnaires. It collected data on the demographic profile and outcomes of interest (e.g., telemedicine readiness and acceptance). Technological readiness was determined through the 16-item modified version of Technological Readiness Index (TRI) version 2.0, while telemedicine acceptance was determined through the modified version of the 19-item Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Descriptive and analytical statistics were performed at a 95% confidence interval. Results: The study had an 87% response rate with 205 respondents, 62% of whom were physicians in training (resident physicians and fellows). The respondents had a median age of 33 years and were mostly males. Only 19% had telemedicine experience before the pandemic. The majority (51%) learned telemedicine on their own. The most common devices used for telemedicine were mobile or smartphones (53%) and laptops (38%). The primary source of internet for telemedicine was mobile broadband (e.g., cellular data) (40%). The majority practiced telemedicine at their home or residence (51%), followed closely by the hospital or clinic (47%). The mean score of the respondents on TRI was 3.56 (very good technological readiness), and 4.00 (very good telemedicine acceptance) on UTAUT (behavioral intention to use the system). Performance expectancy (p = 0.02), effort expectancy (p = 0.03), and self-efficacy (p = 0.02) were significantly directly related to telemedicine adoption, while anxiety (p = 0.03) was significantly inversely related. Conclusion The PGH medical staff were found to have very good telemedicine readiness and acceptance. This suggests a willingness to use telemedicine during the pandemic. Further studies on the organization and technical support system of the telemedicine program in the PGH are strongly recommended. The quality and efficiency of the program will strongly influence the continued use of telemedicine by the medical staff even after the pandemic.
Health Services Administration ; Telemedicine ; Telecommunications ; Remote Consultation ; COVID-19

The coronavirus disease 2019 (COVID-19) epidemic is evolving in Latin America despite implementation of government measures. We report a familial cluster in Lima, Peru, with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Two young and two middle-aged adults with a wide range of COVID-19 manifestations experienced successful management under telehealth outpatient monitoring. Telehealth monitoring was scheduled as suggested by Peruvian Ministry of Health Guidelines and was performed by a designated physician who assessed the patients and prescribed treatment. On May 14, 2020, a 25-year-old male, who worked treating COVID-19 patients, reported constitutional symptoms and tested positive for SARS-CoV-2. Clinical improvement was achieved with azithromycin and ivermectin therapy. He had been in contact with his parents (Cases 2 and 3) and his sister (Case 4). Cases 2 and 3 developed moderate pulmonary compromise requiring oxygen supplementation and pharmacological therapy, including corticosteroids and anticoagulation, under home medical assessment and telehealth monitoring. Case 4 developed mild symptoms and periorbital rash, an atypical dermatological finding. To our knowledge this represents the first report of a familial cluster with COVID-19 that was successfully managed under scheduled telehealth outpatient monitoring in Latin America.
SARS-CoV-2 ; COVID-19 ; Telemedicine ; Remote Consultation

BACKGROUDN: Telemedicine has the potential to reform the delivery system of dermatologic health care. OBJECTIVE: The purpose of this study was to investigate the concordance and accuracy of diagnosis and the management plan of dermatologist's teleconsultation and traditional clinic-based consultation. METHODS: Eighty-eight lesions of 77 patients were examined by digital image and clinic-based consultation by one dermatologist. The reliability and accuracy of the dermatologist's diagnoses and the reliability of the management recommendations were compared. RESULTS: The concordance of diagnosis between telemedicine and clinic-based consultation showed high levels(complete agreement, 92.05%; complete + partial agreement, 97.73%). The agreement on management recommendations was variable. The diagnostic confidence and the image quality affected the agreement. CONCLUSION: The digital image consultations result in reliable diagnostic outcomes when compared with the traditional clinic-based consultaion. And it is necessary to investigate the accuracy of teledermatology and to identify clinical conditions inappropriate for teleconsultation.
Delivery of Health Care ; Dermatology* ; Diagnosis ; Humans ; Referral and Consultation ; Remote Consultation* ; Telemedicine

