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Karabulut I, Demirdogen SO, Ramazanoglu MA, Sam E, Cinislioglu AE, Al S, Altay MS, Yilmazel FK, Bicaklioglu F, Aydin HR, Adanur S. Desires and attitudes of outpatients and physicians regarding the use of teleurology during the pandemic: a prospective survey study. Aktuelle Urol 2024; 55:430-438. [PMID: 35172348 DOI: 10.1055/a-1648-2146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE It is not known to date how many patients admitted to urology outpatient clinics are willing to use telemedicine. We aimed to investigate knowledge levels and attitudes concerning the utilization of teleurology by patients applying to urology outpatient clinics. METHODS This prospective multicentre survey study included 334 patients aged 18-65 years who applied to an urology outpatient clinics. The patients were asked questions about their attitudes and expectations regarding teleurology. Diseases were divided into seven subgroups due to the broad spectrum of diagnoses. Physicians' and patients' opinions on whether it was possible to manage the current medical condition via teleurology were recorded. RESULTS 69.5% of patients stated that they had sufficient technical skills to use teleurology by themselves for medical examination. 55.4% of patients and 78.4% of physicians responded that the existing complaints were suitable for teleurology. Both patients and physicians deemed genital system diseases and urinary tract infections suitable for teleurology (p<0.001, p<0.001 for physicians, and p<0.001, p<0.001 for patients), whereas urine transport, storage and emptying disorders (p=0.003) and benign prostatic hyperplasia (p=0.029) were deemed to be suitable for teleurology only by the physicians. CONCLUSION Our study shows that (i) the majority of our patient population has a telecommunications infrastructure suitable for teleurology, (ii) teleurology has aroused interest among patients, particularly during the pandemic period, and (iii) physicians and patients have high expectations that the problem can be solved with teleurology in suitable patients.
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Affiliation(s)
- Ibrahim Karabulut
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Saban Oguz Demirdogen
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Mehmet Akif Ramazanoglu
- Urology, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Emre Sam
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Ahmet Emre Cinislioglu
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Salih Al
- Urology, Ataturk University Faculty of Medicine, Ezurum, Turkey
| | - Mehmet Sefa Altay
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Fatih Kursat Yilmazel
- Urology, University of Health Sciences, Regional Training and Research Hospital, Erzurum, Turkey
| | - Fatih Bicaklioglu
- Urology, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Hasan Riza Aydin
- Urology, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Senol Adanur
- Urology, Ataturk University Faculty of Medicine, Ezurum, Turkey
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Khera M, Bernie HL, Broderick G, Carrier S, Faraday M, Kohler T, Jenkins L, Watter D, Mulhall J, Raheem O, Ramasamy R, Rubin R, Spitz A, Yafi F, Sadeghi-Nejad H. Sexual Medicine Society of North America (SMSNA)/American Urological Association (AUA) telemedicine and men's health white paper. J Sex Med 2024; 21:318-332. [PMID: 38430132 DOI: 10.1093/jsxmed/qdad151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 03/03/2024]
Abstract
PURPOSE The purpose of this white paper is to educate health care professionals about the evolution of telemedicine (TM) and to propose a hybrid model that leverages the strengths of traditional in-person medicine as well as virtual medicine while maximizing the safety and quality of men's sexual health care. LITERATURE SEARCH STRATEGY A literature search focused on the use of TM in urology and men's health was performed through PubMed/MEDLINE, Embase, and Web of Science (January 1, 2012-April 26, 2022). Keywords included all known permutations of the terminology used to refer to virtual health, care as well as the terminology used to refer to urologic diseases, issues specific to men's health, and men's sexual health concerns. Publications that emerged after the literature search that met this criterion also were incorporated. Opinion pieces, letters to the editor, meeting abstracts, and conference proceedings were excluded. Additional resources were retrieved, such as governmental technical reports, legislative updates and reviews, and blogs. This search strategy yielded 1684 records across databases after removal of duplicates. Abstracts from the retrieved records were reviewed for relevance. Relevant publications were defined as those that reported data on any aspect of TM use specific to urology, men's health, and/or men's sexual health. If relevance was unclear from the abstract, then the full text of the article was retrieved for a more detailed review. In addition, the published evidence-based practice guidelines relevant to care for erectile dysfunction, Peyronie's disease, ejaculatory dysfunction, and hypogonadism were retrieved. The most common reasons for article exclusions were a focus on TM use in disciplines other than urology and the absence of data (ie, opinion pieces). After exclusions, a total of 91 publications remained and constituted the evidence base for this paper.
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Affiliation(s)
- Mohit Khera
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Helen L Bernie
- Department of Urology, Indiana University, Indianapolis, IN 46202, United States
| | - Gregory Broderick
- Department of Urology, Mayo Clinic Alix School of Medicine, Jacksonville, Florida 32224, United States
| | - Serge Carrier
- Surgical Department /Urology Division, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Martha Faraday
- Four Oaks Consulting, Berryville, VA 22611, United States
| | - Tobias Kohler
- Department of Urology, Mayo Clinic, Rochester, MN 55905, United States
| | - Lawrence Jenkins
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112, United States
| | - Daniel Watter
- Morris Psychological Group, P.A., Parsippany, NJ 07054, United States
| | - John Mulhall
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10022, United States
| | - Omer Raheem
- Section of Urology, Department of Surgery, University of Chicago, Chicago, IL 60637, United States
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL 33136, United States
| | - Rachel Rubin
- Department of Urology, Georgetown University, Washington, DC 20007, United States
| | - Aaron Spitz
- Orange County Urology Associates, Laguna Hills, California, CA 92653, United States
| | - Faysal Yafi
- Department of Urology, University of California Irvine, CA 92660, United States
| | - Hossein Sadeghi-Nejad
- Department of Urology, NYU Langone Grossman School of Medicine, New York, NY 10017, United States
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Kim AE, Anderson-Bialis J, Citro L, Gracia CR. Patient satisfaction with telemedicine and in-person visits in reproductive endocrinology and infertility clinics. Reprod Biomed Online 2023; 47:103286. [PMID: 37619518 DOI: 10.1016/j.rbmo.2023.103286] [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] [Received: 03/01/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 08/26/2023]
Abstract
RESEARCH QUESTION Is patient satisfaction higher with telemedicine visits or in-person visits for an initial consultation in the ambulatory fertility setting? DESIGN A survey study of fertility patients who had an initial consultation visit between January 2018 and September 2022 was conducted using a nationally distributed survey. Patient satisfaction and other outcomes pertaining to patient experience were compared between telemedicine and in-person visits. RESULTS In total, 682 participants completed the survey nationwide; of these, 425 respondents had an in-person visit and 257 respondents had a telemedicine visit. Age, geographic region, race, education level, employment status, income level and marital status did not differ between the groups. Overall, 69.6% of participants were satisfied with telemedicine visits, with improvement in partner participation. More patients were satisfied with in-person visits compared with telemedicine visits (82.6% versus 69.6%, P<0.001), and more patients preferred in-person visits to telemedicine visits regardless of the type of appointment they had for their initial visit. In a subgroup analysis of patients seen during the coronavirus disease 2019 pandemic, patients who had telemedicine visits were younger, more likely to be White, more educated and had a higher income compared with patients who had in-person visits. CONCLUSIONS Previously, the impact of telemedicine in the fertility setting was largely unknown. This study demonstrated that the majority of patients were satisfied with health care through telemedicine visits. However, patients were more satisfied with in-person visits, and preferred in-person visits to telemedicine visits. Further studies are needed to help clarify the differences in patient satisfaction with visit type, and to assess the role of telemedicine in future fertility care.
