Synchronous Telemedicine in Allergy: Lessons Learned and Transformation of Care During the COVID-19 Pandemic

Satisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review

Background: Telemedicine became a fundamental part of healthcare provision during COVID-19 pandemic. An evaluation of telemedicine-associated satisfaction helps the service develop more viable applications. This review evaluated the satisfaction of healthcare users and providers and their willingness to use this modality in future.Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A search on empirical articles published between March 2020 and December 2022 was performed on 'PubMed' and 'Scopus' databases. Findings that reported on satisfaction of patients, families and caregivers as well as clinicians were extracted and analysed. Quality of included studies was assessed. After applying inclusion and exclusion criteria, the review included 27 eligible studies.Results: Data was found from a variety of emergency and non-emergency departments of primary, secondary, and specialised healthcare. Almost all studies were undertaken within the NHS. There were many tools that measured satisfaction. Satisfaction was high among recipients of healthcare, scoring 9-10 on a scale of 0-10 or ranging from 73.3% to 100%. Convenience was rated high in every specialty examined. Satisfaction of clinicians was high throughout the specialities despite connection failure and concerns about confidentiality of information. Nonetheless, studies reported perception of increased barriers to accessing care and inequalities for vulnerable patients especially in older people. In general, willingness to use telemedicine in future was high in the recipients as well as the providers of healthcare.Conclusion: COVID-19 pandemic has transformed healthcare in the UK and promoted a revolution in telemedicine applications. Satisfaction was high among both recipient and provider of healthcare. Telemedicine managed to provide a continued care throughout the pandemic while maintaining social distance. The current review presented commendable evidence to encourage different specialities to engage in telemedicine application.

The paradigm shift in allergy consultations through a digital ecosystem

In Spain, specialist outpatient care traditionally relied on in-person consultations at public hospitals, leading to long wait times and limited clinical analysis in appointment assignments. However, the emergence of Information and Communication Technologies (ICTs) has transformed patient care, creating a seamless healthcare ecosystem. At the Allergy Department, we aimed to share our experience in transitioning form a traditional linear model of patient flow across different healthcare levels to the implementation of a digital ecosystem. By telemedicine, we can prioritize individuals based on clinical relevance, promptly and efficiently addressing potentially life-threatening conditions such as severe uncontrolled asthma or hymenoptera venom anaphylaxis. Furthermore, our adoption of telephone consultations has markedly reduced the need for in-person hospital visits, while issues with unstable patients are swiftly addressed via WhatsApp. This innovative approach not only enhances efficiency but also facilitates the dissemination of personalized medical information through various channels, contributing to public awareness and education, particularly regarding allergies. Concerns related to confidentiality, data privacy, and the necessity for informed consent must thoroughly be addressed. Also, to ensure the success of ICT integration, it is imperative to focus on the quality of educational information, its efficient dissemination, and anticipate potential unforeseen consequences. Sharing experiences across diverse health frameworks and medical specialties becomes crucial in refining these processes, drawing insights from the collective experiences of others. This collaborative effort aims to contribute to the ongoing development of a more effective and sustainable healthcare system.

Self-Management in Allergic Rhinitis: Strategies, Outcomes and Integration into Clinical Care

Allergic rhinitis (AR) is a common disease, characterized by typical symptoms and type 2 inflammation. Standard treatment is usually effective and safe, and most medications are available as over-the-counter (OTC). Therefore, AR patients, mostly at the AR onset or if symptoms are mild, prefer to manage symptoms themselves. However, self-management could be associated with problems, including inadequate control or medication abuse. Therefore, this paper aimed at presenting and discussing this issue. Ideally, self-management should be conducted under medical supervision. In this regard, telemedicine could represent a valuable tool for implementing self-management. Visual analog scale (VAS) is a perfect parameter to measure symptom severity, medications use, and AR control. In addition, VAS is easily monitored over time. Presently, a mobile application allows to AR patients of self-managing themselves. Therefore, mobile healthcare may supply fundamental support in communication and decision-making. In this regard, VAS represents the best tool to monitor symptoms' severity and control over time. Finally, pharmacological and non-pharmacological remedies are numerous and effective but should be used wisely.

