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Cited by 203Telemedicine and Telehealth ImplementationHealthcare Systems and TechnologyTechnology and Human Factors in Education and Health

Recent directions in telemedicine: Review of trends in research and practice

Open access
Wilson, Laurence S., Maeder, Anthony J.·2015·Healthcare Informatics Research
DOI 10.4258/hir.2015.21.4.213PMC PMC4659877
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Abstract

OBJECTIVES: Healthcare is now routinely delivered by telecommunications-based services in all developed countries and an increasing number of developing countries. Telemedicine is used in many clinical specialities and across numerous healthcare settings, which range from mobile patient-centric applications to complex interactions amongst clinicians in tertiary referral hospital settings. This paper discusses some recent areas of significant development and progress in the field with the purpose of identifying strong trends in both research and practice activities. METHODS: To establish the breadth of new ideas and directions in the field, a review of literature was made by searching PubMed for recent publications including terms (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), for all searchable categories. 3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015. RESULTS: The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology. CONCLUSIONS: It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service. These areas offer promise for further study and enhancement of applicable telemedicine methods and have the potential for large-scale deployments internationally, which would contribute significantly to the advancement of healthcare.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review surveys recent telemedicine research and practice trends, focusing on selected synchronous and asynchronous clinical applications. It concludes that contemporary development is driven mainly by high-volume demand for a service and/or high criticality of need for timely specialist expertise.

Key findings

  • A PubMed search identified 3,433 publications since January 1, 2005 (2,172 since January 1, 2010), with current interest spanning synchronous areas such as intensive care, emergency medicine, and mental health, and asynchronous areas such as wound/burns care, dermatology, and ophthalmology.
  • Two major drivers of contemporary telemedicine development are identified: high volume demand for a particular clinical service, and/or high criticality of need for clinical expertise to deliver the service.
  • In intensive care, the paper notes approximately 4,000 intensivists for 4,000 adult ICUs in the United States; a review of 25 studies found most showed some mortality reduction after eICU introduction, though with high variation across projects.
  • In telestroke, the TEMPiS project treated 54,804 strokes and transient ischemic attacks in 15 regional hospitals, performed 31,864 teleconsultations, applied intravenous thrombolysis to 3,331 cases, reduced median onset-to-treatment time from 150 to 120 minutes, and reduced door-to-needle time from 80 to 40 minutes.

Methods

  • Narrative literature review searching PubMed for publications containing (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), across all searchable categories; search conducted June 1, 2015.
  • The review selected illustrative applications rather than covering the entire field, grouping them into synchronous telemedicine (intensive care, emergency medicine, mental health) and asynchronous telemedicine (wound care, teledermatology, teleophthalmology).
  • The paper states that home/mobile-based applications and educational or administrative services were not further discussed; a simple keyword analysis of the most relevant publications was used to identify clinical areas.

Limitations

  • Stated in the paper: a comprehensive review of the entire telemedicine field is beyond its scope, so only a few important applications are highlighted; home/mobile applications and educational or administrative services are excluded.
  • Evident from the text: the search is PubMed-only, uses broad keyword terms, and no systematic screening, formal inclusion criteria, quality appraisal, or quantitative synthesis is described.
  • Evident from the text: the review is narrative and time-bound to a June 1, 2015 search, so its trends reflect literature available up to that point.

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

Integrity signals

Registry

Crossref · 10.4258/hir.2015.21.4.213

Cites

57 of 57 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 56 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    There is a worldwide shortage of intensive care specialists (intensivists).

    “While intensive care units exist in most hospitals, there is a worldwide shortage of intensive care specialists (intensivists).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Ahn, 2012, ICU Dir source

      Not checked in the free run.

  • Premisecitation

    The ECHONET project recorded high levels of satisfaction for the ability of the system to integrate a number of activities closely across two geographically separated sites.