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Affiliation(s)
- Anne E Kim
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | | | - Lauren Citro
- FertilityIQ, 2443 Fillmore Street #133, San Francisco, CA 94115, USA
| | - Clarisa R Gracia
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Saeedi S, Ghazisaeedi M, Ebrahimi M, Seifpanahi MS, Bouraghi H. The willingness and attitudes of speech-language pathologists towards the use of mobile health technology: a survey study. BMC Health Serv Res 2023; 23:336. [PMID: 37016337 PMCID: PMC10071768 DOI: 10.1186/s12913-023-09339-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/25/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) technology could be used in different ways to treat various speech and language disorders. The attitude of speech-language pathologists (SLPs) towards this technology and their willingness to use it can play a significant role in the success of the therapies they provide. This study was conducted to investigate the willingness and attitude of SLPs towards the use of mHealth technology. METHODS This cross-sectional study was conducted from September 2021 to April 2022 in Iran. A researcher-made questionnaire consisting of three parts (information related to demographic variables, attitude and willingness) was designed based on the past studies, and then given to all SLPs throughout Iran. Data were analyzed by SPSS software, using descriptive and inferential statistics (frequency, mean, Fisher's exact test, and analysis of variance). Also, the SLPs' willingness to use the desired technology was interpreted as a percentage as follows: 0-20% = not at all willing, 21-40% = slightly willing, 41-60% = moderately willing, 61-80% = highly willing, and above 80% = extremely willing. RESULTS One hundred sixty speech-language pathologists from all over Iran participated in this study. The results showed that the willingness of 65.25% of SLPs to use the mentioned technology was at a good level, and according to the mentioned category, they had a high willingness to use this technology. In regard to the attitude of SLPs, the findings showed that SLPs believed that patients receive a higher quality of care during in-person visits than through mHealth technology. Also, this survey showed that SLPs were more inclined to use this technology to answer patients' questions. Non-payment of services provided through mHealth technology and privacy concerns were the reasons for the lack of use of this technology by SLPs. CONCLUSIONS SLPs are willing to use mHealth technology after solving the related challenges, including payment of costs and privacy concerns. However, SLPs believed that this technology will not be a suitable alternative to face-to-face sessions.
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Affiliation(s)
- Soheila Saeedi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marjan Ghazisaeedi
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Ebrahimi
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad-Sadegh Seifpanahi
- Department of Speech and Language Pathology, Autism Spectrum Disorders Research Center, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Hamid Bouraghi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
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Naik N, Hameed BMZ, Nayak SG, Gera A, Nandyal SR, Shetty DK, Shah M, Ibrahim S, Naik A, Kamath N, Mahdaviamiri D, D'costa KK, Rai BP, Chlosta P, Somani BK. Telemedicine and Telehealth in Urology-What Do the 'Patients' Think About It? Front Surg 2022; 9:863576. [PMID: 35495745 PMCID: PMC9051070 DOI: 10.3389/fsurg.2022.863576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/14/2022] [Indexed: 01/08/2023] Open
Abstract
Telemedicine is the delivery of healthcare to patients who are not in the same location as the physician. The practice of telemedicine has a large number of advantages, including cost savings, low chances of nosocomial infection, and fewer hospital visits. Teleclinics have been reported to be successful in the post-surgery and post-cancer therapy follow-up, and in offering consulting services for urolithiasis patients. This review focuses on identifying the outcomes of the recent studies related to the usage of video consulting in urology centers for hematuria referrals and follow-up appointments for a variety of illnesses, including benign prostatic hyperplasia (BPH), kidney stone disease (KSD), and urinary tract infections (UTIs) and found that they are highly acceptable and satisfied. Certain medical disorders can cause embarrassment, social exclusion, and also poor self-esteem, all of which can negatively impair health-related quality-of-life. Telemedicine has proven beneficial in such patients and is a reliable, cost-effective patient-care tool, and it has been successfully implemented in various healthcare settings and specialties.