Provision of Food Allergy Care in the United Kingdom and United States: Current Issues and Future Directions

Food allergy (FA) is a growing issue worldwide. The United Kingdom and United States are high-income, industrialized countries with reported increases in FA prevalence over the past few decades. This review compares delivery of FA care in the United Kingdom and United States and each country's response to the heightened demand and disparities for FA services. In the United Kingdom, allergy specialists are scarce and general practitioners (GPs) provide most allergy care. Whereas the United States has more allergists per capita than the United Kingdom, there is still a shortage of allergy services owing to the greater reliance on specialist care for FA in America and wide geographic variation in access to allergist services. Currently, generalists in these countries lack the specialty training and equipment to diagnose and manage FA optimally. Moving forward, the United Kingdom aims to enhance training for GPs so they may provide better quality frontline allergy care. In addition, the United Kingdom is implementing a new tier of semi-specialized GPs and increasing cross-center collaboration through clinical networks. The United Kingdom and United States aim to increase the number of FA specialists, which is critical at a time of rapidly expanding management options for allergic and immunologic diseases requiring clinical expertise and shared decision-making to select appropriate therapies. While these countries aim to grow their supply of quality FA services actively, further efforts to build clinical networks and perhaps recruit international medical graduates and expand telehealth services are necessary to reduce disparities in access to care. For the United Kingdom in particular, increasing quality services will require additional support from the leadership of the centralized National Health Service, which remains challenging.

Reshaping the Management of Allergic Rhinitis in Primary Care: Lessons from the COVID-19 Pandemic

The COVID-19 pandemic presented unique challenges to the delivery of healthcare for patients with allergic rhinitis (AR) following its disruption and impact on the healthcare system with profound implications. Reliance on self-care for AR symptom management was substantial during the pandemic with many patients encouraged to only seek in-person medical care when necessary. The advantage of digital technology becomes apparent when patients and healthcare providers had to change and adapt their method of interaction from the regular physical face-to-face consultation to telehealth and mobile health in the provision of care. Despite the pandemic and the ever-evolving post pandemic situation, optimal management of AR remains paramount for both patients and healthcare professionals. A reshaping of the delivery of care is essential to accomplish this goal. In this paper, we present what we have learned about AR management during the COVID-19 pandemic, the role of digital technology in revolutionizing AR healthcare, screening assessment in the identification and differentiation of common upper respiratory conditions, and a framework to facilitate the management of AR in primary care.

Allergic diseases and immunodeficiencies in children, lessons learnt from COVID-19 pandemic by 2022: A statement from the EAACI-section on pediatrics

By the April 12, 2022, the COVID-19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short- and long-term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health-care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID-19 or dying from infection. Allergic diseases are not associated with a higher COVID-19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high-standard care. Although children faced a multitude of pandemic-related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.

The Use of Big Data via 5G to Alleviate Symptoms of Acute Stress Disorder Caused by Quarantine Measures

This article investigates the role of Big Data in situations of psychological stress such as during the recent pandemic caused by the COVID-19 health crisis. Quarantine measures, which are necessary to mitigate pandemic risk, are causing severe stress symptoms to the human body including mental health. We highlight the most common impact factors and the uncertainty connected with COVID-19, quarantine measures, and the role of Big Data, namely, how Big Data can help alleviate or mitigate these effects by comparing the status quo of current technology capabilities with the potential effects of an increase of digitalization on mental health. We find that, while Big Data helps in the pre-assessment of potentially endangered persons, it also proves to be an efficient tool in alleviating the negative psychological effects of quarantine. We find evidence of the positive effects of Big Data on human health conditions by assessing the effect of internet use on mental health in 173 countries. We found positive effects in 110 countries with 90 significant results. However, increased use of digital media and exclusive exposure to digital connectivity causes negative long-term effects such as a decline in social empathy, which creates a form of psychological isolation, causing symptoms of acute stress disorder.

