Course Project - Introduction and Outline

Research Reading Journal

First source ************************************************************************************

SOURCE CITATION: North, S. (2020). Telemedicine in the time of COVID and beyond.  The Journal of Adolescent Health,  67(2), 145. https://pmc.ncbi.nlm.nih.gov/articles/PMC7320687/

SUMMARY OF SOURCE: North (2020) studies the increase in the usage of telemedicine during the COVID-19 global health crisis particularly in adolescent health to continue the care delivery while in compliance with social distancing. This is regarding confidentiality for adolescents and the potential for eroding any gains made in reducing health inequalities since some young people are now able to access technological platforms. North also highlights other policies that enabled the growth of telemedicine and doubts whether those changes will remain after COVID-19.

ASSESSMENT OF THE SOURCE: I can say that North's article is reliable since it was sourced from a peer-reviewed journal. The relevance is important because it discusses the effects of Telemedicine on adolescent care while taking care of the main objective of my study, which is access and confidentiality in the use of Telemedicine. In promoting the general argument on the future of telemedicine in healthcare delivery, this article provides both merits and demerits of telemedicine which are resourceful in my discussion.

Direct Quotation with In-Text Citation	Paraphrase with in-text citation	Explanation	Application
"Only 9% of primary care physicians worked in a practice that did not offer telemedicine" (North, 2020, p. 146).	North (2020) notes that COVID-19 brought the usage of telemedicine to the next level, and today only a small percentage of practices can still be considered non-telemedicine.	Explains how COVID-19 accelerated the uptake of telemedicine, showing how its use soared in primary care.	This statistic will help to build the fact that COVID-19 is the turning point in the telemedicine adoption rate.
"Confidentiality can be compromised...by the presence of parents or others during the encounter" (North, 2020, p. 147).	North (2020) observes that the confidentiality of adolescent patients is slightly difficult because families are usually around during the telehealth sessions.	Emphasizes the issue of confidentiality due to telehealth attendance by adolescents with other people around, cases that may hamper honest reporting from patients.	This information we will use for the above section on telemedicine's drawbacks with regards to adolescent care; including in discussions that are sensitive in nature.

Second source ************************************************************************************

REFERENCE CITATION: Barbosa, W., Zhou, K., Waddell, E., Myers, T., & Dorsey, E. R. (2021). Improving access to care: telemedicine across medical domains.  Annual review of public health,  42(1), 463-481. https://www.annualreviews.org/content/journals/10.1146/annurev-publhealth-090519-093711

SUMMARY: In this article, Barbosa et al (2021) present a narrative synthesis about telemedicine in all the established fields of medicine, as well as the potential of increasing access to care, health outcomes, and a means of mitigating geographical distances. They point out that although telemedicine has been effective in treatment areas like stroke, heart failure, diabetes, or pregnancy it is less successful in eradicating social determinants.

ASSESSMENT: This article is written well, it is from a reputable peer-reviewed journal, as well as written by a prominent scholar in the field of telemedicine. This review involves significant work and gives a comprehensive look at the presented topic.

Direct Quotation & Citation	Paraphrase & Citation	Explanation	Application
"Telemedicine has improved access to care for a wide range of clinical conditions ranging from stroke to pregnancy" (Barbosa et al., 2021, p. 467).	According to Barbosa et al. (2021), telemedicine has been proven to enhance access to care across a range of medical conditions comprised of Acute and Chronic diseases.	Barbosa et al. (2021) discuss that telemedicine has been effective in increasing the accessibility to treatment in a variety of pathologies, both those that require urgent care and those that are chronic in nature.	This information shall be utilized in my research on expanded access to care to show the versatility of telemedicine across many presenting illnesses.
"Telemedicine has addressed geographical, but less so social, barriers to care" (Barbosa et al., 2021, p. 470).	Barbosa et al. (2021) found that although telemedicine progresses the geographic challenges, it is not as successful in social inequalities in care.	This will explain that telemedicine can magnify health prejudices for those who are in underprivileged territories and stress social determinants of health such as income or education level.	These findings will be used to advocate for policy amendments and specific interventions that will aim at increasing equitable access to telemedicine by all people.

Third source ************************************************************************************

REFERENCE CITATION: George, A. S., & George, A. S. H. (2023). Telemedicine: A new way to provide healthcare. Zenodo. https://puiij.com/index.php/research/article/view/53

SUMMARY: In their conventions, George and George (2023) analyze telemedicine as the delivery model in rural and other underserved communities. The paper reveals that there are benefits of telemedicine; the services enhance the delivery of healthcare services, cost saving, and overall patient satisfaction however there are a few drawbacks; poor infrastructure and the legislation about the use of telemedicine. It suggests that more research and policy action should be taken to improve the efficiency of telemedicine, especially by improving the regulation and Addendum А А scenario and by considering privacy issues.

ASSESSMENT: This article forms a good review of the literature augmented with the survey and interview data collected for the purpose of exploring telemedicine. It is also a scholarly source, from an improved academic database, and provides a useful assessment of the functionality of telemedicine in tackling health inequities. Smirking at the fact that the focus of the journal is on policy implications and challenges identified, I have to state that it relates directly to my research interests concerning the question of better access to healthcare, especially in the regions not closely attended by major healthcare providers.

Direct Quotation & Citation	Paraphrase & Citation	Explanation	Application
"Telemedicine offers various applications, including remote consultations with doctors, prescription delivery, and remote patient monitoring" (George & George, 2023, p. 3).	George & George (2023) state that telemedicine can enable several services like consultation services, prescription services, and continuous patient follow-up, particularly for patients in rural regions.	This shows the need to apply telemedicine as a way of providing complete care, which is crucial in increasing access in rural and other hard-to-reach regions.	This will be used to show how telemedicine can be used to deliver basic healthcare services where physical consultations may be impossible.

Fourth source ************************************************************************************

REFERENCE CITATION: Arora, S., Huda, R. K., Verma, S., Khetan, M., & Sangwan, R. K. (2024). Challenges, barriers, and facilitators in telemedicine implementation in India: a scoping review.  Cureus,  16(8), e67388. https://pmc.ncbi.nlm.nih.gov/articles/PMC11414145/

SUMMARY: In their scoping review, Arora and his team (2024) identified the challenges, barriers, and facilitators to telemedicine implementation in India. The review also outlines individual, provider, and system-level challenges. These are; low levels of computer and internet usage, inadequate physical infrastructure, and cultural and social barriers that prefer face-to-face consultation. These are family engagement, community connection, staff development, and policy enhancement.

ASSESSMENT: The present work is a scoping review of twenty-six studies that identified the implementation of telemedicine in India. It is authoritative and trustworthy, providing a balanced view of the barriers and enablers unique to the Indian environment. As the article is devoted to the infrastructural and cultural barriers to the application of telemedicine, it is useful for my study on the integration of telemedicine in rural and underserved areas.

Direct Quotation & Citation	Paraphrase & Citation	Explanation	Application
"Individual-level challenges include limited digital literacy, particularly among older adults and those in rural areas" (Arora et al., 2024, p. 3).	According to Arora et al. (2024), one of the most significant challenges of telemedicine implementation in India is the low level of digital literacy, particularly among senior citizens and those living in rural areas.	This barrier is a good example of the problems that arise when using telemedicine in areas with low technological advancement.	This quote will be employed in the context of analyzing the role of the digital divide in the slow uptake of telemedicine in rural and other hard-to-reach areas.