The Final version of the Integrated Investigation Project. Ideally, all of you just need to make

INTEGRATED INVESTIGATION HYPOTHESIS 3

Integrated Investigation Hypothesis: The effectiveness of the Telehealth Model

COVID-19 pandemic changed life as many people knew it. Due to the nature and transmission of the diseases, governments instituted measures that curbed movement. Cities were put under lockdowns and the public was instructed to stay indoors unless going out for supplies. Consequentially, very few people in need of health services visited health care centers. Only people with serious medical conditions and those suspected of having the COVID-19 diseases visited hospitals. To ensure that health services were available even when people could not visit hospitals, health care centers and hospitals adopted and implemented telehealth. Some individuals believe that telehealth is effective at handling the majority of minor health complications. Some are of the contrary opinion.

To establish whether telehealth is an effective health model that can be compared to physical physician visits an investigation will be carried out. To conduct the test, the research team will approach one of the local hospitals that have implemented telehealth and request to carry out the investigation. The hospital will offer data on at least fifteen patients suffering from similar conditions but on different treatment models; telehealth and physical physician visits. The data will prove if the two models are equal in health care services provision. The expected outcome of the investigation is that telehealth is an effective model for the treating of minor illness just as physical physician visits.

Comment :

I like your idea; however, unless you already have a relationship with a hospital AND you fill out a ton of paperwork concerning protecting privacy, you are going to have a TON of roadblocks and hurdles for this study. This is NOT a criticism of your idea. It is just me telling you that the amount of work and legal clearance required to get this idea off the ground is more than I am expecting for the students. I think an easier (and better) idea based upon your initial ideas would be a hypothesis that sounds like: "do undergraduates feel that telehealth is as useful (or trustworthy or anything else that you may like to add here) as in-person healthcare?" This study would be a bit different that the other practice TTests we've done, but not different enough that is is difficult. Basically, you would be comparing people's opinions of in-person health care to telemedicine. Your survey would be two questions that are both "sliding-scale" type questions: (1) "on a scale of 1 to 5 where 1 is "not at all" and 5 is "absolutely", how useful do you feel telehealth medicine is?' and (2) "on a scale…, how useful do your feel in-person health care is?"

Timothy Schmalz, Feb 14 at 3:30pm

This is a lot… I know. You are free to dismiss everything I wrote or change it some or just accept whatever I wrote. Like I said above, I would rather you avoided trying to communicate with the actual healthcare infrastructure – especially after this past year of stress and pain. I believe that hospitals simply not interested in providing personal data to a (random) undergraduate student. Nothing personal. Please talk with me about this project and we can work something out.

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TELEHEALTH 5

LITERATURE REVIEW.

COVID-19 pandemic has led to a tremendous development in telehealth services around the world. This has primarily been owed to necessities behind the social distancing necessities and the requisite to prevent transmission of the pandemic. Though telehealth has been existing before, COVID-19 pandemic has increased awareness and adaption of telehealth by many healthcare providers, patients and the society at large. As a result of the COVID-19 pandemic Scotland experienced a 1000% increase in video consultations, during a 2 week period in March 2020. The proportion of consultations through videoconference in Australia, increased from 0.2% (February 2020) to 35% (April 2020) provided through videoconference and telephone. In USA, Telehealth programme empowered 1300 health specialists to be telehealth-ready. the percentage of telehealth consultations in USA increased from less than 1% to 70% of the total visits Within a month, this allowed >1000 video visits a day.  An Australian survey on telehealth use reported >80% of the participants considered telehealth service as of good quality or excellent (Thomas et al., 2020).

During COVID-19 pandemic epidemic, mental health surveys where done online in China with the aid of applications such as WeChat and TikTok. Chinese government launched an online consultation network carried out through the internet or on telephone consultations. During the COVID-19 pandemic Iranian Society of Radiology delivered teleconsultation and teleradiology services through social media in response to shortage of onsite thoracic radiologists. In the USA staff use remote health technology in developing staffing plans and carrying out healthcare billing to protect patient’s health and safety. According to a study carried out in the United States electronic health records and phone calls facilitates screening and treating patients without face to face visits, this improves decision making amongst healthcare workforce in emergency and ambulance care (Monaghesh, 2020).

