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Cited by 338Telemedicine and Telehealth ImplementationDental Research and COVID-19Mobile Health and mHealth Applications

The role of eHealth, telehealth, and telemedicine for chronic disease patients during COVID-19 pandemic: A rapid systematic review

Open access
Bitar, Hind, Alismail, Sarah·2021·DIGITAL HEALTH
DOI 10.1177/20552076211009396PMC PMC8060773
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Abstract

Objective: To summarize the current status of, and the current expert opinions, recommendation and evidence associated with the use and implementation of electronic health (eHealth), telemedicine, and/or telehealth to provide healthcare services for chronic disease patients during the COVID-19 pandemic. Materials and methods: We searched four electronic databases (PubMed, Google Scholar, Science Direct, and Web of Science Core Collection) to identify relevant articles published between 2019 and 2020. Searches were restricted to English language articles only. Two independent reviewers screened the titles, abstracts, and keywords for relevance. The potential eligible articles, papers with no abstract, and those that fall into the uncertain category were read in full text independently. The reviewers met and discussed which articles to include in the final review and reached a consensus. Results: We identified 51 articles of which 25 articles met the inclusion criteria. All included articles indicated the promising potential of eHealth, telehealth, and/or telemedicine solutions in delivering healthcare services to patients living with chronic diseases/conditions during the COVID-19 pandemic. We synthesized the main findings into ten usages and eight recommendations concerning the different activities for delivering healthcare services remotely for those living with chronic diseases/conditions in the era of COVID-19. Discussion and conclusions: There is limited evidence available about the effectiveness of such solutions. Further research is required during this pandemic to improve the credibility of evidence on telemedicine, telehealth, and/or eHealth-related outcomes for those living with chronic diseases.

AI snapshot

Written from the paper’s full text.

TL;DR

This rapid systematic review synthesized 25 included articles on eHealth, telehealth, and/or telemedicine for chronic disease patients during the COVID-19 pandemic. All included articles indicated promising potential for remote care, but the authors report limited evidence on effectiveness and call for further rigorous research.

Key findings

  • Of 51 retrieved articles, 25 met inclusion criteria; all included articles indicated the promising potential of eHealth, telehealth, and/or telemedicine for delivering healthcare services to chronic disease patients during COVID-19.
  • Most articles used the term telemedicine (n = 17; 68%), followed by telehealth (n = 15; 53.8%), while two used eHealth (7.7%); some articles used more than one term.
  • The review synthesized main findings into eight recommendations for remote healthcare delivery; most included articles concentrated on continuity of care, ten on remote outpatient care, four on system integration, three on standardized transition, two on cost-effectiveness, two on privacy/data sharing, one on billing reimbursement, and one on simplicity.
  • The abstract reports ten usages and eight recommendations, while the results section describes six usages: follow-up visits, training, consultations, medications, communication, and caregiver support.

Methods

  • Rapid systematic review searching PubMed, Google Scholar, Science Direct, and Web of Science Core Collection on April 20, 2020, and again on May 15, 2020; searches were restricted to English-language articles using keywords “eHealth,” OR “telemedicine,” OR “telehealth,” AND “COVID-19,” OR “coronavirus,” AND “chronic disease.”
  • Inclusion criteria required focus on any chronic disease/condition, relation to COVID-19, use of eHealth/telemedicine/telehealth, and completion between December 1, 2019, and May 15, 2020; all study designs were included, such as preprints, commentary, and opinion papers.
  • Two independent reviewers screened titles, abstracts, and keywords; eligible, no-abstract, and uncertain articles were read in full text independently, then reviewers reached consensus; data extracted included author, year, paper type, country, population/chronic disease, technology type, current status, and outcomes.

Limitations

  • Stated: the review is not comprehensive because it was limited to English-language articles; the quality of included articles is not known; there is limited evidence on effectiveness, with no experimental design studies found; some chronic diseases were limited or under-represented; only “chronic disease” was used as a diagnosis-specific search keyword; 12 included articles (46.1%) had no specified country; the rapid timeframe means more articles were rapidly emerging; and the review was not registered on PROSPERO.
  • Evident from the text: the abstract reports “ten usages” while the results section reports “six usages,” indicating an internal inconsistency in the synthesis.
  • Evident from the text: most included articles were reviews and expert opinions, and quality of evidence was not assessed due to the absence of included trials, limiting the strength of conclusions about effectiveness.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/20552076211009396

Cites

38 of 38 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 64 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Most of the articles used the term telemedicine (n = 17; 68%) to describe the used technology or recommended to use in providing healthcare services needed for chronic disease patients.

