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Abstract Objective: to map nurses’ skills for nursing teleconsultation in Primary Health Care. Method: this is a scoping review guided by the recommendations of the Joanna Briggs Institute Reviewer’s Manual, carried out in seven databases and repositories of theses and dissertations. The selection of studies was carried out in Rayyan by two independent, blind reviewers. Data analysis was carried out descriptively. Results: 23 studies were selected, which showed that the skills necessary for nursing teleconsultation in primary care were: communication, clinical, technological and ethical. The lack of digital infrastructure was identified as one of the main barriers to the implementation of teleconsultation. The lack of access to information and communications technology and/or the internet, the severity of the clinical condition and the patient’s non-adherence to the remote consultation were also identified. Conclusion: nursing teleconsultation in primary care is an emerging way of providing health care. However, for its implementation it is necessary to train nurses in the following skills: communication, clinical, technological, ethical and those related to the infrastructure of the teleconsultation environment.

Resumen: La teleconsulta es una consulta sanitaria a distancia que se realiza mediante tecnologías de la información y la comunicación (TIC). Existen diferentes modalidades que requieren de habilidades técnicas y comunicativas específicas. Aunque en España la teleconsulta ocupa una posición destacada, la evidencia a su alrededor es limitada.El artículo aborda la aplicabilidad, barreras, facilitadores y retos futuros de la teleconsulta. Aunque tiene el potencial de mejorar el acceso a la atención sanitaria, así como de ahorrar tiempo y costes tanto para los pacientes como para los profesionales sanitarios, debe enfrentar una serie de desafíos como la brecha digital y la resistencia al cambio. Para superar estos obstáculos y abordar nuevos retos es crucial la confianza de pacientes y profesionales, así como mejorar la formación en las competencias necesarias para optimizar su uso.La investigación futura debe centrarse en proporcionar evidencias sólidas en términos de seguridad y coste-efectividad para asegurar su implementación. Abstract: Teleconsultation is a remote health consultation using information and communication technologies. There are different modalities and specific practical and communication skills are required. Notwithstanding its prominence in Spain, there is little evidence on teleconsultation.This article explores the applicability, barriers, facilitators and future challenges of teleconsultation. While it has the potential to improve access to healthcare, as well as save time and costs for both patients and healthcare professionals, it faces a number of challenges such as the digital divide and resistance to change.To address new challenges and overcome obstacles, it is crucial to gain the trust of patients and professionals. Improving training in the skills required to optimize their use is also essential.Future research should aim to provide robust evidence regarding safety and cost-effectiveness to ensure successful implementation.

ABSTRACT OBJECTIVE To present the results of a cost analysis of remote consultations (teleconsultations) compared to in-person consultations for patients with type 2 diabetes, in the Brazilian public healthcare system (SUS) in the city of Joinville, Santa Catarina (SC). In addition to the costs from the local manager’s perspective, the article also presents estimates from the patient’s perspective, based on the transportation costs associated with each type of consultation. METHOD Data were collected from 246 consultations, both remote and in-person, between 2021 and 2023, in the context of a randomized clinical trial on the impact of teleconsultation carried out in the city of Joinville, SC. Teleconsultations were carried out at Primary Health Units (PHU) and in-person consultations at the Specialized Health Center. The consultation costs were calculate by the method time and activity-based costing (TDABC), and for the estimate of transportation costs data was collected directly from the research participants . The mean costs and time required to carry out each type of consultation in different scenarios and perspectives were analyzed and compared descriptively. RESULTS Considering only the local SUS manager’s perspective, the costs for carrying out a teleconsultation were 4.5% higher than for an in-person consultation. However, when considering the transportation costs associated with each patient, the estimated value of the in-person consultation becomes 7.7% higher and, in the case of consultations in other municipalities, 15% higher than the teleconsultation. CONCLUSION The results demonstrate that the incorporation of teleconsultation within the SUS can bring economic advantages depending on the perspective and scenario considered, in addition to being a strategy with the potential to increase access to specialized care in the public network.

The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model. Obstacles were related to the massive, forced, and unplanned implementation of teleconsultations. The main benefits included providing care during isolation-distancing and addressing epidemiological doubts. Changes were highlighted in care strategies, consultation frameworks, exchange among colleagues, referral criteria, requests for complementary studies, and in the profiles of those seeking consultations. A misuse of the system by individuals and a trivialization of the consultation moment emerged. The rise of communication and information technologies undoubtedly allowed the continuity of healthcare processes, but it does not replace in-person care, and normative guidelines are needed for its continuity.

