B. Annotated Bibliography:

1.

Kwak, M. Y., Hwang, E. J., & Lee, T. H. (2021). Effects of the Physician-Primary-Healthcare Nurse Telemedicine Model (P-NTM) on Medication Adherence and Health-Related Quality of Life (HRQoL) of Patients with Chronic Disease at Remote Rural Areas. (2502, Ed.) Int. Journal of Environtal Research & Public Health , 18(5), 2502.https://doi.org/10.3390/ijerph18052502

Summary:

This study investigates the impact of a physician-nurse telemedicine model (P-NTM) on medication adherence and health-related quality of life (HRQoL) for patients with chronic diseases in rural areas. The findings indicate that the P-NTM model significantly improves medication adherence and HRQoL, suggesting that telemedicine can effectively bridge healthcare gaps in remote areas.

Purpose:

The purpose of the study is to assess the effectiveness of a collaborative telemedicine model in managing chronic diseases in underserved rural areas. The study contributes to the literature by providing empirical evidence on how telemedicine can improve patient outcomes in settings with limited access to healthcare.

Methodology:

The research employs a quasi-experimental design with pre- and post-intervention data collection. The study uses a survey instrument to measure medication adherence and HRQoL among chronic disease patients before and after implementing the P-NTM model.

Research Design:

Data was collected through self-reported questionnaires, and statistical analysis was conducted to assess changes in medication adherence and HRQoL scores. The intervention period spanned six months, with follow-up assessments conducted at three-month intervals.

Key Concepts:

The key concepts in this study include medication adherence, health-related quality of life (HRQoL), and the P-NTM telemedicine model. These concepts are directly relevant to the research question as they address how telehealth interventions can impact chronic disease management in rural areas.

Kwak, Hwang & Lee (2021)explore the impact of a physician-primary healthcare nurse telemedicine model on medication adherence and health-related quality of life in rural patients with chronic diseases. The findings demonstrate improved self-management and treatment adherence, crucial for reducing emergency visits and managing chronic conditions effectively in remote areas.

Synthesis:

Kwak et al (2021) examined the Physician-Primary-Healthcare Nurse Telemedicine Model (P-NTM). They found it significantly improved medication adherence and health-related quality of life among chronic disease patients in rural areas. This demonstrates telehealth's ability to maintain treatment consistency and reduce acute health episodes, ultimately decreasing the need for emergency room visits in remote settings. This study aligns with other sources exploring telehealth's role in improving chronic disease outcomes. It specifically addresses medication adherence and patient quality of life.

Evaluation:

The source is credible, as it is published in a peer-reviewed journal and presents empirical data using a well-structured research design. Using statistical analysis to validate findings adds to its reliability and relevance to the research question.

Research Question:

This source informs the research question by demonstrating how a structured telemedicine model can enhance chronic disease management in rural healthcare settings. The findings support the argument that telehealth interventions can effectively address access barriers and improve patient outcomes.

2.Williams, C., & Shang, D. (2024). Telehealth for Chronic Disease Management Among Vulnerable Populations. Journal of Racial and Ethnic Health Disparities, 11, 1089-1096.https://doi.org/10.1007/s40615-023-01588-4

Summary:

This article examines the effectiveness of telehealth interventions in managing chronic diseases in vulnerable populations, focusing on racial and ethnic minorities in rural settings. The authors emphasize the role of telehealth in mitigating health disparities and improving access to care for underserved populations.

Purpose:

This study explores how telehealth can reduce healthcare disparities by providing accessible chronic disease management services to vulnerable populations. By addressing how telehealth can be leveraged to promote equity in healthcare delivery, the study contributes to literature.

Methodology:

The research employs a mixed-methods approach, combining quantitative patient outcome data with qualitative interviews from healthcare providers and patients. Data were collected over 12 months to assess the impact of telehealth on chronic disease management.

Research Design:

Data was collected through surveys, patient health records, and semi-structured interviews. The authors utilized thematic analysis to identify recurring themes and statistical analysis to assess patient outcomes.

