Brandon M Welch

• MS, PhD
• Professor (Assistant) at Medical University of South Carolina

Background In the postpandemic era, telemedicine continues to enable mental health care access for many people, especially persons living in areas with mental health care provider shortages. However, as lawmakers consider long-term telemedicine policy decisions, some question the safety and appropriateness of prescribing via telemedicine, and wheth...

BACKGROUND Virtual reality (VR) has strong potential to enhance the effectiveness of telemental health care (TMH) by providing accessible, personalized treatment from home. While there is ample research supporting VR for in-person treatment, there is only preliminary data on the efficacy of telemedicine-based VR. Further, the majority of VR applica...

Background Virtual reality (VR) has strong potential to enhance the effectiveness of telemental health care (TMH) by providing accessible, personalized treatment from home. While there is ample research supporting VR for in-person treatment, there is only preliminary data on the efficacy of telemedicine-based VR. Furthermore, the majority of VR app...

BACKGROUND In response to the COVID-19 pandemic, the U.S. extended regulatory flexibilities to make telemedicine more accessible to providers and patients. Some of these flexibilities allowed providers to in-take patients over telemedicine and prescribe certain scheduled medications without an in-person visit. OBJECTIVE We aim to understand provid...

Background In response to the COVID-19 pandemic, the United States extended regulatory flexibilities to make telemedicine more accessible to providers and patients. Some of these flexibilities allowed providers to intake patients over telemedicine and prescribe certain scheduled medications without an in-person visit. Objective We aim to understan...

Objectives Missed appointments can lead to treatment delays and adverse outcomes. Telemedicine may improve appointment completion because it addresses barriers to in-person visits, such as childcare and transportation. This study compared appointment completion for appointments using telemedicine versus in-person care in a large cohort of patients...

Virtual reality (VR) is an emerging technology that can enhance experiences and outcomes in mental healthcare. However, mental health therapists have been slow to adopt VR into practice. Implementation of telehealth-based VR therapy (tele-VR) could catalyze adoption and innovation in mental healthcare. To explore therapists’ perspectives on tele-VR...

BACKGROUND In the post-pandemic era, telemedicine continues to enable mental health care access for many people, especially persons living in areas with mental health care provider shortages. However, as lawmakers consider long-term policy decisions related to telemedicine, some have raised questions about the safety and appropriateness of prescrib...

Objective: Family health history (FHx) is an important tool in assessing one's risk towards specific health conditions. However, user experience of FHx collection tools is rarely studied. ItRunsInMyFamily.com (ItRuns) was developed to assess FHx and hereditary cancer risk. This study reports a quantitative user experience analysis of ItRuns. Meth...

Virtual reality (VR) can enhance mental health care. In particular, the effectiveness of VR-based exposure therapy (VRET) has been well-demonstrated for treatment of anxiety disorders. However, most applications of VRET remain localized to clinic spaces. We aimed to explore mental health therapists’ perceptions of telehealth-based VRET (tele-VRET)...

Background During the COVID-19 pandemic, federal and state health policies allowed temporary flexibilities for Medicare and Medicaid beneficiaries, leading to a sharp increase in telemedicine use. However, many of the flexibilities that enabled innovation and growth in telemedicine continue temporarily since the federal emergency declaration ended...

Telemedicine enables critical human communication and interaction between researchers and participants in decentralized research studies. There is a need to better understand the overall scope of telemedicine applications in clinical research as the basis for further research. This narrative, nonsystematic review of the literature sought to review...

BACKGROUND Homework is implemented with variable effectiveness in real-world therapy settings, indicating a need for innovative solutions to homework challenges. We developed Adhere.ly, a user-friendly, HIPAA compliant, web-based platform to help therapists implement homework with youth clients and their caregivers. The initial version had limited...

Background Homework is implemented with variable effectiveness in real-world therapy settings, indicating a need for innovative solutions to homework challenges. We developed Adhere.ly, a user-friendly, Health Insurance Portability and Accountability Act–compliant web-based platform to help therapists implement homework with youth clients and their...

BACKGROUND Mental health care providers have widely adopted telemedicine since the beginning of the COVID-19 pandemic. Some providers have reported difficulties implementing telemedicine and are still determining its sustainability. Recommendations, best practices, and guidelines have been published for telemedicine-based mental health care (i.e.,...