ABSTRACT Objectives: to understand the ethical problems experienced by primary health care nurses in using nursing teleconsultations for people living with the human immunodeficiency virus during the coronavirus pandemic. Methods: qualitative research, anchored in Constructivist Grounded Theory. Data was collected between July and September 2020, with 17 participants. Results: the first category highlights the ethical problems in conducting teleconsultations, managing high demand, communication barriers, and risks related to data security. The second emphasizes the potential of teleconsultations in communication and access, by generating changes in the work process and the use of protocols to guide clinical practice. Conclusions: nurses’ work in digital mode requires professional qualification, with a view to stimulating reflection on teleconsultation practice, ethical-moral deliberation and combating stigma, and also adopting data security-centered conduct.

Objective: to map nurses' skills for nursing teleconsultation in Primary Health Care., Method: this is a scoping review guided by the recommendations of the Joanna Briggs Institute Reviewer's Manual, carried out in seven databases and repositories of theses and dissertations. The selection of studies was carried out in Rayyan by two independent, blind reviewers. Data analysis was carried out descriptively., Results: 23 studies were selected, which showed that the skills necessary for nursing teleconsultation in primary care were: communication, clinical, technological and ethical. The lack of digital infrastructure was identified as one of the main barriers to the implementation of teleconsultation. The lack of access to information and communications technology and/or the internet, the severity of the clinical condition and the patient's non-adherence to the remote consultation were also identified., Conclusion: nursing teleconsultation in primary care is an emerging way of providing health care. However, for its implementation it is necessary to train nurses in the following skills: communication, clinical, technological, ethical and those related to the infrastructure of the teleconsultation environment.

Introduction and Objectives: The development of IT tools and interlevel relationships in the management of the most prevalent processes has led to a semi-presential assessment approach. In cardiology, this form of assessment is possible through a close collaboration with primary care. The aim of this study is to analyze the results of our e-consultation program and to establish the effectiveness of this new form of assistance., Methods: Single-center study that included e-consultations referred from 15 September 2021 to 30 September 2022. Subsequently, we analyzed the events in which patients were discharged directly during the e-consultation with no need for an on-site visit., Results: We included 3,155 e-consultations. The mean age of the patients was 57±17.6 years. Of the consultations, 75% were answered within 48h (62% within 24h). A total of 1,988 patients completed one year of follow-up in e-consultation. Out of these, 1,278 patients (64.2%) were discharged from the e-consultation with no need for an on-site visit: 685 patients (53.5%) during the first consultation, and 593 (46.5%) upon request of a complementary test. After one year of follow-up, 13 patients (0.006%) were admitted due to cardiological pathology, and 16 patients (0.008%) died, only one due to cardiovascular causes. The mean age of the deceased was 80.5 years., Conclusions: E-consultation as a single referral system from primary care to cardiology improves patient accessibility, speeds up patient assessment and is effective for patients discharged without the need for an on-site consultation., (Copyright © 2024 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Teleconsultation in the context of clinical laboratories is a valuable tool for the early detection of dyslipidemia and prevention of cardiovascular risk. Here, we describe a patient who was referred to the Lipid Unit of the Virgen Macarena Hospital due to an alert for severe hypertriglyceridemia through its teleconsultation program., Case Presentation: A comprehensive clinical and biochemical study of the patient was carried out, and genetic testing was performed on the patient and his family. The proband and his family showed mild to severe hypertriglyceridemia and various secondary factors, together with a genetic background associated with a triglyceride-raising effect., Conclusion: This extensive study has identified a family at high risk of cardiovascular disease and acute pancreatitis. These findings can help maximize lifestyle changes and improve the clinical management of their dyslipidemia., (Copyright © 2024 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

ABSTRACT Objectives: to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic. Methods: a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence. Results: the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations. Final Considerations: the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders.

ABSTRACT Purpose: to verify Brazilian speech-language-hearing therapists’ perception of speech-language teletherapy. Methods: a qualitative/quantitative cross-sectional study. The 22 participants answered an online questionnaire on sociodemographic information, academic degree, occupation, and teletherapy experience. Absolute and relative frequencies in scale and multiple-choice answers were calculated, whereas the content of qualitative data was analyzed. Results: the mean age of the speech-language-hearing therapists was 28 years; 86.4% were females, and 63.3% graduated from public institutions. All participants (100%) reported knowing the guidelines prescribed by the Federal Speech-Language-Hearing Council. Most of them treated children (77.3%), with oral language procedures (54.5%); 59.1% faced difficulties, while 63.7% felt qualified to practice teletherapy. Conclusion: all participants said they knew speech-language teletherapy. Most of them reported that the topic was not addressed in their undergraduate studies; hence, they sought training from other sources to offer teleconsultation. Moreover, they reported that most patients agreed to continue with that type of care, although the number of new patients seeking treatment during the pandemic decreased.