    “Most of the articles used the term telemedicine (n = 17; 68%) to describe the used technology or recommended to use in providing healthcare services needed for chronic disease patients.14–30”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [14] Omboni S. Telemedicine during the COVID-19 in Italy: a missed opportunity? Telemed J E Health 2020; 26: 973– 975. 32324109 PMC7415870 source

      Not checked in the free run.

    • cites [15] Ryczek R Krzesiński P. Cardiac patients and COVID-19: What the general practitioner should know. Pediatr Med Rodz 2019; 15: C6– C9. source

      Not checked in the free run.

    • cites [16] Compton M Soper M Reilly B, et al. A feasibility study of urgent implementation of cystic fibrosis multidisciplinary telemedicine clinic in the face of COVID-19 pandemic: single-center experience. Telemed J E Health 2020; 26: 978– 984. 32357084 source

      Not checked in the free run.

    • cites [17] Lewis GD Hatch SS Wiederhold LR, et al. Long-term institutional experience with telemedicine services for radiation oncology: a potential model for long-term utilization. Adv Radiat Oncol 2020; 5: 780– 782. 32391444 PMC7205717 source

      Not checked in the free run.

    • cites [18] Desideri I Pilleron S Battisti NML, et al. Caring for older patients with cancer during the COVID-19 pandemic: a young international society of geriatric oncology (SIOG) global perspective. J Geriatr Oncol 2020; 11: 1175– 1181. 32402764 PMC7252080 source

      Not checked in the free run.

    • cites [19] Shanthanna H Strand N Provenzano D, et al. Caring for patients with pain during the COVID‐19 pandemic: consensus recommendations from an international expert panel. Anaesthesia 2020; 75: 935– 944. 32259288 PMC7262200 source

      Not checked in the free run.

    • cites [20] Al Kasab S Almallouhi E Holmstedt CA. Optimizing the use of teleneurology during the COVID-19 pandemic. Telemed J E Health 2020; 26: 1197– 1198. 32329661 source

      Not checked in the free run.

    • cites [21] Kadir MA. Role of telemedicine in healthcare during COVID-19 pandemic in developing countries. Telehealth Med Today 2020; source

      Not checked in the free run.

    • cites [22] Boehm K Ziewers S Brandt MP, et al. Telemedicine online visits in urology during the COVID-19 pandemic – potential, risk factors, and patients’ perspective. Eur Urol 2020; 78: 16– 20. 32362498 PMC7183955 source

      Not checked in the free run.

    • cites [23] Brough HA Kalayci O Sediva A, et al. Managing childhood allergies and immunodeficiencies during respiratory virus epidemics – the 2020 COVID‐19 pandemic: a statement from the EAACI‐section on pediatrics. Pediatr Allergy Immunol 2020; 31: 442– 448. 32319129 PMC7264548 source

      Not checked in the free run.

  • Findingown data

    All included articles indicated the promising potential of eHealth, telehealth, and/or telemedicine solutions in delivering healthcare services to patients living with chronic diseases/conditions during the COVID-19 pandemic.

    “All included articles indicated the promising potential of eHealth, telehealth, and/or telemedicine solutions in delivering healthcare services to patients living with chronic diseases/conditions during the COVID-19 pandemic.”
    Quote in the paperSubstantial claim
  • Findingown data

    The majority of the included articles were reviews and experts' opinions.

    “The majority of the included articles were reviews and experts’ opinions; thus, the quality of evidence was not assessed due to the absence of included trails.”
    Quote in the paperSubstantial claim
  • Findingcitation

    One article noted the utilization of video calls to help provide caregiver support virtually.

    “one noted the utilization of video calls to help provide caregiver support virtually;18”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Desideri I Pilleron S Battisti NML, et al. Caring for older patients with cancer during the COVID-19 pandemic: a young international society of geriatric oncology (SIOG) global perspective. J Geriatr Oncol 2020; 11: 1175– 1181. 32402764 PMC7252080 source

      Not checked in the free run.

  • Findingreasoning

    Most of the included articles concentrated on the provision of continuity of care.

