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Vinadé Chagas ME, Cristina Jacovas V, de Campos Moreira T, Rodrigues Moleda Constant HM, Fernanda Rohden S, Stiehl Alves S, Santini F, Dall'Agnol S, König Klever E, Cezar Cabral F, da Silva Terres M. Are We Adequately Measuring Patient Satisfaction with Telemedicine? A Systematic Review with a Meta-Analysis. Telemed J E Health 2024; 30:1522-1538. [PMID: 38436274 DOI: 10.1089/tmj.2023.0530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Introduction: Telemedicine has gained significant attention as an effective means of providing health care remotely, particularly during the COVID-19 pandemic. Patient satisfaction is a critical aspect of implementing telemedicine, but we have no comprehensive understanding of satisfaction levels and the associated factors. The aim of this systematic review and meta-analysis was to assess patient satisfaction related to telemedicine consultations and to identify key factors influencing satisfaction levels. Results: The search yielded a total of 147 cross-sectional studies, of which 107 met the criteria for inclusion in the meta-analysis. Overall, patient satisfaction with teleconsultations was found to be high, with satisfaction levels ranging from 38 to 100 on a scale of 0 to 100. Only a small percentage (2.72%) of the studies reported satisfaction levels below 75%. Surprisingly, most studies used nonvalidated satisfaction questionnaires, which highlight the need for the development of standardized measurement instruments. Conclusions: This systematic review and meta-analysis provide evidence that patients generally exhibit high levels of satisfaction with telemedicine consultations. The use of nonvalidated satisfaction questionnaires in many studies, however, suggests a need for more standardized assessment tools. Factors such as the time interval between the consultation and the assessment were found to influence satisfaction levels. Understanding these factors can help health care providers improve telemedicine services and patient-provider relationships and optimize health care delivery in the context of telemedicine. Further research is warranted to develop validated satisfaction measurement instruments and explore any additional factors that influence patient satisfaction with telemedicine.
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Affiliation(s)
- Maria Eulália Vinadé Chagas
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | - Suelen Stiehl Alves
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Santini
- Universidade do Vale do Rio dos Sinos (Unisinos), Business School, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sara Dall'Agnol
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Emanuele König Klever
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Mellina da Silva Terres
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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O'Neil LM, O'Neill M, Whelan F, Leahy T, Wormald R, Hinton-Bayre AD, Ghandour J, Kuthubutheen J. Novel ENT live telehealth and live video-otoscopy clinics in remote Australia: outcomes and comparisons to traditional clinic models. J Laryngol Otol 2024; 138:253-257. [PMID: 37698117 DOI: 10.1017/s0022215123001561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
BACKGROUND Coronavirus disease 2019 challenged the delivery of healthcare in Australia, disproportionately impacting vulnerable patients, including Aboriginal and/or Torres Strait Islander peoples and those living in remote regions. The otolaryngology service provided to remote Western Australia adapted to these barriers by altering clinical consultations to a digital model. METHODS A review was undertaken of patients in regional Western Australia. Demographics and clinical outcomes from 20 live telehealth clinics were retrospectively reviewed and compared to 16 face-to-face clinics. RESULTS The demographics of patients reviewed in both live telehealth and face-to-face clinics were similar, except for a larger proportion of Aboriginal and/or Torres Strait Islander patients utilising telehealth. The outcomes of patients reviewed through each model of care were comparable. Live video-otoscopy provided diagnostic quality images in 92 per cent of cases. CONCLUSION The findings of our review suggest that, despite its limitations, a large proportion of ENT patients may be safely assessed through a live telehealth model.