ABSTRACT In this study, a script for the telepractice of speech language pathology and audiology services for adult patients at home, is presented. This tool was developed in three stages and used for a community project during the COVID-19 pandemic. A literature search was performed to identify the facilitators and barriers to remote patient care before implementing telepractice at a primary health care unit. This practical experience led to further discussions about the facilitators of clinical performance and different ways to remotely offer quality assessments and rehabilitation. Divided into three sections, the final script was organized into twenty items. To provide comprehensive patient care, detailed discussions were held about each item to verify the effectiveness and quality of the teleconsultations, for the script to be written. This guide is intended to be used as a tool for speech language pathology and audiology telepractice. However, it must be adapted to the cultural and social realities of the professionals and patients who use it. Additionally, it does not constitute a closed set of practices and procedures and should be updated as new procedures and technologies become available.

Estimada Editora: La pandemia secundaria a la infección por SARS-CoV-2 (COVID-19) aisló durante meses al mundo y produjo un impacto en las cifras de morbilidad y mortalidad. Al 27 de agosto de 2021 se han reportado a nivel mundial 215,047,649 casos y 4,480,486 muertes. En Colombia, para la misma fecha se reportaron 4,899,085 casos y 124,567 muertes (1). Entre las medidas sanitarias para disminuir la propagación de la infección se implementó el aislamiento obligatorio, condición que impulsó a todos los sectores a generar transformaciones. Para el caso del sistema de salud, entre sus estrategias se generó una rápida implementación de la telemedicina (TM). El término TM se introdujo en 1970 como la “curación a distancia”, definida por la Organización Mundial de la Salud como “la prestación de servicios de atención médica mediante el uso de tecnologías de la información y la comunicación para realizar un diagnóstico, tratamiento y prevención de enfermedades” (2). Los objetivos de la TM son mejorar la calidad del servicio de salud, reducción de los costos de transporte, disminución de los tiempos de espera para la atención y brindar mayor oportunidad de atención a zonas geográficas distantes. Sumado a lo anterior, en el contexto de la pandemia permitió disminuir la exposición a la infección en los pacientes y profesionales en salud (3,4). Dear editor: The pandemic caused by SARS-CoV-2 (COVID-19) infection isolated the world for months and impacted morbidity and mortality rate figures. 215,047,649 cases and 4,480,486 deaths have been reported worldwide as of August 27, 2021. In Colombia, 4,899,085 cases and 124,567 deaths were reported as of the same date (1). Mandatory isolation was among the health measures to reduce propagation. This situation drove all sectors to transform. With respect to the health care system, telemedicine (TM) was quickly implemented as one of its strategies. The term TM was introduced in 1970 as “healing at a distance,” defined by the World Health Organization as “The delivery of health care services using information and communication technologies for diagnosis, treatment and prevention of disease” (2). The objectives of TM are to improve the quality of health care services, reduce transportation costs, reduce wait times and provide more opportunities to attend to geographically distant areas. In addition to the above, it allowed decreasing patients and health care professionals’ exposure to the infection in pandemic context (3,4).

Objective: to report the experience of implementation of teleconsultation in rehabilitation nursing during the pandemic by the coronavirus. Method: Descriptive study, of the type report of experience, occurred from March to October of 2020. Teleconsultation was offered to all patients under treatment (72), with the option of rejection and future return. The teleconsultation included audio and video calls in real time and sending educational material. Results: Of the 72 patients, 57 accepted and followed with good evolution. The others (15) are waiting for a future return in person. Positive findings of the teleconsultation: less exposure to the virus, improved therapeutic bond, comfort and cost reduction. Negatives: difficulty with technology; some procedures require face-to-face follow-up. Conclusions: The teleconsultation was an effective tool for most of the processes, it assists the distant regions, of few health resources or transport, therefore, applicable, as a viable and positive alternative for times of pandemic.

Abstract Objective: to analyze the psychosocial implications arising from the COVID-19 pandemic, reported in online service, from the perspective of Michel Foucault’s concepts of biopower, biopolitics and governmentality. Method: qualitative documental research, with analysis of medical records of users assisted in a therapeutic listening chat, between April and October 2020. Results: the data were organized into two themes: Governmentality in the COVID-19 pandemic and the production of psychosocial implications of anxiety and fear and Discipline and subjection in the COVID-19 pandemic: subjectivities marked by sadness and anguish. The first demonstrates that the “art of governing” in Brazil produced instabilities and uncertainties that influenced the production of fear of contamination/death/and non-access to treatment and anxiety. In the second theme, we can see how disciplinary control and biopolitical regulation are combined. In Brazil, an extremely unequal country, subjectivity and subjectivities marked by anguish, feelings of discouragement and sadness have been produced. Conclusion: the exclusionary processes were deepened in the pandemic, with the exercise of a biopolitics that makes life precarious and produces psychological distress.