    “High levels of satisfaction were recorded for the ability of the system to integrate a number of activities closely across the two geographically-separated sites.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Hansen, 2013, J Int Soc Telemed eHealth

      Not checked in the free run.

  • Premisecitation

    A single 50-minute mental health consultation can be replaced by two or three shorter interviews using telemedicine.

    “For example, while the basic mental health consultation is an interview between clinician and patient, the ease of access provided by telemedicine can allow a single 50-minute consultation to be replaced by two or three shorter interviews [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Mohr, 2009, Clin Psychol Sci Pract source

      Not checked in the free run.

  • Premisecitation

    In the TEMPiS project, intravenous thrombolysis was applied to 3,331 stroke cases.

    “Intravenous thrombolysis was applied to 3,331 of these stroke cases.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Muller-Barna, 2014, Stroke source

      Not checked in the free run.

  • Premisecitation

    A study of 838 ambulance-transported patients in Korea, of whom 188 were subject to in-ambulance monitoring, demonstrated that the choice of the treating hospital could be improved if physicians were made aware of continuous monitoring of vital signs.

    “A recent study of 838 ambulance-transported patients in Korea (of whom 188 were subject to in-ambulance monitoring) demonstrated that the choice of the treating hospital could be improved if physicians were made aware of continuous monitoring of vital signs [16].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Kim, 2011, Telemed J E Health source

      Not checked in the free run.

  • May combine two claims. 26
  • Classified as probably not a substantial claim. 19
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingown data

    The literature search identified 3,433 publications that have appeared since January 1, 2005, of which 2,172 appeared since January 1, 2010, based on a search conducted on June 1, 2015.

    “3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015.”
    • Also stated in: § 2. Literature Search · plain
      “3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A simple keyword analysis of the publications deemed most relevant to telemedicine showed that numerous clinical areas were addressed, but far fewer technologies.

    “A simple keyword analysis of those deemed most relevant to telemedicine showed that numerous clinical areas were addressed, but far fewer technologies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    The current interest areas in the identified papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology.

    “The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Two major drivers of contemporary telemedicine development are a high volume demand for a particular clinical service and/or a high criticality of need for clinical expertise to deliver the service.

    “It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    A 2009 World Health Organization survey found that teleradiology was the most common telemedicine application, practised in 62% of WHO member states that responded to the survey.

    “A 2009 survey conducted by the World Health Organization (WHO) [1] focused on four specialities, and found that teleradiology was the most common application, practised in 62% of WHO member states which responded to the survey.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] World Health Organisation, 2010

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Telehealth adoption was highest in Europe, the Americas, and South-East Asia, and lowest in Africa and the Eastern Mediterranean.

    “Telehealth adoption in Europe, the Americas, and South-East Asia was highest, while Africa and the Eastern Mediterranean had the lowest uptake.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] World Health Organisation, 2010

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the TEMPiS project, the median onset-to-treatment time was reduced from 150 to 120 minutes, and door-to-needle time was reduced from 80 to 40 minutes.

    “The median onset-to-treatment time was reduced from 150 to 120 minutes, and door-to-needle time was reduced from 80 to 40 minutes [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Muller-Barna, 2014, Stroke source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A similar project in Arizona connected a level 1 trauma centre in Tucson to five rural hospitals with minimal specialist support; although the sample size was too small for detailed analysis, the authors reported considerable savings in the cost of transporting patients.

    “A similar project in Arizona, USA connected a level 1 trauma centre in Tucson to five rural hospitals with minimal specialist support [15]. Although the sample size was too small for detailed analysis, the authors reported considerable savings in the cost of transporting patients.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Latifi, 2009, Am J Surg source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Premisecitation

    The global implementation of telehealth, measured by either number of patients or revenue from services and technology sales, will increase tenfold between 2012 and 2018.

