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Healthcare
Special Issues
The Role of Telemedicine in Transforming Healthcare Delivery—Capabilities and Barriers
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The Role of Telemedicine in Transforming Healthcare Delivery—Capabilities and Barriers

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "TeleHealth and Digital Healthcare".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 9875

Special Issue Editor

Dr. Motti Haimi

E-Mail Website
Guest Editor
1. Meuhedet Healthcare Services, Tel Aviv-Jaffa 6203854, Israel
2. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3525433, Israel
3. Health Administration Department, The Max Stern Yezreel Valley College, Emek Yezrael 1930600, Israel
Interests: telemedicine; digital health; health disparities

Special Issue Information

Dear Colleagues,

Telemedicine plays a significant role in improving access to healthcare services by overcoming traditional barriers, increasing convenience, and enhancing healthcare delivery. Telemedicine allows individuals in remote or underserved areas to access medical care without the need to travel long distances. This is particularly important in rural and isolated regions where there is a shortage of healthcare providers. Telemedicine helps ensure access to healthcare services for vulnerable populations, such as those who are elderly, are disabled, or have chronic conditions, who may have difficulty traveling to medical facilities. Patients can more easily receive follow-up care through telemedicine, reducing the need for multiple in-person visits. This is particularly beneficial for those with chronic conditions. Telemedicine provides a means for patients with chronic diseases to regularly monitor and manage their conditions, reducing hospital readmissions and improving overall health outcomes. Mobile apps and wearable devices connected to telemedicine platforms allow for real-time monitoring of patients' health, making it easier for healthcare providers to intervene when necessary. While telemedicine offers numerous benefits for improving healthcare access, it is essential to address issues such as healthcare disparities and reimbursement policies and to ensure that patients have access to the necessary technology and training to use telemedicine effectively. Nevertheless, it continues to be a vital tool in making healthcare more accessible and convenient for people around the world.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Patient Education: educating patients about the availability and benefits of telemedicine;
  • Provider Training: training healthcare providers in telemedicine best practices, including conducting virtual examinations, protecting patient privacy, and using telemedicine platforms effectively;
  • Remote Monitoring: utilizing remote monitoring tools and wearable devices to collect patient data and to monitor chronic conditions;
  • Scheduling and Workflow Optimization: streamlining appointment scheduling and workflows to ensure that telemedicine appointments are efficient;
  • Telemedicine Apps: developing telemedicine apps that make it easy for patients to schedule appointments, to receive reminders, and to access their medical records;
  • Emergency Protocols: developing protocols for handling emergency situations during telemedicine appointments.

I look forward to receiving your contributions.

Dr. Motti Haimi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • telemedicine
  • e-health
  • health disparities
  • remote treatment and monitoring
  • usability
  • e-health literacy
  • patient safety
  • digital divide

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  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
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  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
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Further information on MDPI's Special Issue polices can be found here.

Published Papers (6 papers)