PURPOSE: Dental trauma is frequently unpredictable. The initial assessment and urgent treatment are essential for dentists to save the patient's teeth. Mobile-phone-assisted teleconsultation and telediagnosis for dental trauma could be an aid when a dentist is not available. In the present in-vitro study, we evaluated the success rate and time to transfer images under various conditions. MATERIALS AND METHODS: We analyzed the image quality of cameras built into mobile phones based on their resolution, autofocus, white-balance, and anti-movement functions. RESULTS: The image quality of most built-in cameras was acceptable to perform the initial assessment, with the autofocus function being essential to obtain high-quality images. The transmission failure rate increased markedly when the image size exceeded 500 kappaB and the additional text messaging did not improve the success rate or the transmission time. CONCLUSION: Our optimal protocol could be useful for emergency programs running on the mobile phones.
Cellular Phone ; Dentists ; Emergencies ; Humans ; Remote Consultation ; Running ; Text Messaging ; Tooth ; Tooth Injuries

OBJECTIVES: This paper introduces a telemedicine innovation network and reports its implementation in Tehran University of Medical Sciences. The required conditions for the development of future projects in the field of telemedicine are also discussed; such projects should be based on the common needs and opportunities in the areas of healthcare, education, and technology. METHODS: The development of the telemedicine innovation network in Tehran University of Medical Sciences was carried out in two phases: identifying the beneficiaries of telemedicine, and codification of the innovation network memorandum; and brainstorming of three workgroup members, and completion and clustering ideas. The present study employed a qualitative survey by using brain storming method. Thus, the ideas of the innovation network members were gathered, and by using Freeplane software, all of them were clustered and innovation projects were defined. RESULTS: In the services workgroup, 87 and 25 ideas were confirmed in phase 1 and phase 2, respectively. In the education workgroup, 8 new programs in the areas of telemedicine, tele-education and teleconsultation were codified. In the technology workgroup, 101 and 11 ideas were registered in phase 1 and phase 2, respectively. CONCLUSIONS: Today, innovation is considered a major infrastructural element of any change or progress. Thus, the successful implementation of a telemedicine project not only needs funding, human resources, and full equipment. It also requires the use of innovation models to cover several different aspects of change and progress. The results of the study can provide a basis for the implementation of future telemedicine projects using new participatory, creative, and innovative models.
Brain ; Delivery of Health Care ; Education ; Financial Management ; Humans ; Remote Consultation ; Technology Transfer ; Telemedicine*

OBJECTIVES: Through telehealth, medical services have expanded beyond spatial boundaries and are now available in living spaces outside of hospitals. It can also contribute to patient medical knowledge improvement because patients can access their hospital records and data from home. However, concepts of telehealth are rather vague in Korea. METHODS: We refer to several clinical reports to determine the current clinical status of and obstacles to telehealth in Korea. RESULTS: Patients' health conditions are now reported regularly to doctors remotely, and patients can receive varied assistance. Self-improvement based on minute details that are beyond medical staff's reach is another possible benefit that may be realized with the help of a variety of medical equipment (sensors). The feasibility, clinical effect, and cost-benefit of telehealth have been verified by scientific evidence. CONCLUSIONS: Patients will be able to improve their treatment adherence by receiving help from various professionals, such as doctors, nurses, nutritionists, and sports therapists. This means that the actual treatment time per patient will increase as well. Ultimately, this will increase the quality of patients' self-administration of care to impede disease progression and prevent complications.
Disease Progression ; Hospital Records ; Humans ; Korea* ; Nutritionists ; Remote Consultation ; Sports ; Telecommunications ; Telemedicine*

CONTEXT: The Internet is increasingly used by consumers to seek health and medical information, but online medical consultation has not been explored systematically. OBJECTIVE: To analyze Questions and Answers in Internet Based Medical Consultation in Oriental Traditional Medicine and to provide what is the need for this area. SUBJECTS AND METHOD: 1188 Dialogues of 96 consutant O.M.D(Oriental Medical Doctor) on 6 Web sites which is analyzed through frequency, correlation and ANOVA RESULTS AND CONCLUSIONS: First, Amount of Answer is small(290 characters). Responding time is long. And Numbers per consultant O.M.D is small. So Service Provider need to develope 'Supporting Tool for Writing Answer' . Secondly, User asked of home therapy and everyday discomfort, but Consultant didn t suggest appropriate answers. Thirdly, About 30% of total questions was inappropriate. 'Supporting Tool for Questioning' could decrease the ratio of inappropriate questions.
Consultants ; Humans ; Internet* ; Medicine, East Asian Traditional* ; Needs Assessment ; Remote Consultation ; Writing