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Affiliation(s)
- Nithesh Naik
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
| | - B. M. Zeeshan Hameed
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Department of Urology, Father Muller Medical College, Mangalore, India
| | - Sanjana Ganesh Nayak
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Anshita Gera
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | | | - Dasharathraj K. Shetty
- Department of Humanities and Management, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Milap Shah
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Robotics and Urooncology, Max Hospital and Max Institute of Cancer Care, New Delhi, India
| | - Sufyan Ibrahim
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Aniket Naik
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Nagaraj Kamath
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Delaram Mahdaviamiri
- Manipal College of Pharmaceutical Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Kenisha Kevin D'costa
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Bhavan Prasad Rai
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University in Krakow, Kraków, Poland
| | - Bhaskar K. Somani
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
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6
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Nourian A, Smith N, Kleinman L, Boxer R, Shelton JB. A 5-Year Single-Institution Experience Integrating Telehealth Into Urologic Care Delivery. Telemed J E Health 2021; 27:997-1002. [DOI: 10.1089/tmj.2020.0267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alex Nourian
- Department of Urology, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
- Department of Urology, University of California, Los Angeles, Los Angeles, California, USA
| | - Nicholas Smith
- Department of Urology, University of California, Los Angeles, Los Angeles, California, USA
| | - Leonard Kleinman
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Richard Boxer
- Department of Urology, University of California, Los Angeles, Los Angeles, California, USA
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Jeremy B. Shelton
- Department of Urology, University of California, Los Angeles, Los Angeles, California, USA
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
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Shin C, Allen AZ, Zhu D, Tellechea L, Watts KL, Abraham NE. Patient satisfaction and savings, and clinical outcomes of televisits in female pelvic medicine and reconstructive surgery at an urban academic center. Neurourol Urodyn 2021; 40:1834-1844. [PMID: 34342368 DOI: 10.1002/nau.24759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/03/2021] [Accepted: 07/15/2021] [Indexed: 12/19/2022]
Abstract
AIM To evaluate patient satisfaction and savings, and compare visit outcomes based on chief complaint (CC) of women presenting for a televisit to a female pelvic medicine and reconstructive surgery (FPMRS) clinic at an urban academic center. METHODS A cross-sectional study of women completing a televisit with an FPMRS specialist at our institution from June 19, 2020 to July 17, 2020 was conducted. A telephone questionnaire was administered to patients to assess satisfaction and savings (travel costs/time avoided). Electronic medical records were reviewed to collect patient demographics and comorbidities, CC, and televisit outcomes (e.g., face-to-face (F2F) exam scheduled, orders placed). Logistic regression was used to analyze predictors of satisfaction and need for F2F follow-up. RESULTS One hundred eighty-seven of 290 (64.5%) women called completed the survey, of whom 168 (89.8%) were satisfied with their televisit. Eighty-eight (48.1%) saved at least an hour and 54 (28.9%) saved more than $25 on transportation. There were no significant associations between patient characteristics, CC, or televisit outcomes and satisfaction. Ninety-nine (52.9%) televisits resulted in F2F follow-up, with CC of prolapse (odds ratio [OR] = 4.2 (1.7-10.3); p = 0.002), new patient (OR = 2.2 (1.2-4.2); p = 0.01), and Hispanic ethnicity (OR = 3.9 (1.2-13.6); p=.03) as significant predictors. CONCLUSION Most patients were satisfied with FPMRS televisits at our urban academic center. Televisits resulted in patient travel time and cost savings. Women presenting with prolapse and for new patient visits would likely benefit from initial F2F visits instead of televisits. Televisits are an important mode of health care and in some cases can replace F2F visits.
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Affiliation(s)
- Christina Shin
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ariel Z Allen
- Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Urology, Montefiore Medical Center, Bronx, New York, USA
| | - Denzel Zhu
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Laura Tellechea
- Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Bronx, New York, USA
| | - Kara L Watts
- Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Urology, Montefiore Medical Center, Bronx, New York, USA
| | - Nitya E Abraham
- Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Urology, Montefiore Medical Center, Bronx, New York, USA
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Checcucci E, De Luca S, Alessio P, Verri P, Granato S, De Cillis S, Amparore D, Sica M, Piramide F, Piana A, Volpi G, Manfredi M, Balestra G, Autorino R, Fiori C, Porpiglia F. Implementing telemedicine for the management of benign urologic conditions: a single centre experience in Italy. World J Urol 2021; 39:3109-3115. [PMID: 33385246 PMCID: PMC7775638 DOI: 10.1007/s00345-020-03536-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/19/2020] [Indexed: 02/01/2023] Open
Abstract
PURPOSE To assess the use of telemedicine with phone-call visits as a practical tool to follow-up with patients affected by urological benign diseases, whose clinic visits had been cancelled during the acute phase of the COVID-19 pandemic. METHODS Patients were contacted via phone-call and a specific questionnaire was administered to evaluate the health status of these patients and to identify those who needed an "in-person" ambulatory visit due to the worsening of their condition. Secondarily, the patients' perception of a potential shift towards a "telemedicine" approach to the management of their condition and to indirectly evaluate their desire to return to "in-person" clinic visits. RESULTS 607 were contacted by phone-call. 87.5% (531/607) of the cases showed stability of the symptoms so no clinic in-person or emergency visits were needed. 81.5% (495/607) of patients were more concerned about the risk of contagion than their urological condition. The median score for phone visit comprehensibility and ease of communication of exams was 5/5; whilst patients' perception of phone visits' usefulness was scored 4/5. 53% (322/607) of the interviewees didn't own the basic supports required to be able to perform a real telemedicine consult according to the required standards. CONCLUSION Telemedicine approach limits the number of unnecessary accesses to medical facilities and represents an important tool for the limitation of the risk of transmission of infectious diseases, such as COVID-19. However, infrastructures, health workers and patients should reach out to a computerization process to allow a wider diffusion of more advanced forms of telemedicine, such as televisit.
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Affiliation(s)
- Enrico Checcucci
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
- Uro-technology and SoMe Working Group of the Young Academic Urologists (YAU) Working Party of the European Association of Urology (EAU), Arnhem, The Netherlands.
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.
| | - Stefano De Luca
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Paolo Alessio
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Paolo Verri
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Stefano Granato
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Sabrina De Cillis
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Daniele Amparore
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Michele Sica
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Federico Piramide
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Alberto Piana
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Gabriele Volpi
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Matteo Manfredi
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Gabriella Balestra
- Department of Electronics and Telecommunications, Polytechnic University of Turin, Turin, Italy
| | | | - Cristian Fiori
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
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Andino J, Zhu A, Chopra Z, Daignault-Newton S, Ellimoottil C, Dupree JM. Video Visits are Practical for the Follow-up and Management of Established Male Infertility Patients. Urology 2021; 154:158-163. [PMID: 34022261 PMCID: PMC9752825 DOI: 10.1016/j.urology.2021.03.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/15/2021] [Accepted: 03/31/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study the use of video visits for male infertility care prior to the COVID-19 pandemic METHODS: We reviewed video visits for male infertility patients completed at a tertiary academic center in southeast Michigan. These patients had follow-up after an initial in-person evaluation. We designed this retrospective case series to describe the diagnostic categories seen through telehealth, management steps completed during video visits, and to understand whether additional in-person care was required within 90 days of video visits. In addition, we estimated time and cost savings for patients attributed to video visits. RESULTS Most men seen during video visits had an endocrinologic (29%) or anatomic (21%) cause for their infertility. 73% of video visits involved reviewing results; 30% included counseling regarding assistive reproductive technologies; and 25% of video visits resulted in prescribing hormonally active medications. The two patients (3%) who were seen in clinic after their video visit underwent a varicocelectomy in the interim. No patients required an unplanned in-person visit. From a patient perspective, video visits were estimated to save a median of 97 minutes (IQR 64-250) of travel per visit. Median cost savings per patient- by avoiding travel and taking time off work for a clinic visit-were estimated to range from $149 (half day off) to $252 (full day off). CONCLUSION Video visits for established male infertility patients were used to manage different causes of infertility while saving patients time and money. Telehealth for established patients did not trigger additional in-person evaluations.
