Practice management: The road ahead

Current and Future Applications of Telemedicine to Optimize the Delivery of Care in Chronic Liver Disease

Precision medicine is a novel approach to preventing, predicting, diagnosing, and treating diseases by gathering information from an individual's genome, biology, lifestyle, and environment. Precision health is one step ahead of precision medicine, which aims to make one healthier and attend health-promoting activities. There are four key steps to achieving precision medicine, including the establishment of large-scale databases from various sources and formats of health care records. Advances in multiomics enable the generation of new data from biospecimens. Artificial intelligence (AI) uses supervised and unsupervised algorithms to build multilayer and interconnected algorithms to analyze these big datasets for application in clinical workflow and to renovate health care. Patients with chronic liver disease need surveillance for disease progression; AI has been used to monitor liver disease. The first step is digitalizing health indicators and to generate digital biomarkers. Mobile health has been used extensively to track various health information, providing reminders and even digital therapeutics, through wearable devices, smartphones, smart mirror systems, as well as various applications in specific tasks. The application of telemedicine delivers health care outside the hospital setting to provide continuous care in remote areas and during the pandemic. AI provides the promising capability to renovate the health care system and facilitate precision health by using multidisciplinary collaboration. Advances in data collection, sharing, the protection of data privacy, and validation of clinical effectiveness are needed. The application of AI in precision medicine and precision health of liver disease is changing the landscape of health care and will benefit both physicians and patients.

Long-term care combined with complex follow-up processes is among the essential needs of lung transplantation. Therefore, Telemedicine-based strategies can provide an effective approach for both patients and clinicians by applying remote patient monitoring. Hence, the main objective of this study was to investigate Telemedicine and telehealth usage in lung transplantation.

A systematic review was conducted in four databases using keywords. Eligible studies were all English papers that developed Telemedicine-based programs to enhance patient care in lung organ transplantation. The interventions were analyzed analysis to determine the main descriptive areas. The quality of the included articles was evaluated using Mixed Methods Appraisal Tool (MMAT) tool by two authors.

Of the 261 retrieved articles, 27 met our inclusion criteria. Of these, 22 studies were devoted to the post-transplantation phase. All articles were published from 2002 to 2021 and the trend of publications has increased in recent years. Most of the studies were conducted in the United States and Canada. All eligible studies can be categorized into five types of Telemedicine interventions, 15 (55.56%) articles devoted to Telemonitoring, four (14.81%) for Teleconsultation, four (14.81%) articles for Telerehabilitation, three (11.11%) articles for Telespirometery, and one (3.70%) article were done regarding Tele-education.

This integrated review provides researchers with a new understanding of Telemedicine-based care solutions. Findings show that remote patient care in lung transplantation includes various aspects, especially self-care improvement.