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Affiliation(s)
- Luke M O'Neil
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
| | - Margie O'Neill
- Western Australian Country Health Service, Perth, Australia
| | - Fiona Whelan
- Western Australian Country Health Service, Perth, Australia
| | - Travis Leahy
- Western Australian Country Health Service, Perth, Australia
- Division of Otolaryngology, Medical School, The University of Notre Dame, Perth, Australia
| | - Robert Wormald
- Western Australian Country Health Service, Perth, Australia
| | - Anton D Hinton-Bayre
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
| | | | - Jafri Kuthubutheen
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
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Montalbaron MB, Achlatis E, Johnson AM, Ma Y, Young VN, Rosen CA, Amin MR, Kwak PE. Presumptive Diagnosis in Tele-Health Laryngology: A Multi-Center Observational Study. Ann Otol Rhinol Laryngol 2023; 132:1511-1519. [PMID: 37070580 DOI: 10.1177/00034894231165811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVES Early in the COVID-19 pandemic, outpatient visits were adapted for the virtual setting, forcing laryngologists to presume certain diagnoses without the aid of laryngoscopy, solely based on history and the limited physical exam available via video visit. This study aims to examine the accuracy of presumptive diagnoses made via telemedicine, compared to subsequent in-person follow up, where endoscopic examination could confirm or refute suspected diagnoses. METHODS A retrospective chart review was conducted of 38 patients evaluated for voice-related issues at NYU Langone Health and the University of California-San Francisco. Presumptive diagnoses at the initial telemedicine encounter were noted, along with diagnostic cues used for clinical reasoning and recommended treatment plans. These presumptive diagnoses were compared to diagnoses and plans established following laryngoscopy at follow-up in-person visits. RESULTS After laryngoscopy at the first in-person visit, 38% of presumptive diagnoses changed, as did 37% of treatment plans. The accuracy varied among conditions. Muscle tension dysphonia and Reinke's edema were accurately diagnosed without laryngoscopy, but other conditions, including vocal fold paralysis and subglottic stenosis, were not initially suspected, relying on laryngoscopy for diagnosis. CONCLUSIONS While some laryngologic conditions may be reasonably identified without in-person examination, laryngoscopy remains central to definitive diagnosis and treatment. Telemedicine can increase access to care, but it may provide more utility as a screening tool, triaging which patients should present more urgently for in-person laryngoscopy. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Michael B Montalbaron
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Efstratios Achlatis
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Aaron M Johnson
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Yue Ma
- UCSF Voice and Swallowing Center, Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - VyVy N Young
- UCSF Voice and Swallowing Center, Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Clark A Rosen
- UCSF Voice and Swallowing Center, Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Milan R Amin
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Paul E Kwak
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
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Kattih O, Battistoni V, Coughlin E, Mhaskar R, Menezes L, Greene K. Patient perceptions of urgency of their pelvic floor disorders during the COVID-19 pandemic. Int Urogynecol J 2023; 34:2447-2458. [PMID: 37191888 PMCID: PMC10186321 DOI: 10.1007/s00192-023-05545-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 03/31/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION AND HYPOTHESIS During the COVID-19 pandemic, many surgical societies released guidelines that included cancellation of elective cases. The aim of this study was to better understand our patients' perceptions of the severity of their pelvic floor disorders (PFDs) and to determine what factors influenced this perception. We also aimed to better understand who might be amenable to telemedicine visits and what factors influenced this decision. METHODS This is a cross-sectional quality improvement study that included women at least 18 years of age diagnosed with a pelvic floor disorder being evaluated within a university Female Pelvic Medicine and Reconstructive Surgery clinic during the COVID-19 pandemic. Patients whose appointments and procedures were being cancelled were queried on whether they would be willing to answer a telephone questionnaire developed by the clinical and research teams. We gathered descriptive data from 97 female patients with PFDs using a primary phone questionnaire. The data were analyzed using proportions and descriptive statistics. RESULTS Of the 97 patients, the majority (79%) viewed their conditions as non-urgent. Factors that influenced patients' perception of urgency included race (p=0.037), health status (p≤0.001), a history of diabetes (p=0.011), and willingness to attend an in-person appointment (p=0.010). Further, 52% of respondents were willing to attend a tele-health appointment. Statistically significant factors influencing this decision were ethnicity (p=0.019), marital status (p=0.019), and willingness to attend an in-person appointment (p=0.011). CONCLUSION The majority of women did not view their conditions as urgent during the COVID-19 pandemic and were amenable to a telehealth appointment.