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Affiliation(s)
- Juan Andino
- Michigan Medicine Department of Urology, Ann Arbor, MI.
| | - Alex Zhu
- Michigan Medicine Department of Urology, Ann Arbor, MI
| | - Zoey Chopra
- University of Michigan Medical School, Ann Arbor, MI
| | | | - Chad Ellimoottil
- Michigan Medicine Department of Urology, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, Ann Arbor, MI
| | - James M Dupree
- Michigan Medicine Department of Urology, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, Ann Arbor, MI
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10
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Allen AZ, Zhu D, Shin C, Glassman DT, Abraham N, Watts KL. Patient Satisfaction with Telephone Versus Video-Televisits: A Cross-Sectional Survey of an Urban, Multiethnic Population. Urology 2021; 156:110-116. [PMID: 34333039 DOI: 10.1016/j.urology.2021.05.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/16/2021] [Accepted: 05/28/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine differences between telephone and video-televisits and identify whether visit modality is associated with satisfaction in an urban, academic general urology practice. METHODS A cross sectional analysis of patients who completed a televisit at our urology practice (summer 2020) was performed. A Likert-based satisfaction telephone survey was offered to patients within 7 days of their televisit. Patient demographics, televisit modality (telephone vs video), and outcomes of the visit (eg follow-up visit scheduled, orders placed) were retrospectively abstracted from each chart and compared between the telephone and video cohorts. Multivariate regression analysis was used to evaluate variables associated with satisfaction while controlling for potential confounders. RESULTS A total of 269 patients were analyzed. 73% (196/269) completed a telephone televisit. Compared to the video cohort, the telephone cohort was slightly older (mean 58.8 years vs. 54.2 years, P = .03). There were no significant differences in the frequency of orders placed for medication changes, labs, imaging, or for in-person follow-up visits within 30 days between cohorts. Survey results showed overall 84.7% patients were satisfied, and there was no significant difference between the telephone and video cohorts. Visit type was not associated with satisfaction on multivariable analyses, while use of an interpreter [OR:8.13 (1.00-65.94); P = .05], labs ordered [OR:2.74 (1.12-6.70); P = .03] and female patient gender [OR:2.28 (1.03-5.03); P = .04] were significantly associated with satisfaction. CONCLUSION Overall, most patients were satisfied with their televisit. Additionally, telephone- and video-televisits were similar regarding patient opinions, patient characteristics, and visit outcome. Efforts to increase access and coverage of telehealth, particularly telephone-televisits, should continue past the COVID-19 pandemic.
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Affiliation(s)
| | - Denzel Zhu
- Albert Einstein College of Medicine, Bronx, NY
| | | | | | - Nitya Abraham
- Albert Einstein College of Medicine, Bronx, NY; Department of Urology, Montefiore Medical Center, Bronx, NY; Department of Gynecology, Urogynecology Division, Montefiore Medical Center, Bronx, NY
| | - Kara L Watts
- Albert Einstein College of Medicine, Bronx, NY; Department of Urology, Montefiore Medical Center, Bronx, NY.
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11
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Shiff B, Frankel J, Oake J, Blachman-Braun R, Patel P. Patient Satisfaction With Telemedicine Appointments in an Academic Andrology-focused Urology Practice During the COVID-19 Pandemic. Urology 2021; 153:35-41. [PMID: 33450281 PMCID: PMC9754887 DOI: 10.1016/j.urology.2020.11.065] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/10/2020] [Accepted: 11/29/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate patient satisfaction with telemedicine appointments as an alternative to in-person appointments at an Andrology-focused academic urology practice during the coronavirus disease 2019 pandemic. METHODS Between March and June 2020, all appointments at the practice of a single Andrology-focused academic urologist were conducted by telephone. Consecutive patients were contacted by telephone following their appointment to complete a telephone questionnaire. Baseline demographic information was obtained, and perceptions regarding telephone appointments were assessed using a Likert scale. RESULTS Ninety-six patients completed the telephone questionnaire. Median age was 48.5 years (interquartile range 37.3-62.8 years) with 55 of 96 (57.3%) of the appointments Andrology-focused. Mean distance of residence from the hospital was 8.4 km (interquartile range 4.7-25.2 km). Only 9 of 96 (9.3%) of the patients felt that the telephone format did not adequately address their needs. However, 26 of 96 (27.1%) of patients said they would prefer an in-person appointment. On multivariable analysis adjusting for age, gender, presenting complaint, type of appointment, education level, and employment status, no factors were associated with feeling that the telephone appointment adequately addressed needs or preference for an in-person appointment in the future. CONCLUSION Patients were generally satisfied with telephone appointments as an alternative to in-person appointments during the coronavirus disease 2019 pandemic. Nonetheless, a substantial portion of patients said they would prefer in-person appointments in the future.
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Affiliation(s)
- Benjamin Shiff
- Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jed Frankel
- Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Justin Oake
- Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Premal Patel
- Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada.
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12
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Margolin EJ, Pina Martina LA, Miles CH, Wenske S, McKiernan JM, DeCastro GJ, Hyams ES, Drake CG, Lim EA, Stein MN, Deutsch I, Anderson CB. Telemedicine in management of genitourinary malignancies: Patient and physician perspectives. Urol Oncol 2021; 39:480-486. [PMID: 34092480 DOI: 10.1016/j.urolonc.2021.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/22/2021] [Accepted: 04/01/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE The rapid expansion of telemedicine has presented a challenge for the care of patients with genitourinary malignancies. We sought to assess patient and physician perspectives on the use of telemedicine for genitourinary cancer care. METHODS We conducted a prospective cross-sectional study of patients who had telemedicine visits with urology, medical oncology, or radiation oncology for management of genitourinary malignancies from July-August 2020. Patients and physicians each received a questionnaire regarding the telemedicine experience. Responses were scored on a 5-point Likert scale. The primary outcomes of the study were patient and physician satisfaction. RESULTS Of the 115 patients who enrolled, we received 96 patient responses and 46 physician responses. Overall, 77% of patients and 70% of physicians reported being "extremely satisfied" with the telemedicine encounter. Satisfaction was high among all components of the encounter including patient-physician communication, counseling, shared decision making, time spent, timeliness and efficiency, and convenience. Additionally, 78% of patients and 85% of physicians "strongly agreed" that they were able to discuss sensitive topics about cancer care as well as they could at an in-person visit. Nine telemedicine visits (9%) encountered technological barriers. Technological barriers were associated with lower overall satisfaction scores among both patients and physicians (p ≤ 0.01). CONCLUSION We observed high levels of patient and physician satisfaction for telemedicine visits for management of genitourinary malignancies. Technological barriers were encountered by 9% of patients and were associated with decreased satisfaction.