UNSTRUCTURED With the end of the Public Health Emergency in the U.S. on May 11, 2023, Congress has allowed certain flexibilities and waivers to continue as lawmakers try to promulgate permanent, effective regulations and rules for successful telemedicine implementation. We review key barriers, challenges, and potential solutions to telemedicine com...

The US COVID-19 Public Health Emergency ended on May 11, 2023. Lawmakers and regulators extended some flexibilities while they deliberate effective long-term telemedicine policy. Here, we discuss critical challenges in telemedicine compliance and regulation grounded in scholarly literature and current events. We specifically consider obstacles and...

BACKGROUND Digital health and telemedicine are potentially important strategies to decrease healthcare’s environmental impact and contribution to climate change by reducing transportation-related air pollution and greenhouse gas emissions. However, we currently lack robust national estimates of emissions savings attributable to telemedicine. OBJEC...

Background Digital health and telemedicine are potentially important strategies to decrease health care’s environmental impact and contribution to climate change by reducing transportation-related air pollution and greenhouse gas emissions. However, we currently lack robust national estimates of emissions savings attributable to telemedicine. Obje...

Introduction: The COVID-19 pandemic led to a rapid transition to telemedicine for mental health care and redefined many providers' work environments and practices. The purpose of the study was to investigate the impact of work location on telemental health (TMH) benefits, disruptions, and concerns to further understand the rapid implementation of t...

BACKGROUND A 2017 survey of patient perspectives showed overall willingness and comfort to use telemedicine, but low actual use. Given recent growth and widespread exposure of patients to telemedicine, patient preferences are likely to have changed. OBJECTIVE This study aimed to (1) identify demographic trends in patient preferences and experience...

Background A 2017 survey of patient perspectives showed overall willingness and comfort to use telemedicine, but low actual use. Given recent growth and widespread exposure of patients to telemedicine, patient preferences are likely to have changed. Objective This study aimed to (1) identify demographic trends in patient preferences and experience...

BACKGROUND Self-administered online questionnaires are widely used to collect health data from patients and clinical research participants. Research Electronic Data Capture (REDCap) is a global, secure web application for building and managing electronic data capture. Unfortunately, stakeholder needs and preferences of electronic data collection vi...

Background Self-administered web-based questionnaires are widely used to collect health data from patients and clinical research participants. REDCap (Research Electronic Data Capture; Vanderbilt University) is a global, secure web application for building and managing electronic data capture. Unfortunately, stakeholder needs and preferences of ele...

Objective: To investigate determinants of telemental health (TMH) providers' openness to discuss and confidence to use online mental health information with patients, focusing on providers' eHealth literacy and perceived usefulness of online MH information. Methods: TMH providers (N = 472) completed a web-based survey with questions about discus...

Introduction: Virtual conversational agents (i.e., chatbots) are an intuitive form of data collection. Understanding older adults' experiences with chatbots could help identify their usability needs. This quality improvement study evaluated older adults' experiences with a chatbot for health data collection. A secondary goal was to understand how...

BACKGROUND Consensus guidelines and recommendations play an important role in fostering quality, safety, and best practices, as they represent an expert interpretation of the biomedical literature and its application to practice. However, it is unclear whether the recent collective experience of implementing telemedicine and the concurrent growth i...

Background Consensus guidelines and recommendations play an important role in fostering quality, safety, and best practices, as they represent an expert interpretation of the biomedical literature and its application to practice. However, it is unclear whether the recent collective experience of implementing telemedicine and the concurrent growth i...

Communication technologies are designed with the goal of fostering information exchanges that are more efficient and convenient than traditional methods. As communication technologies evolve alongside advancements in science and technology, they become closer to humanizing the electronic experience and more precisely meeting the needs of their user...

Background: Mental health care pivoted to telemedicine during COVID-19, and there is uncertainty around the sustainability of this rapid shift. Objective: This study examined how intentions to continue using telemedicine post-COVID are influenced by provider perceptions of usefulness, ease of use, professional social influence, facilitating orga...

Objective: Virtual conversational agents, or chatbots, have emerged as a novel approach to health data collection. However, research on patient perceptions of chatbots in comparison to traditional online forms is sparse. This study aimed to compare and assess the experience of completing a health assessment using a chatbot vs. an online form. Meth...

Purpose: To identify clinical and informational services that telemental health (TMH) providers need to be more successful in their practice. Methods: In February-March 2021, 472 TMH providers completed a cross-sectional survey. Providers indicated the degree to which they need clinical (e.g., build therapeutic alliances) and informational (e.g., l...

