Tag: telehealth

Categories : IT in Healthcare Obstetrics & GynaecologyTags :

Virtual Antenatal Care Linked to Poorer Pregnancy Outcomes

On By ModernMedia
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Women who receive more virtual antenatal care during their second or third trimesters could experience poorer pregnancy outcomes, including higher risks of preterm birth, Caesarean sections and neonatal intensive care unit admissions, a new study suggests.

Increased virtual antenatal care in later pregnancy was also found to be associated with lower rates of early skin-to-skin contact with the newborn and fewer instances of breastfeeding as the first feed.

Led by King’s College London and published in the American Journal of Obstetrics & Gynecology, the study looked at associations between virtual antenatal care and pregnancy outcomes in more than 34 000 pregnancies from a diverse, South London population, from periods before and during the COVID-19 pandemic.

Women were split into four groups, according to the proportion of virtual antenatal care appointments received during their pregnancy – low and stable virtual antenatal care throughout pregnancy, high first trimester virtual antenatal care, high second trimester virtual antenatal care, and high third trimester virtual antenatal care.

Pregnancy and birth outcome data were obtained from hospital records via the Early Life Cross-Linkage in Research, Born in South London (eLIXIR-BiSL) platform, funded by the UKRI Medical Research Council (MRC).

Analyses of the data revealed that, compared with those who received a low and stable proportion of virtual antenatal care throughout their pregnancy:

  • Women who received a high proportion of virtual antenatal care in their second trimester experienced more premature births (before 37 weeks), labour inductions, breech presentation, and bleeding after birth; and
  • Women who received a high proportion of virtual antenatal care in their third trimester had more premature births (before 37 weeks), elective or emergency Caesarean sections, and neonatal intensive care unit admissions; as well as lower rates of third- or fourth-degree vaginal tears, early skin-to-skin contact with the newborn and fewer instances of breastfeeding as the first feed.

During the COVID-19 pandemic, the use of virtual antenatal care increased, to limit face-to-face contact and prevent spread of the SARS-CoV-2 virus. While research has looked at the experiences of women and healthcare providers receiving and delivering virtual care, fewer studies have focused on the impact of virtual antenatal care on pregnancy outcomes.

Our work adds an important perspective to the growing evidence base on virtual antenatal care, suggesting that the timing of its use during pregnancy may influence pregnancy outcomes.

Dr Katie Dalrymple, Lecturer at King’s and first author of the study

The findings build on an earlier study by the team, which found that virtual maternity care during the COVID-19 pandemic was linked to higher NHS costs – with each 1% increase in virtual antenatal care associated with a £7 increase in maternity costs to the NHS.

In addition to the cost implications of virtual care, the findings from the new study suggest that virtual antenatal care could come with increased risks to mother and baby. The authors conclude that careful consideration may be needed to minimise these risks before using virtual antenatal care in future health system shocks or to replace face-to-face care.

Our study findings suggest the need for careful integration of virtual care in maternity services, to minimise potential risks.

Professor Laura Magee, Professor of Women’s Health at King’s and co-senior author of the paper

Source: King’s College London

Categories : Expert Opinion IT in HealthcareTags :

Dr Jessica Voerman Highlights Key Healthcare Trends to Watch for in 2025 

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The healthcare landscape is rapidly evolving, and 2025 is poised to bring significant changes driven by technological advancements and shifting patient needs. As the sector faces ongoing challenges such as rising costs, limited access, and increasing demand for mental health services, innovative solutions will be key to addressing these issues. From the rise of virtual healthcare and wearable technologies to the growing influence of artificial intelligence, these trends are reshaping how care is delivered and experienced.

“The healthcare sector must embrace innovation to address challenges like affordability and accessibility while leveraging technologies such as AI, virtual healthcare, and wearables to reshape how we deliver care,” said Dr Jessica Voerman, Chief Clinical Officer at SH Inc. Healthcare.

