Browsing by Subject "Telehealth"

Now showing 1 - 7 of 7
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    Communication intervention for children with severe neurodevelopmental disabilities: An application of telehealth as a service delivery mechanism
    (2016-08) Simacek, Jessica
    The current study examined the efficacy of a parent-implemented communication assessment and intervention package with coaching via telehealth (i.e., video conferencing) on the acquisition of early communication skills for three young children (3- 4 years old) with severe neurodevelopmental disabilities. Assessment included a structured descriptive assessment (3 participants) and functional analysis (2 participants) to identify communicative contexts and idiosyncratic/potentially communicative responses for the participants. Following assessment, three communicative contexts with high levels of idiosyncratic responses were embedded with Functional Communication Training (FCT). To investigate the efficacy of FCT, participants’ use of aided augmentative and alternative communication (AAC) responses and idiosyncratic responses were measured in an adapted multiple probe design across contexts. All three participants acquired the targeted AAC responses; whereas, prior to intervention, none of the participants engaged in easily recognizable communication forms. Idiosyncratic responses were functionally related to the reinforcers in the communicative contexts, as demonstrated by changes to response patterns during differential reinforcement. Parents implemented the interventions with a high level of fidelity to the coached procedures. At the conclusion of the study, parents rated the interventions as ‘highly acceptable.’ These results provide empirical evidence to telehealth-coached, parent-implemented FCT as an intervention to improve early communication skills for young children with severe neurodevelopmental disabilities. Implications are considered in regards to telehealth as a mechanism to improve access to communication intervention.
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    Essays on Digital Technology-Enabled Mental Healthcare Delivery
    (2024-06) Tang, Yi
    Mental health disorders are a leading cause of disability worldwide, affecting over 700 million people and incurring significant economic costs consisting of direct healthcare spending and lost earnings due to mental health-induced disabilities. The COVID-19 pandemic has exacerbated these issues, highlighting the urgent need for accessible mental health services. Traditional healthcare systems often fall short, particularly due to unique challenges in mental health care delivery, such as stigma and the reluctance of individuals to seek help, as well as a significant shortage of mental health care providers. These barriers are especially pronounced for underserved populations facing economic, geographic, and social obstacles. This dissertation examines the potential of digital technologies to address these gaps through three essays focused on different stages of the mental health help-seeking pathway: initiating care, escalating to professional care, and delivering professional care.The first essay investigates whether mental health mobile apps (MHMAs) can mitigate the inequities seen in traditional mental health services by helping patients gain equitable self- and peer-support. Using detailed usage data from 1,688 users, the study examines the extent to which MHMAs are utilized and beneficial across different socio-demographic groups. The findings indicate that MHMA usage and benefits are statistically equivalent between underserved and better-served populations, suggesting that these apps can potentially promote equity in mental health support and encourage help-seeking behavior, especially among underserved populations. The second essay addresses the challenge faced by patients who have already initiated help-seeking on online platforms but lack timely referrals to professional care when needed. It adopts an abductive reasoning research design and explores the development and exploratory evaluation of an AI-enabled platform designed to improve the mental health service referral process. This platform uses advanced algorithms such as large language models to match users with appropriate mental health services based on their specific needs and socio-demographic backgrounds and deliver the personalized referral process through a chatbot. Initial testing with healthcare providers demonstrates that our proposed AI-enabled online mental health service referral platform has the potential to connect certain patients who have unmet mental health needs with professional mental health services, effectively bridging gaps in service delivery and ensuring timely escalation to professional care for those patients. However, the technology is not universally applicable; it is most effective for certain target populations. The essay also highlights that this AI solution can promote equity by encouraging patients from underserved populations to seek professional care, addressing a key issue where providers, due to long waiting lists, lack the incentive to prioritize equitable service delivery. The third essay investigates the delivery of professional mental health care through telemental health services, focusing on the factors that influence their uptake and impact on mental health condition at the population level. Using 3-digit Zip Code Tabulation Area-level longitudinal data across 19 U.S. states, the study examines how improvements in provider-side technological infrastructure, specifically enhanced broadband access, and telehealth coverage and payment parity laws affect the adoption of telemental health services. The key finding is that these improvements have a synergistic effect: both enhanced broadband access and telehealth parity laws must work together to drive higher uptake of telemental health services and result in better population mental health condition. This synergy is crucial for maximizing the benefits of telemental health and improving overall population mental health. This dissertation makes significant contributions to the healthcare operations management literature, particularly in the underexplored context of mental health services. Addressing the unique challenges of mental health care delivery is vital for improving outcomes and reducing the overall burden of mental health disorders. Firstly, the dissertation underscores the importance of expanding healthcare operations management research to include the entire help-seeking pathway, not just the interaction between patients and professional care providers. By focusing on digital technologies that facilitate the initiation of care and the escalation to professional services, this research highlights how these early stages can significantly influence overall care accessibility and effectiveness, contributing to reducing inequities by ensuring that underserved populations can engage with mental health services from the outset. Secondly, the research emphasizes the need to go beyond the traditional 3A-framework of affordability, access, and awareness in healthcare service delivery. The findings suggest that patient acceptance is a critical factor in the effective delivery of mental health services. Ensuring that patients are willing to engage with the services offered, particularly through digital platforms, is essential for achieving equitable health outcomes. In terms of practical implications, this dissertation offers valuable guidance for policymakers, healthcare providers, and technology developers. For policymakers, the research highlights the necessity of supporting telehealth infrastructure and enacting telehealth parity laws to enhance the uptake of telemental health services. Enhanced provider broadband access combined with telehealth parity laws can work synergistically to improve mental health condition. Healthcare providers can adopt AI-enabled referral platforms to improve the efficiency and accuracy of connecting patients with the appropriate services, thereby addressing a critical gap in the current healthcare system. For technology developers, the findings underscore the importance of designing digital health solutions that are not only accessible and affordable but also acceptable to the target populations. By focusing on these areas, stakeholders can leverage digital technologies to promote equity and efficiency in mental health care, ultimately leading to better population health outcomes.