Telepharmacy is defined as the practice of remote pharmaceutical care, using information and communication technologies. Given its growing importance in outpatient pharmaceutical care, the Spanish Society of Hospital Pharmacy developed a consensus document, Guía de entrevista telemática en atención farmacéutica, as part of its strategy for the development and expansion of telepharmacy, with key recommendations for effective pharmacotherapeutic monitoring and informed dispensing and delivery of medications through telematic interviews. The document was developed by a working group of hospital pharmacists with experience in the field. It highlights the benefits of telematic interviewing for patients, hospital pharmacy professionals, and the healthcare system as a whole, reviews the various tools for conducting telematic interviews, and provides recommendations for each phase of the interview. These recommendations cover aspects such as tool/platform selection, patient selection, obtaining authorization and consent, assessing technological skills, defining objectives and structure, scheduling appointments, reviewing medical records, and ensuring humane treatment. Telematic interview is a valuable complement to face-to-face consultations but its novelty requires a strategic and formal framework that this consensus document aims to cover. The use of appropriate communication tools and compliance with recommended procedures ensure patient safety and satisfaction. By implementing telematic interviews, healthcare institutions can improve patient care, optimize the use of resources and promote continuity of care., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Telepharmacy is defined as the practice of remote pharmaceutical care, using information and communication technologies. Given its growing importance in outpatient pharmaceutical care, the Spanish Society of Hospital Pharmacy developed a consensus document, "Guía de entrevista telemática en atención farmacéutica," as part of its strategy for the development and expansion of telepharmacy, with key recommendations for effective pharmacotherapeutic monitoring and informed dispensing and delivery of medications through telematic interviews. The document was developed by a working group of hospital pharmacists with experience in the field. It highlights the benefits of telematic interviewing for patients, hospital pharmacy professionals, and the healthcare system as a whole, reviews the various tools for conducting telematic interviews, and provides recommendations for each phase of the interview. These recommendations cover aspects such as tool/platform selection, patient selection, obtaining authorization and consent, assessing technological skills, defining objectives and structure, scheduling appointments, reviewing medical records, and ensuring humane treatment. Telematic interview is a valuable complement to face-to-face consultations but its novelty requires a strategic and formal framework that this consensus document aims to cover. The use of appropriate communication tools and compliance with recommended procedures ensure patient safety and satisfaction. By implementing telematic interviews, healthcare institutions can improve patient care, optimize the use of resources and promote continuity of care., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Teleconsultation is a remote health consultation using information and communication technologies. There are different modalities and specific practical and communication skills are required. Notwithstanding its prominence in Spain, there is little evidence on teleconsultation. This article explores the applicability, barriers, facilitators and future challenges of teleconsultation. While it has the potential to improve access to healthcare, as well as save time and costs for both patients and healthcare professionals, it faces a number of challenges such as the digital divide and resistance to change. To address new challenges and overcome obstacles, it is crucial to gain the trust of patients and professionals. Improving training in the skills required to optimize their use is also essential. Future research should aim to provide robust evidence regarding safety and cost-effectiveness to ensure successful implementation., (Copyright © 2024 The Authors. Publicado por Elsevier España S.L.U. All rights reserved.)

Resumen: Objetivo: Se realiza un estudio observacional antes y después para valorar el efecto de la consulta virtual (eConsulta) sobre la frecuentación posterior que realiza el paciente a su centro de atención primaria una vez ha realizado su primera consulta virtual. Emplazamiento: Población asignada de los Centros de Atención Primaria Masnou-Alella y Ocata-Teià del Institut Català de la Salut. Participantes: Se realiza un muestreo aleatorizado y se comparan 329 pacientes que realizaron eConsultas respecto de 329 pacientes estadísticamente similares en edad, sexo y complejidad médica que no realizaron ninguna eConsulta. Mediciones principales: Se midieron las visitas realizadas con medicina primaria y enfermería de su equipo, tanto presenciales, telefónicas y eConsultas, durante el periodo de estudio. Resultados: Los pacientes que realizaron consultas virtuales mostraron una frecuentación previa en la atención primaria mayor que aquellos que no realizaron eConsultas (4,44 visitas médicas/año versus 3,11). Tras el uso de la eConsulta, después de un año de seguimiento, su frecuentación se redujo hasta niveles del grupo control (3,16 visitas médicas/año versus 3,00). Tras la primera visita virtual, los pacientes redujeron las visitas presenciales en un 28,7%. Conclusiones: La eConsulta podría ser una herramienta eficaz para dar respuesta a las necesidades de los pacientes que no requieran de una visita presencial, en especial en los pacientes más frecuentadores. Abstract: Objective: A «before and after» type observational study was carried out to assess the impact of the virtual consultation (eConsulta) on the frequency with which the patient visits their primary care center once they have had their first virtual consultation. Setting: Assigned population of the primary care center of Masnou-Alella and Ocata-Teià, Catalan Health Institute. Participants: A random sampling was performed and 329 patients who engaged in eConsulta were compared with 329 statistically similar patients in age, sex and medical complexity who did not engage in eConsulta. Principal mediations: Visits with primary care and nursing in their team are measured, both face-to-face, telephone and eConsulta, over the study period. Results: Patients who performed virtual consultations showed a previous frequent attendance in primary care higher than those who did not perform eConsulta (4.44 medical visits year/versus 3.11). Following the use of the eConsulta, after a year of follow-up, frequency was reduced to levels of the control group (3.16 medical visits/year versus 3.00). After the first virtual visit, patients reduced face-to-face visits by 28.7%. Conclusions: The eConsulta could be an effective tool to respond to the needs of patients who do not require a face-to-face visit, especially in the most frequent patients.