    “Most of the included articles concentrated on the provision of continuity of care due to the nature of the diseases and conditions that were examined in this research.14,15,17,19–22,26–28,30–34,37”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [14] Omboni S. Telemedicine during the COVID-19 in Italy: a missed opportunity? Telemed J E Health 2020; 26: 973– 975. 32324109 PMC7415870 source

      Not checked in the free run.

    • cites [15] Ryczek R Krzesiński P. Cardiac patients and COVID-19: What the general practitioner should know. Pediatr Med Rodz 2019; 15: C6– C9. source

      Not checked in the free run.

    • cites [17] Lewis GD Hatch SS Wiederhold LR, et al. Long-term institutional experience with telemedicine services for radiation oncology: a potential model for long-term utilization. Adv Radiat Oncol 2020; 5: 780– 782. 32391444 PMC7205717 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. 31
  • May combine two claims. 12

  • Classified as probably not a substantial claim.

    Findingown data

    The review synthesized the main findings into ten usages and eight recommendations concerning different activities for delivering healthcare services remotely for those living with chronic diseases/conditions in the era of COVID-19.

    “We synthesized the main findings into ten usages and eight recommendations concerning the different activities for delivering healthcare services remotely for those living with chronic diseases/conditions in the era of COVID-19.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The review identified 51 articles, of which 25 met the inclusion criteria.

    “We identified 51 articles of which 25 articles met the inclusion criteria.”
    • Also stated in: § Overview · plain
      “Of the 51 retrieved articles, 25 met the inclusion criteria.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Fifteen articles used the term telehealth (53.8%).

    “Fifteen articles used the term telehealth (53.8%),15–17,27–38”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [15] Ryczek R Krzesiński P. Cardiac patients and COVID-19: What the general practitioner should know. Pediatr Med Rodz 2019; 15: C6– C9. source

      Not checked in the free run.

    • cites [16] Compton M Soper M Reilly B, et al. A feasibility study of urgent implementation of cystic fibrosis multidisciplinary telemedicine clinic in the face of COVID-19 pandemic: single-center experience. Telemed J E Health 2020; 26: 978– 984. 32357084 source

      Not checked in the free run.

    • cites [17] Lewis GD Hatch SS Wiederhold LR, et al. Long-term institutional experience with telemedicine services for radiation oncology: a potential model for long-term utilization. Adv Radiat Oncol 2020; 5: 780– 782. 32391444 PMC7205717 source

      Not checked in the free run.

    • cites [27] Bloem BR Dorsey ER Okun MS. The coronavirus disease 2019 crisis as catalyst for telemedicine for chronic neurological disorders. JAMA Neurol 2020; 77: 927. 32329796 source

      Not checked in the free run.

    • cites [28] Płońska-Gościniak E Suwalski P Bartuś S, et al. Valvular and structural heart disease management during the COVID-19 pandemic. Expert opinion of the working group on valvular heart diseases, the working group on cardiac surgery, and the association of cardiovascular interventions of the polish cardiac society. Kardiologia Polska 2020; 78: 498–507. 32415767

      Not checked in the free run.

    • cites [29] Sarsak H. Telerehabilitation services: a successful paradigm for occupational therapy clinical services. Int Phys Med Rehabil J 2020; 5: 93– 98.

      Not checked in the free run.

    • cites [30] Khera A Baum SJ Gluckman TJ, et al. Continuity of care and outpatient management for patients with and at high risk for cardiovascular disease during the COVID-19 pandemic: a scientific statement from the American Society for Preventive Cardiology. Am J Prev Cardiol 2020; 1: 100009. 32835347 PMC7194073 source

      Not checked in the free run.

    • cites [31] Parisien RL Shin M Constant M, et al. Telehealth utilization in response to the novel coronavirus (COVID-19) pandemic in orthopaedic surgery. J Am Acad Orthop Surg 2020; 28: e487– e492. 32459409 PMC7197336 source

      Not checked in the free run.

    • cites [32] Nicholls SJ Nelson M Astley C, et al. Optimising secondary prevention and cardiac rehabilitation for atherosclerotic cardiovascular disease during the COVID-19 pandemic: a position statement from the cardiac society of Australia and New Zealand (CSANZ). Heart Lung Circ 2020; 29: e99– e104. 32473781 PMC7192068 source

      Not checked in the free run.