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Affiliation(s)
- Ezra J Margolin
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Luis A Pina Martina
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Caleb H Miles
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY
| | - Sven Wenske
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - James M McKiernan
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - G Joel DeCastro
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Elias S Hyams
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Charles G Drake
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Emerson A Lim
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Mark N Stein
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Israel Deutsch
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
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13
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Efthymiadis A, Hart EJ, Guy AM, Harry R, Mahesan T, Chedid WA, Uribe-Lewis S, Perry MJ. Are telephone consultations the future of the NHS? The outcomes and experiences of an NHS urological service in moving to telemedicine. Future Healthc J 2021; 8:e15-e20. [PMID: 33791468 DOI: 10.7861/fhj.2020-0076] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective To evaluate urology patient satisfaction with telephone consultations during the COVID-19 pandemic. Methods All patients who received a telephone appointment in a 1-month period were invited to complete a questionnaire. An adaption of the Telehealth Satisfaction Scale (TeSS) was used. Patient responses were compared based on type of clinic, age and gender. Results 119 questionnaires were completed. The majority of responses to the adapted TeSS (Q1-7) were graded as 'Excellent', ranging from 79 (66%) to 112 (94%). 'Agree' responses ranged from 92 (77%) to 117 (98%) for questions (Q8-12), indicating high satisfaction. Patients consulted in post radical prostatectomy and PSA surveillance clinics gave a significantly greater number of 'Excellent' or 'Agree' responses. Older age was associated with a significantly greater number of 'Agree' responses to one item only. Responses were not affected by gender. Conclusion Our study demonstrates high overall satisfaction with the use of telephone consultations among urology patients. For some patients, telephone consultations are more suitable and may be utilised more frequently in the future. However, it is clear that in selected cases face-to-face consultations are required for safe, comprehensive clinical assessment.
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14
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Kirshenbaum E, Rhee EY, Gettman M, Spitz A. Telemedicine in Urology: The Socioeconomic Impact. Urol Clin North Am 2021; 48:215-222. [PMID: 33795055 DOI: 10.1016/j.ucl.2021.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The emergence of the COVID-19 pandemic and subsequent public health emergency (PHE) have propelled telemedicine several years into the future. With the rapid adoption of this technology came socioeconomic inequities as minority communities disproportionately have yet to adopt telemedicine. Telemedicine offers solutions to patient access issues that have plagued urology, helping address physician shortages in rural areas and expanding the reach of urologists. The Centers for Medicare & Medicaid Services have adopted changes to expand coverage for telemedicine services. The expectation is that telemedicine will continue to be a mainstay in the health care system with gradual expansion in utilization.
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Affiliation(s)
- Eric Kirshenbaum
- Uropartners, Suite 312, 1475 E Belvidere Rd, Grayslakle, IL 60030, USA.
| | - Eugene Y Rhee
- Kaiser Permanente Urology, 4405 Vandever Ave, San Diego, CA 92120, USA; Urology, Permanente Federation
| | - Matthew Gettman
- Mayo Clinic Department of Urology, 200 First Street SW, Rochester, MN 55905, USA
| | - Aaron Spitz
- Orange County Urology, 23961 Calle De La Magdalena, Laguna Hills, CA 92653, USA
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15
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[COVID-19 in urology : Influence of the pandemic on telemedicine, education and surgery]. Urologe A 2021; 60:301-305. [PMID: 33533961 PMCID: PMC7856848 DOI: 10.1007/s00120-021-01451-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 11/12/2022]
Abstract
Die COVID-19-Pandemie („coronavirus disease 2019“) hat weltweit zu wirtschaftlichen und klinischen Katastrophen geführt. In den Hochphasen mit hohen Infektionsraten verlagerte sich der klinische Alltag in den Notfallbereich und betrifft alle Fachbereiche und somit auch die Urologie. Es ist ein schmaler Grat zwischen Verschiebung einer Operation, um das Risiko einer möglichen Infektion der Patienten zu minimieren und gleichzeitig das Ergebnis der Behandlung nicht negativ zu beeinflussen. Im ambulanten Sektor konnte durch die forcierte Integration der Telemedizin die Routine kompensiert werden. Auch die Ausbildung der Urologieanwärter kann bis zu einem gewissen Punkt durch die Telemedizin aufrechterhalten werden, die operative Ausbildung fällt zunächst allerdings zurück. Das tatsächliche Ausmaß der Pandemie in der Urologie bleibt noch abzuwarten und kann erst nach Stabilisierung der Infektionswellen mit den zu erwarteten Impfstoffen erfasst werden.
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16
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Ong CSH, Lu J, Tan YQ, Tan LGL, Tiong HY. Implementation of a Ureteric Colic Telemedicine Service: A Mixed Methods Quality Improvement Study. Urology 2021; 147:14-20. [PMID: 33091386 PMCID: PMC7573635 DOI: 10.1016/j.urology.2020.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the effectiveness of a telemedicine service for ureteric colic patients in reducing the number of unnecessary face-to-face consultations and shortening waiting time for appointments. METHODS A telemedicine workflow was implemented as a quality improvement study using the Plan-Do-Study-Act method. All patients presenting with ureteric colic without high-risk features of fever, severe pain, and hydronephrosis, were recruited, and face-to-face appointments to review scan results were replaced with phone consultations. Data were prospectively collected over 3 years (January 2017 to December 2019). Patient outcomes including the reduction in face-to-face review visits, time to review, reattendance and intervention rates, were tracked in an interrupted time-series analysis, and qualitative feedback was obtained from patients and clinicians. RESULTS Around 53.2% of patients presenting with ureteric colic were recruited into the telemedicine workflow. A total of 465 patients (46.2%) had normal scan results and 250 patients (24.9%) did not attend their scan appointments, hence reducing the number of face-to-face consultations by 71.1%. A total of 230 patients (22.9%) required subsequent follow-up with urology, while 61 patients (6.1%) were referred to other specialties. Mean (SD) time to review was 30.0 (6.2) days, 6-month intervention rate was 3.4% (n = 34) and unplanned reattendance rate was 3.2% (n = 32). Around 93.1% of patients reported satisfaction with the service. CONCLUSION The ureteric colic telemedicine service successfully and sustainably reduced the number of face-to-face consultations and time to review without compromising on patient safety. The availability of this telemedicine service has become even more important in helping us provide care to patients with ureteric colic in the current COVID-19 pandemic.