Key Concepts:

Key concepts include healthcare disparities, vulnerable populations, telehealth, and chronic disease management. The emphasis on racial and ethnic minorities in rural areas directly relates to the research question, focusing on how telehealth can reduce healthcare gaps.

Relevance

Williams & Shang (2024)focus on how telehealth supports chronic disease management among vulnerable populations. Their research highlights improved health outcomes through virtual care, which can reduce ER congestion by preventing complications that would otherwise lead to emergency interventions.

Synthesis:

This study is consistent with other sources that explore telehealth as a mechanism for improving healthcare access. It also addresses healthcare access but focuses more broadly on underserved populations rather than racial and ethnic minorities. Williams & Shang (2024) Explored the effectiveness of telehealth in chronic disease management for vulnerable populations, noting its capacity to improve access, education, and patient engagement. Their findings support telehealth as a proactive tool that helps prevent emergency exacerbations by addressing chronic issues before they escalate, especially among underserved communities.

Evaluation:

The source is credible as it is published in a peer-reviewed journal and includes a robust methodology that incorporates both quantitative and qualitative data. The focus on healthcare disparities provides valuable insights into the broader implications of telehealth in rural healthcare settings.

Research Question:

This source informs the research question by highlighting how telehealth can mitigate disparities in healthcare access, particularly for vulnerable populations in rural areas.

3.

Hendy, A., Abdelalie, S. M., Zaher, A., Sadek, B. N., Nashwan, A. J., Al-Jabri, M. M., . . . Sinnokrot, S. M. (2025). Telehealth satisfaction among patients with chronic diseases: a cross-sectional analysis. PeerJ Publishing Journals of Life and Environment.https://doi.org/10.7717/peerj.19245

Summary:

(Hendy, et al., 2025) conducted a cross-sectional analysis to evaluate patient satisfaction with telehealth services among individuals with chronic diseases. The study assessed patient perceptions regarding accessibility, convenience, and communication effectiveness through telehealth platforms. The researchers found that most patients reported high levels of satisfaction, citing improved access to care and time-saving benefits as major contributors. However, some concerns were raised about technical issues and the perceived lack of personal interaction compared to in-person visits.

Purpose:

The purpose of this study was to assess the overall satisfaction of patients with chronic diseases using telehealth services, specifically focusing on perceived effectiveness, communication, and accessibility. The study contributes to the literature by providing insights into the strengths and limitations of telehealth for chronic disease management, helping healthcare providers and policymakers understand the patient experience to enhance service delivery.

Methodology:

The study employed a cross-sectional survey methodology. Data were collected from a diverse sample of patients with chronic diseases using a structured questionnaire. The survey included both quantitative and qualitative questions aimed at capturing patient satisfaction levels with various aspects of telehealth services. Data analysis involved statistical methods to identify common themes and trends.

Research Design:

The research design was descriptive, utilizing a cross-sectional survey approach. Data collection methods included online and telephone surveys, targeting patients with chronic conditions who had used telehealth services within the past six months. Data analysis techniques included descriptive statistics, thematic analysis, and regression analysis to assess factors influencing satisfaction levels.

Key Concepts:

1. Telehealth Satisfaction - The perceived effectiveness, accessibility, and convenience of telehealth services as experienced by patients with chronic diseases.
2. Chronic Disease Management - Strategies employed to manage long-term health conditions through remote monitoring and consultation.
3. Patient-Centered Care - Healthcare delivery that prioritizes patient experiences, needs, and preferences.

Relevant Key Concepts:

The concept of telehealth satisfaction is directly relevant to understanding how remote services impact chronic disease management, aligning with the research focus on patient experiences and service effectiveness. Hendy et al. (2025) study evaluates patient satisfaction with telehealth for chronic disease care. High satisfaction levels suggest strong potential for continued use of telehealth, which can enhance disease monitoring, reduce unnecessary hospital visits, and ultimately ease ER burdens.

Synthesis:

Like (Utami, Achour, & Pascale, 2025), Hendy et al. (2025) examine patient experiences with telehealth for chronic disease management. Both studies highlight the benefits of increased accessibility and convenience, but Hendy et al. (2025) focus more on patient satisfaction metrics, whereas (Utami, Achour, & Pascale, 2025) emphasize challenges in low- and middle-income countries. A gap identified in Hendy et al. (2025) is the lack of focus on the impact of socioeconomic status on telehealth satisfaction, which is addressed in (Utami, Achour, & Pascale, 2025).