    “A recent report [5] suggested that the global implementation of telehealth, as measured by either number of patients or revenue from services and technology sales, will increase tenfold between 2012 and 2018.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Global telehealth market to expand 10x by 2018 [Internet]. [place unknown]. Modern Health Talk. 2014. cited at 2015 Mar 20. Available from: http://www.mhealthtalk.com/global-telehealth-market-to-expand-10x-by-2018/#more-7937

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The ECHONET project produced other benefits including enhanced training opportunities and reduced stress for staff in the rural ICU.

    “Other benefits included enhanced training opportunities and reduced stress for staff in the rural ICU.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Hansen, 2013, J Int Soc Telemed eHealth

      Not checked in the free run.

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

    Premisecitation

    Home-based telemental health has benefits including better adherence to appointments and medication, overcoming social isolation, access to contextual information such as the patient's home situation, improved patient and practitioner safety, and removal of the fears of stigma attached to attending a mental health clinic.

    “A recent review paper [21] pointed out a number of benefits of HBTMH, including better adherence to appointments and medication, overcoming social isolation, access to contextual information such as the patient's home situation, improved patient and practitioner safety, and removal of the fears of stigma attached to attending a mental health clinic.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Pruitt, 2014, Prof Psychol Res Pr source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Among 25 studies, most showed some reduction in mortality following the introduction of the eICU, although the actual reduction exhibited high variation across different projects.

    “A recent review [11] showed that among 25 studies, most showed some reduction in mortality following the introduction of the eICU, although the actual reduction exhibited a high variation across different projects.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Kumar, 2013, Perspect Health Inf Manag

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the TEMPiS project, between February 2003 and December 2012, 54,804 strokes and transient ischemic attacks were treated in 15 regional hospitals, and 31,864 teleconsultations were performed.

    “As an example, in the TeleMedical Project for Integrative Stroke Care (TEMPiS) in Bavaria, Germany, between February 2003 and December 2012, 54,804 strokes and transient ischemic attacks were treated in 15 regional hospitals, and 31,864 teleconsultations were performed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Muller-Barna, 2014, Stroke source

      Not checked in the free run.

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

    Premisecitation

    The World Health Organization has estimated that 450 million people are affected by mental or behavioural disorders worldwide, and five of the ten leading causes of disability and premature death are associated with psychiatric conditions.

    “The World Health Organization [18] has estimated that 450 million people are affected by mental or behavioural disorders worldwide, and five of the ten leading causes of disability and premature death are associated with psychiatric conditions.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] World Health Organization. Prevention of mental disorders: effective interventions and policy options [Internet]. Geneva, Switzerland. World Health Organization. 2004. cited at 2015 Apr 3. Available from: http://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf

      Not checked in the free run.

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

    Premisecitation

    In the United States, it is estimated that there are approximately 4,000 intensivists to staff the 4,000 adult intensive care units.

    “For example, in the United States, it is estimated [9] that there are approximately 4,000 intensivists to staff the 4,000 adult intensive care units (ICUs) in the nation.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Ahn, 2012, ICU Dir source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The potentially fatal effects of depression and other mental conditions can be prevented or greatly attenuated with timely intervention, but this is difficult to implement due to limitations in access to providers.

    “The potentially fatal effects of depression and other mental conditions can be prevented or greatly attenuated with timely intervention, but this is difficult to implement, due to such factors as limitations in access to providers [19].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] Yellowlees, 2011, Telemed J E Health source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The growth in telehealth implementation is driven largely by the rapid proliferation of mobile and home-based devices, which in turn is driven by the need for cost-effective management of chronic and aging-related disease.

    “This growth is driven largely by the rapid proliferation of mobile and home-based devices, which in turn is driven by the need for the cost-effective management of chronic and aging-related disease.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Mental health is an increasing challenge for health systems worldwide.

    “Mental health is an increasing challenge for health systems worldwide.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] World Health Organization. Prevention of mental disorders: effective interventions and policy options [Internet]. Geneva, Switzerland. World Health Organization. 2004. cited at 2015 Apr 3. Available from: http://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf

      Not checked in the free run.