ABSTRACT Objective: Identify users, services, and reasons for seeking online mental health care during the COVID-19 pandemic. Methods: A descriptive, retrospective study, with documentary analysis of medical records of users served between April and July 2020. Results: Of the 258 accesses, 159 were complete, and 99 were offline messages. Although there were 61 (38.36%) consultations in May, in April, there were 49 (30.82%) in 18 days of reception. More than 89% of accesses were women between 40 and 59 years. Among the motivations in the search for care, anxiety, fear, depression, sadness, crying, stress, and suicidal ideation stand out. Final considerations: Chat is a quick, early and short-wait intervention opportunity for people in need of mental health care. Therefore, the study emphasizes the importance of investing in the training of nursing professionals to act in mental health.

Abstract Information and communication technologies are transforming the way we understand health, via a hyper-connected world in which patients, professionals and society take on new challenges and roles. This change is creating an ecosystem called connected health, in which telemedicine acquires special importance when distance (not only geographical), is a critical factor. It can respond to financial, social or safety needs or questions of dignity, as is the case with prisoners when they are transferred handcuffed and under custody to hospitals. Bringing health services closer to patients who cannot autonomously travel contributes towards humanising healthcare. Tele-consultations, long-distance encounters between patients and health professionals, reduce the direct and social costs inherent to habitual clinical practice and are very highly valued by patients in prison. Despite its potential benefits in the prison setting, the implementation of telemedicine in Spain continues to be scarce and irregular, which, amongst other things, is due to a lack of awareness of this healthcare practice, the severe shortage of resources currently endemic to the prison health service system and the lack of interoperability solutions for clinical information between the healthcare administration and the prison health services, which unfortunately continue to depend on an organisation outside the healthcare ambit (the Ministry of Home Affairs), despite the legal provisions requiring them to be fully integrated into regional health services. The SARA (Administration Applications and Networks Systems) Network and the Reúnete© Service offer solid, secure, free technology is available to all prisons, to set in motion telemedicine programs at a nationwide level.

Teleconsultation is one of the assets of telemedicine that allows medical professionals to provide diagnostic or therapeutic advice to patients through electronic means. The objective of this study was to estimate the frequency of teleconsultation implementation in hospitals in the city of Cordoba from 2020 to 2022. A descriptive, observational and cross-sectional study was carried out, providing an online survey (Google Forms) to hospital representatives in Córdoba. Descriptive statistics were used. The study was conducted in 30 out of the 50 hospitals in the city, including 17 private (57%) and 13 public institutions (43%). Teleconsultation was provided by a higher percentage of private healthcare facilities (82%) compared to public ones (77%). The results showed that the SARS-CoV-2 pandemic was the main driver behind the implementation of teleconsultation, with 92% of all hospitals having implemented it due to the pandemic while the remaining 8% had already offered this service prior to the pandemic. The most requested services were Internal Medicine and Infectology, and phone calls were the most commonly used tool. Among the hospitals that did not offer teleconsultation, 67% did not plan to do so in the future, while the remaining 33% were making arrangements for its implementation in 2023. Although the pandemic catalyzed the implementation of teleconsultations in most hospitals, there are still some institutions that do not plan to incorporate this modality. This study provides valuable data for improving future medical care strategies in the city of Cordoba., (Universidad Nacional de Córdoba)

ABSTRACT Purpose: to verify whether the complementary remote speech-language-hearing follow-up is an effective tool in the monitoring of cochlear implant users in the immediate postoperative period. Methods: a total of 26 relatives participated in the study, divided into two groups: with and without remote speech-language-hearing follow-up. By the time the device was activated, they were given instructions on four subjects: the device, family, school, and speech-language-hearing therapy. After one week, the group with remote speech-language-hearing follow-up started receiving such care via mobile phone. In the in-person follow-up visit, a questionnaire was administered (containing questions on the guidance given), as well as an interview with the parents/guardians that received the remote follow-up. The data obtained from the questionnaire were analyzed with Fisher’s exact test, with 5% significance. The qualitative data were analyzed based on Bardin’s theme content analysis technique. Results: there was a significant difference in the quantitative results between the groups regarding “device” and “school”. In the qualitative data, it was verified that the remote speech-language-hearing follow-up furnished greater assurance to the relatives of the cochlear implant users, helping them in the therapeutic process and at school. Conclusion: the complementary remote speech-language-hearing follow-up proved to be an effective tool in the subjects researched, especially regarding the handling of the device and guidance to school.