Telemedicine in allergy/immunology in the era of COVID-19: a Canadian perspective

Background

In the era of COVID-19, utilization of telemedicine has dramatically increased. In addition to reduced travel times, patient expenses, and work or school days missed, telemedicine allows clinicians to provide continued care while minimizing face-to-face interactions, maintaining social distancing, and limiting potential COVID-19 exposures. Clinical Immunology and Allergy (CIA), like many specialties, has adapted to incorporate telemedicine into practice. Previous studies have demonstrated similar patient satisfaction between virtual and in-person visits. However, evidence from fully publicly funded health care systems such as Canada has been limited.

Methods

We performed a quality improvement (QI) initiative to assess the feasibility of telemedicine. Between 1 March and 30 September 2020, patient encounters of two academic allergists at a single institution in London, Ontario, Canada were analyzed. Assessments were categorized into in-person or telemedicine appointments. A random sample of patients assessed virtually completed a voluntary patient satisfaction survey. Qualitative analysis was performed on survey comments.

Results

In total 3342 patients were seen. The majority were adults (n = 2162, or 64.7%) and female (n = 1872, or 56%). 1543 (46.2%) assessments were virtual and 1799 (53.8%) assessments were in-person. 67 of 100 random patient surveys sent to those in the virtual assessment group were completed. 89.6% (n = 60) agreed or strongly agreed when asked if they were satisfied with their telemedicine visit. 64.2% (n = 43) felt they received the same level of care compared to in-person assessments and 91% (n = 61) stated they would attend another virtual appointment. 95.4% (n = 62) of patients reported saving time with virtual assessment, the majority (n = 42, 62.7%) estimating between 1–4 h saved. Reported shortcomings included technical difficulties, “feeling rushed”, and missing in-person interactions.

Conclusions

Our quality improvement initiative demonstrated high patient satisfaction and time savings with virtual assessment in a publicly funded health care system. Studies suggest that CIA may be uniquely situated to benefit from permanent integration of virtual care into regular practice for both new and follow-up appointments. We anticipate continued increased utilization of telemedicine, signifying a lasting beneficial change in the delivery of healthcare.

Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review

BACKGROUND

Technologies have been extensively implemented to provide health care services for all types of clinical conditions during the COVID-19 pandemic. While several reviews have been conducted regarding technologies used during the COVID-19 pandemic, they were limited by focusing either on a specific technology (or features) or proposed rather than implemented technologies.

OBJECTIVE

This review aims to provide an overview of technologies, as reported in the literature, implemented during the first wave of the COVID-19 pandemic.

METHODS

We conducted a scoping review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. Studies were retrieved by searching 8 electronic databases, checking the reference lists of included studies and relevant reviews (backward reference list checking), and checking studies that cited included studies (forward reference list checking). The search terms were chosen based on the target intervention (ie, technologies) and the target disease (ie, COVID-19). We included English publications that focused on technologies or digital tools implemented during the COVID-19 pandemic to provide health-related services regardless of target health condition, user, or setting. Two reviewers independently assessed the eligibility of studies and extracted data from eligible papers. We used a narrative approach to synthesize extracted data.

RESULTS

Of 7374 retrieved papers, 126 were deemed eligible. Telemedicine was the most common type of technology (107/126, 84.9%) implemented in the first wave of the COVID-19 pandemic, and the most common mode of telemedicine was synchronous (100/108, 92.6%). The most common purpose of the technologies was providing consultation (75/126, 59.5%), followed by following up with patients (45/126, 35.7%), and monitoring their health status (22/126, 17.4%). Zoom (22/126, 17.5%) and WhatsApp (12/126, 9.5%) were the most commonly used videoconferencing and social media platforms, respectively. Both health care professionals and health consumers were the most common target users (103/126, 81.7%). The health condition most frequently targeted was COVID-19 (38/126, 30.2%), followed by any physical health conditions (21/126, 16.7%), and mental health conditions (13/126, 10.3%). Technologies were web-based in 84.1% of the studies (106/126). Technologies could be used through 11 modes, and the most common were mobile apps (86/126, 68.3%), desktop apps (73/126, 57.9%), telephone calls (49/126, 38.9%), and websites (45/126, 35.7%).