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Research

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14 pages, 430 KiB  
Article
Telehealth Perceived Benefits and Self-Efficacy Do Not Mediate the Effects of Demographic, Health, and Social Determinants on Telehealth Use of Low-Income African American and Latino Residents of Public Housing in Los Angeles
by Sharon Cobb, Attallah Dillard, Ehsan Yaghmaei, Mohsen Bazargan and Shervin Assari
Healthcare 2025, 13(3), 286; https://doi.org/10.3390/healthcare13030286 - 31 Jan 2025
Viewed by 733
Abstract
Background: Marginalized low-income racial and ethnic minority residents of public housing represent an intersectional population with multiple health needs and low healthcare utilization. Telehealth has been proposed as a solution to address healthcare access disparities, yet the role of telehealth attitudes, including perceived [...] Read more.
Background: Marginalized low-income racial and ethnic minority residents of public housing represent an intersectional population with multiple health needs and low healthcare utilization. Telehealth has been proposed as a solution to address healthcare access disparities, yet the role of telehealth attitudes, including perceived benefits and self-efficacy, in influencing telehealth use of this population remains unknown. Objective: This study investigates whether two domains of telehealth attitudes, namely self-efficacy and perceived benefits (expectancy), mediate the relationship between demographic, health, and social determinants of telehealth use among low-income racial and ethnic minority residents of public housing in Los Angeles. Methods: This cross-sectional study analyzed data collected from low-income racial and ethnic minority residents of public housing in Los Angeles. Measures included demographic factors (age and gender), social determinants of health (e.g., education, language, and primacy care provider), health (chronic illnesses and physical mobility), telehealth attitudes (perceived benefits and self-efficacy), and telehealth use frequency. Mediation analysis was conducted to test whether telehealth attitudes explained the association between demographic, social, and health determinants of telehealth use. Results: The findings revealed that neither of the two domains of telehealth attitudes, including perceived benefits and self-efficacy, were significantly associated with telehealth use. As such, these attitude domains did not operate as mediators of the relationship between demographic, health, and social determinants of telehealth use. Conclusion: The study results suggest that structural barriers, rather than individual attitudes, primarily drive telehealth use disparities among this intersectional population. Interventions aimed at increasing telehealth adoption should prioritize addressing systemic inequities rather than focusing solely on changing individual attitudes. These findings underscore the importance of structural solutions to promote equitable telehealth access in marginalized communities. Full article
(This article belongs to the Special Issue The Role of Telemedicine in Transforming Healthcare Delivery—Capabilities and Barriers)
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<p>Summary of the structural equation model with telehealth frequency as the outcome. Note: CMC: chronic medical condition; Reg Doc: having a regular provider; Educ: own educational attainment; Language (Spanish); Gender: male gender; Physical Fit (SF12 Score); Expectanc: telehealth expectancy (expected benefits); Frequency: telehealth utilization frequency; Self-effic: self-efficacy to use telehealth.</p> Full article ">
19 pages, 677 KiB  
Article
Telehealth Outreach Program for Child Traumatic Stress: Strategies for Long-Term Sustainability
by Emily Johnson, Ryan Kruis, Rosaura Orengo-Aguayo, Rebecca Verdin, Kathryn King, Dee Ford and Regan Stewart
Healthcare 2024, 12(21), 2110; https://doi.org/10.3390/healthcare12212110 - 23 Oct 2024
Viewed by 1368
Abstract
Background: There are high documented rates of exposure to traumatic events and mental health disorders among youths yet existing disparities in access to care for racial and ethnic minority youths and youths in rural communities. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based [...] Read more.
Background: There are high documented rates of exposure to traumatic events and mental health disorders among youths yet existing disparities in access to care for racial and ethnic minority youths and youths in rural communities. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based behavioral health therapy for children. The delivery of TF-CBT via telehealth can decrease access to care barriers. An interdisciplinary clinical team developed a training program to guide clinicians to effectively provide TF-CBT via telehealth. The goal of this study was to describe variation in implementation processes of the telehealth TF-CBT program and identify barriers and facilitators to program implementation post-training, which were utilized to develop implementation strategies for intervention sustainability. Methods: Using a mixed-methods approach, data were collected on telehealth implementation processes and facilitators and barriers to the delivery of telehealth TF-CBT. This study was guided by an adapted implementation science framework, namely the Exploration, Preparation, Implementation, Sustainment model. Interviews and surveys were completed with clinical site leaders who had participated in the telehealth TF-CBT training. Results: Throughout clinical sites, there was varied adoption and penetration of the telehealth TF-CBT program. Facilitators to implementation included leadership and site staff buy in, community needs, and training resources, while barriers included funding, available logistical resources, and child and family involvement. Conclusions: The feedback gained from this project assisted in the development of implementation strategies for increased adoption and sustainment of TF-CBT delivered via telehealth. Strategies include ongoing interactive assistance and resource support, enhanced training for stakeholders, and program adaptations, with the goal to increase access to quality mental health care for underserved populations. Full article
(This article belongs to the Special Issue The Role of Telemedicine in Transforming Healthcare Delivery—Capabilities and Barriers)
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<p>Framework for implementation of telehealth Trauma-Focused Cognitive Behavioral Therapy.</p> Full article ">
21 pages, 707 KiB  
Article
Investigating Physicians’ Adoption of Telemedicine in Romania Using Technology Acceptance Model (TAM)
by Abigaela Bîlbîie, Andreea-Ionela Puiu, Viorel Mihăilă and Marin Burcea
Healthcare 2024, 12(15), 1531; https://doi.org/10.3390/healthcare12151531 - 1 Aug 2024
Viewed by 1770
Abstract