The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model. Obstacles were related to the massive, forced, and unplanned implementation of teleconsultations. The main benefits included providing care during isolation-distancing and addressing epidemiological doubts. Changes were highlighted in care strategies, consultation frameworks, exchange among colleagues, referral criteria, requests for complementary studies, and in the profiles of those seeking consultations. A misuse of the system by individuals and a trivialization of the consultation moment emerged. The rise of communication and information technologies undoubtedly allowed the continuity of healthcare processes, but it does not replace in-person care, and normative guidelines are needed for its continuity.

Introduction. Usability in a telemedicine system directly affects the efficiency and effectiveness of remote health care. Objective. To assess the usability of teleconsultations during the COVID-19 pandemic. Population and method. This was a cross-sectional study. The caregivers of children aged 1 month to 12 years were included. Usability was assessed with the Telehealth Usability Questionnaire, adapted to Spanish. Socioeconomic data were also assessed. Results. The response rate was 70.2% (n = 221). Most responders were women whose average age was 33 years, had completed secondary education and had public health insurance. Of them, 87.8% selected telephone health care and 88.2% had their first teleconsultation. The overall satisfaction was high, with lower scores for ease of use and learning how to use video calls. Conclusion. Regardless of modality, the usability of teleconsultations by caregivers of children aged 1 month to 12 years was adequate., (Sociedad Argentina de Pediatría.)

Background: The medical care paradigm is face-to-face; however, technological development has led to the digital modality., Objective: To determine cost-effectiveness of digital care and face-to-face care at the first level of care., Material and Methods: Cost-effectiveness study. 2 groups were integrated: the digital service and the face-to-face service. The sample size was calculated with the percentage formula for 2 groups, and the result was 217 per group. The effectiveness was evaluated in 3 dimensions: the satisfaction of the patient, of the doctor and of the medical assistant. In all 3 cases the Visual analogue scale was used. The cost corresponded to the fixed unit cost estimated with the technique of times and movements adjusted for the duration of care. The statistical analysis included averages, percentages and cost-effectiveness ratio., Results: The cost of digital attention is $343.83 and face-to-face attention is $171.91 (all estimated in Mexican pesos). From the patient's perspective, the effectiveness in digital care is $9.47 and in face-to-face is $9.25. The cost to reach effectiveness of 10 in face-to-face care is $185.85 and in digital care $363.20. From the physician's perspective, the cost to achieve effectiveness of 10 is $419.13 in digital care and $184.52 in face-to-face care. From the perspective of the medical assistant, to achieve effectiveness of 10, the cost in digital care is $468.43 and in face-to-face $179.83., Conclusions: Currently, the best cost-effectiveness ratio corresponds to face-to-face care; however, digital care is an option that will have to evolve., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

Objective: to evaluate the evidence about telehealth strategies in caring for people with chronic kidney disease., Method: integrative literature review. The search for primary studies was carried out in six databases: PubMed/MEDLINE, Web of Science, EMBASE, CINAHL, LILACS, and Scopus. The sample consisted of 48 articles published between 2000 and 2021. The telehealth strategy was applied by a multidisciplinary team of doctors, nurses, pharmacists, nutritionis, and social workers. The type of study, country, strategy applied, setting, population, and professional were extracted from the articles. The studies were selected by reading the title and abstract (phase 1) and then reading them in full (phase 2), categorizing them by telehealth strategy. The results were summarized descriptively and the studies were classified according to their level of evidence., Results: the home was the most representative in dialysis and conservative treatment. Six categories of telehealth strategies were identified: remote monitoring devices, teleconsultation, digital platforms, apps, multimodality strategies, and telephone contact., Conclusion: using these strategies for the care of people with chronic kidney disease presents different forms and implementations, being feasible for the renal population at any stage of the disease and applicable by different health professionals with an emphasis on the home environment. The evidence shows that telehealth favors lower cost, accessibility to remote locations, and better monitoring of dialysis with positive resul in symptom control, risk reduction, and patient training., Background: Telehealth in chronic kidney disease care is feasible and promising. (2) Telehealth is feasible for people at all stages of CKD. (3) Health promotion and monitoring were the most applied by telehealth. (4) Remote care can reduce costs, emergencies, and contac with the clinic. (5) Nurses mainly used telephone contact and teleconferencing.

