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Studies reveal healthcare disparities for people with disabilities (PwD) due to various barriers. Digital health offers promise but raises concerns about the digital divide. To address that, health Information and Communication Technologies (ICTs) should follow inclusive design principles for accessibility to all, including PwD. We examine the design of ICTs in healthcare to address the needs of people with disabilities. Three research questions guide the study: (i) how health technologies contribute to healthcare accessibility and inclusion; (ii) what the main challenges are in implementing these technologies; (iii) how health ICTs are structured to meet users’ limitations and enhance performance. Research questions are addressed through a scoping review and critical literature analysis, drawing from seven databases and grey literature. The analysis of research question (iii) uses the accessibility fundamentals recommended by the Web Accessibility Initiative as starting point. Our research reveals a predominant focus on the elderly, with cognitive impairment as the most studied limitation, followed by mobility, reach and dexterity, vision, and hearing. We emphasize the need for inclusive design for all health technologies and investigate their potential to improve user and healthcare system performance. We also propose four promising research directions for further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Telemedicine has shown promising results, allowing specialists to provide rapid and effective care in remote locations. However, to our knowledge, current evidence is not robust enough to prove the effectiveness of this tool. This cluster-randomized trial (CRT) aimed to evaluate the impact of telemedicine on clinical care indicators in pediatric intensive care units (PICUs). Methods: An open-label CRT was conducted in 16 PICUs within the Brazilian public health system. The trial took place from August 2022 to December 2023 and compared an intervention group, which received telemedicine support, with a control group, which received usual PICU care. The primary outcome was the PICU length of stay. The main secondary outcomes were mortality rate and ventilator-free days. Results: A total of 1393 participants were included, 657 in the control group and 736 in the intervention group. The mean PICU length of stay was 10.42 (SD, 10.71) days for the control group and 11.52 (SD, 10.80) days for the intervention group. The overall mean of ventilator-free days was 6.82 (SD, 7.71) days. Regarding mortality, 7.54% of participants died in total. No significant difference was found in the outcomes between the groups. Conclusion: Despite the potential benefits of telemedicine, its effective implementation in the Brazilian public health system faces considerable challenges, highlighting the continued importance of investigating and improving the role of telemedicine in pediatric critical care. Clinical trial registration: ClinicalTrials.gov NCT05260710 and ReBEC – RBR-7×j4wyp. [ABSTRACT FROM AUTHOR]

Introduction: Telemedicine has gained significant attention as an effective means of providing health care remotely, particularly during the COVID-19 pandemic. Patient satisfaction is a critical aspect of implementing telemedicine, but we have no comprehensive understanding of satisfaction levels and the associated factors. The aim of this systematic review and meta-analysis was to assess patient satisfaction related to telemedicine consultations and to identify key factors influencing satisfaction levels. Results: The search yielded a total of 147 cross-sectional studies, of which 107 met the criteria for inclusion in the meta-analysis. Overall, patient satisfaction with teleconsultations was found to be high, with satisfaction levels ranging from 38 to 100 on a scale of 0 to 100. Only a small percentage (2.72%) of the studies reported satisfaction levels below 75%. Surprisingly, most studies used nonvalidated satisfaction questionnaires, which highlight the need for the development of standardized measurement instruments. Conclusions: This systematic review and meta-analysis provide evidence that patients generally exhibit high levels of satisfaction with telemedicine consultations. The use of nonvalidated satisfaction questionnaires in many studies, however, suggests a need for more standardized assessment tools. Factors such as the time interval between the consultation and the assessment were found to influence satisfaction levels. Understanding these factors can help health care providers improve telemedicine services and patient-provider relationships and optimize health care delivery in the context of telemedicine. Further research is warranted to develop validated satisfaction measurement instruments and explore any additional factors that influence patient satisfaction with telemedicine.