The Australian government announced an AUS $2.4 billion healthcare package to fight COVID-19 with AUS $100 million promised to fund telehealth consultations through video or phone and on March 30, 2020, it announced financing of AUS $669 million a universal telehealth programme for all the citizens of the country enabling healthcare access through telephone or video from home. On March 10 Scotland announced that they were accelerating an investment of US $1.5 million plus US $10 million implementation costs to support video consultations. The United States announced development of telehealth services through telephone and videos, allowing people to use the services over 6 months in platforms such as Facetime and Skype (Fisk, 2020).

REFERENCES.

Fisk, M., Livingstone, A., & Pit, S. W. (2020). Telehealth in the context of COVID-19: Changing perspectives in Australia, the United Kingdom, and the United States (Preprint). doi:10.2196/preprints.19264

Monaghesh, E., & Hajizadeh, A. (2020). The role of Telehealth during COVID-19 outbreak: A systematic review based on current evidence. doi:10.21203/rs.3.rs-23906/v2

Thomas, E. E., Haydon, H. M., Mehrotra, A., Caffery, L. J., Snoswell, C. L., Banbury, A., & Smith, A. C. (2020). Building on the momentum: Sustaining Telehealth beyond COVID-19. Journal of Telemedicine and Telecare, 1357633X2096063. doi:10.1177/1357633×20960638

Comment:- Great!!

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TELEHEALTH 2

METHODOLOGY.

In this study, establishing whether telehealth is an effective health model than physical physician visits involved conducting a questionnaire survey on patients in a hospital that has implemented the telehealth model. The questionnaire was administered to 15 patients containing similar questions (e.g., was your medical issue addressed effectively?) that ranked the effectiveness of both models on a 10-point scale with 1 – not effective to 10 – extremely effective. The scores from each of the participants were averaged to generate a composite score for each patient. These composite scores generated variables under two categories: patients not enrolled in telehealth and patients enrolled in telehealth. The results were compiled in excel, and descriptive summary statistics, e.g., such as a measure of central tendency, were conducted. A t-test was also conducted to investigate whether there is a difference in the models' effectiveness and if telehealth is an effective health model compared to physical physician visits.

Comment:-

You are suggesting what is called a metanalysis… those have a place in science, but that is not what I want you to be doing. I want you to be doing your own ORIGINAL research, not analyzing other people's stuff. If you were to do this, it will require WAY more work that I am asking you to do and you would have to modify this to include at least one TTest. That is even more work that you are already suggesting in this writing. I think that you could do something that still focuses on people's attitudes about in-person vs telehealth, but use a regular survey asking people to rank the two and asking a demographic question or two or three (age, gender, race/ethnicity, etc.). I do not want to discourage you from pursuing this avenue of research and investigation. Metanalyses play an important role in science, but they are just not the type of science I want you to be doing now. Please resubmit something more inline with my expectations (and talk to me if I can help) and I will regrade this.

Timothy Schmalz, Mar 23 at 10:32am

Why are you limiting yourself to 15 people? I think the best course of action is just to make the questionnaire like you mention and just post it onto social media asking those people to share yours survey, too. I am not too sure if you've already made and distributed the survey, but based upon what I understand of your study, it would be way better if you have 100 respondents instead of 15. I am not sure I follow all of your methodology. What exactly are your averaging – their opinions of telehealth and their opinions of in-person care? I think if you just had all of your opinion data sorted by "those that have telehealth experience" and "those that do not have any telehealth experience" and used ttests to comprare them, this would be a very beneficial study. As you wrote this methodology, it sounds like you have added extra steps that do not necessarily improve the quality and clarity of your study's outcomes. Some of the best studies in the history of studies are the simplest.

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Running head: conclusion 1

conclusion 8

Discussion, Conclusion and Recommendation

Discussion

The research analysis results indicate that telehealth is indeed an effective health model compared to physical physician visits (P<0.5). When comparisons are made on the health models' enrolment, it was evident that fewer individuals had enrolled on the telehealth program (a difference of 1 from the sample). This implies that the program had not yet gained popularity amongst most people or that most hospitals had not implemented the health model, as explained by Thomas et al. (2020) in the literature review. The effectiveness of telehealth was statistically significant, thus forming the basis to accept the claim put forth in the hypothesis. Since the study was also done during the COVID-19 pandemic period, the results affirm telehealth's role in this period.