Hendy et al. (2025) useda cross-sectional analysis, and Hendy et al. assessed patient satisfaction with telehealth for chronic diseases and found high approval rates. Positive user experiences indicate increased patient engagement and adherence to care plans, both of which are key factors in reducing ER dependency and maintaining stability in chronic conditions.

Evaluation:

The source is credible as it is published in a peer-reviewed journal and includes comprehensive data analysis supported by patient feedback. It is relevant to the research as it provides empirical evidence regarding patient satisfaction with telehealth, a key aspect of evaluating remote healthcare services for chronic conditions.

Research Question:

This source informs the research question by providing data on patient satisfaction levels with telehealth, highlighting factors that influence perceptions of care quality, communication, and service accessibility, which are critical in assessing the overall effectiveness of telehealth for chronic disease management.

4.

Utami, A., Achour, N., & Pascale, F. (2025). Evaluating Telemedicine for Chronic Disease Management in Low- and Middle-Income Countries During Coronavirus Disease 2019 (COVID-19). Journal of MDPI Hospitals, 2(2), 9-19.https://doi.org/10.3390/hospitals2020009

Summary:

(Utami, Achour, & Pascale, 2025) conducted a study to evaluate the effectiveness of telemedicine in managing chronic diseases in low- and middle-income countries during the COVID-19 pandemic. The study focused on identifying challenges and opportunities in telemedicine implementation, such as accessibility, digital literacy, and infrastructure. The findings revealed that while telemedicine offered essential support in maintaining care continuity, significant barriers included limited internet access and inadequate training for both patients and healthcare providers.

Purpose:

The purpose of this study was to assess the viability of telemedicine for chronic disease management in resource-limited settings, specifically during the COVID-19 pandemic. This research contributes to the literature by highlighting the distinct challenges faced by low- and middle-income countries and proposing targeted strategies to improve telemedicine adoption and outcomes.

Methodology:

The study employed a mixed-methods approach, combining quantitative data from patient satisfaction surveys with qualitative interviews with healthcare providers. The sample included patients with chronic diseases and healthcare providers who utilized telemedicine services during the pandemic. Data analysis involved thematic analysis and statistical analysis to identify key barriers and facilitators in telemedicine implementation.

Research Design:

A mixed-methods design was used, consisting of structured surveys and semi-structured interviews. The data collection methods included online questionnaires for patients and in-depth interviews with healthcare providers. Data were analyzed using a combination of descriptive statistics and thematic coding to identify prevalent themes and patterns.

Key Concepts:

1. Telemedicine Effectiveness - The extent to which telemedicine services meet the healthcare needs of patients in low-resource settings.
2. Digital Literacy - The ability of patients and providers to effectively use telemedicine platforms.
3. Infrastructure Gaps - Limitations in internet connectivity and access to necessary devices for telemedicine use.

Relevant Key Concepts:

The concepts of telemedicine effectiveness and infrastructure gaps are directly relevant to understanding the barriers to telehealth adoption in resource-constrained environments, aligning with the focus on healthcare delivery and patient outcomes.

Synthesis:

Compared to (Hendy, et al., 2025), which focuses on patient satisfaction in general chronic disease management, (Utami, Achour, & Pascale, 2025) specifically address the barriers in low- and middle-income countries. Both studies emphasize the importance of telehealth for chronic disease management, but (Utami, Achour, & Pascale, 2025) provide a broader perspective by examining systemic challenges, including digital literacy and infrastructure gaps.

Evaluation:

The source is credible as it is published in a reputable peer-reviewed journal and incorporates data from multiple sources, enhancing the depth and reliability of the findings. It is relevant to the research as it highlights unique challenges faced by low- and middle-income countries in implementing telemedicine, offering a critical perspective on telehealth scalability and accessibility.

