Impact of Remote Medical Devices on Utilization of Medical Services in Pediatric Patients with Upper Respiratory Infections: A Retrospective Study.

Background: Remote mobile examination devices in telemedicine are a new technology in healthcare. Objective: To assess the utilization of visits using remote medical devices. Methods: A retrospective analysis of follow-up visits, referrals, laboratory testing and antibiotic prescriptions of 470,845 children's video visits with and without remote medical examination device and in-clinic visits. Results: Rates of follow-up visits, referrals and laboratory tests were higher in video visits compared to visit with medical device (OR of 1.27, 1.08, 1.93 respectfully). For in-clinic visits, rates of follow-up were lower but higher for referrals to subspecialists and laboratory test referrals when compared to telemedicine. Antibiotic prescriptions were provided at a lower rate in video visits compared to visits with a medical device (OR = 0.48) and in-clinic visits. Conclusions: Incorporating a remote medical device may reduce follow up visits, referrals and laboratory tests compared to a video visit without a device. The prevalence of antibiotic prescriptions did not escalate in telemedicine consultations.

Shared Decision Making and Trust Matter: Patient's Use of Video Consultations and a Remote Medical Device in Primary Care.

Background: There is growing interest in the incorporation of video consultations in primary care. Remote medical devices used for remote physical examinations are a new complementary addition to these consultations and may increase their effectiveness. This study examines a social behavioral-technological model by the factors predicting the acceptance of video consultation with or without a technological medical device, their perceived ease of use (PEU), and their perceived usefulness (PU), as well as social behavioral factors: trust and shared decision making. Methods: We conducted an online survey among patients who had visited a physician during 2021 and had the option to receive video consultations with or without remote medical devices. Structural equation modeling was applied to assess the proposed model of predicting the extent of future telemedicine use. Results: Among the 1,198 patient responders, the intention to use telemedicine video consultation had a significant positive association with trust, shared decision making, PEU, and PU and with high socioeconomic constructs. The intention to use telemedicine video consultation with a medical device had a significant positive association with shared decision making, PEU, and PU. The statistical results suggest a good fit with the proposed models. Conclusions: The proposed social behavioral-technological model demonstrated that to successfully adopt video consultations and new remote medical devices in primary care, there is a need for trust and shared decision making to be established in patient-physician relationships.