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Affiliation(s)
- Obada Kattih
- Morsani College of Medicine, University of South Florida, 17353 Emerald Chase Dr. Tampa, Tampa, FL, 33647, USA.
| | - Valentina Battistoni
- Morsani College of Medicine, University of South Florida, 17353 Emerald Chase Dr. Tampa, Tampa, FL, 33647, USA
| | - Emily Coughlin
- College of Medicine Department of Medical Education, University of South Florida, Tampa, FL, USA
| | - Rahul Mhaskar
- College of Medicine Office of Research, University of South Florida, Tampa, FL, USA
| | - Lynette Menezes
- International, USF Health, University of South Florida, Tampa, FL, USA
| | - Kristie Greene
- Department of Obstetrics & Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University of South Florida, Tampa, FL, USA
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Arrighi-Allisan AE, Wong A, Gidumal S, Shah J, Filip P, Omorogbe A, Rosenberg J, Govindaraj S, Iloreta AM. Otolaryngology Patient Satisfaction with In-Office Appointments and Virtual Visits Due to COVID-19. Ann Otol Rhinol Laryngol 2023; 132:1168-1176. [PMID: 36433692 PMCID: PMC9705504 DOI: 10.1177/00034894221137273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND The COVID-19 pandemic forced otolaryngologists to seek new methods of providing patient care in a remote setting. The effect of this paradigm shift on patient satisfaction, however, remains unelucidated. This study compares patient satisfaction with telehealth visits during the COVID-19 pandemic to that with in-office visits during the same period in 2019. METHODS Press Ganey survey responses of patients seen by otolaryngologists within a large, academic, multicenter hospital system were gathered. Responses were included in analyses if they corresponded with a visit that occurred either in clinic March to December 2019 or via telehealth March to December 2020. Chi-Square Test of Independence and Fisher's Exact Test were employed to detect differences between years. Binary logistic regressions were performed to detect the factors most predictive of positive telehealth experiences. RESULTS Patient overall satisfaction with in-office and telehealth visits did not differ significantly (76.4% in 2019 vs 78.0% in 2020 rated visit overall as "very good," P = .09). Patients seen by a Head and Neck (odds ratio 4.13, 95% confidence interval 1.52-11.26, P = .005), Laryngology (OR 5.96, 95% CI 1.51-23.50, P = .01), or Rhinology (OR 4.02, 95% CI 1.55-10.43, P = .004) provider were significantly more likely to report a positive telehealth experience. CONCLUSIONS Patients seen via telehealth during COVID-19 reported levels of satisfaction similar to those seen in-office the year prior. These telehealth satisfaction levels, however, are contextualized within the expected confines of a pandemic. Further research is required to determine whether satisfaction remains consistent as telemedicine becomes a ubiquitous component of medical practice.
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Affiliation(s)
| | - Anni Wong
- Department of Otolaryngology, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
| | - Sunder Gidumal
- Department of Otolaryngology, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
| | - Janki Shah
- Department of Otolaryngology, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter Filip
- Department of Otolaryngology, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
| | - Aisosa Omorogbe
- Department of Otolaryngology, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua Rosenberg
- Department of Otolaryngology, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
| | - Satish Govindaraj
- Department of Otolaryngology, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
| | - Alfred-Marc Iloreta
- Department of Otolaryngology, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
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Shah SR, Munhall CC, Nguyen SA, O'Rourke AK, Miccichi K, Meyer TA. Diagnostic accuracy and management concordance of otorhinolaryngological diseases through telehealth or remote visits: A systematic review & meta-analysis. J Telemed Telecare 2023:1357633X231156207. [PMID: 36916306 DOI: 10.1177/1357633x231156207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
INTRODUCTION COVID-19 has led to delays in providing healthcare in both emergency and non-emergency settings, especially in surgical subspecialties which rely heavily on referrals and in-person visits. Without an established telehealth infrastructure, many otorhinolaryngological departments experienced decreases in consultations. Telemedicine has attempted to bridge the gap between pre- and post-pandemic periods by creating a safe avenue of communication between otorhinolaryngologists and patients. This review hopes to address the accuracy of telemedicine in patient diagnosis and management. METHODS Searches were conducted since study conception until June 30, 2022, on multiple databases including PubMed, SCOPUS, and CINAHL for this systematic review and meta-analysis. Diagnostic accuracy, management accuracy, kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were meta-analyzed by comparing virtual visits to in-person visits (gold standard). RESULTS Nineteen studies were included in this review. A total of 1518 patients were included across all studies. When comparing virtual visits against in-person visits, accurate diagnosis was made in 86.2% [82.1,89.9, I2 = 73.5%, P < 0.0001] of patients and management accuracy was 91.5% [86.1,95.7, I2 = 81.8%, P < 0.0001] when treating patients. Kappa value determining interrater reliability was 0.8 [0.7,0.9, I2 = 81.8%, P < 0.0001]. CONCLUSION Our data suggest that diagnostic and management concordance is above 80% when comparing diagnosis and management strategies in patients who underwent both telehealth and in-person visits with an otorhinolaryngologist. In uncomplicated patients, telehealth might be a reliable source for diagnosis and management however, in-person consultation is likely still required for pathologies in which physical exam, imaging or procedural elements represent a vital component of the work-up.