Research Question:

This source informs the research question by providing insights into the challenges and potential solutions for implementing telemedicine in resource-limited settings, emphasizing the importance of digital literacy, infrastructure development, and targeted training to improve telemedicine outcomes.

5.

Butzner, M., & Cuffee, Y. (2021). Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review. JMIR Advanced Digital Health and Open Science Journal, 23(8). Retrieved fromhttps://www.jmir.org/2021/8/e29575/

Summary:

(Butzner & Cuffee, 2021) conducted a narrative review to assess the effectiveness of telehealth interventions and their outcomes in rural communities across the United States. The study synthesized findings from various telehealth programs targeting chronic disease management, mental health support, and emergency care. The authors identified key benefits such as increased access to healthcare services, reduced travel time, and improved health outcomes. However, they also noted significant barriers, including limited internet connectivity, lack of digital literacy, and financial constraints.

Purpose:

The purpose of the study was to evaluate the impact of telehealth interventions on health outcomes in rural areas, with a specific focus on chronic disease management and mental health services. The study contributes to the literature by providing a comprehensive overview of telehealth programs and their efficacy in underserved rural populations, highlighting both the advantages and ongoing challenges in implementation.

Methodology:

The study employed a narrative review methodology, analyzing existing literature on telehealth interventions in rural communities. Data sources included peer-reviewed journals, government reports, and health organization publications. The researchers employed thematic analysis to identify common patterns and challenges in telehealth implementation.

Research Design:

The research design was a narrative review, involving a systematic analysis of qualitative and quantitative studies. Data collection involved reviewing studies published between 2015 and 2021 that addressed telehealth implementation in rural areas. The analysis focused on identifying common themes related to accessibility, health outcomes, and barriers to telehealth adoption.

Key Concepts:

1. Telehealth Interventions - Programs and strategies designed to deliver healthcare services remotely to rural populations.
2. Access to Healthcare - The ability of patients in rural areas to access necessary medical services via telehealth.
3. Digital Divide - The gap in access to digital resources and internet connectivity in rural versus urban areas.

Relevant Key Concepts:

The concept of access to healthcare is particularly relevant to the research question, as it aligns with the focus on evaluating how telehealth can bridge service delivery gaps in rural settings. This narrative review discusses various telehealth interventions and their outcomes in rural U.S. communities. It emphasizes the reduction of healthcare disparities and preventing emergency care episodes through early intervention and remote chronic disease management.

Synthesis:

In comparison to (Hendy, et al., 2025) and (Utami, Achour, & Pascale, 2025), Butzner and Cuffee (2021) emphasize rural settings as a focal point of telehealth intervention studies. While Hendy et al. (2025) assess patient satisfaction in general, and Utami et al. (2025) address low- and middle-income countries, Butzner and Cuffee (2021) provide insights into rural healthcare challenges, particularly the digital divide and access to healthcare.

Evaluation:

The source is credible as it is published in a peer-reviewed journal and synthesizes data from multiple studies, ensuring comprehensive coverage of telehealth outcomes in rural areas. It is relevant to the research as it addresses the unique challenges and benefits of telehealth for underserved populations, which is critical in assessing the overall effectiveness of telehealth services.

Research Question:

This source informs the research question by providing data on telehealth outcomes in rural communities, emphasizing the importance of access to healthcare, digital literacy, and infrastructure improvements in enhancing telehealth effectiveness.

6.

David-Olawade, A. C., Olawade, D. B., Ojo, I. O., Famujimi, M. E., Olawumi, T. T., & Esan, D. T. (2024). Nursing in the Digital Age: Harnessing telemedicine for enhanced patient care. Informatics and Health Journal, 100-110.https://www.sciencedirect.com/science/article/pii/S294995342400016X

Summary:

(David-Olawade, et al., 2024) explored the impact of telemedicine on nursing practice, emphasizing its role in enhancing patient care in the digital age. The study examined how telemedicine has transformed nursing workflows, improved patient monitoring, and facilitated timely interventions, especially in managing chronic diseases. The authors identified key benefits, such as increased patient engagement and reduced hospital readmission rates, while also addressing challenges like technical difficulties and the need for specialized training.