KEY TRENDS POISED TO DEFINE HEALTHCARE IN 2025

  1. RISING HEALTHCARE COSTS AND ACCESS CHALLENGES
    As we approach 2025, the escalation of healthcare costs is expected to persist, with medical aid contributions outpacing inflation and the general expense of healthcare services becoming increasingly burdensome. This growing financial pressure is placing significant strain not only on patients, but also on healthcare providers and the broader healthcare system. In response, identifying and implementing innovative solutions to alleviate this looming financial crisis remains a critical priority for healthcare businesses nationwide. For many South Africans, the rising cost of healthcare is exacerbating issues of accessibility and affordability, with an increasing number of individuals unable to access necessary medical care. In light of this, we anticipate a strong focus on policy reform aimed at addressing these inequalities. As such, addressing healthcare disparities will continue to be a central theme in the ongoing development of healthcare policies and initiatives in the coming years. 
  2. INCREASING DEMAND FOR MENTAL HEALTHCARE SERVICES
    One of the most prominent shifts anticipated in the healthcare landscape by 2025 is the significant rise in demand for mental healthcare services. The recognition that mental health is integral to overall well-being has led to a growing push to integrate mental health services into primary healthcare systems. Such integration is proving to be both preventative and curative, as early intervention can improve long-term outcomes. Furthermore, mental healthcare is particularly well-suited for the adoption of digital health tools, such as virtual consultations, which can enhance access to care, particularly in underserved or rural areas. The increased focus on mental health will likely continue to drive growth in this sector, as more individuals seek professional support to manage mental health challenges. 
  3. EXPANSION OF VIRTUAL HEALTHCARE
    The trend towards virtual healthcare is expected to continue its upward trajectory in 2025, as more patients turn to telemedicine as either a primary or supplementary means of accessing healthcare services. According to a McKinsey report, telemedicine is projected to account for more than 20% of outpatient consultations by 2025. This shift is expected to be particularly pronounced in areas such as primary healthcare, chronic disease management, dermatology, and mental healthcare. Virtual consultations offer patients the convenience of receiving care remotely, which can help to reduce barriers related to distance, time, and accessibility. For healthcare providers, virtual healthcare offers opportunities to streamline services, increase operational efficiency, and reach a broader patient population. 
  4. THE ROLE OF WEARABLES AND HEALTH DATA COLLECTION
    Wearable health technologies, including biosensors capable of monitoring, transmitting, and analysing vital signs, represent another exciting frontier in digital health. These devices have the potential to revolutionise the management of both acute and chronic conditions by providing continuous, real-time data that can inform clinical decision-making. With their ability to track everything from heart rate and blood glucose levels to oxygen saturation and sleep patterns, wearables offer unprecedented insights into an individual’s health status. This wealth of data has the potential to improve patient outcomes, empower individuals to take a more proactive role in managing their health, and help healthcare providers tailor interventions more precisely. As these technologies evolve, they will become an increasingly important tool in both disease prevention and management. 
  5. THE GROWING IMPACT OF ARTIFICIAL INTELLIGENCE (AI)
    Artificial intelligence (AI) continues to make significant strides in healthcare, particularly in areas such as clinical decision-making, diagnostics, and operational efficiency. AI algorithms have demonstrated their ability to improve the speed, accuracy, and reliability of diagnoses, enabling healthcare professionals to make more informed decisions. Furthermore, AI-driven tools are improving clinical workflows, optimizing resource allocation, and enhancing the overall patient experience. In the realm of surgery, robotic-assisted technologies are increasingly being used to improve the precision of procedures, reduce the risk of human error, and shorten recovery times for patients. Additionally, the use of virtual and augmented reality technologies in medical training and physical rehabilitation is gaining traction, offering immersive, interactive experiences that improve learning outcomes and accelerate recovery for patients.

Looking ahead to 2025, healthcare is set to evolve rapidly, driven by technological advancements and growing demand for accessible, affordable care. Key trends such as rising costs, expanded mental health access, virtual healthcare, wearable technologies, and artificial intelligence are reshaping the sector.

For businesses and policymakers, staying ahead of these changes is crucial to ensuring sustainable, equitable, and effective care. By embracing digital tools, AI, and data-driven solutions, the healthcare system can improve both patient outcomes and overall efficiency. Collaboration and innovation across all sectors will be essential to meeting the evolving needs of patients and society.

Categories : Mental HealthTags :

Online Anger Management Therapy can be Effective

On By ModernMedia
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Problems with managing anger can have severe consequences for the afflicted individual and their loved ones. A new study from Karolinska Institutet shows a four-week therapy course delivered over the internet can help people to deal with their anger and aggression. The results have been published in the Journal of Consulting and Clinical Psychology.

The study, which the researchers have chosen to call the “anger study”, is the first to compare different internet-mediated emotion regulation strategies against anger. The results are expected to be important for understanding emotion regulation and for the dissemination of evidence-based methods.

Easy to recruit participants

“It is usually very difficult to recruit participants for treatment studies. For the anger study, however, it was very easy, and we had to close the recruitment site after a few weeks due to the high number of applicants. This suggests that there is a pent-up need for the psychological treatment of anger. Many people who have problems with anger feel ashamed, and we think the internet format suits this group particularly well because they don’t have to wait in a reception room or sit face-to-face with a therapist and talk about their anger,” says lead researcher Johan Bjureberg, assistant professor at Karolinska Institutet.

The anger study evaluated the effect of two emotion regulation strategies: mindful emotion awareness; and cognitive reappraisal. Mindful emotion awareness focuses on the ability to notice and accept one’s feelings and thoughts without judging or acting on them. Cognitive reappraisal, on the other hand, focuses on the ability to reinterpret thoughts and situations and identify alternative thoughts that do not trigger difficult feelings.