The COVID-19 pandemic has restructured most of the conventions in healthcare, such as physical physician visits. This study has indicated that though less popular among people, telehealth should be the model to be implemented in most healthcare facilities and promotions done to enlighten people. This will help 'flatten' the COVID-19 death and infection curve as it promotes physical distancing. There are, however, a few weaknesses with the study. The sample size was very small, and this may interfere with accurate predictions. Also, there was a considerable variation in the scores given by patients enrolled in the telehealth program (SD=2.1). Therefore, the application should be narrowed down to a few hospitals that the research was conducted. I Would recommend further studies to be done on the same topic but with a larger sample size for reliability. Also, this study has only tackled one aspect, healthcare, irrespective of demographic variables. I would recommend further research to include demographic variables such as age, region, and gender.

References Thomas, E. E., Haydon, H. M., Mehrotra, A., Caffery, L. J., Snoswell, C. L., Banbury, A., & Smith, A. C. (2020). Building on the momentum: Sustaining Telehealth beyond COVID-19. Journal of Telemedicine and Telecare, 1357633X2096063. doi:10.1177/1357633×20960638

Comment:

I thought your study was on the satisfaction or perception of telehealth compared to in-person, but you write as if you are comparing the actual RESULTS of healthcare. If I am wrong about anything – and I usually am – be sure that you are clear about what you are trying to say, I really like your writing and these parts really read like the way a published article should… with one exception: NO PERSONAL PRONOUNS. when you start saying "I", you are injecting yourself into the study and (sadly) you come with all kinds of issues that the reader must now think about rather than the research and the conclusion. Obviously, YOU did the study, but the job of a academic writer is to marginalize yourself as much as possible. Make is seem like this study was done by itself AND it now can speak for itself.

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Running head: telehealth 1

telehealth 8

Telehealth

Table 1

Descriptive statistics

	Not enrolled in telehealth	Enrolled in telehealth
Mean	7.625	6.7142857
Standard Error	0.497762852	0.7781016
Median	7.5	6
Standard Deviation	1.407885953	2.058663459
Minimum	5	5
Maximum	9	10

A total of 15 patients participated in the study. From the number, eight of the patients were not enrolled in the telehealth program. Seven were enrolled in the program. On a composite scale from 1-10, the average score of patients not enrolled in telehealth was 7.6 compared to those enrolled, which had a score of 6.7. There was a big variation between the scores given by patients enrolled in the telehealth program. The scores had a standard deviation of about 2.1 compared to the deviation of the patients not enrolled; the scores had a standard deviation of 1.4. This can be justified by the big variation between the minimum score and the maximum scores. For the enrolled patients, the maximum score was 10, and the minimum was 5, while for the non-enrolled patients, the maximum was 9, and the minimum was 5.

Figure 1

Distribution of satisfaction score.

The box plot indicates the distribution of the satisfaction scores. It is evident from the diagram that patients enrolled in telehealth had a bigger variation, as depicted by the wide box. However, there was no outlier score within the range of the scores. The median score for the non-enrolled patients was also high compared to that of the enrolled, as indicated by the line within the box. In both models, much of the satisfaction scores were distributed within the higher scores. This is as indicated by the bigger portion above the median line, thus dragging the mean towards the higher end as seen by the 'X.'

An independent sample t-test was conducted to test whether there is a difference in the two health models' effectiveness. The results indicated a statistically significant difference in the effectiveness of the health models and that, according to the hypothesis, telehealth is an effective health model compared to physical physician visits (P < 0.5). The null hypothesis was rejected.

Comment:- I like the format, but put words first, not the table. Add "Contentment of Healthcare" after "Descriptive Statistics" in the title of Table 1. I do not know if "Contentment" is the best word… you put a word that conveys what the 7.625 and 6.714 are referring to. Maybe "satisfaction"? In the final paragraph, add the actual p-value in parentheses or refer to it directly in your writing. I would remove the "(P<0.5)" and put in the p-value there. THAT BEING SAID, the "magic' p-value is 0.05 NOT 0.5; so, without knowing your actual p-value, I am not 100% that you interpreted this correctly. Many of your classmates did this part wrong. I need to be sure that you did it right… maybe you just forgot to add the extra "0" or maybe you interpreted a ttest wrong, I just don't know and that is a problem.

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