The Patient Journey Record System (PaJR) was conceptualised and designed by general practitioners (GP), in the out-of-hours setting in Ireland, to improve the journey care of vulnerable, ill or frail patients who attended or who had home visits in 2010. It was a telehealth service, that is disease agnostic, with lay navigators making regular phonecalls to patients identified as being at risk of emergency department visits or acute admissions. The PaJR system has been operational in Victoria, Australia since 2018.This abstract outlines the conceptual evolution, development, and practical implementation of the PaJR system, summarising findings from trials and evaluations across diverse healthcare contexts. Evaluation methods included pragmatic controlled trials, service reviews, and case vignettes, with outcomes such as hospital utilisation and patient satisfaction.Lessons highlight the value of relational care, narrative data, and localised GP care in patient journeys. Key challenges included integrating with changing health systems and ensuring sustainable resources. Broader adoption enabled by digital platform scalability, supportive policy, and ongoing workforce development, with ongoing iterative research to develop and refine telehealth-enabled GP complex care models.Future enhancements involve artificial intelligence for voice metrics for improved risk prediction and triage, while maintaining the essential human element in care. Sustainable adoption requires supportive policy, funding, and ongoing workforce development, with further research needed to guide best practice.The PaJR system integrates structured telehealth conversations, predictive alerts, and relational coaching to support early detection of deterioration and adaptive care planning. Across multiple deployments, PaJR has demonstrated reductions in inpatient bed-days, improved care coordination, and high patient satisfaction. The synthesis highlights both the promise and challenges of implementing anticipatory, human-centred care models in real-world systems.

Prediabetes significantly increases the risk of diabetes, cardiovascular diseases, and mortality. In XXX, the prevalence is around 29.6%. The primary management approach is lifestyle modification, yet the best method for sustainable change is debated. During the pandemic, continuous glucose monitoring and telehealth have shown promise for diabetes management, especially for insulin users. However, their application for prediabetes remains under-researched.Evaluate the efficacy of remote education with continuous glucose monitoring versus traditional in-person lifestyle education in managing prediabetes.In this single-center, randomized controlled study, participants diagnosed with prediabetes are recruited and divided into two groups. Following screening and consent, participants are either assigned to a control group, which receives two in-person education sessions, or an experimental group, equipped with a 14-day continuous glucose monitor and two remote sessions. Post- intervention evaluations at 3 and 6 months measure fasting glucose and BMI. Any adverse events are closely monitored. Data analysis is conducted using ANOVA in STATA, focusing on the effects of interventions over time and across groups, with post-hoc tests and Bonferroni adjustments applied as needed.At six months, 26 participants completed follow-up. Compared with the control group, the CGM group demonstrated greater improvements in glycemic outcomes, including non-significant trends toward reductions in HbA1c and fasting glucose. BMI showed a modest downward trend in the CGM group, although between-group differences were not statistically significant. No serious adverse events occurred, and CGM-related skin irritation was mild and self-limited.The findings suggest that integrating short-term CGM use with remote education provides measurable benefits for individuals with prediabetes, surpassing traditional in-person education. Continuous visual feedback from CGM may enhance self-awareness of dietary, facilitating more sustained metabolic improvements. The observed enhancements in glycemic regulation and quality of life align with emerging evidence supporting CGM as a behavioral intervention tool. However, the modest sample size and single-center design may limit generalizability.A brief CGM-supported intervention combined with remote counseling appears feasible, safe, and more effective than standard education in improving glycemic outcomes among adults with prediabetes. These results highlight the potential of CGM-guided lifestyle modification as an early preventive strategy and warrant further evaluation in larger, long-term studies.