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Affiliation(s)
- Chloe Shu Hui Ong
- Department of Urology, National University Hospital, National University Health System, Singapore
| | - Jirong Lu
- Department of Urology, National University Hospital, National University Health System, Singapore.
| | - Yi Quan Tan
- Department of Urology, National University Hospital, National University Health System, Singapore
| | - Lincoln Guan Lim Tan
- Department of Urology, National University Hospital, National University Health System, Singapore
| | - Ho Yee Tiong
- Department of Urology, National University Hospital, National University Health System, Singapore
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17
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Berg WT, Goldstein M, Melnick AP, Rosenwaks Z. Clinical implications of telemedicine for providers and patients. Fertil Steril 2020; 114:1129-1134. [PMID: 33280717 PMCID: PMC8024108 DOI: 10.1016/j.fertnstert.2020.10.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 01/16/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has resulted in paradigm shifts in the delivery of health care. Lockdowns, quarantines, and local mandates forced many physician practices around the United States to move to remote patient visits and adoption of telemedicine. This has several long-term implications in the future practice of medicine. In this review we outline different models of integrating telemedicine into both male and female fertility practices and recommendations on performing video physical examinations. Moving forward we foresee two general models of integration: one conservative, where initial intake and follow-up is performed remotely, and a second model where most visits are performed via video and patients are only seen preoperatively if necessary. We also discuss the impact THAT telemedicine has on coding and billing and our experience with patient satisfaction.
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Affiliation(s)
- William T Berg
- Department of Urology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York.
| | - Marc Goldstein
- Center for Male Reproductive Medicine and Microsurgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York
| | - Alexis P Melnick
- Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Zev Rosenwaks
- Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
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18
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Bansal D, Chaturvedi S, Kumar A. Strategic use of telemedicine for restarting urological outpatient services during COVID-19 pandemic. AFRICAN JOURNAL OF UROLOGY 2020; 26:77. [PMID: 33169061 PMCID: PMC7609827 DOI: 10.1186/s12301-020-00091-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/22/2020] [Indexed: 11/26/2022] Open
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19
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Demaerschalk BM, Cassivi SD, Blegen RN, Borah B, Moriarty J, Gullerud R, TerKonda SP. Health Economic Analysis of Postoperative Video Telemedicine Visits to Patients' Homes. Telemed J E Health 2020; 27:635-640. [PMID: 32907513 DOI: 10.1089/tmj.2020.0257] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract Importance: A postoperative video telemedicine follow-up program was introduced by the Mayo Clinic. An attempt was made to understand the potential cost savings to patients before contemplating full-scale expansion across all potentially eligible surgical patients and practices. Objective: The primary purpose was to estimate potential cost savings to patients with video telemedicine follow-up to home compared with face-to-face follow-up in a standard clinic setting. Design: The research was designed collaboratively by the Center for Connected Care and the surgical practice to address the question of estimated cost savings of postoperative video telemedicine visits. The intervention arm is the postoperative video telemedicine follow-up visit to home setting and the comparator is the face-to-face visit at Mayo Clinic. Setting: Large, integrated, academic multispecialty practice supporting patient care delivery, research, and education. Participants: The population under study comprised routine uncomplicated postoperative patients who underwent video telemedicine or face-to-face follow-up visits that fell within the 90-day global period across multiple (general, neurosurgery, plastic, thoracic, transplant, and urology) surgical specialties. Main Outcome(s) and Measure(s): Economic outcomes were cost of travel, accommodations, meals, and missed work. Additional outcomes included time expenditure and patient satisfaction. Cost/benefit analysis unit was US dollars (USD). All costs were inflated to 2018 USD, using the Gross Domestic Product Implicit price deflator. Results: Patients who utilized video telemedicine rather than face-to-face clinic visit for postoperative follow-up were estimated to save $888 per visit on average. More specifically, patients residing more than 1,635 miles round trip from clinic saved an estimated $1,501 per visit and patients not needing accommodation still saved an estimated $256 per visit. Patient satisfaction over video telemedicine postoperative follow-up visits remained high over the 6-year period of study. Conclusions and Relevance: The use of video telemedicine for routine uncomplicated postoperative follow-up visits to replace face-to-face follow-up visits has the potential to be financially advantageous for patients. Key points Question: For postoperative patients, what are the health economic outcomes associated with video telemedicine follow-up to home compared with face-to-face follow-up in a standard clinic setting? Findings: Video telemedicine offers a cost benefit for patients through avoidance of travel costs and missed work. Meaning: For uncomplicated routine postoperative follow-up visits, video telemedicine is a less costly alternative for most patients.
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Affiliation(s)
- Bart M Demaerschalk
- Center for Connected Care, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA.,Center for Digital Health, Mayo Clinic, Rochester, Minnesota, USA.,Clinical Neurological Sciences, Neurology & Neurosurgery, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Stephen D Cassivi
- Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Rebecca N Blegen
- Center for Connected Care, Mayo Clinic, Rochester, Minnesota, USA.,Center for Digital Health, Mayo Clinic, Rochester, Minnesota, USA
| | - Bijan Borah
- Healthcare and Policy Research, Mayo Clinic, Rochester, Minnesota, USA
| | - James Moriarty
- Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Rachel Gullerud
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Sarvam P TerKonda
- Center for Connected Care, Mayo Clinic, Rochester, Minnesota, USA.,Center for Digital Health, Mayo Clinic, Rochester, Minnesota, USA.,Plastic Surgery, Department of Surgery, Mayo Clinic, Jacksonville, Florida, USA
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20
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Sarmah PB, Broadley GA, Khwaja S, Delves GH. Clinical Safety and Cost-Effectiveness of Follow-up Virtual Clinic for Bladder Outflow Obstruction Surgery. J Endourol 2020; 34:1161-1166. [PMID: 32668986 DOI: 10.1089/end.2020.0319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction: Bladder outflow obstruction (BOO) surgery is among the most commonly performed urologic procedures. Postoperative assessment consists of physical measurement of uroflowmetry and post-void residual volume, but health systems worldwide have experienced pressures in demand, leading to exploration of greater efficiency in organizing clinic protocols. International Prostate Symptom Score (IPSS) questionnaire measurement has been identified as a tool to predict change in postoperative management. Our institution established a nurse-led follow-up virtual clinic (VC) for patients undergoing BOO surgery based on IPSS measurement. We present the clinical and economic outcomes of this new service. Materials and Methods: Patients with a successful postoperative trial without catheter were contacted by telephone via VC and discharged by a Urology Clinical Nurse Specialist (UCNS) if IPSS was <8. Data were analyzed for IPSS, arrangement of subsequent clinic visits, and numbers discharged. Primary outcome was the proportion of patients discharged after VC consultation. Secondary outcomes were overall discharge rate following subsequent face-to-face (FTF) appointment; and the proportion of patients re-referred from Primary Care within 3 months of discharge from VC. Cost savings were calculated based on tariffs of £135 for first attendance with UCNS, £199 for uroflowmetry, and £47.84 for VC appointment. Results: The first 50 patients to be recipients of the new VC were included. The median IPSS and quality-of-life score were 13 (interquartile range [IQR] 5) and 3 (IQR 1), respectively. Thirty-nine (78%) patients were discharged from VC; 36 (72%) had IPSS <8. Overall discharge rate following subsequent FTF appointment was 88%. Two patients discharged from VC (5.1%) were subsequently re-referred, neither of whom required additional treatment. Total cost savings with VC amounted to £10,634. Conclusion: Telephone follow-up for BOO surgery based on IPSS is clinically safe and cost-effective, providing greater efficiency for clinic protocols.