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Affiliation(s)
- Sunny R Shah
- Department of Otolaryngology - Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Christopher C Munhall
- Department of Otolaryngology - Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Shaun A Nguyen
- Department of Otolaryngology - Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Ashli K O'Rourke
- Department of Otolaryngology - Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Kate Miccichi
- Department of IT Telemedicine, 23410McLeod Health, Florence, SC, USA
| | - Ted A Meyer
- Department of Otolaryngology - Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
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How COVID-19 Broke the Barriers Related to the Implementation of Telecare-Patients' Experiences with a New form of Providing Health Services in Primary Health Care. Healthcare (Basel) 2023; 11:healthcare11040497. [PMID: 36833033 PMCID: PMC9956090 DOI: 10.3390/healthcare11040497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly contributed to accelerating the development of telemedicine and eHealth. The main aim of this study was to assess the attitudes of patients towards remote care implemented in general practice (GP) during the pandemic. METHODS The study was a pilot study conducted in March-April 2021, considering technical aspects of using teleconsultations, and evaluating the difficulties, advantages and disadvantages for patients. When assessing opinions, a simple Likert scale was used, where a value of 1 meant the worst possible assessment or strong disagreement and the upper value the best or full agreement of the respondent. RESULTS The study covered 408 respondents. Their biggest organizational challenge reaching GPs by telephone, regardless of the patients' home location (p = 0.23698). Obtaining e-documents was not problematic but was rated as worse by men (p = 0.048295). Respondents rated the overall effectiveness of teleconsultations more highly if they could speak directly with a doctor (p = 0.0005). There were no differences in willingness to recommend teleconsultations based on gender (p = 0.2432), place of residence (p = 0.7878), age (p = 0.290355) or education (p = 0.9109), but people assessing the overall effectiveness of telemedicine more highly were more willing to recommend it (p = 0.000). CONCLUSIONS Respondents assess teleconsultations in a differentiated way, noticing both positive and negative features of the remote form of providing health services.
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Virtual vs in-person otolaryngology evaluation: The patient perspective. Am J Otolaryngol 2022; 43:103546. [DOI: 10.1016/j.amjoto.2022.103546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/24/2022] [Indexed: 11/20/2022]
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Lampickienė I, Davoody N. Healthcare Professionals' Experience of Performing Digital Care Visits-A Scoping Review. Life (Basel) 2022; 12:913. [PMID: 35743944 PMCID: PMC9225275 DOI: 10.3390/life12060913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023] Open
Abstract
The use of digital care visits has been increasing during the COVID-19 pandemic. Learning more about healthcare professionals' technology experiences provides valuable insight and a basis for improving digital visits. This study aimed to explore the existing literature on healthcare professionals' experience performing digital care visits. A scoping review was performed following Arksey & O'Malley's proposed framework using the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The collected data were analyzed using thematic content analysis. Five main themes were identified in the literature: positive experiences/benefits, facilitators, negative experiences/challenges, barriers, and suggestions for improvement. Healthcare professionals mostly reported having an overall positive experience with digital visits and discovered benefits for themselves and the patients. However, opinions were mixed or negative regarding the complexity of decision making, workload and workflow, suitability of this type of care, and other challenges. The suggestions for improvement included training and education, improvements within the system and tools, along with support for professionals. Despite overall positive experiences and benefits for both professionals and patients, clinicians reported challenges such as physical barriers, technical issues, suitability concerns, and others. Digital care visits could not fully replace face-to-face visits.