CONCLUSIONS

Technologies played a crucial role in mitigating the challenges faced during the COVID-19 pandemic. We did not find papers describing the implementation of other technologies (eg, contact-tracing apps, drones, blockchain) during the first wave. Furthermore, technologies in this review were used for other purposes (eg, drugs and vaccines discovery, social distancing, and immunity passport). Future research on studies on these technologies and purposes is recommended, and further reviews are required to investigate technologies implemented in subsequent waves of the pandemic.

The applications of eHealth technologies in the management of asthma and allergic diseases

Portable devices, such as smartphones and mobile Internet access have become ubiquitous in the last decades. The term 'eHealth' stands for electronic health. The tools included in the eHealth concept utilize phones, computers and the Internet and related applications to improve the health care industry. Implementation of eHealth technologies has been documented for the management of different chronic diseases, including asthma and allergic conditions. Clinicians and patients have gained opportunity to communicate in new ways, which could be used cost-effectively to improve disease control and quality of life of those affected. Additionally, these innovations bring new opportunities to academic researchers. For example, eHealth has allowed researchers to compile data points that were previously unavailable or difficult to access, and analyse them using novel tools, collectively described as 'big data'. The role of eHealth become more important since early 2020, due to the physical distancing rules and the restrictions on mobility that have been applied worldwide as a response to the coronavirus disease 2019 pandemic. In this review, we summarize the most recent developments in various eHealth platforms and their relevance to the speciality of allergy and immunology, from the point of view of three major stakeholders: clinicians, patients and researchers.

Opportunities and Challenges of Telehealth in Disease Management during COVID-19 Pandemic: A Scoping Review

OBJECTIVE

The novel coronavirus disease 2019 (COVID-19) pandemic is an unexpected universal problem that has changed health care access across the world. Telehealth is an effective solution for health care delivery during disasters and public health emergencies. This study was conducted to summarize the opportunities and challenges of using telehealth in health care delivery during the COVID-19 pandemic.

METHODS

A structured search was performed in the Web of Science, PubMed, Science Direct, and Scopus databases, as well as the Google Scholar search engine, for studies published until November 4, 2020. The reviewers analyzed 112 studies and identified opportunities and challenges. This review followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) protocols. Quality appraisal was done according to the Mixed Methods Appraisal Tool (MMAT) version 2018. Thematic analysis was applied for data analysis.

RESULTS

A total of 112 unique opportunities of telehealth application during the pandemic were categorized into 4 key themes, such as (1) clinical, (2) organizational, (3) technical, and (4) social, which were further divided into 11 initial themes and 26 unique concepts. Furthermore, 106 unique challenges were categorized into 6 key themes, such as (1) legal, (2) clinical, (3) organizational, (40 technical, (5) socioeconomic, and (6) data quality, which were divided into 16 initial themes and 37 unique concepts altogether. The clinical opportunities and legal challenges were the most frequent opportunities and challenges, respectively.

CONCLUSION

The COVID-19 pandemic significantly accelerated the use of telehealth. This study could offer useful information to policymakers about the opportunities and challenges of implementing telehealth for providing accessible, safe, and efficient health care delivery to the patient population during and after COVID-19. Furthermore, it can assist policymakers to make informed decisions on implementing telehealth in response to the COVID-19 pandemic by addressing the obstacles ahead.

Speech-Language Pathology and Audiology in South Africa: Clinical Training and Service in the Era of COVID-19

INTRODUCTION AND PURPOSE

The novel coronavirus (COVID-19) presented new and unanticipated challenges to the provision of clinical services, from student training to the care of patients with speech-language and hearing (SLH) disorders. Prompt changes in information and communication technologies (ICT), were required to ensure that clinical training continued to meet the Health Professions Council of South Africa's regulations and patients received effective clinical care. The purpose of this study was to investigate online clinical training and supervision to inform current and future training and clinical care provision in SLH professions.