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Affiliation(s)
| | | | - Sikandar Khwaja
- Department of Urology, Queen's Hospital Burton, Burton-on-Trent, United Kingdom
| | - George Henry Delves
- Department of Urology, Queen's Hospital Burton, Burton-on-Trent, United Kingdom
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21
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Edison MA, Connor MJ, Miah S, El-Husseiny T, Winkler M, Dasgupta R, Ahmed HU, Hrouda D. Understanding virtual urology clinics: a systematic review. BJU Int 2020; 126:536-546. [PMID: 32463991 DOI: 10.1111/bju.15125] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To perform a systematic review to identify the clinical, fiscal and environmental evidence on the use of urological telehealth and/or virtual clinic (VC) strategies, and to highlight research gaps in this rapidly evolving field. METHODS Our PROSPERO-registered (CRD42019151946) systematic search of Embase, Medline and the Cochrane Review Database was performed to identify original research articles pertaining to adult urology telehealth or VC strategies. Risk-of-bias (RoB) assessment was performed according to the Cochrane 2.0 RoB tool or the Joanna Briggs Institute Checklist for non-randomized studies. RESULTS A total of 5813 participants were included from 18 original articles (two randomized controlled trials [RCTs], 10 prospective studies, six retrospective studies). Urology sub-specialities comprised: uro-oncology (n = 6); general urology (n = 8); endo-urology (n = 2); and lower urinary tract symptoms and/or incontinence (n = 2). Across all sub-specialties, prospective studies using VCs reported a primary median (interquartile range [IQR]) VC discharge rate of 16.6 (14.7-29.8)% and a primary median (IQR) face-to-face (FTF) clinic referral rate of 32.4 (15.5-53.3)%. Direct cost analysis demonstrated median (IQR) annual cost savings of £56 232 (£46 260-£61 116). Grade II and IIIb complications were reported in two acute ureteric colic studies, with rates of 0.20% (3/1534) and 0.13% (2/1534), respectively. The annual carbon footprint avoided ranged from 0.7 to 4.35 metric tonnes of CO2 emissions, depending on the mode of transport used. Patient satisfaction was inconsistently reported, and assessments lacked prospective evaluation using validated questionnaires. CONCLUSION Urology VCs are a promising new platform which can offer clinical, financial and environmental benefits to support an increasing urological referral burden. Further prospective evidence is required across urological sub-specialties to confirm equivalency and safety against traditional FTF assessment.
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Affiliation(s)
- Marie Alexandra Edison
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Martin John Connor
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - Saiful Miah
- Department of Urology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust, Amersham, UK
| | - Tamer El-Husseiny
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Mathias Winkler
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ranan Dasgupta
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Hashim Uddin Ahmed
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - David Hrouda
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
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22
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Novara G, Checcucci E, Crestani A, Abrate A, Esperto F, Pavan N, De Nunzio C, Galfano A, Giannarini G, Gregori A, Liguori G, Bartoletti R, Porpiglia F, Scarpa RM, Simonato A, Trombetta C, Tubaro A, Ficarra V. Telehealth in Urology: A Systematic Review of the Literature. How Much Can Telemedicine Be Useful During and After the COVID-19 Pandemic? Eur Urol 2020; 78:786-811. [PMID: 32616405 PMCID: PMC7301090 DOI: 10.1016/j.eururo.2020.06.025] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
Abstract
Context Coronavirus disease 2019 (COVID-19) pandemic has caused increased interest in the application of telehealth to provide care without exposing patients and physicians to the risk of contagion. The urological literature on the topic is sparse. Objective To perform a systematic review of the literature and evaluate all the available studies on urological applications of telehealth. Evidence acquisition After registration on PROSPERO, we searched PubMed and Scopus databases to collect any kind of studies evaluating any telehealth interventions in any urological conditions. The National Toxicology Program/Office of Health Assessment and Translation Risk of Bias Rating Tool for Human and Animal Studies was used to estimate the risk of bias. A narrative synthesis was performed. Evidence synthesis We identified 45 studies (11 concerning prostate cancer [PCa], three hematuria management, six urinary stones, 14 urinary incontinence [UI], five urinary tract infections [UTIs], and six other conditions), including 12 randomized controlled trials. The available literature indicates that telemedicine has been implemented successfully in several common clinical scenarios, including the decision-making process following a diagnosis of nonmetastatic PCa, follow-up care of patients with localized PCa after curative treatments, initial diagnosis of hematuria, management diagnosis and follow-up care of uncomplicated urinary stones and uncomplicated UTIs, and initial evaluation, behavioral therapies, and pelvic floor muscle training in UI patients, as well as follow-up care after surgical treatments of stress urinary incontinence or pelvic organ prolapse. The methodological quality of most of the reports was good. Conclusions Telehealth has been implemented successfully in selected patients with PCa, UI, pelvic organ prolapse, uncomplicated urinary stones, and UTIs. Many urological conditions are suitable for telehealth, but more studies are needed on other highly prevalent urological malignant and benign conditions. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine. More robust data on long-term efficacy, safety, and health economics are necessary. Patient summary The diffusion of coronavirus disease 2019 (COVID-19) infections has recently increased the interest in telehealth, which is the adoption of telecommunication to deliver any health care activity. The available literature indicates that telemedicine has been adopted successfully in selected patients with several common clinical urological conditions, including prostate cancer, uncomplicated urinary stones, uncomplicated urinary infections, urinary incontinence, or pelvic organ prolapse. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine, but more robust data on long-term efficacy, safety, and costs are necessary.