This study investigates Romanian physicians’ acceptance of telemedicine using the Technology Acceptance Model. We analyzed 1093 responses to an online survey distributed nationwide to physicians via email by the National Authority of Quality Management in Health, employing the partial least squares algorithm to [...] Read more.
This study investigates Romanian physicians’ acceptance of telemedicine using the Technology Acceptance Model. We analyzed 1093 responses to an online survey distributed nationwide to physicians via email by the National Authority of Quality Management in Health, employing the partial least squares algorithm to estimate the relationship between the behavioral intention to adopt telemedicine and its potential determinants. Our findings reveal that the model accounts for 84.6% of the variance in behavioral intention to use telemedicine. Among the two constructs of the TAM model, perceived usefulness is a stronger predictor of behavioral intention than perceived ease of use. Additionally, subjective norms positively and significantly influence physicians’ intention to use telemedicine and their perception of its usefulness. Furthermore, perceived incentives and accessibility to medical records also positively impact the behavioral intention to use telemedicine. Full article
(This article belongs to the Special Issue The Role of Telemedicine in Transforming Healthcare Delivery—Capabilities and Barriers)
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<p>The research model.</p> Full article ">
13 pages, 1962 KiB  
Article
Satisfaction with Teleophthalmology Services: Insights from Remote Areas of Taiwan
by Nancy Chen, Jen-Hung Wang and Cheng-Jen Chiu
Healthcare 2024, 12(8), 818; https://doi.org/10.3390/healthcare12080818 - 11 Apr 2024
Cited by 1 | Viewed by 1583
Abstract
During and after the COVID-19 pandemic, teleophthalmology provided access to eye care for rural populations. This study aimed to assess the efficacy of and satisfaction with an integrated real-time videoconferencing module. This project incorporated ophthalmic instruments and telecommunication devices and provided on-site consultations [...] Read more.
During and after the COVID-19 pandemic, teleophthalmology provided access to eye care for rural populations. This study aimed to assess the efficacy of and satisfaction with an integrated real-time videoconferencing module. This project incorporated ophthalmic instruments and telecommunication devices and provided on-site consultations via videoconferencing. Both patients and healthcare providers completed satisfaction questionnaires. From May 2020 to May 2021, this project provided eye care services to 395 patients (aged 6–90 years). The most frequent eye condition was chronic conjunctivitis (n = 197), followed by senile cataract (n = 163), dry eye (n = 103), and refractive error (n = 95). Among them, 40 (10.1%) patients were referred to secondary or tertiary hospitals for further evaluation or treatment. In total, 181 recruited respondents provided good satisfaction scores in all dimensions, including quality of medical care (4.50 of 5.00), financial aspects of care (4.48), supportive attitude toward the project (4.47), quality of service (4.40), and quality of telecommunication (4.40). Women had a substantially more supportive attitude toward the project, and 25 healthcare providers provided low ratings in areas representing the quality of telecommunication (4.04) and user-friendliness of the instrument (4.00). This teleophthalmology system provided efficient and satisfactory eye care to participants in remote communities. However, better internet access and training in instrument use can reduce obstacles to the future implementation of the project. Full article
(This article belongs to the Special Issue The Role of Telemedicine in Transforming Healthcare Delivery—Capabilities and Barriers)
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<p>Map of eastern Taiwan showing the involved infirmaries and the distance between these infirmaries and the medical center, Hualien Tzu Chi Hospital.</p> Full article ">Figure 2
<p>Flowchart showing the virtual vision module process.</p> Full article ">Figure 3
<p>The frequency of eye conditions and the number of referrals.</p> Full article ">Figure 4
<p>Satisfaction scores of (<b>A</b>) patients and (<b>B</b>) healthcare providers.</p> Full article ">
12 pages, 537 KiB  
Article
Personalizing Communication of Clinicians with Chronically Ill Elders in Digital Encounters—A Patient-Centered View
by Gillie Gabay, Hana Ornoy, Attila Gere and Howard Moskowitz
Healthcare 2024, 12(4), 434; https://doi.org/10.3390/healthcare12040434 - 8 Feb 2024
Cited by 1 | Viewed by 1517
Abstract
Background: Chronically ill elderly patients are concerned about losing the personal connection with clinicians in digital encounters and clinicians are concerned about missing nonverbal cues that are important for the diagnosis, thus jeopardizing quality of care. Aims: This study validated the expectations and [...] Read more.
Background: Chronically ill elderly patients are concerned about losing the personal connection with clinicians in digital encounters and clinicians are concerned about missing nonverbal cues that are important for the diagnosis, thus jeopardizing quality of care. Aims: This study validated the expectations and preferences of chronically ill elderly patients regarding specific communication messages for communication with clinicians in telemedicine. Methods: The sample comprised 600 elderly chronically ill patients who use telehealth. We used a conjoint-based experimental design to test numerous messages. The outcome variable is elder patient expectations from communication with clinicians in telemedicine. The independent variables were known categories of patient–clinician communication. Respondents rated each of the 24 vignettes of messages. Results: Mathematical clustering yielded three mindsets, with statistically significant differences among them. Members of mindset 1 were most concerned with non-verbal communication, members of mindset 2 prefer communication that enhances the internal locus of control, and members of mindset 3 have an external locus of control and strongly oppose any dialogue about their expectations from communication. Conclusions: The use of the predictive algorithm that we developed enables clinicians to identify the belonging of each chronically ill elderly patient in the clinic to a sample mindset, and to accordingly personalize the communication in the digital encounters while structuring the encounter with greater specificity, therefore enhancing patient-centered care. Full article
(This article belongs to the Special Issue The Role of Telemedicine in Transforming Healthcare Delivery—Capabilities and Barriers)
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<p>An example of mathematical clustering to identify commonalities by the perceived importance of messages.</p> Full article ">Figure 2
<p>The predictive algorithm listing the six most discriminating elements with binary answers needed to predict the mindset membership of new participants.</p> Full article ">