Virtual care is expected to improve access to general practice for people in residential aged care homes (RACHs), yet uptake remains slow as pressures on primary care intensify. A central challenge in many countries is how GPs and RACHs can implement virtual care sustainably and equitably. A systems engineering approach was used to examine barriers to virtual care for residents in RACHs with general practice, offering insights into why adoption has struggled despite clear clinical need.To identify work system factors influencing safe and effective virtual care in RACHs and outline improvements that could support general practice workflows.Semi-structured interviews were conducted with thirty two participants, including eleven GPs, eleven registered nurses, three practice managers, five residents and two carers. Analysis followed the Systems Engineering Initiative for Patient Safety model to examine interactions across people, tasks, technologies, environments and organisational processes.Coordination problems were a significant barrier. Staff availability rarely aligned with GP schedules, and misaligned workflows meant residents, devices and essential information were not ready together, leading to delays. Communication limitations related to hearing loss, visual impairment, cognitive decline and language differences with residents reduced assessment quality. Technology issues including weak connectivity, systems learnability and minimal integration disrupted workflow. High staff turnover, limited device access and duplicating documentation added to workload. Environmental pressures including noise, privacy constraints and unclear funding rules created further strain. Facilitators included access to vital signs before consultations, combined GP/RACH training, reliable access to clinical information systems and dedicated devices in homes.Workflow barriers restrict routine use, and existing guidance does not reflect the pressures clinicians face. Evidence using systems engineering principles remains limited, although this approach provides a structured way to understand how technology functions in complex environments.Virtual care remains difficult to embed within general practice and aged care home workflows. This systems engineering analysis using human factors methods explains the adoption gap, and identifies actions to support reliable and efficient care. Improved coordination processes, stronger workflow alignment, reduced documentation load and access to reliable devices offer a path toward sustainable and equitable virtual care with GPs for people in aged care homes.

XXXX has rapidly advanced its digital health agenda, with telemedicine becoming a strategic tool for improving access to care in remote and underserved regions. Rural PHC settings have been central targets of these reforms. Since 2021, 110 rural ambulatories have been equipped with telemedicine capabilities, enabling remote consultations, digital diagnostics, and virtual mentoring for frontline providers. Several national actors have supported rural sites through improved connectivity and digitized clinical workflows.In November 2025, an online semi-structured survey gathered insights from senior representatives of the XXXX Family Medicine Association, rural primary care providers, and independent experts.. The survey explored organizational roles, motivations for entering telemedicine work, experiences with rural implementation, integration challenges, and perceived outcomes. Many respondents reported the beginning of telemedicine activities during the COVID-19 pandemic, using remote consultations, digital mentoring, and tele-screening initiatives to strengthen rural access. Strengths included high acceptance among rural PHC teams, improved patient reach, and enhanced provider confidence. Limitations included fragmented national coordination, variable infrastructure, and a lack of standardized digital pathways.Key lessons highlight the importance of strong national coordination to ensure coherent and equitable implementation. Telemedicine initiatives must be grounded in the practical needs of the PHC system rather than driven solely by technological possibilities.  Moving forward, establishing a central telemedicine hub, adopting unified technical standards, integrating services with electronic medical record systems, and investing in continuous workforce training will be critical to strengthening and scaling telemedicine nationwide.Institutional perspectives confirm that rural telemedicine success relies on contextual adaptation, strong PHC integration, and clear coordination mechanisms across stakeholders.Telemedicine deployment across rural settings demonstrates significant potential for improving access and reducing disparities. Scaling these gains will require coordinated national oversight, standardized systems, and sustained investment in PHC workforce capacity.

Primary health care underpins sustainable, resilient health systems; understanding patients' attitudes toward telemedicine services is crucial for enhancing quality and planning.This cross-sectional study examines these attitudes and their influencing factors.In the study, a 38-item questionnaire—including questions on demographic characteristics, employment status, health status, healthcare service utilization, and the Attitude Scale Towards the Use of Telemedicine Services—was administered to patients visiting the Family Medicine Outpatient Clinics of Ankara University Hospitals between January and March 2025. The scale yields scores between 18 and 90; higher scores reflect a more positive attitude toward telemedicine use. Normality was assessed visually and statistically; groups were compared via t-test/ANOVA, and age-scale correlation was analyzed using Pearson's test.A total of 155 patients participated in study, with an average scale score of 58.5±16.7. Scale scores were significantly higher among university and postgraduate graduates (62.6±16.5) compared to high school (55.1±15.9) and below high school graduates (51.1±15.0); among employed individuals (63.9±16.6) compared to unemployed (54.3±15.5), and among full-time workers (66.5±14.5) compared to those with other working arrangements (52.5±20.4). A low negative correlation was found between scale score and age (r=-0.221, p=0.006).In line with prior research, younger age and higher educational attainment were associated with more favorable attitudes toward telehealth, likely reflecting greater digital literacy and familiarity with technology. Contrary to several studies reporting higher acceptance among patients with chronic conditions, our participants without chronic disease had higher attitude scores, possibly indicating concerns about the adequacy of remote care for complex problems. Higher scores among employed and full-time workers suggest that telehealth is particularly attractive for time-constrained adults. Evaluating these patterns in a tertiary family medicine outpatient clinic adds novel evidence from Turkey to the primary care telehealth literature.This study demonstrated that attitudes towards telemedicine services are significantly associated with educational level, employment status, and work arrangement. At the same time, the findings offer significant contributions toward developing strategic interventions to enhance the adoption of telemedicine services.