METHODOLOGY

A scoping review was conducted using the Arksey and O'Malley (2005) framework. The electronic bibliographic databases Science Direct, PubMed, Scopus, MEDLINE, and ProQuest were searched to identify publications about online clinical training and supervision and their impact on clinical service during COVID-19. Selection and analysis were performed by three independent reviewers using pretested forms.

RESULTS AND CONCLUSIONS

The findings revealed important benefits of teletraining and telepractice with potential application to South African clinical training and service provision. Five themes emerged: (1) practice produces favorable outcomes, (2) appreciation for hybrid models of training and service delivery, (3) cost effectiveness is a "big win" (4) internationalization of remote clinical training and service provision, and (5) comparable modality outcomes. These findings may have significant implications for teletraining and telepractice in low-and-middle income countries (LMICs) in the COVID-19 era and beyond, wherein demand versus capacity challenges (e.g., in human resources) persist. Current findings highlight the need for SLH training programmes to foster a hybrid clinical training model. Few studies were conducted in LMICs, indicating a gap in such research.

Impact of Rapid Transition to Telemedicine-Based Delivery on Allergy/Immunology Care During COVID-19

BACKGROUND

Coronavirus disease 2019 (COVID-19) necessitated wide-scale adoption of telemedicine (TM) and restriction of in-person care. The impacts on allergy/immunology (A/I) care delivery are still being studied.

OBJECTIVE

To describe the outcomes of rapid transition to TM-based care (video visit followed by in-person visits dedicated to diagnostic and therapeutic procedures when needed) at an academic A/I practice during COVID-19.

METHODS

Demographic data were compared for patients originally scheduled for in-person visits between March 10, 2020, and April 30, 2020, who completed a video visit instead between March 10, 2020, and June 30, 2020, and those who did not. Appointment completion, diagnoses, and drug allergy and skin testing completion were compared for visits between March 10, 2020, and June 30, 2020, and 1 year prior (March 10, 2019-June 30, 2019).

RESULTS

Sixty-nine percent (265 of 382) of patients originally scheduled between March 10, 2020, and April 30, 2020, were able to complete video visits. Patients who completed video visits were more likely to be white (52% vs 33%; P < .001), English-speaking (96% vs 89%; P = .01), and privately insured (70% vs 54%; P = .004). With TM-based care compared with in-person care, there were significant decreases in environmental and food skin testing completion rates (91% and 92% in 2019 vs 60% and 64% in 2020, respectively, P < .001). Drug allergy testing completed after internal referral remained low but comparable (51% in 2019 vs 52% in 2020). Transitioning nonprocedural visits to video allowed allergen immunotherapy and biologic injection visits to resume at a volume similar to pre-COVID. No COVID-19 infections resulted from in-clinic exposure.

CONCLUSIONS

Although transitioning to TM-based care allowed continued A/I care delivery, strategies are needed to achieve higher testing completion rates and ensure video visits do not exacerbate existing health disparities.

Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review (Preprint).. [DOI: 10.2196/preprints.29136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

Technologies have been extensively implemented to provide health care services for all types of clinical conditions during the COVID-19 pandemic. While several reviews have been conducted regarding technologies used during the COVID-19 pandemic, they were limited by focusing either on a specific technology (or features) or proposed rather than implemented technologies.

OBJECTIVE

This review aims to provide an overview of technologies, as reported in the literature, implemented during the first wave of the COVID-19 pandemic.

METHODS

We conducted a scoping review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. Studies were retrieved by searching 8 electronic databases, checking the reference lists of included studies and relevant reviews (backward reference list checking), and checking studies that cited included studies (forward reference list checking). The search terms were chosen based on the target intervention (ie, technologies) and the target disease (ie, COVID-19). We included English publications that focused on technologies or digital tools implemented during the COVID-19 pandemic to provide health-related services regardless of target health condition, user, or setting. Two reviewers independently assessed the eligibility of studies and extracted data from eligible papers. We used a narrative approach to synthesize extracted data.