    • cites [33] Neubeck L Hansen T Jaarsma T, et al. Delivering healthcare remotely to cardiovascular patients during COVID-19: a rapid review of the evidence. Eur J Cardiovasc Nurs 2020; 19: 486– 494. 32380858 PMC7717235 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    One article reported the use of virtual reality to provide surgical training for surgeons as well as to remotely deliver physical activity sessions to patients at home.

    “Furthermore, one reported the use of virtual reality to provide surgical training for surgeons as well as to remotely deliver physical activity sessions to patients at home.38”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Bini SA Schilling PL Patel SP, et al. Digital orthopaedics. A glimpse into the future in the midst of a pandemic. J Arthroplasty 2020; 35: 3056. PMC7175889 32416956 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Twelve articles had no defined setting.

    “Twelves articles had no defined setting.19,22–24,26–29,33,35,36,38”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The settings of included articles included the United States, Western China, developing countries, Europe, Australia, Canada, Mexico, and Asia.

    “The settings included the United States,16,17,20,30,31,34,37,38 Western China,25 developing countries,21 Europe,14,15,18 Australia,32 Canada,18 Mexico,18 and Asia.18”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Two articles referenced the importance of ensuring access to medications as well as tracking the prescription of medication electronically.

    “two referenced the importance of ensuring access to medications as well as tracking the prescription of medication electronically.18,32”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [18] Desideri I Pilleron S Battisti NML, et al. Caring for older patients with cancer during the COVID-19 pandemic: a young international society of geriatric oncology (SIOG) global perspective. J Geriatr Oncol 2020; 11: 1175– 1181. 32402764 PMC7252080 source

      Not checked in the free run.

    • cites [32] Nicholls SJ Nelson M Astley C, et al. Optimising secondary prevention and cardiac rehabilitation for atherosclerotic cardiovascular disease during the COVID-19 pandemic: a position statement from the cardiac society of Australia and New Zealand (CSANZ). Heart Lung Circ 2020; 29: e99– e104. 32473781 PMC7192068 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Training patients on how to use a home blood pressure cuff became important for pregnant women with hypertensive disorders receiving telehealth care, and such training can facilitate the provision of virtual prenatal care.

    “For instance, training patients on how to use a home blood pressure cuff become important for pregnant women with hypertensive disorders receiving telehealth care; thus, such training can facilitate the provision of virtual prenatal care.37”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Aziz A Zork N Aubey JJ, et al. Telehealth for high-risk pregnancies in the setting of the COVID-19 pandemic. Am J Perinatol 2020; 37: 800–808. PMC7356069 32396948

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Findingown data

    The review synthesized the main findings into eight recommendations in accordance with the remote healthcare delivery life cycle for chronic disease patients during the pandemic.

    “We synthesized the main findings of this rapid review into eight recommendations in accordance with the remote healthcare delivery life cycle for chronic disease patients during the pandemic (see Figure 3).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Some of the included articles used more than one term.

    “However, some of these articles used more than one term (e.g.,17).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Lewis GD Hatch SS Wiederhold LR, et al. Long-term institutional experience with telemedicine services for radiation oncology: a potential model for long-term utilization. Adv Radiat Oncol 2020; 5: 780– 782. 32391444 PMC7205717 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Two articles used the term eHealth (7.7%).

    “while two articles used the term eHealth (7.7%).18,32”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [18] Desideri I Pilleron S Battisti NML, et al. Caring for older patients with cancer during the COVID-19 pandemic: a young international society of geriatric oncology (SIOG) global perspective. J Geriatr Oncol 2020; 11: 1175– 1181. 32402764 PMC7252080 source

      Not checked in the free run.

    • cites [32] Nicholls SJ Nelson M Astley C, et al. Optimising secondary prevention and cardiac rehabilitation for atherosclerotic cardiovascular disease during the COVID-19 pandemic: a position statement from the cardiac society of Australia and New Zealand (CSANZ). Heart Lung Circ 2020; 29: e99– e104. 32473781 PMC7192068 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Three articles stated the standardized transition process.

    “three articles stated the standardized transition process,13,15,18”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [13] Khangura S Konnyu K Cushman R, et al. Evidence summaries: the evolution of a rapid review approach. Syst Rev 2012; 1: 10. 22587960 PMC3351736 source

      Not checked in the free run.