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    Exploring the Nexus of Telemedicine and Written Mobile Communications
    (2019-05-06) Gresbrink, Emily K
    There is plentiful research covering how we write for mobile, as well as how mobile users write, process, and synthesize information on a screen. There is also a substantial amount of research covering the outcomes telemedicine, or the use of electronic information and communication technologies to supply and support health care services when distance separates participants (Luyegu 2017). However, it is unknown what research exists at the nexus of these two fields. This systematic literature review focuses on discovering research that covers telemedicine and written mobile communications. The review looks to discover what literature, if any, exists, and how it can inform future written communication work in the healthcare and mobile shared space. The review found that no literature currently exists, and future research must occur in this field due to the rapid growth of telemedicine and mobile device usage.
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    Interview with Stuart Speedie
    (2015-01-29) Speedie, Stuart; Tobbell, Dominique
    Stuart Speedie begins by discussing his educational background and his early career spent first at the Northwest Regional Educational Laboratory in Portland, Oregon, and then at the University of Maryland School of Pharmacy where he served as Director of Education. He discusses his early interest in information systems and technology and his five-year NSF-funded research project on the development of expert systems on the appropriate use of drugs in hospital settings, which he developed during a sabbatical year at Stanford University. He describes his responsibilities disseminating information technology at the University of Maryland and the information systems research he conducted there. Next he discusses his move to the University of Minnesota, his appointment in the Division of Health Computer Sciences and in the office of the Provost of the Academic Health Center, and his role on the Provost’s Reengineering Task Force on Information Technology. He discusses his role within the Division of Health Computer Sciences (subsequently renamed the Division of Health Informatics); his work in telehealth and telemedicine; and his collaboration with Stanley Finkelstein on the use of telehealth technologies in homecare. He next discusses the NLM Research Training in Medical Informatics program. He describes the efforts to establish the terminal Masters in Health Informatics; the influence of different directors—Laël Gatewood, Donald Connelly, Julie Jacko—on the Division and later, the Institute for Health Informatics; his collaborations with Donald Connelly on the impact of health information exchange on patients and hospital emergency departments; the influence of Connie Delaney’s appointment to the Institute for Health Informatics; and the Division and Institute’s long-term relationship with the Mayo Clinic.
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    Measuring the impact of technology on nurse workflow: a mixed methods approach.