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Patel R, Fang CH, Grube JG, Eloy JA, Hsueh WD. COVID-19 and rhinological surgery. OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY--HEAD AND NECK SURGERY 2022; 33:103-111. [PMID: 35502266 PMCID: PMC9046134 DOI: 10.1016/j.otot.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Coronavirus-19 (COVID-19) pandemic has caused disruptions in the normal patient care workflow, necessitating adaptations within the healthcare profession. The objective of this article is to outline some of these adaptations and considerations necessitated by COVID-19 within the subspeciality of rhinology and endoscopic skull base surgery.
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Affiliation(s)
- Rushi Patel
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Christina H Fang
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York
| | - Jordon G Grube
- Division of Otolaryngology, Albany Medical College, Albany, New York
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey
- Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center - RWJ Barnabas Health, Livingston, New Jersey
| | - Wayne D Hsueh
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
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Fang CH, Smith RV. COVID-19 and the resurgence of telehealth in otolaryngology. OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY-HEAD AND NECK SURGERY 2022; 33:158-164. [PMID: 35505953 PMCID: PMC9047697 DOI: 10.1016/j.otot.2022.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this review is to examine the impact of the ongoing Coronavirus disease 2019 (COVID-19) pandemic on the use of telehealth in Otolaryngology. The use of telemedicine rose dramatically during the pandemic to meet the need for continued patient care while allowing for physical separation of providers and patients. Telemedicine has been used to evaluate patients with a variety of pathologies including dysphonia, vertigo, and anosmia. Innovative use of at-home exams, such as video-otoscopy has aided providers in overcoming challenges associated with a highly specialized physical exam. The use of telemedicine in Otolaryngology will likely remain essential in the post-pandemic era and has promising results for improving clinical efficiency.
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Affiliation(s)
- Christina H Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, New York
| | - Richard V Smith
- Department of Otorhinolaryngology, Head and Neck Surgery, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, New York
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12
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Dahiya M, Olayinka L, Kaplan GG, Reeb L, Ma C, Panaccione R, Kroeker KI. The Impact of the COVID-19 Pandemic on IBD Care in Alberta: Patient and Provider Perspectives. J Can Assoc Gastroenterol 2022; 6:42-49. [PMID: 36785573 PMCID: PMC8807203 DOI: 10.1093/jcag/gwab042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objective The COVID-19 pandemic necessitated changes in the delivery of ambulatory care for patients with inflammatory bowel disease (IBD), including transitioning many visits to virtual formats and delaying non-urgent assessments. We aimed to evaluate the impact of the COVID-19 pandemic on IBD patient care from health care providers' (HCP) and patients' perspectives. Methods We administered a 42-question HCP survey and a 44-question patient survey, which evaluated HCP and patient experience and satisfaction with care delivery and delays in access to IBD care during the first wave of the COVID-19 pandemic. Results Surveys were completed by 19.2% (24/125) HCPs and 25.8% (408/1581) patients. Overall, 82.7% of patients with IBD maintained their care without disruption. The majority of patients were satisfied with a transition to virtual care. All HCPs were willing to use virtual care in the future; however, 60% (14/24) of HCPs reported that virtual care was not equivalent to in-person visits. Patients reported concerns around access to health resources, the uncertainty of IBD-specific care, and fear and stress due to employment uncertainty and safety. Providers also reported concerns about patient safety, patient education, adequate remuneration and challenges with providing care for new patients on virtual platforms. Conclusion While some delays in health care delivery occurred during the first wave of the pandemic, both patients and HCPs were satisfied with a transition to new models of care delivery. These models may remain in place post-pandemic and allow for flexibility in care delivery that is acceptable to both patients and HCPs.