RESULTS

Of 7374 retrieved papers, 126 were deemed eligible. Telemedicine was the most common type of technology (107/126, 84.9%) implemented in the first wave of the COVID-19 pandemic, and the most common mode of telemedicine was synchronous (100/108, 92.6%). The most common purpose of the technologies was providing consultation (75/126, 59.5%), followed by following up with patients (45/126, 35.7%), and monitoring their health status (22/126, 17.4%). Zoom (22/126, 17.5%) and WhatsApp (12/126, 9.5%) were the most commonly used videoconferencing and social media platforms, respectively. Both health care professionals and health consumers were the most common target users (103/126, 81.7%). The health condition most frequently targeted was COVID-19 (38/126, 30.2%), followed by any physical health conditions (21/126, 16.7%), and mental health conditions (13/126, 10.3%). Technologies were web-based in 84.1% of the studies (106/126). Technologies could be used through 11 modes, and the most common were mobile apps (86/126, 68.3%), desktop apps (73/126, 57.9%), telephone calls (49/126, 38.9%), and websites (45/126, 35.7%).

CONCLUSIONS

Technologies played a crucial role in mitigating the challenges faced during the COVID-19 pandemic. We did not find papers describing the implementation of other technologies (eg, contact-tracing apps, drones, blockchain) during the first wave. Furthermore, technologies in this review were used for other purposes (eg, drugs and vaccines discovery, social distancing, and immunity passport). Future research on studies on these technologies and purposes is recommended, and further reviews are required to investigate technologies implemented in subsequent waves of the pandemic.

Drug Allergy Labels Lost in Translation: From Patient to Charts and Backwards

The current method of defining, reporting, assessment, labeling, delabeling, and reconciliation of adverse drug reactions (ADRs), and specifically immunologically mediated drug hypersensitivity reactions (HSRs), in electronic health records (EHRs) is inadequate and compromises care quality and safety. It is critical to accurately and succinctly report the signs and symptoms associated with ADRs and suspected HSRs to enable clinicians to determine the plausible reaction type and help guide appropriate future management plans. Despite the current limitations of the EHR allergy module, we must encourage improved clinical documentation and demand technological improvements. Telehealth methods have been shown to be valuable in the assessment of ADRs and HSRs, particularly in the case of penicillin allergy evaluation and delabeling. The implementation, assessment, and refinement of advanced technologies, including clinical informatics and artificial intelligence, along with continued education of health care providers have potential to improve EHR documentation and communication, thereby advancing patient safety efforts.

Patient Satisfaction with In-Person, Video, and Telephone Allergy/Immunology Evaluations During the COVID-19 Pandemic

BACKGROUND

The SarsCoV2, novel coronavirus (COVID-19) pandemic necessitated a rapid transition from in-person evaluations to remote delivery of care, including both video and telephone visits, in allergy/immunology practices.

OBJECTIVE

To evaluate patient satisfaction, patient and physician impression of encounter completeness, and reimbursement between in-person, video, and telephone encounters. This study also assessed factors influencing patient satisfaction, perception of completeness, and choice of future evaluation type.

METHODS

This was a prospective study of all encounters at a health care-system owned practice. Encounter type, encounter modality, patient demographics, primary diagnoses, reimbursement data, and physician assessment of encounter completeness were tracked. Patient satisfaction was assessed via standardized questions.

RESULTS

There were 447 encounters, with 303 in-person (67.8%), 98 video (21.9%), and 46 telephone (10.3%). Patient satisfaction data was obtained from 251 patients. There was similar patient satisfaction among all encounter modalities. Both patients and physicians were more likely to deem an in-person encounter as complete. Physicians were more likely to report an in-person encounter to be complete for food allergy (P < .001) and chronic rhinitis (P = .001) compared with video or telephone, whereas patients reported in-person encounters for food allergy to be complete compared with other modalities (P = .002). Patients reported that future encounter types should depend on the clinical situation.

CONCLUSIONS

There was similar patient satisfaction with in-person, video, and telephone encounters in an allergy/immunology practice during the COVID-19 pandemic. Chronic rhinitis and food allergy are more likely to call for an in-person evaluation. New patient visits are likely to be the highest yield to focus on for in-person evaluations.