Purpose:

The purpose of the study was to assess how telemedicine has influenced nursing practice, particularly in terms of patient care delivery, communication, and patient monitoring. The research contributes to the literature by providing a nursing-centered perspective on telemedicine adoption, highlighting both the operational advantages and the areas requiring further development.

Methodology:

The study utilized a descriptive research design, employing a combination of surveys and interviews with nursing professionals who had integrated telemedicine into their practice. Data collection included responses from nurses working in hospitals and outpatient clinics. Data analysis was conducted using statistical analysis and thematic coding to identify key patterns and themes in telemedicine adoption.

Research Design:

A descriptive design was implemented, involving surveys and semi-structured interviews with nursing staff. Data were collected over six months, focusing on areas such as patient monitoring, communication with patients, and perceived improvements in care quality. The analysis included both quantitative data analysis and qualitative thematic analysis.

Key Concepts:

1. Telemedicine in Nursing - The integration of telemedicine into nursing practice to enhance patient care delivery.
2. Patient Monitoring - The use of telemedicine tools to monitor patient health remotely, enabling timely interventions.
3. Digital Competency - The ability of nursing staff to effectively utilize digital tools in patient care.

Relevant Key Concepts:

The concept of telemedicine in nursing is particularly relevant to understanding how digital tools can support nursing workflows and patient care, aligning with the broader focus on telehealth outcomes and operational effectiveness. The study explores the role of nurses in using telemedicine to enhance patient care. It highlights how digital tools empower nurses to proactively monitor and manage chronic conditions, helping reduce emergency incidents and hospital overcrowding.Aanuoluwapo David-Olawade, Olawade & Esan's (2024) study builds upon previous work, further examining how nurses integrate telemedicine to support chronic care delivery. The emphasis on training and digital competency reflects the importance of consistent care that prevents ER escalation.

Synthesis:

Compared to (Butzner & Cuffee, 2021) , which focuses on telehealth interventions in rural settings, David-Olawade et al. (2024) provide a more specific focus on nursing practice and patient care through telemedicine. Both studies emphasize the importance of digital literacy and infrastructure, but David-Olawade et al. (2024) present a more targeted perspective on nursing operations and patient monitoring.

Evaluation:

The source is credible as it is published in a reputable journal and includes both quantitative and qualitative data, enhancing the reliability of the findings. It is relevant to the research as it provides specific insights into how telemedicine can be leveraged in nursing practice to improve patient care and reduce hospital readmission rates.

Research Question:

This source informs the research question by illustrating how telemedicine can improve patient monitoring and care delivery in nursing practice, providing evidence on the operational benefits and challenges associated with telemedicine integration in healthcare settings.

7.

Emadi, F., Dablizb, R., Molesa, R., Grover, C., Chena, J., & Cartera, S. (2025). Medication-focused telehealth interventions to reduce the hospital readmission rate: a systematic review. Journal of Pharmaceutical Policy and Practice, 18(1).https://doi.org/10.1080/20523211.2025.2457411

Summary:

(Emadi, et al., 2025) conducted a systematic review to assess the effectiveness of medication-focused telehealth interventions in reducing hospital readmission rates. The review highlighted that targeted telehealth programs, including medication reminders and follow-up consultations, significantly decreased readmissions among patients with chronic conditions.

Purpose:

The purpose was to evaluate the impact of medication-centered telehealth interventions on hospital readmission rates, contributing to the literature by demonstrating the potential of telehealth to enhance post-discharge care and medication adherence.

Methodology:

The study employed a systematic review design, analyzing peer-reviewed articles published between 2019 and 2025. Data were synthesized to identify trends in telehealth interventions targeting medication adherence.

Research Design:

A systematic review design was used, with data sourced from academic journals and clinical reports. Key themes included medication management, patient follow-up, and readmission prevention.

Key Concepts:

1. Medication Adherence - Ensuring patients follow prescribed medication regimens through telehealth.
2. Readmission Prevention - Strategies to reduce hospital readmission through remote monitoring.

Relevance

Emadi et al. (2025)conducted a systematic review on medication-focused telehealth interventions to reduce hospital readmissions. The results show that telehealth can prevent treatment lapses, thereby reducing ER visits related to poorly managed chronic diseases.