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Affiliation(s)
- Monica Dahiya
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lily Olayinka
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Gilaad G Kaplan
- Department of Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leanne Reeb
- Department of Medicine, Digestive Health Strategic Clinical Network, Alberta Health Services, Alberta, Canada
| | - Christopher Ma
- Department of Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Remo Panaccione
- Department of Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karen I Kroeker
- Correspondence: Karen I. Kroeker, MSc, MD, FRCPC, Division of Gastroenterology, University of Alberta, 2-40 Zeidler Ledcor Centre, 8540 – 112 Street, Edmonton, Alberta, T6G 2X8, Canada, e-mail:
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Tong JY, Hartkorn AR, Sataloff R. Otolaryngology residency program websites in a socially distanced application cycle. EAR, NOSE & THROAT JOURNAL 2022:1455613211064005. [PMID: 34983198 DOI: 10.1177/01455613211064005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To provide an updated evaluation of otolaryngology residency program websites during a socially distanced application cycle. Criteria were selected to evaluate for level of comprehensiveness, new content accommodating a virtual interview cycle, and stated commitment to diversity and inclusion. STUDY DESIGN Review of otolaryngology residency program websites. SETTING Online websites between December 2020 and January 2021. METHODS Otolaryngology residency program websites were evaluated for selected criteria. Programs were categorized by geographic location, size, and Doximity rankings. Differences between groups were analyzed using Student's t-test and analysis of variance with a significance level of P < .05. RESULTS 118 otolaryngology residency program websites contained a mean (SD) of 16.3 (4.7) of 31 criteria (52.6%). Fewer than one third included virtual/video tours of facilities or the surrounding area. Only 33% had a stated commitment to diversity and inclusion. There was no difference in number of criteria included when categorized by geographic location (P = .22). Larger programs (17.9 vs 14.5, P < .001) and programs ranked in the top 50 by Doximity (17.7 vs 15.2, P = .003) included a significantly greater number of criteria. CONCLUSION While the comprehensiveness of otolaryngology residency program websites has improved, considerable room for improvement remains. Programs should strive to maintain updated websites that highlight training opportunities, program culture, and commitment to diversity and inclusion. Programs also should consider prioritizing the development of new online resources that may be especially useful to applicants during a virtual interview cycle.
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Affiliation(s)
- Jane Y Tong
- Department of otolaryngology-head and neck surgery12312, University of Maryland, Baltimore, Maryland
| | - Alyssa R Hartkorn
- Department of Otolaryngology-Head and Neck Surgery, 6556Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Robert Sataloff
- Department of Otolaryngology-Head and Neck Surgery, 12312Drexel University College of Medicine, Philadelphia, PA, USA
- Lankenau Institute for Medical Research, Philadelphia, PA, USA
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Telehealth in cancer care during COVID-19: disparities by age, race/ethnicity, and residential status. J Cancer Surviv 2021; 16:44-51. [PMID: 34800257 PMCID: PMC8605776 DOI: 10.1007/s11764-021-01133-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/06/2021] [Indexed: 02/08/2023]
Abstract
Purpose Telehealth may remain an integral part of cancer survivorship care after the SARS-CoV-2 pandemic. While telehealth may reduce travel/waiting times and costs for many patients, it may also create new barriers that could exacerbate care disparities in historically underserved populations, manifesting as differences in overall care participation, and in differential video versus phone use for telehealth. Methods We reviewed visits by cancer survivors between January and December 2020 at a designated cancer center in Minnesota. We used descriptive statistics, data visualization, and generalized estimating equation logistic regression models to compare visit modalities and trends over time by age, urban/rural status, and race/ethnicity. Results Among 159,301 visits, including 33,242 telehealth visits, older and rural-dwelling individuals were underrepresented in telehealth compared with in-person care. Non-Hispanic White individuals, those aged 18–69 years, and urban residents used video for > 50% of their telehealth visits. In contrast, those aged ≥ 70 years, rural residents, and most patient groups of color used video for only 33–43% of their telehealth visits. Video use increased with time for everyone, but relative differences in telehealth modalities persisted. Visits of Black/African American patients temporarily fell in spring/summer 2020. Conclusions Our findings underscore reduced uptake of telehealth, especially video, among potentially vulnerable patient populations. Future research should evaluate reasons for differential telehealth utilization and whether visit modality (in-person versus video versus phone) affects cancer outcomes. Implications for Cancer Survivors A long-term cancer care model with integrated telehealth elements needs to account for specific barriers for vulnerable populations. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01133-4.
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