    • cites [15] Ryczek R Krzesiński P. Cardiac patients and COVID-19: What the general practitioner should know. Pediatr Med Rodz 2019; 15: C6– C9. source

      Not checked in the free run.

    • cites [18] Desideri I Pilleron S Battisti NML, et al. Caring for older patients with cancer during the COVID-19 pandemic: a young international society of geriatric oncology (SIOG) global perspective. J Geriatr Oncol 2020; 11: 1175– 1181. 32402764 PMC7252080 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Ten articles recommended focusing on remote outpatient care activity.

    “Ten articles recommended focusing on remote outpatient care activity;17,23,24,28,32,33,35–38”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [17] Lewis GD Hatch SS Wiederhold LR, et al. Long-term institutional experience with telemedicine services for radiation oncology: a potential model for long-term utilization. Adv Radiat Oncol 2020; 5: 780– 782. 32391444 PMC7205717 source

      Not checked in the free run.

    • cites [23] Brough HA Kalayci O Sediva A, et al. Managing childhood allergies and immunodeficiencies during respiratory virus epidemics – the 2020 COVID‐19 pandemic: a statement from the EAACI‐section on pediatrics. Pediatr Allergy Immunol 2020; 31: 442– 448. 32319129 PMC7264548 source

      Not checked in the free run.

    • cites [24] Boettler T Newsome PN Mondelli MU, et al. Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper. JHEP Rep 2020; 2: 100113. 32289115 PMC7128473 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The included articles focused on various chronic conditions: six on cardiovascular disease, two on cancer, two on chronic orthopedic conditions, two on chronic neurological disorders, two on cirrhosis and chronic liver diseases, and one each on chronic pain, cystic fibrosis, urologic chronic conditions, mental health disorders, chronic diseases requiring occupational therapy, allergies/asthma/and/

    “Six articles focused on cardiovascular disease (CVD),15,28,30,32,33,36 two on cancer,17,18 two on chronic orthopedic conditions,31,38 two on chronic neurological disorders,20,27 one on chronic pain,19 one on cystic fibrosis,16 one on urologic chronic conditions,22 one on mental health disorders,34 one on chronic diseases requiring occupational therapy,29 one on allergies, asthma, and ImmunoDeficIe”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Two articles highlighted the need to conduct more cost-effectiveness studies.

    “two articles highlighted the need to conduct more cost-effectiveness studies,16,31”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [16] Compton M Soper M Reilly B, et al. A feasibility study of urgent implementation of cystic fibrosis multidisciplinary telemedicine clinic in the face of COVID-19 pandemic: single-center experience. Telemed J E Health 2020; 26: 978– 984. 32357084 source

      Not checked in the free run.

    • cites [31] Parisien RL Shin M Constant M, et al. Telehealth utilization in response to the novel coronavirus (COVID-19) pandemic in orthopaedic surgery. J Am Acad Orthop Surg 2020; 28: e487– e492. 32459409 PMC7197336 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Another article stated the importance of simplicity in the technology.

    “while another article stated the importance of simplicity in the technology.32”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Nicholls SJ Nelson M Astley C, et al. Optimising secondary prevention and cardiac rehabilitation for atherosclerotic cardiovascular disease during the COVID-19 pandemic: a position statement from the cardiac society of Australia and New Zealand (CSANZ). Heart Lung Circ 2020; 29: e99– e104. 32473781 PMC7192068 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    To the authors' knowledge, this is the first review that explores the role of eHealth, telehealth, and telemedicine technology in the delivery of healthcare services to patients living with chronic diseases/conditions during the COVID-19 crisis.

    “To our knowledge, this is the first review that explores the role of eHealth, telehealth, and telemedicine technology in the delivery of healthcare services to patients living with chronic diseases/conditions during the COVID-19 crisis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    Most of the included articles used the term telemedicine, followed by telehealth, whereas few articles used the term eHealth.

    “Most of the included articles used the term telemedicine, followed by telehealth, whereas few articles used the term eHealth.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    There were variations in using these terms in which some seemed to use them interchangeably while others distinguish between them.

    “In fact, there were variations in using these terms in which some seemed to use them interchangeably while others distinguish between them.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One article emphasized billing reimbursement.