BACKGROUND Mental health care pivoted to telemedicine during COVID-19, and there is uncertainty around the sustainability of this rapid shift. OBJECTIVE This study examined how intentions to continue using telemedicine post-COVID are influenced by provider perceptions of usefulness, ease of use, professional social influence, and facilitating orga...

The COVID-19 pandemic accelerated adoption of telemental health (TMH). Providers with limited TMH experience faced challenges during the rapid switch to remote patient care. We investigated TMH providers’ perceptions about remote care one year into the pandemic according to when providers adopted telemedicine (i.e., before vs. after March 2020) and...

Phobias and related anxiety are common and costly mental health disorders. Experts anticipate the prevalence of phobias will increase due to the COVID-19 pandemic. Exposure therapies have been established as effective and reliable treatments for anxiety, including recent innovations in virtual reality-based exposure therapy (VRET). With the recent...

Introduction: Primary care providers (PCPs) and oncologists lack time and training to appropriately identify patients at increased risk for hereditary cancer using family health history (FHx) and clinical practice guideline (CPG) criteria. We built a tool, "ItRunsInMyFamily" (ItRuns) that automates FHx collection and risk assessment using CPGs. Th...

Background Family health history (FHx) is an effective tool for identifying patients at risk of hereditary cancer. Hereditary cancer clinical practice guidelines (CPG) contain criteria used to evaluate FHx and to make recommendations for genetic consultation. Comparing different CPGs used to evaluate a common set of FHx provides insight into how we...

Background: While telemedicine has been expanding over the past decade, the COVID-19 pandemic era restrictions regarding in-person care have led to unprecedented levels of telemedicine utilization. To the authors' knowledge, no studies to date have quantitatively analyzed both national and regional trends in telemedicine utilization during COVID-1...

BACKGROUND Identifying patients at risk of hereditary cancer based on their family health history is a highly nuanced task. Frequently, patients at risk are not referred for genetic counseling because providers lack time and training to collect and assess family health history. Consequently, patients at risk are not receiving the genetic counseling...

Background Identifying patients at risk of hereditary cancer based on their family health history is a highly nuanced task. Frequently, patients at risk are not referred for genetic counseling as providers lack the time and training to collect and assess their family health history. Consequently, patients at risk do not receive genetic counseling a...

Unstructured: The COVID-19 pandemic caused widespread challenges and revealed vulnerabilities across global healthcare systems. In response, many healthcare providers turned to telehealth solutions, which have been widely embraced and are likely to become standard for modern care. Immersive extended reality (XR) technologies have the potential to...

Purpose: We developed a Web-based chatbot (ItRunsInMyFamily.com) to help individuals collect their family health history (FHx) and determine their risk for hereditary cancer. The purpose of the current study was to assess the characteristics of users and identify opportunities to improve the FHx collection tool. Methods: During Family Health His...

As precision medicine becomes a mainstay in health care, the use of health information technology (IT) platforms will play an important role in the delivery of services across the cancer care continuum. Currently, there is both limited understanding about perceptions of health IT tools and barriers to their use among cancer genetic counselors. We a...

Background Health information technology (IT) is becoming increasingly utilized by cancer genetic counselors (CGCs). We sought to understand the current engagement, satisfaction, and opportunities to adopt new health IT tools among CGCs. Methods We conducted a mixed‐mode survey among 128 board‐certified CGCs using both closed‐ and open‐ended quest...

Background: Clinical trials are key to ensuring high-quality, effective, and safe health care interventions, but there are many barriers to their successful and timely implementation. Difficulties with participant recruitment and enrollment are largely affected by difficulties with obtaining informed consent. Teleconsent is a telemedicine- based a...

BACKGROUND Informed consent is among the biggest challenges in recruiting participants for clinical research studies. Researchers face many challenges in conducting clinical trials, some of which include budgetary restrictions, lack of trained personnel, and difficulty recruiting study participants--particularly minorities and participants from rur...

Background: Informed consent is among the biggest challenges in recruiting participants for clinical research studies. Researchers face many challenges in conducting clinical trials, some of which include budgetary restrictions, lack of trained personnel, and difficulty recruiting study participants-particularly minorities and participants from ru...

