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  1. Sharifi M, Ayat M, Jahanbakhsh M, Tavakoli N, Mokhtari H, Wan Ismail WK
    Telemed J E Health, 2013 Feb;19(2):122-8.
    PMID: 23374035 DOI: 10.1089/tmj.2012.0071
    E-health encompasses a wide scope and has excellent potential to grow in the future. Growing numbers of experts believe that e-health will fuel the next breakthroughs in health system improvements throughout the world. There is frequent evidence that largely indicates failures or unsustainable e-health implementations in different countries for different reasons. Iran is also a developing country that is presently applying this promising technology for its traditional healthcare delivery.
  2. Khan SA, Omar H
    Telemed J E Health, 2013 Jul;19(7):565-7.
    PMID: 23672799 DOI: 10.1089/tmj.2012.0200
    Teledentistry can be defined as the remote provision of dental care, advice, or treatment through the medium of information technology, rather than through direct personal contact with any patient(s) involved. Within dental practice, teledentistry is used extensively in disciplines like preventive dentistry, orthodontics, endodontics, oral surgery, periodontal conditions, detection of early dental caries, patient education, oral medicine, and diagnosis. Some of the key modes and methods used in teledentistry are electronic health records, electronic referral systems, digitizing images, teleconsultations, and telediagnosis. All the applications used in teledentistry aim to bring about efficiency, provide access to underserved population, improve quality of care, and reduce oral disease burden.
  3. Lua PL, Neni WS
    Telemed J E Health, 2012 Dec;18(10):777-84.
    PMID: 23078181 DOI: 10.1089/tmj.2012.0047
    Telemedicine innovations, including short message service (SMS), have been used to address a range of health concerns in a variety of settings. Practical, safe, and cost-effective, this simple tool can also potentially improve patients' understanding toward their own diseases via knowledge enhancement. This study was designed to develop and assess the feasibility and acceptability of an SMS-based epilepsy educational program for epilepsy patients.
  4. Varghese S, Scott RE
    Telemed J E Health, 2004;10(1):61-9.
    PMID: 15104917
    Developing countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services. However, this process faces disparities, and no complementarity in telehealth policy development. Telehealth has the potential to transcend geopolitical boundaries, yet telehealth policy developed in one jurisdiction may hamper applications in another. Understanding such policy complexities is essential for telehealth to realize its full global potential. This study investigated 12 East Asian countries that may represent a microcosm of the world, to determine if the telehealth policy response of countries could be categorized, and whether any implications could be identified for the development of complementary telehealth policy. The countries were Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Three categories of country response were identified in regard to national policy support and development. The first category was "None" (Cambodia, Myanmar, and Vietnam) where international partners, driven by humanitarian concerns, lead telehealth activity. The second category was "Proactive" (China, Indonesia, Malaysia, Singapore, South Korea, Taiwan, and Thailand) where national policies were designed with the view that telehealth initiatives are a component of larger development objectives. The third was "Reactive" (Hong Kong and Japan), where policies were only proffered after telehealth activities were sustainable. It is concluded that although complementarity of telehealth policy development is not occurring, increased interjurisdictional telehealth activity, regional clusters, and concerted and coordinated effort amongst researchers, practitioners, and policy makers may alter this trend.
  5. Haron N, Zain RB, Nabillah WM, Saleh A, Kallarakkal TG, Ramanathan A, et al.
    Telemed J E Health, 2017 03;23(3):192-199.
    PMID: 27541205 DOI: 10.1089/tmj.2016.0128
    INTRODUCTION: This study examined the concordance in clinical diagnosis of high-risk lesions in the oral cavity and referral decisions between clinical oral examination (COE) and teledentistry.

    MATERIALS AND METHODS: Sixteen individuals with a range of oral potentially malignant disorders (OPMD) and normal oral mucosa were included. Five areas of the oral cavity were photographed by three dentists using mobile phone cameras with 5 MP-13 MP resolutions. On the same day, the patients were given COE by two oral medicine specialists (OMS) and 3 weeks later, they reviewed the images taken using the phone, and concordance was examined between the two by Kappa statistics. The sensitivity and specificity of clinical diagnosis using the phone images were also measured. Pre- and post-program questionnaires were answered by both the dentists and the OMS to determine the feasibility of integrating teledentistry in their clinical practice.

    RESULTS: The Kappa values in determining the presence of lesion, category of lesion (OPMD or not), and making referral decision were moderate to strong (0.64-1.00). The overall sensitivity was more than 70% and specificity was 100%. The false negative rate decreased as the camera resolution increased. All dentists agreed that the process could facilitate early detection of oral mucosal lesion, and was easy to use in the clinic.

    CONCLUSIONS: This study provides evidence that teledentistry can be used for communication between primary care and OMS and could be readily integrated into clinical setting for patient management.

  6. Haron N, Zain RB, Ramanathan A, Abraham MT, Liew CS, Ng KG, et al.
    Telemed J E Health, 2019 May 13.
    PMID: 31081720 DOI: 10.1089/tmj.2018.0285
    Background:

    Up to 86% of oral cancer (OC) patients present at the late stage where survival is dismal. Limited access to specialist diagnosis is a significant factor for late presentation. The increasing use of smartphones presents an opportunity to use digital technology to facilitate early detection of OC.

    Aim:

    To evaluate the feasibility of using Mobile Mouth Screening Anywhere (MeMoSA®) to facilitate early detection of OC.

    Methods:

    A mobile phone app named MeMoSA was developed and the feasibility of integrating this for documentation of oral lesions, and communication between dentists and specialists for management decisions were evaluated. The experience of dentists and specialists in using MeMoSA was determined using qualitative questionnaires.

    Results:

    Communication between specialist and dentists using MeMoSA stratified cases and streamlined referral of patients. Twelve of 48 patients were found to have oral lesions or signs suspicious of cancer and 3 required referrals. The patient's compliance for referral was tracked with MeMoSA. All dentists agreed that MeMoSA could facilitate early detection of OC and believed that MeMoSA could assist in the identification of oral mucosal lesions through direct communication with specialists and continuous learning in the recognition of high-risk lesions.

    Conclusions:

    MeMoSA has the potential to be used to promote equitable health care and streamline patient management that could result in early detection of OC.
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