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

    Premisecitation

    A contemporary review lists a number of activities in mental illness management facilitated through mHealth.

    “A contemporary review [22] lists a number of activities in mental illness management facilitated through mHealth.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Price, 2014, Clin Psychol Psychother source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    The constraints imposed by limited bandwidth availability which prompted the development of asynchronous services have now largely fallen away, so there has been a migration of some of these services to synchronous or near-synchronous.

    “The constraints imposed by limited bandwidth availability which prompted the development of asynchronous services have now largely fallen away, so there has been a migration of some of these services to synchronous (or near-synchronous).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In Australia, a national online consultation and educational service known as TeleDerm has operated for the past decade, providing asynchronous case advice with a 24-hour turn-around.

    “In Australia, a national online consultation and educational service known as TeleDerm has operated for the past decade, providing asynchronous case advice with a 24-hour turn-around [35].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Muir, 2014, Aust Fam Physician

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). May combine two claims.

    Premisecitation

    It has been claimed that accuracy of 81% is achievable with mobile teledermatology, consistent with conventional teledermatology.

    “it has been claimed that accuracy of 81% is achievable [50], consistent with conventional teledermatology.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50] Lamel, 2012, J Am Acad Dermatol source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Teleophthalmology generally requires specialised imaging equipment, is non-invasive, and not reliant on direct clinical expertise in image acquisition, making it easier to achieve cost-effectiveness in large-scale population-wide circumstances.

    “While teleophthalmology generally requires specialised imaging equipment, it is non-invasive and not reliant on direct clinical expertise in the image acquisition process, which makes it easier to achieve cost-effectiveness in large-scale population-wide circumstances.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The performance of teledermatology in skin cancer screening/diagnosis is below that of direct clinical inspection, with typical reported accuracy of diagnosis rates around 80%.

    “It is accepted by many authors that the performance of teledermatology in this area is below that of direct clinical inspection, with typical reported accuracy of diagnosis rates of around 80%, e.g., [45].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Moreno-Ramirez, 2005, J Telemed Telecare source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    In remote areas and developing countries, loss of productivity and opportunities due to diminished vision could be avoided by provision of regular, frequent eye care.

    “Especially in remote areas and developing countries, the loss of productivity and opportunities due to diminished vision could be avoided by the provision of regular, frequent eye care.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Results obtained with publicly available smartphone dermatology applications may be highly variable and unreliable.

    “Cautionary commentary has also appeared suggesting that results obtained with publicly available smartphone dermatology applications may be highly variable and unreliable [51].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Wolf, 2013, JAMA Dermatol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Recognition of potential melanoma and carcinoma from transmitted images has high sensitivity (98%) but low specificity (43%), resulting in excessive referrals.

    “Recognition of potential melanoma and carcinoma from transmitted images was shown to have high sensitivity (98%) but low specificity (43%) [46], resulting in excessive referrals.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [46] Bowns, 2006, Health Technol Assess source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    Often, this recent adoption has been due to the development of a new technological solution that makes this practical.

    “Often, this recent adoption has been due to the development of a new technological solution (e.g., storage and rapid backend processing of large datasets) that makes this practical.”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Interpretationreasoning

    Two trends immediately apparent are implementations demonstrating high volume and high criticality.

    “two trends which are immediately apparent are implementations which demonstrate:”
    Quote in the paperSubstantial claim

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

    Interpretationreasoning

    This evolution is increasingly based on the utility of the applications rather than response to a technology push.

    “This is increasingly based on the utility of the applications rather than response to a technology push, and there is increasing demand for system-wide implementations rather than further unsustainable and unscalable pilots.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationnone given

    High criticality trend: specialist expertise needs to be made available at the point of care within a very strict time frame.

    “High criticality applications, where specialist expertise needs to be made available at the point of care within a very strict time frame.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Other applications reported to be suitable for telemedicine include blurred vision and degenerative eye diseases.