Review

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13 pages, 298 KiB  
Review
Utilizing Telemedicine Applications in Celiac Disease and Other Gluten-Free-Diet-Dependent Conditions: Insights from the COVID-19 Pandemic
by Motti Haimi and Aaron Lerner
Healthcare 2024, 12(11), 1132; https://doi.org/10.3390/healthcare12111132 - 31 May 2024
Cited by 2 | Viewed by 1901
Abstract
Background: Globally, approximately 1.4% of people have celiac disease (CD), induced by gluten sensitivity. If left untreated, it causes small intestinal inflammation and villous atrophy, which can result in failure to thrive, anemia, osteoporosis, malabsorption, and even malignancy. The only treatment option available [...] Read more.
Background: Globally, approximately 1.4% of people have celiac disease (CD), induced by gluten sensitivity. If left untreated, it causes small intestinal inflammation and villous atrophy, which can result in failure to thrive, anemia, osteoporosis, malabsorption, and even malignancy. The only treatment option available is a gluten-free diet (GFD). Few studies have looked at the role and perception of telehealth in relation to CD and selective nutrition both before and after the COVID-19 pandemic. Aim: Our goal was to screen and investigate the research conducted both before and after the COVID-19 pandemic concerning the utilization of telehealth applications and solutions in CD and other GFD-dependent circumstances. Methods: We employed a narrative review approach to explore articles that were published in scholarly journals or organizations between the years 2000 and 2024. Only English-language publications were included. PubMed and Google Scholar searches were mainly conducted using the following keywords: telemedicine, telehealth, telecare, eHealth, m-health, COVID-19, SARS-CoV-2, celiac disease, and gluten-free diet (GFD). Manual searches of the references in the acquired literature were also carried out, along with the authors’ own personal contributions of their knowledge and proficiency in this field. Results: Only a few studies conducted prior to the COVID-19 outbreak examined the viewpoints and experiences of adult patients with CD with relation to in-person clinic visits, as well as other options such as telehealth. The majority of patients believed that phone consultations were appropriate and beneficial. Video conferencing and telemedicine became more popular during the COVID-19 pandemic, demonstrating the effectiveness of using these technologies for CD on a global basis. In recent years, urine assays for gluten identification have become accessible for use at home. These tests could be helpful for CD monitoring with telemedicine assistance. Conclusions: The extended knowledge gathered from the COVID-19 pandemic is expected to complement pre-COVID-19 data supporting the usefulness of telemedicine even after the emergent pandemic, encouraging its wider adoption in standard clinical practice. The monitoring and follow-up of CD patients and other GFD-dependent conditions can greatly benefit from telemedicine. Full article
(This article belongs to the Special Issue The Role of Telemedicine in Transforming Healthcare Delivery—Capabilities and Barriers)
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