Synthesis:

Similar to (David-Olawade, et al., 2024) , (Emadi, et al., 2025) emphasize telehealth's role in chronic care management, but with a specific focus on medication adherence as a determinant of health outcomes. Emadi and colleagues conducted a systematic review of medication-focused telehealth interventions, finding that these tools help reduce hospital readmission rates. By ensuring patients adhere to their medication regimens, the telehealth minimizes health crises that could otherwise result in emergency room visits.

Evaluation:

The source is credible, as it is published in a peer-reviewed journal and uses a systematic approach to data collection. It is relevant as it underscores how telehealth can effectively reduce readmission rates through focused interventions.

Research Question:

This source supports the research by highlighting the effectiveness of targeted telehealth interventions in reducing hospital readmissions, emphasizing the importance of medication adherence in chronic disease management.

8.

Tang, M., Mclarth, E., Bhatt, A. S., Varshney, A. S., Huckman, R. S., & Adler, D. S. (2022). Investigating the Association Between Telemedicine Use and Timely Follow-Up Care After Acute Cardiovascular Hospital Encounters. JAAC Advances Journal, 1(5). Retrieved fromhttps://www.sciencedirect.com/science/article/pii/S2772963X22002344

Summary:

(Tang, et al., 2022) examined the association between telemedicine use and timely follow-up care after acute cardiovascular hospitalizations. The study found that telemedicine effectively facilitated post-discharge follow-ups, reducing delays in care and improving patient outcomes.

Purpose:

The study aimed to assess how telemedicine impacts follow-up care after cardiovascular events, contributing to the literature by identifying telemedicine as a potential tool for ensuring timely post-discharge monitoring.

Methodology:

The researchers conducted a retrospective cohort study using patient data from electronic health records, analyzing follow-up care patterns among patients with cardiovascular conditions.

Research Design:

A cohort design was employed, focusing on patients discharged after acute cardiovascular encounters. Data analysis included statistical comparisons of follow-up timelines between telemedicine users and non-users.

Key Concepts:

1. Follow-Up Care - Ensuring continuity of care post-discharge through telemedicine.
2. Timeliness - Reducing delays in receiving follow-up care after hospitalization.

Relevance

Tang et al. (2022)investigate the association between telemedicine use and timely follow-up care after acute cardiovascular events. Early virtual follow-ups help prevent readmissions and emergency complications, contributing to ER congestion reduction.

Synthesis:

Like (Emadi, et al., 2025), Tang et al. (2022) highlight telemedicine's role in post-discharge care, but with a specific focus on cardiovascular conditions rather than medication adherence. This study examined the relationship between telemedicine follow-up care and outcomes after cardiovascular hospitalizations. Tang et al. concluded that timely virtual follow-ups improve health outcomes and reduce the likelihood of emergency return visits, showing telehealth's preventative role in chronic care settings.

Evaluation:

The source is credible, published in a peer-reviewed journal with robust data analysis. It is relevant as it underscores the importance of timely follow-up care in improving patient outcomes after acute medical events.

Research Question:

This source informs the research by demonstrating how telemedicine can enhance follow-up care after cardiovascular hospitalizations, emphasizing its potential to reduce readmissions and improve patient monitoring.

9.

Snoswell, C. L., Monica L Taylor, Comans, T. A., Smith, A. C., L. C., & Caffery, L. J. (2020). Determining if Telehealth Can Reduce Health System Costs: Scoping Review. Journal of Internet Medical Research, 20(10).https://doi.org/10.2196/17298

Summary:

(Snoswell, et al., 2020) conducted a scoping review to determine if telehealth can effectively reduce health system costs. The study synthesized data from multiple telehealth programs and concluded that telehealth has the potential to lower costs through reduced hospital visits and efficient patient management.

Purpose:

The purpose was to evaluate the economic impact of telehealth in healthcare systems, contributing to the literature by emphasizing cost-saving potential in various telehealth programs.

Methodology:

A scoping review methodology was used, involving a systematic analysis of studies published between 2015 and 2020 that focused on telehealth and cost reduction.

