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Anvari S, Neumark S, Jangra R, Sandre A, Pasumarthi K, Xenodemetropoulos T. Best Practices for the Provision of Virtual Care: A Systematic Review of Current Guidelines. Telemed J E Health 2023; 29:3-22. [PMID: 35532969 DOI: 10.1089/tmj.2022.0004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Telemedicine has emerged as a feasible adjunct to in-person care in multiple clinical contexts, and its role has expanded in the context of the COVID-19 pandemic. However, there exists a general paucity of information surrounding best practice recommendations for conducting specialty or disease-specific virtual care. The purpose of this study was to systematically review existing best practice guidelines for conducting telemedicine encounters. Methods: A systematic review of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) of existing guidelines for the provision of virtual care was performed. Data were synthesized using the Synthesis Without Meta-Analysis (SWiM) guideline, and the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II) tool was used to evaluate the quality of evidence. Results: A total of 60 guidelines for virtual care encounters were included; 52% of these were published in the context of the COVID-19 pandemic. The majority (95%) of provider guidelines specified a type of virtual encounter to which their guidelines applied. Of included guidelines, 65% provided guidance regarding confidentiality/security, 58% discussed technology/setup, and 56% commented on patient consent. Thirty-one guidelines also provided guidance to patients or caregivers. Overall guideline quality was poor. Discussion: General best practices for successful telemedicine encounters include ensuring confidentiality and consent, preparation before a visit, and clear patient communication. Future studies should aim to objectively assess the efficacy of existing clinician practices and guidelines on patient attitudes and outcomes to further optimize the provision of virtual care for specific patient populations.
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Affiliation(s)
- Sama Anvari
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Samuel Neumark
- Translational Research Program, Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rhea Jangra
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Anthony Sandre
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Keerthana Pasumarthi
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ted Xenodemetropoulos
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Division of Education and Innovation, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Muacevic A, Adler JR, Ahmed F, Manickavasagam J. The Effectiveness of Remote Consultations During the COVID-19 Pandemic: A Tool for Modernising the National Health Service (NHS). Cureus 2022; 14:e32301. [PMID: 36627990 PMCID: PMC9822806 DOI: 10.7759/cureus.32301] [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] [Accepted: 12/07/2022] [Indexed: 12/12/2022] Open
Abstract
Objective The coronavirus disease 2019 (COVID-19) pandemic prompted major changes to the delivery of care. There was a move towards remote consultations in order to mitigate the risk of viral exposure and the risk of delaying care. Remote consultations will play a prominent role within the National Health Service (NHS) in the future. This project aimed to evaluate the effectiveness of remote consultations relative to face-to-face (F2F) consultations. Methods A local retrospective audit of remote consultations in ENT was performed by comparing outcome data for video and telephone appointments during the first peak of the pandemic to outcomes for F2F consultations during the same months of the preceding year. Chi-square tests were employed to determine whether there was any statistically significant discrepancy between the two modalities. Results Outcomes from a total of 314 patient consultations were reviewed. One hundred and fifty-four patients were male, and 160 were female; 111 patient consultations were conducted F2F, and 203 remotely (101 via telephone and 102 via video). There was no statistically significant difference detected between remote and F2F groups for rates of investigation, listing for theatre, referral to other specialties, and initiating treatment. Patients reviewed remotely were less likely to be discharged than those reviewed F2F (p=<0.001). Comparing the two remote modalities, telephone patients were more likely to undergo investigation than patients reviewed over video (p = 0.031). Conclusions Remote consultations were an effective and reliable resource for maintaining a high standard of care during the COVID-19 pandemic. Our findings suggest that remote consultations will prove a valuable tool for clinicians in the remobilisation of health services in the post-pandemic era.
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Tysome JR. Improving clinical practice in ENT: Lessons learnt from the COVID-19 pandemic. Clin Otolaryngol 2021; 46:295-296. [PMID: 33484619 PMCID: PMC8014541 DOI: 10.1111/coa.13720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/27/2022]
Abstract
During the COVID‐19 pandemic, the ENT community has demonstrated strong clinical leadership, adaptability to rapid change, enhanced clinical pathways and local networks, widespread use of digital technology for consultation and teaching and redirection of research programmes. These have permanently changed the way we work and, when the current global pandemic improves as COVID‐19 infections drop and vaccination programmes are rolled out, we should ensure that the positive changes that have been made are embedded in clinical practice to improve patient care.
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