Teleconsultation (TC) benefits patients with conditions like diabetes, hypertension, and high cholesterol, offering quality care, aiding patient recall, and saving costs. Yet, its adoption is poor in Malaysia, a developing middle-income country in Southeast Asia.This study explored patients’ perspectives on the barriers to using TC in a primary care clinic.A qualitative study design was adopted. Individual semi-structured interviews was conducted among 13 patients who have used TC in a primary care clinic, and one who did not. Interviews were guided by an interview guide developed from the Theoretical Domains Framework. Interviews were transcribed verbatim and analysed thematically using an inductive approach.Four key themes emerged from the analysis. First, there was a lack of awareness of TC as a service. Many participants were unfamiliar with the term “teleconsultation,” perceiving it as technical jargon, and found doctors’ explanations insufficient. Second, limitations in TC service processes led to confusion and dissatisfaction. Patients were uncertain about medication collection after TC session and viewed TC as redundant when in-person visits were still required to obtain medicines. Third, patients felt that TC lacked social and physical connection. Encounters were perceived as impersonal and rushed, with limited cultural sensitivity. Finally, privacy and security concerns were prominent. Patients feared breaches of confidentiality through session recordings, unauthorized presence of others, and potential cybersecurity risks.While the findings of this study are similar to many studies, this study provided a deeper insights on barriers to TC adoption among patients utilising the qualitative approach. One of the unique findings that is rarely reported in the literature but found in this study was the lack of awareness and understanding of what is TC among patients. This indicates that there is a need to improve patient literacy about TC services. The finding also pointed that there is a need to improve TC workflow integration, train clinicians on empathetic virtual communication, and  enhance privacy for TC service.Low TC uptake in primary care stems from inadequate patient awareness, service process gaps, diminished interpersonal connection, and privacy concerns. Addressing these barriers holistically is essential for effective and equitable TC adoption.

Telemedicine was promptly integrated into primary care during the COVID-19 pandemic, but initial implementation was patchy and inconsistent. Since 2024, it has been legally obligatory to use national eHealth platforms in Slovenian family medicine. Collectively, they make up the digital backbone of communication and documentation, integrating telemedicine features as a core component of day-to-day clinical work. This study presents a two-year follow-up of telemedicine adoption and satisfaction among family doctors in the Pomurje region, which was initially surveyed in 2023.In order to compare physician satisfaction and telemedicine adoption in 2025 with that of 2023, as well as indicate which areas of digital practice became better after legal integration.A repeated cross-sectional survey was conducted among family doctors in Pomurje in 2023 (N = 105) and 2025 (N = 100). The same questionnaires were employed, measuring telemedicine adoption (yes/no) and 15 satisfaction statements on a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree). PSPP was utilized for descriptive statistics as well as for paired comparisons (McNemar, paired-samples t, Wilcoxon tests).Telemedicine use increased from 82% in 2023 to 100% in 2025 (χ²(1) = 23.0, p < 0.001). Out of 105 participants, 23 recently adopted telemedicine, and no participants stopped its use. Mean overall satisfaction improved from 4.68 ± 1.96 to 5.13 ± 1.58 (p < 0.05). Most notable increases were for perceived work quality (4.05 → 4.63), pleasure in use of digital tools (4.14 → 4.63), and patient accessibility (5.11 → 5.57). No negative changes were noted across items.The results indicate a shift from selective adoption to widespread, stable implementation of telemedicine in everyday family medicine practice. Increased satisfaction implies increasing confidence and normalization of workflows at a digital level. Ongoing concerns relate to usability and retaining patient-centred communication in digital care.Telemedicine had come a long way in Pomurje, developing by 2025 from a crisis innovation to a regular, legally sanctioned practice. Doctors expressed increased satisfaction as well as benefits, changing from being forced to being accepting. Future attention needs to shift from implementation towards refinement, fairness, and retaining humanism in digital healthcare.