Research Design: The study reviewed data from peer-reviewed journals, focusing on cost-effectiveness, hospital readmission rates, and healthcare resource utilization.

Research Design:

The study reviewed data from peer-reviewed journals, focusing on cost-effectiveness, hospital readmission rates, and healthcare resource utilization. The study by Snoswell et al. (2020) uses a scoping review research design to explore whether telehealth can reduce health system costs. This method systematically maps existing literature to identify key concepts, research gaps, and evidence related to telehealth's economic impact. The design allows for a broad overview of diverse studies across healthcare settings, without focusing on in-depth quality assessment.

Key Concepts:

1. Cost Reduction - Evaluating telehealth's potential to reduce healthcare expenses.
2. Resource Utilization - Optimizing healthcare resources through remote patient monitoring.

Relevance

Snoswell et al. (2020)A scoping review by Snoswell et al. evaluates telehealth's potential to reduce health system costs. The study suggests cost savings are partly due to reduced ER visits and hospital readmissions, especially for chronic conditions manageable via remote care.

Synthesis:

In contrast to (Tang, et al., 2022), which focuses on cardiovascular follow-up care, Snoswell et al. (2020) provide a broader perspective on telehealth cost reduction across multiple health services. They found strong economic support for telehealth's role in minimizing hospital and ER utilization by facilitating timely interventions and reducing unnecessary service use for chronic conditions.

Evaluation:

The source is credible, published in a reputable journal with comprehensive data analysis. It is relevant as it discusses financial implications, a critical aspect of telehealth program sustainability.

Research Question:

This source informs the research by demonstrating the financial benefits of telehealth in reducing healthcare costs, aligning with broader objectives of efficient healthcare delivery.

10.

Suhartini, T., Andriani, L., Setianingsih, H., Batubara, S. T., & Laksono, R. D. (2024). Telehealth in Nursing Practice: Enhancing Patient Care and Accessibility in Rural Communities. Join: Journal of Social Science, 1(6).https://doi.org/10.59613/5fr8t466

Summary: (Suhartini, Andriani, Setianingsih, Batubara, & Laksono, 2024) explored telehealth's role in nursing practice, focusing on improving patient care and accessibility in rural communities. The study found that telehealth enhances healthcare access and supports nursing functions in underserved areas.

Purpose: To examine how telehealth integration in nursing improves care quality and accessibility in rural settings, contributing to the literature on healthcare equity and technology use.

Methodology: Qualitative study using interviews and focus groups with rural nurses and patients using telehealth.

Research Design:

Thematic analysis of qualitative data to identify benefits and challenges of telehealth in nursing. Suhartini et al. (2024) employs a qualitative research design centered on literature review and library research. This approach synthesizes recent findings on the implementation of telehealth technologies in rural healthcare settings. The study concludes that telehealth holds significant potential to improve patient outcomes in rural communities, but further efforts are needed to address technical and educational barriers to ensure its long-term success in nursing practice.

Key Concepts:

• Telehealth Accessibility: Improving access to healthcare via remote technologies.
• Nursing Practice Enhancement: Using telehealth to support nursing roles and patient monitoring.

Relevance

Suhartini et al. (2024).This article highlights how telehealth enhances accessibility and quality of nursing care in rural communities. Improved access ensures early detection and management of chronic conditions, minimizing the risk of ER visits.

Synthesis:

Similar to (Butzner & Cuffee, 2021), but with a specific focus on nursing roles and rural patient care. Suhartini et al. (2024)analyzed the use of telehealth in rural nursing practice and found that it enhances access to care and early response to patient needs. By bridging the gap between rural patients and healthcare providers, telehealth helps prevent avoidable health deterioration that might otherwise lead to ER congestion.

Evaluation: A credible peer-reviewed source with direct data from rural healthcare practitioners, relevant for studying telehealth's impact on rural nursing.

Research Question:

Shows how telehealth empowers nursing and improves healthcare access in rural areas, addressing equity and care quality.

C. Preliminary Research Question:

"How can telehealth interventions reduce emergency room congestion and improve chronic disease management in rural healthcare settings?"