    (2012-04) Cady, Rhonda Guse
    Background: Investment in health information technology (HIT) is rapidly accelerating. The absence of contextual or situational analysis of the environment in which HIT is incorporated makes it difficult to measure success or failure. The methodology introduced in this paper combines observational research with time-motion study to measure the impact of new HIT on clinician workflow. Objectives: The purpose of this research is the investigation of nurse workflow before and after the implementation of video care delivery in a telephone care delivery setting. The aims are achieved using a sequential mixed methods protocol that explores the workflow of telephone and video care delivery and uses this information to describe the consequences and measure the efficiency of the two delivery modes. Methods: The first phase is a qualitative exploration of nurse workflow in which ethnographic data is collected from nurse informants at a large, urban general pediatrics clinic. The qualitative data is analyzed within the framework of distributed cognition to identify the activity and interaction themes of telephone and video care delivery. The qualitative themes are connected to the quantitative protocol by developing a data collection instrument for the second phase of the protocol: a time-motion study comparing the time (efficiency) of telephone and video care delivery. Qualitative and quantitative results are merged to identify the consequences of adding video care delivery to nurse workflow. The mixed methods protocol is applied to two settings within the general pediatrics clinic: triage office and care coordination office. Results: The workflow of both triage and care coordination are distributed across time, space, persons and artifacts. In both settings, the primary workflow task is coordinating an episode of care and the primary interactions occur with providers, parents and the electronic medical record. The impact of video care delivery on nurse workflow differs between the two settings. In the triage office, adding video care delivery to the existing workflow is disruptive, requiring significantly more time than telephone care delivery. Despite the disruptive effect, triage nurses rate video care delivery as more useful than telephone. In the care coordination office, video care delivery is a standard component of the workflow. It is not disruptive to nurse workflow and does not require significantly more time than telephone care delivery. Applying the mixed method protocol in similar settings provides initial validation for evaluating the impact of new HIT on nurse workflow. Conclusion: Analyzing the quantitative time-motion data within an interpretive framework provides insight into the consequences of new HIT. Adding video to an existing triage workflow results in positive and negative consequences that increase the time spent on workflow tasks. Video facilitates new interaction and communication patterns with parents and children that allow triage nurses to visually supplement and verify their ‘telephone’ assessment, a positive consequence. The internal network architecture creates unpredictable video transmission errors that cause frequent waiting and video care delivery troubleshooting, a negative consequence. Including video as a standard component of the care coordination workflow has a neutral effect on the time of workflow tasks. Video care delivery supports the proactive interactions and increased nurse scope of practice of care coordination provided by an advanced practice nurse. Use of the mixed methods protocol to evaluate other HIT is a necessary step to ensure the methodologies transferability and applicability for use in meta-analysis.
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    A Symphony of the Effects of Music Therapy on Children with Intellectual-Developmental Disabilities
    (2023-01) Wu, Yue
    The structure of this dissertation is a multi-chapter format. Since it is music related, I used symphony as an analogy for this dissertation work and each chapter is one of the movements of the symphony. This dissertation depicts the story of curiosity, compassion, innovation, collaboration, and perseverance in building the bridge. You will read about music therapy, autism spectrum disorder (ASD), telehealth, the experiences of having a child with disabilities in both China and the U.S., the pilot study of tele-music therapy on children with ASD, and a project called Light in the Well, honoring people with disabilities and their families. This dissertation captured the evolution of my research agenda throughout my PhD career. My historical research project on the development of music therapy in China from my master’s program was completed and published at the beginning of my PhD program. With the understanding of the history, I started to participate service projects in different regions in China. From there, I took more interest in learning about accessibility of disability services and people’s experience of having a child with disabilities. That is how the mixed method China study (Movement 2) came to exist. The relationship formed with the local people led me to this question: how to develop a strategy to serve this population in China remotely? This led me to the core of my dissertation: the tele-music therapy study (Movement 3). The original plan was to compare tele-music therapy and in-person music therapy. Due to COVID restrictions, I only could test the feasibility and efficacy of tele-music therapy. The purpose was to eventually provide tele-music therapy to people in China, so they can also receive the service. At the same time, my work as a music therapist propelled me to look at how to bridge the gap between people with and without disabilities and engage all people through music. I started a project using music to tell the stories of people with disabilities and their families, called Light in the Well (Movement 4). The performance allowed musicians with and without disabilities to come together to tell the emotional journey those featured families have been on. Both people with and without disabilities were in the audience. Light in the Well allowed both groups of people to share an experience at the same time in the same space. This project disseminated previous research funding through fine arts, actualizing the work of music therapy in performance art.
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    Using the Unified Theory of Acceptance and Use of Technology (UTAUT) to predict the behavioral intent of teledentistry utilization amongst United States adults
    (2022-06) VanDeWiele, Mercedes
    Objectives: Teledentistry is an innovative health care delivery platform that can potentially improve oral health outcomes and access. The purpose of this study was to predict teledentistry utilization intentions of U.S. adults.Methods: This mixed-methods, cross-sectional study surveyed 899 participants from two independent samples in August and September 2021: Minnesota State Fair attendees and ResearchMatch. Data were analyzed using univariate analysis and multiple linear regression. Qualitative responses were coded using UTAUT constructs. Results: Univariate analysis showed statistical significance between each construct with BI (P < 0.0001). Multiple linear regression revealed statistical significance between PE and SI with BI (P < 0.0001). Qualitative responses corroborated quantitative results and revealed a lack of teledentistry knowledge. Conclusion: Participant BI was significantly associated with PE and SI. The general lack of knowledge suggests that intervention designs building on PE and SI could help develop educational or marketing strategies to increase teledentistry uptake.