    “one article also emphasized billing reimbursement,15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Ryczek R Krzesiński P. Cardiac patients and COVID-19: What the general practitioner should know. Pediatr Med Rodz 2019; 15: C6– C9. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Two articles highlighted studies on privacy and data sharing.

    “and studies on privacy and data sharing.14,32”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] Omboni S. Telemedicine during the COVID-19 in Italy: a missed opportunity? Telemed J E Health 2020; 26: 973– 975. 32324109 PMC7415870 source

      Not checked in the free run.

    • cites [32] Nicholls SJ Nelson M Astley C, et al. Optimising secondary prevention and cardiac rehabilitation for atherosclerotic cardiovascular disease during the COVID-19 pandemic: a position statement from the cardiac society of Australia and New Zealand (CSANZ). Heart Lung Circ 2020; 29: e99– e104. 32473781 PMC7192068 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Findingnone given

    This rapid review confirms that researchers from several specialties across the world have made a huge effort to improve healthcare services for chronic disease patients.

    “This rapid review confirms that researchers from several specialties across the world have made a huge effort to improve healthcare services for chronic disease patients.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Some included articles support and encourage the continuity of using such technological solutions in the future when the COVID-19 crisis is over.

    “Some of these articles also support and encourage the continuity of using such technological solutions in the future when the COVID-19 crisis is over.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Initial screening for articles was performed by two independent reviewers based on titles, abstracts, and keywords for relevance.

    “Initial screening for articles was performed by two independent reviewers (HB and SA) based on titles, abstracts, and keywords for relevance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Patients with chronic disease conditions, such as diabetes and/or heart condition, may be vulnerable to the COVID-19 pandemic, meaning they are a high-risk population.

    “Patients with chronic disease conditions, such as patients living with diabetes and/or heart condition, may be vulnerable to the COVID-19 pandemic, which means that they are a high-risk population.4”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4] Centers for Disease Control and Prevention. People who are at higher risk for severe illness, www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html (2020, accessed 29 March 2021).

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The reviewers met and discussed which articles to include in the final review and reached a consensus.

    “Then, the reviewers met and discussed which articles to include in the final review and reached a consensus.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The COVID-19 pandemic has disrupted the way health care services are delivered and prioritized the urgency of preventing community transmission.

    “This has disrupted the way health care services are delivered and prioritized the urgency of preventing community transmission.1”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] Zheng S-q Yang L Zhou P-x, et al. Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: a China perspective. Res Social Adm Pharm 2021; 17: 1819– 1824. 32249102 PMC7102520 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    This rapid systematic review was not registered on PROSPERO.

    “Since this is a rapid systematic review and due to the urgent nature of the pandemic and time constraints, this review was not registered on PROSPERO.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The potential eligible articles, papers with no available abstract, and those falling into the uncertain category were read in full text independently.

    “To confirm eligibility, the potential eligible articles, papers with no available abstract, and those falling into the uncertain category were read in full text independently.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A lack of infrastructure in addition to other factors (e.g., less educated patients) would affect the quality of health care delivered to these patients-it could be more harmful than beneficial.

    “A lack of infrastructure in addition to other factors (e.g., less educated patients41) would affect the quality of health care delivered to these patients—it could be more harmful than beneficial.42”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [41] Anwar S Prasad R. Framework for future telemedicine planning and infrastructure using 5G technology. Wireless Pers Commun 2018; 100: 193– 208. source

      Not checked in the free run.

    • cites [42] Electronic Health Reporter. Dividing e-health, telehealth and telemedicine, https://electronichealthreporter.com/dividing-e-health-telehealth-and-telemedicine/ (2018, accessed 29 March 2021).

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The quality of the included articles is not known, so caution should be exercised when interpreting this evidence.

    “Furthermore, the quality of the included articles is not known; hence, we should exercise caution when interpreting this evidence.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Evidence on the role or effect of using such technological solutions to deliver healthcare services to patients during the pandemic may vary based on the type of chronic disease/condition.

    “Evidence on the role or effect of using such technological solutions to deliver healthcare services to patients during the pandemic may vary based on the type of chronic disease/condition.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Experts concur that the use of such technologies is likely to offer an opportunity to warrant the continuity of delivering the needed healthcare services to patients living with chronic health diseases or conditions during and after this pandemic.