The 234 participants, all with significant anger problems, were randomly assigned to four weeks of either mindful emotion awareness, cognitive reappraisal, or a combination of these two strategies. All treatments were of approximately the same length and were associated with decreased self-reported anger and aggressiveness at the end of the treatment.

Combination therapy most effective

The combined treatment resulted in significantly lower levels of outward anger expression, aggression, and anger rumination, but not anger suppression, compared to mindful emotion awareness or cognitive reappraisal alone. The combination was particularly effective for participants who were experiencing very high levels of anger at the start of the study. The results strengthen research and theories suggesting that difficulties in regulating emotions and interpreting events and situations can be a major contributing factor to problems in managing anger.

“Our results suggest that a very short treatment of only four weeks administered over the internet with minimal therapist support is effective in reducing anger problems. Our hope is that follow-up studies support this finding and that the treatment can be offered broadly within regular care,” explains Johan Bjureberg.

Source: Karolinska Institutet

Categories : COVIDTags :

Home Pulse Oximeters in COVID no Better Than Just Asking

On By ModernMedia
Photo by Mufid Majnun on Pexels

Self-measurement of oxygen levels with pulse oximeters is no better than just regularly asking patients with COVID if they are short of breath, according to new research published in the New England Journal of Medicine. Pulse oximeters have often been applied because of concerns that patients might not notice their blood oxygen levels sliding dangerously. 

However, people in Penn Medicine’s COVID Watch programme, which monitors patients recovering at home via automated text messaging, had the same outcomes whether they used oxygen-measuring devices or not.

“Compared to remotely monitoring shortness of breath with simple automated check-ins, we showed that the addition of pulse oximetry did not save more lives or keep more people out of the hospital,” said the study’s co-lead author, Anna Morgan, MD, medical director of the COVID Watch program and an assistant professor of General Internal Medicine. “And having a pulse oximeter didn’t even make patients feel less anxious.”

The COVID Watch was launched in March 2020 to remotely monitor COVID patients at home, with 28 500 people enrolled to date. Twice a day for two weeks, text messages were automatically sent to these patients asking how they felt and if they were having difficulty breathing. If patients indicated dyspnoea, the programme would alert a nurse to make contact and arrange care.

“The programme made it easy to identify the sickest patients who needed the hospital, and keep the others at home safely,” said David Asch, MD, executive director of the Center for Health Care Innovation and a professor of Medicine, Medical Ethics and Health Policy. “The programme was associated with a 68 percent reduction in mortality, saving a life approximately every three days during peak enrollment early in the pandemic.”

However it was not known if monitoring blood oxygen would help.

“Early in the pandemic, there was a prevalent theory that oxygen levels in the blood dropped before a COVID patient became symptomatic and short of breath,” said study co-lead author Kathleen Lee, MD. “Detecting this earlier with a home pulse oximeter might provide an opportunity to get patients who are on the cusp of deteriorating to the hospital faster and initiate time-sensitive therapies to improve outcomes.”

The use of pulse oximeters was so intuitively appealing that the process got adopted even before this trial, the first randomised trial to test whether it actually worked.

“Several health systems, and even states like Vermont and countries like the United Kingdom, have integrated pulse oximetry into the routine home management of patients with COVID, but there’s been scant evidence to show this strategy makes a difference,” said the research project’s principal investigator M. Kit Delgado, MD.

In this study, more than 2000 patients enrolled in COVID Watch between Nov. 29, 2020, and Feb. 5, 2021, were randomised to receive standard COVID Watch care or the same program with the addition of a pulse oximeter.

However, no statistical difference was seen in the main study measure, the average number of days enrolled patients spent alive and out of the hospital in the 30 days after they were enrolled. For patients with pulse oximeters, the measure was 29.4 days; for those without, it was 29.5, with no difference across racial liines. This was important as black patients are known to have had worse COVID outcomes and concerns had been raised about the accuracy of pulse oximeters in people with darker skin.
The researchers cautioned that the study focused on pulse oximeters in established programme of remote monitoring, and patients don’t have access to a system like COVID Watch or on-call clinicians, self-monitoring with pulse oximeters may still be a reasonable approach until there is evidence to the contrary.

“Overall, these findings suggest that a low-tech approach for remote monitoring systems based on symptoms is just as good as a more expensive one using additional devices. Automated text messaging is a great way for health systems to enable a small team of on-call nurses to manage large populations of patients with COVID,” said co-principal investigator, Krisda Chaiyachati, MD. “There are a lot of other medical conditions where the same kind of approach might really help.”

Source: University of Pennsylvania School of Medicine