Through the use of Information and Communication Technologies, distance education exceeded the limits for the qualification of family healthcare teams through permanent education. This study aims to evaluate the existing relation between the thematic areas that are requested in the teleconsultations and the themes proposed for videoconferences conducted between January 2008 and December 2012. It is an exploratory study with a qualitative approach. Secondary data provided by the Telehealth Nucleus of a university in Minas Gerais were used. Records of 495 teleconsultations and 89 videoconferences were analyzed. The study enabled the conclusion of the approximation of the thematic areas of the doubts described in the teleconsultations with the themes proposed for the videoconferences, indicating that the professionals use Telehealth resources to discuss questions about the health care reality. The possibility of expansion of the project and its actions was evidenced.

Objective: To evaluate the perceptions and preferences of users and health professionals on teleconsultation in primary care., Design: Cross-sectional study with a telephone survey of users and a face-to-face survey of professionals carried out at 2021., Setting: Urban primary health care., Participants: Random sample of users with teleconsultations in the last year, stratified by sex and age, and doctors and nurses from participating centres., Measurements: Likert variables assessing teleconsultation according to consultation motives, preferences and related aspects. Descriptive analysis and comparison of proportions and means., Results: Three hundred patients and 48 professionals answered the questionnaire. Both groups value positively the teleconsultation for the management of the electronic prescription (EP) (83% and 83%, respectively), sick leave (SL) (80% and 64%) and issues related to COVID-19 (71% and 58%). The positive assessment of teleconsultation decreases for the treatment of acute pathologies (47% and 25%) and chronic diseases (49% and 33%). Globally, people <70 years value teleconsultation more highly (P<.001), without differences between sexes. Users and professionals prefer face-to-face consultation for chronic diseases (82% and 83%) and acute pathologies (82% and 94%), and teleconsultation for EP (68.7% and 88.6%). 52% of users prefer face-to-face visits for SL compared to 29% of professionals (P<.05)., Conclusions: Teleconsultation implementation has been well valued by both patients and professionals. The face-to-face visit is preferred for chronic and acute pathologies, especially in the elderly. It will be necessary to define in which cases teleconsultation is the best tool according to the characteristics of each population., (Copyright © 2023 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: It has been proposed that primary care diagnose and treat hepatitis C virus (HCV) infection. However, a care circuit between primary and specialized care based on electronic consultation (EC) can be just as efficient in the micro-elimination of HCV. It is proposed to study characteristics and predictive factors of continuity of care in a circuit between primary and specialized care., Methods: From February/2018 to December/2019, all EC between primary and specialized care were evaluated and those due to HCV were identified. Variables for regression analysis and to identify predictors of completing the care cascade were recorded., Results: From 8098 EC, 138 were performed by 89 (29%) general practitioners over 118 patients (median 50.8 years; 74.6% men) and were related to HCV (1.9%). Ninety-two patients (78%) were diagnosed>6 months ago, and 26.3% met criteria for late presentation. Overall, 105 patients required assessment by the hepatologist, 82% (n=86) presented for the appointment, of which 67.6% (n=71) were viraemic, 98.6% of known. Finally, 61.9% (n=65) started treatment. Late-presenting status was identified as an independent predictor to complete the care cascade (OR 1.93, CI 1.71-1.99, p<0.001)., Conclusion: Communication pathway between Primary and Specialized Care based on EC is effective in avoiding significant losses of viraemic patients. However, the referral rate is very low, high in late-stage diagnoses, heterogeneous, and low in new diagnoses. Therefore, early detection strategies for HCV infection in primary care are urgently needed., (Copyright © 2022 Elsevier España, S.L.U. All rights reserved.)

Background: The coronavirus disease pandemic of 2019 (COVID-19) made necessary to remodel the hospital's clinical consultations., Objective: To evaluate the telematic consultation in endocrine surgery, as well as to select the group of patients susceptible to perform a telematic consultation in the future according to this assessment., Methods: The study population were patients who had a clinical consultation by telephone. The evaluation was made with the Net Promoter Score (NPS)., Statistical Analysis: SPSS v.28, X 2 test and a multivariate analysis., Results: 55 patients were analyzed. The NPS was +16, 24 promoters (43.6%) and 15 detractors (27.2%). There were differences between those whose main reason for consultation was malignant pathology (OR 4.5; p = 0.033). The NPS between malignant vs. non-malignant pathology was -13 vs. +38 (p > 0.001). The evaluation of the telematic consultations for the future was: telephone (83% very well), video call (58%), videoconference (19%)., Conclusions: The evaluation of the telephone consultation has been good, finding a better assessment among patients with non-malignant pathology. Its future implementation could be necessary, being the telephone the preferred way., (Copyright © 2022 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

The coronavirus pandemic has transformed the way we communicate. Telehealth has gained relevance and has become a priority issue on the innovation agenda of health systems. Clinical attention of the adolescent population has some unique characteristics that set it apart from others. The objective of this document is to generate a guide of good practices that is useful in the virtual consultation with the adolescent patient. This guide is presented as a support tool for health professionals, understanding that it must be reviewed and updated in successive versions., Competing Interests: None., (Sociedad Argentina de Pediatría.)