    “However, experts concur that the use of such technologies is likely to offer an opportunity to warrant the continuity of delivering the needed healthcare services to patients living with chronic health diseases or conditions during and after this pandemic.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    This rapid review was conducted in a short timeframe.

    “However, this rapid review was conducted in a short timeframe, and more articles are rapidly emerging daily.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The term "chronic disease" was the only diagnosis-specific search keyword used to search the databases, which may result in excluding articles that only use the exact diagnosis term (e.g., diabetes) in their papers.

    “It is important to note that the term “chronic disease” was the only diagnosis specific search keyword used to search in the databases, which may result in excluding articles that only use the exact diagnosis term (e.g., diabetes) in their papers.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    These variations may infer the ambiguity and the lack of clarity in the terms' definitions and their concepts.

    “It may be the case that these variations can infer the ambiguity and the lack of clarity in the terms’ definitions and their concepts.10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Fatehi F Wootton R. Telemedicine, telehealth or e-health? A bibliometric analysis of the trends in the use of these terms. J Telemed Telecare 2012; 18: 460– 464. 23209265 source

      Not checked in the free run.

36 of 36

  • The paper relies on this without support.

    Social distancing is a key factor to slow the spread of COVID-19.

    “In response to the existential health threat of a global pandemic, social distancing is a key factor to slow the spread of COVID-19, with the result that medical visits have been changed from in-person to remote medical appointments.”

  • The authors state this as an assumption.

    The spread of the COVID-19 pandemic creates the need to rapidly assess and synthesize the evidence that has been generated.

    “The justification of the present paper is that the spread of the pandemic creates the need to rapidly assess and synthesize the evidence that has been generated.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Abstract reports ten usages, but Results report six

    Minor

    The abstract says the review synthesized ten usages, while the Results section identifies and lists six usages.

  • Reference 13 is classified as an included article despite its 2012 publication date

    Minor

    The overview lists reference 13 among the included articles, although the stated inclusion period begins in December 2019 and reference 13 is dated 2012.

  • Article 38 is listed as having no defined setting despite a US setting in the table

    Minor

    The overview includes reference 38 among articles with no defined setting, but Table 1 gives its country as the United States.

  • Reference 22 has conflicting paper-type classifications

    Minor

    The overview counts reference 22 as a review paper, whereas Table 1 calls it a brief correspondence.

  • eHealth percentage does not match the included-article count

    Minor

    Of 25 included articles, two represent 8.0%, not 7.7%.

    Reported 7.7 · recomputed 8

  • Reference 31 has conflicting paper-type classifications

    Minor

    The overview calls reference 31 a position statement, while Table 1 classifies it as a quantitative study.

  • Telehealth percentage does not match the included-article count

    Minor

    The review includes 25 articles, so 15 articles represent 60%, not 53.8%.

    Reported 53.8 · recomputed 60

  • Reference 30 has conflicting paper-type classifications

    Minor

    The overview calls reference 30 a quantitative study, while Table 1 classifies it as a clinical practice statement.

8 of 8

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. Tricco AC, 2017, Rapid reviews to strengthen health policy and systems: a practical guide
  2. Płońska-Gościniak E, 2020, Kardiologia Polska
  3. Sarsak H., 2020, Int Phys Med Rehabil J, 5, 93
  4. Aziz A, 2020, Am J Perinatol
  5. Yusif S, 2014, J Health Inform Develop Countries, 8

Cited by

Sorted by citations

Related

Authors
Bitar, H., & Alismail, S.
Affiliations
  • King Abdulaziz University (SA)
  • Claremont Graduate University (US)
Corresponding author
Bitar, Hind
ORCID
Venue
DIGITAL HEALTH
Publisher
SAGE Publications
Published
2021-01
Volume
7
Pages
20552076211009396-20552076211009396
ISSN
2055-2076 (ISSN-L)
DOI
10.1177/20552076211009396
PMC
PMC8060773
OpenAlex
W3152586041
Cited by
325
References
38
Citations by year
2026: 26 · 2025: 38 · 2024: 33 · 2023: 44 · 2022: 171 · 2021: 12 · 2012: 1
FWCI
11.58
Type
journal article
Language
en
Open access
Licence
Locations
  • Digital Health (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
e-health, telemedicine, chronic disease, COVID-19 pandemic, remote healthcare delivery, telehealth implementation, healthcare access during pandemic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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