Family health history (FHx) is one of the most important pieces of information available to help genetic counselors and other clinicians identify risk and prevent disease. Unfortunately, the collection of FHx from patients is often too time consuming to be done during a clinical visit. Fortunately, there are many electronic FHx tools designed to he...

Purpose: To evaluate the potential of implementing established family cancer guidelines as clinical decision support within meaningful use (MU)-compliant health information technology systems. Methods We conducted a systematic analysis of cancer guidelines involving family health history (FHx) published before 2015. By comparing existing cancer gu...

Lack of recruitment of qualified research participants continues to be a significant bottleneck in clinical trials, often resulting in costly time extensions, underpowered results, and in some cases early termination. Some of the reasons for suboptimal recruitment include laborious consent processes and access to participants at remote locations. W...

Genomics is a promising tool that is becoming more widely available to improve the care and treatment of individuals. While there is much assertion, genomics will most certainly require the use of clinical decision support (CDS) to be fully realized in the routine clinical setting. The National Human Genome Research Institute (NHGRI) of the Nationa...

Family health history (FHx) is one of the most important risk factors for disease. Unfortunately, collection and use of FHx is under-utilized in the clinical setting. Efforts to improve collection of FHx have had minimal impact. A novel approach to collect FHx using social networking capabilities is being explored. We conducted a nationwide survey...

When coupled with a common information model, a common terminology for clinical decision support (CDS) and electronic clinical quality measurement (eCQM) could greatly facilitate the distributed development and sharing of CDS and eCQM knowledge resources. To enable such scalable knowledge authoring and sharing, we systematically developed an extens...

Clinical decision support interventions are typically heterogeneous in nature, making it difficult to identify why some interventions succeed while others do not. One approach to identify factors important to the success of health information systems is the use of meta-regression techniques, in which potential explanatory factors are correlated wit...

In 2004, a nationwide survey found that the majority (96.3%) of Americans believed their family health history (FHx) was important for their own health; however, only a third (29.8%) of respondents had ever actively collected this information. Over the past decade, government agencies, advocacy groups, professional societies, and healthcare provide...

This Viewpoint discusses the importance of the family health history and the need for novel family history tools in the changing health care environment. Every medical student remembers the clinical lesson to collect a family health history. In fact, the family history remains one of the most important resources available to help clinicians identi...

Whole genome sequence (WGS) information could soon be routinely available to clinicians to support the personalized care of their patients. At such time, clinical decision support (CDS) integrated into the clinical workflow will likely be necessary to support genome-guided clinical care. Nevertheless, developing CDS capabilities for WGS information...

The ease with which whole genome sequence (WGS) information can be obtained is rapidly approaching the point where it can become useful for routine clinical care. However, significant barriers will inhibit widespread adoption unless clinicians are able to effectively integrate this information into patient care and decision-making. Electronic healt...

Whole genome sequence (WGS) information may soon be widely available to help clinicians personalize the care and treatment of patients. However, considerable barriers exist, which may hinder the effective utilization of WGS information in a routine clinical care setting. Clinical decision support (CDS) offers a potential solution to overcome such b...

Whole genome sequencing (WGS) is rapidly approaching widespread clinical application. Technology advancements over the past decade, since the first human genome was decoded, have made it feasible to use WGS for clinical care. Future advancements will likely drive down the price to the point wherein WGS is routinely available for care. However, were...

OBJECTIVES: About 1 in 8 U.S. women will develop invasive breast cancer during their lifetime. Response to treatment varies among women depending on several factors. This work identified and prioritized the essential variables to implement personalized cancer treatment, and determined the feasibility of obtaining these variables from available data...

Poster

A standards-based, service-oriented architecture for clinical decision support (CDS) has the potential to significantly enhance CDS scalability and robustness. To enable such a CDS architecture, the Health Level 7 CDS Work Group reviewed the literature, hosted multi-stakeholder discussions, and consulted domain experts to identify and prioritize th...

Objective: To review the literature on clinical decision support (CDS) for genetically guided personalized medicine (GPM). Materials and methods: MEDLINE and Embase were searched from 1990 to 2011. The manuscripts included were summarized, and notable themes and trends were identified. Results: Following a screening of 3416 articles, 38 primar...

Parkinson's disease (PD) affects >1 million Americans and is marked by the loss of dopaminergic neurons in the substantia nigra. PD has been linked to two causative factors: genetic risks (hereditary PD) and environmental toxins (idiopathic PD). In recent years, considerable effort has been devoted to the development of a Drosophila model of human...