Aim: To explore the perceptions and experiences of the general population regarding the impact of the implementation of teleconsultation in primary health care during the pandemic., Design: methodology with a descriptive-interpretative approach, whose fieldwork was carried out between May and November 2020., Place: Study conducted in Navarra and Euskadi. Population groups with different profiles of associated and non-associated citizenship in both Autonomous Communities. A total of 62 primary health care users have participated and 10 focus groups were carried out., Method: The focus groups followed a semi-structured script based on the variables of analysis and dimensions of interest according to the different participant profiles and objectives. The sessions were recorded and transcribed. An inductive content analysis was performed. Data triangulation was realized in order to ensure validity., Results: The perception of teleconsultation by the population has varied throughout the pandemic and has been heterogeneous. The participants consider that the non-face-to-face modality may have repercussions on the quality of care, as well as amplifying inequalities in access to primary health care., Conclusions: It is essential to carry out analyses and evaluations from a health equity perspective in order to make decisions related to the use of technology in general and teleconsultation in particular, in the post-pandemic future of primary health care., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Many health systems have initiated electronic consultation (e-consultation) programs, although little is known about their impact on accessibility, safety, and satisfaction. The aim of this study was to assess the clinical impact of the implementation of an outpatient care model that includes an initial e-consultation and to compare it with a one-time face-to-face consultation model., Methods: We selected patients who visited the cardiology service at least once between 2010 and 2019. Using an interrupted time series regression model, we analyzed the impact of incorporating e-consultation into the health care model (started in 2013), and evaluated waiting times, emergency services, hospital admissions, and mortality., Results: We analyzed 47 377 patients: 61.9% were attended in e-consultation and 38.1% in one-time face-to-face consultations. The waiting time for care was shorter in the e-consultation model (median [IQR]: 7 [5-13] days) than in the face-to-face model (median [IQR]: 33 [14-81] days), P<.001. The interrupted time series regression model showed that the introduction of e-consultation substantially decreased waiting times, which held steady at around 9 days, although with slight oscillations. Patients evaluated via e-consultation had fewer hospital admissions (0.9% vs 1.2%, P=.0017) and lower mortality (2.5% vs 3.9%, P<.001)., Conclusions: An outpatient care program that includes an e-consultation reduced waiting times significantly and was safe, with a lower rate of hospital admissions and mortality in the first year., (Copyright © 2021 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Teleconsultation is one of the components of telemedicine. Developmental pediatricians provide assessments and followup to children with developmental challenges. During the pandemic, due to movement and travel restrictions and the importance of continued care, pediatricians started working remotely with virtual consultations. The objective of this study was to describe the implementation of virtual care, the characteristics of patients seen, and their families' perception. A total of 122 teleconsultations were scheduled. Patients' mean age was 40 ± 13 months. The most common reasons for consultation were absence of and delay in language and behavioral difficulties. Although 16 % of families described some obstacles, all were grateful for the consultations. Virtual health care should be regarded as a complement to in-person care, alongside reductions in costs and travel time and the possibility., Competing Interests: None, (Sociedad Argentina de Pediatría.)

Objective: A «before and after» type observational study was carried out to assess the impact of the virtual consultation (eConsulta) on the frequency with which the patient visits their primary care center once they have had their first virtual consultation., Setting: Assigned population of the primary care center of Masnou-Alella and Ocata-Teià, Catalan Health Institute., Participants: A random sampling was performed and 329 patients who engaged in eConsulta were compared with 329 statistically similar patients in age, sex and medical complexity who did not engage in eConsulta., Principal Mediations: Visits with primary care and nursing in their team are measured, both face-to-face, telephone and eConsulta, over the study period., Results: Patients who performed virtual consultations showed a previous frequent attendance in primary care higher than those who did not perform eConsulta (4.44 medical visits year/versus 3.11). Following the use of the eConsulta, after a year of follow-up, frequency was reduced to levels of the control group (3.16 medical visits/year versus 3.00). After the first virtual visit, patients reduced face-to-face visits by 28.7%., Conclusions: The eConsulta could be an effective tool to respond to the needs of patients who do not require a face-to-face visit, especially in the most frequent patients., (Copyright © 2021 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)