    “Other applications reported to be suitable for telemedicine include blurred vision [59] and degenerative eye diseases [60].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [59] Tan, 2013, J Telemed Telecare source

      Not checked in the free run.

    • cites [60] Maa, 2014, Telemed J E Health source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    There is increasing demand for system-wide implementations rather than further unsustainable and unscalable pilots.

    “This is increasingly based on the utility of the applications rather than response to a technology push, and there is increasing demand for system-wide implementations rather than further unsustainable and unscalable pilots.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    The distinction between the telemedicine consultation and the patient record is already blurred in telepsychiatry, but convergence of telemedicine and medical informatics is likely to make this distinction even less relevant in the future.

    “The distinction between the telemedicine consultation and the patient record is already blurred in telepsychiatry, but the convergence of telemedicine and medical informatics is likely to make this distinction even less relevant in the future.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Many of the barriers to telemedicine expansion lie in the care models domain rather than technology, which has outpaced telemedicine applications.

    “Many of the barriers to telemedicine expansion lie in this domain rather than technology, which has, if anything, outpaced telemedicine applications [62].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [62] Jang-Jaccard, 2014, Telemed J E Health source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationnone given

    Telemedicine has tended to follow fixed models of care, based either on replicating conventional care delivery methods or introducing new methods.

    “Telemedicine has tended to follow fixed models of care, based either on replicating conventional care delivery methods (e.g., videoconferencing replacing face to face live consultations) or introducing new methods (e.g., home-based patient health status monitoring).”
    Quote in the paperSubstantial claim

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

    Interpretationnone given

    In most developed countries, increasing availability of reliable broadband communications and user interface devices has effectively removed the cost and availability of this technology as a barrier to the uptake of telemedicine.

    “In most developed countries, the increasing availability of reliable broadband communications and user interface devices has effectively removed the cost and availability of this technology as a barrier to the uptake of telemedicine.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Health informatics has evolved largely independently of telemedicine, but telemedicine systems are already evolving to work in an environment of complex digital information.

    “Health informatics has evolved largely independently of telemedicine, but telemedicine systems are already evolving to work in an environment of complex digital information.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Co-location can occur in time as well as in space, creating demand for asynchronous telemedicine.

    “Such co-location can occur in time as well as in space, which will continue to create demand for asynchronous telemedicine, as discussed in Section III of this paper.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Increasing pressure on health systems to deliver high-quality healthcare within strict financial constraints will drive the trend to leverage healthcare resources more effectively.

    “Increasing pressure on health systems to deliver high-quality healthcare within strict financial constraints will drive this trend to leverage healthcare resources more effectively.”
    Quote in the paperNot a substantial claim
40 of 40

  • The paper relies on this without support.

    Thrombolytic drugs, if delivered within a strict post-stroke time window, have a high rate of reversal of many of the long-term effects of stroke.

    “Thrombolytic drugs, if delivered within a strict post-stroke time window, have demonstrated a high rate of reversal of many of the long-term effects of stroke.”

  • The paper relies on this without support.

    There is risk to the patient if thrombolytic drugs are administered when stroke is not indicated.

    “However, there is risk to the patient if these drugs are administered when stroke is not indicated, and the assessment involves CT scans, blood tests, and an assessment of the patient's neurological function.”

  • The paper relies on this without support.

    Neurological specialists qualified to make the decision on drug administration are sparsely distributed outside major cities in most countries with advanced healthcare systems.

    “The neurological specialists qualified to make the decision on drug administration are sparsely distributed outside major cities in most countries with advanced healthcare systems, but recently their expertise has been increasingly exploited using telemedicine.”

  • The paper relies on this without support.

    The delay limit for drug administration in acute stroke is about four hours from stroke onset.

    “This application is highly time-critical (the delay limit for drug administration as about four hours from stroke onset) and requires the transmission of a variety of information types (including CT scans) as well as an interactive examination of the patient.”