C1. Revision Decision:

Revised Research Question:

"What are the most effective telehealth interventions for reducing emergency room congestion and enhancing chronic disease management in rural healthcare settings?"

Justification for Revision:

The revised question narrows the focus by specifying the need to identify the most effective telehealth interventions, which allow for clearer investigation and practical recommendations. It also emphasizes both the reduction of ER congestion and the enhancement of chronic disease management, aligning closely with the challenges faced in rural healthcare. This refinement makes the question more actionable and researchable by focusing on effectiveness rather than general possibilities.

Bibliography

Butzner, M., & Cuffee, Y. (2021). Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review. JMIR Advanced Digital Health and Open Science Journal, 23(8). Retrieved fromhttps://www.jmir.org/2021/8/e29575/

David-Olawade, A. C., Olawade, D. B., Ojo, I. O., Famujimi, M. E., Olawumi, T. T., & Esan, D. T. (2024). Nursing in the Digital Age: Harnessing telemedicine for enhanced patient care. Informatics and Health Journal, 100-110. Retrieved fromhttps://www.sciencedirect.com/science/article/pii/S294995342400016X

Emadi, F., Dablizb, R., Molesa, R., Grover, C., Chena, J., & Cartera, S. (2025). Medication-focused telehealth interventions to reduce the hospital readmission rate: a systematic review. Journal of Pharmaceutical Policy and Practice,18(1).https://doi.org/10.1080/20523211.2025.2457411

Hendy, A., Abdelaziz, S. M., Zaher, A., Sadek, B. N., Nashwan, A. J., Al-Jabri, M. M., . . . Sinnokrot, S. M. (2025). Telehealth satisfaction among patients with chronic diseases: a cross-sectional analysis. PeerJ Publishing Journals of Life and Environment.https://doi.org/10.7717/peerj.19245

Kwak, M. Y., Hwang, E. J., & Lee, T. H. (2021). Effects of the Physician-Primary-Healthcare Nurse Telemedicine Model (P-NTM) on Medication Adherence and Health-Related Quality of Life (HRQoL) of Patients with Chronic Disease at Remote Rural Areas. (2502, Ed.) Int. Journal of Environtal Research & Public Health , 18(5), 2502. https://doi.org/10.3390/ijerph18052502

Snoswell, C. L., Monica L Taylor, Comans, T. A., Smith, A. C., L. C., & Caffery, L. J. (2020). Determining if Telehealth Can Reduce Health System Costs: Scoping Review. Journal of Internet Medical Research, 20(10).https://doi.org/10.2196/17298

Suhartini, T., Andriani, L., Setianingsih, H., Batubara, S. T., & Laksono, R. D. (2024). Telehealth in Nursing Practice: Enhancing Patient Care and Accessibility in Rural Communities. Join: Journal of Social Science, 1(6).https://doi.org/10.59613/5fr8t466

Tang, M., Mclarth, E., Bhatt, A. S., Varshney, A. S., Huckman, R. S., & Adler, D. S. (2022). Investigating the Association Between Telemedicine Use and Timely Follow-Up Care After Acute Cardiovascular Hospital Encounters. JAAC Advances Journal, 1(5). Retrieved fromhttps://www.sciencedirect.com/science/article/pii/S2772963X22002344

Utami, A., Achour, N., & Pascale, F. (2025). Evaluating Telemedicine for Chronic Disease Management in Low- and Middle-Income Countries During Coronavirus Disease 2019 (COVID-19). Journal of MDPI Hospitals, 2(2), 9-19.https://doi.org/10.3390/hospitals2020009

Williams, C., & Shang, D. (2024). Telehealth for Chronic Disease Management Among Vulnerable Populations. Journal of Racial and Ethnic Health Disparities, 11,1089-1096. https://doi.org/10.1007/s40615-023-01588-4

QUESTION

Discuss how the source relates to one another in each of the ten sources in your bibliography by identifying the following similarities for each source:

themes

conflicts

gaps

How sources align with one another, with specific examples, connections between individual sources that address each of the required points of theme, gap, and conflict for each of the ten sources