  • The paper relies on this without support.

    There is a stigma attached to seeking treatment for mental conditions, which creates barriers between patients and those who can offer treatment.

    “There is a stigma attached to seeking treatment for mental conditions, which creates further barriers between patients and those who can offer treatment.”

  • The paper relies on this without support.

    Mobile devices are especially well received by adolescents.

    “Furthermore, such devices can support a high degree of self-management, and are especially well received by such groups as adolescents.”

  • The paper relies on this without support.

    The need to inspect a patient's wound condition approximately daily leads to significant workload and expense.

    “The need to inspect the patient's condition approximately daily leads to significant workload and expense, while the benefits of personalizing the treatment of the patient and achieving faster or better recovery can be substantial.”

  • The paper relies on this without support.

    Telemedicine and medical informatics have evolved independently, with telemedicine focusing on synchronous activity and informatics focusing on patient data.

    “Telemedicine and medical informatics have, to a large extent, evolved independently of one another, with telemedicine having a focus on synchronous activity, while informatics has a focus on patient data.”

  • The paper relies on this without support.

    Clinical management of wounds makes up a substantial fraction of day care and outpatient clinic activities in the acute sector, and imposes a burden on home or aged care and outreach nursing activities.

    “Clinical management of wounds makes up a substantial fraction of day care and outpatient clinic activities in the acute sector, and it imposes a burden on home or aged care and outreach nursing activities.”

  • The paper relies on this without support.

    The reviewed literature is representative of telemedicine research and practice trends.

    “In this paper, we have reviewed a number of clinical application areas, and two trends which are immediately apparent are implementations which demonstrate:”
10 of 10

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.

  • Home and mobile applications are discussed despite stated exclusion

    Minor

    The Methods section says home and mobile-based applications will not be discussed further, but the Results section discusses home-based telemental health and its use of mobile devices.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 9

  1. World Health Organisation, 2010, Telemedicine: opportunities and developments in member states
  2. Hansen, 2013, J Int Soc Telemed eHealth, 1, 19
  3. Kumar, 2013, Perspect Health Inf Manag, 10, 1f
  4. Gray, 2010, Wound Pract Res, 18, 158
  5. Canadian Agency for Drugs and Technologies in Health, 2014, Personal wireless device use for wound care consultation: a review of safety, clinical benefits and guidelines
  6. Muir, 2014, Aust Fam Physician, 43, 828
  7. Vrucinic, 2010, Acta Med Median, 49, 23
  8. Muir, 2008, Stud Health Technol Inform, 131, 245
  9. Cuadros, 2004, Stud Health Technol Inform, 107, 207

Cited by

Sorted by citations

Related

Authors
Wilson, L. S., & Maeder, A. J.
Affiliations
Western Sydney University (AU)
Corresponding author
Maeder, Anthony J.
ORCID
Maeder, Anthony J.
Venue
Healthcare Informatics Research
Publisher
The Korean Society of Medical Informatics
Published
2015
Volume
21
Issue
4
Pages
213
ISSN
  • 2093-3681 (ISSN-L)
  • 2093-369X
DOI
10.4258/hir.2015.21.4.213
PMC
PMC4659877
OpenAlex
W2183234860
Semantic Scholar
b85c428452f623640d4be8d3c4d882bdc5729013
Cited by
203
References
57
Citations by year
2026: 8 · 2025: 13 · 2024: 24 · 2023: 24 · 2022: 26 · 2021: 22 · 2020: 27 · 2019: 15 · 2018: 17 · 2017: 12 · 2016: 13 · 2015: 2
FWCI
2.13
Type
journal article
Language
en
Open access
Licence
Locations
  • Healthcare Informatics Research (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Flinders Academic Commons (Flinders University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
Keywords
telemedicine, synchronous telemedicine, asynchronous telemedicine, intensive care, emergency medicine, mental health, dermatology, ophthalmology, research trends

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 2026-10-10.

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

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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