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Affiliation(s)
- Giacomo Novara
- Department Surgery, Oncology and Gastroenterology, Urologic Unit, University of Padova, Italy.
| | - Enrico Checcucci
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | | | - Alberto Abrate
- Urology Section, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Francesco Esperto
- Department of Urology, Campus Biomedico University of Rome, Rome, Italy
| | - Nicola Pavan
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, University La Sapienza, Rome, Italy
| | | | - Gianluca Giannarini
- Urology Unit, Academic Medical Centre, "Santa Maria della Misericordia" Hospital, Udine, Italy
| | | | - Giovanni Liguori
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Riccardo Bartoletti
- Department of Translational Research and New Technologies, Urologic Unit, University of Pisa, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | | | - Alchiede Simonato
- Urology Section, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy; Urology Unit, Department of Surgery, S. Croce e Carle Hospital, Cuneo, Italy
| | - Carlo Trombetta
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, University La Sapienza, Rome, Italy
| | - Vincenzo Ficarra
- Department of Human and Pediatric Pathology "Gaetano Barresi", Urologic Section, University of Messina, Italy
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Microscopic Hematuria: Diagnosis Is Only Half the Battle. Eur Urol 2020; 77:599-600. [DOI: 10.1016/j.eururo.2019.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 12/12/2019] [Indexed: 11/23/2022]
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Kwon YS, Tabakin AL, Patel HV, Backstrand JR, Jang TL, Kim IY, Singer EA. Adapting Urology Residency Training in the COVID-19 Era. Urology 2020; 141:15-19. [PMID: 32339555 PMCID: PMC7194676 DOI: 10.1016/j.urology.2020.04.065] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Young Suk Kwon
- Division of Urology, Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Alexandra L Tabakin
- Division of Urology, Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Hiren V Patel
- Division of Urology, Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | - Thomas L Jang
- Division of Urology, Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Isaac Y Kim
- Division of Urology, Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Eric A Singer
- Division of Urology, Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
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Tafuri A, Ashrafi AN, Palmer S, Shakir A, Cacciamani GE, Iwata A, Iwata T, Cai J, Sali A, Gupta C, Medina LG, Stern MC, Duddalwar V, Aron M, Gill IS, Abreu A. One-Stop MRI and MRI/transrectal ultrasound fusion-guided biopsy: an expedited pathway for prostate cancer diagnosis. World J Urol 2019; 38:949-956. [PMID: 31175460 DOI: 10.1007/s00345-019-02835-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/01/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To assess the feasibility, safety, and outcomes of an expedited One-Stop prostate cancer (PCa) diagnostic pathway. PATIENTS AND METHODS We identified 370 consecutive patients who underwent multiparametric magnetic resonance imaging (mpMRI) and transrectal ultrasound fusion prostate biopsy (MRI/TRUS-PBx) from our institutional review board-approved database. Patients were divided according to diagnostic pathway: One-Stop (n = 74), with mpMRI and same-day PBx, or Standard (n = 296), with mpMRI followed by a second visit for PBx. mpMRIs were performed and interpreted according to Prostate Imaging-Reporting and Data System (PI-RADS v2). Grade group ≥ 2 PCa defined clinically significant PCa (csPCa). Statistical significance was considered when p < 0.05. RESULTS Age (66 vs 66 years, p = 0.59) and PSA density (0.1 vs 0.1 ng/mL2, p = 0.26) were not different between One-Stop vs Standard pathway, respectively. One-Stop patients lived further away from the hospital than Standard patients (163 vs 31 km; p < 0.01), and experienced shorter time from mpMRI to PBx (0 vs 7 days; p < 0.01). The number (p = 0.56) and distribution of PI-RADS lesions (p = 0.67) were not different between the groups. All procedures were completed successfully with similar perioperative complications rate (p = 0.24). For patients with PI-RADS 3-5 lesions, the csPCa detection rate (49% vs 41%, p = 0.55) was similar for One-Stop vs Standard, respectively. The negative predictive value of mpMRI (PI-RADS 1-2) for csPCa was 78% for One-Stop vs 83% for Standard (p = 0.99). On multivariate analysis, age, prostate volume and PI-RADS score (p < 0.01), but not diagnostic pathway, predicted csPCa detection. CONCLUSION A One-Stop PCa diagnostic pathway is feasible, safe, and provides similar outcomes in a shorter time compared to the Standard two-visit diagnostic pathway.
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Affiliation(s)
- Alessandro Tafuri
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Akbar N Ashrafi
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Suzanne Palmer
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Aliasger Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Atsuko Iwata
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tsuyoshi Iwata
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jie Cai
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Akash Sali
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chhavi Gupta
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Luis G Medina
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mariana C Stern
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Vinay Duddalwar
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Manju Aron
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Inderbir S Gill
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Andre Abreu
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA.
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Cohen AJ, Ndoye M, Fergus KB, Lindsey J, Butler C, Patino G, Anger JT, Breyer BN. Forecasting Limited Access to Urology in Rural Communities: Analysis of the American Urological Association Census. J Rural Health 2019; 36:300-306. [DOI: 10.1111/jrh.12376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/18/2019] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Andrew J. Cohen
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - Medina Ndoye
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - Kirkpatrick B. Fergus
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - John Lindsey
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - Christi Butler
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - German Patino
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - Jennifer T. Anger
- Cedars‐Sinai Department of SurgeryDivision of Urology Los Angeles California
| | - Benjamin N. Breyer
- Department of UrologyUniversity of California‐San Francisco San Francisco California
- Department of Biostatistics and EpidemiologyUniversity of California‐San Francisco San Francisco California
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Small AC, Thorogood SL, Shah O, Healy KA. Emerging Mobile Platforms to Aid in Stone Management. Urol Clin North Am 2019; 46:287-301. [PMID: 30961861 DOI: 10.1016/j.ucl.2018.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Nephrolithiasis is an increasingly common condition worldwide and mobile technology is revolutionizing how patients with kidney stone are being diagnosed and managed. Emerging platforms include software applications to increase adherence to stone prevention, mobile compatible hardware, online social media communities, and telemedicine. Applications and hardware specifically relevant to increasing hydration, diet modification, medication adherence, and rapid diagnosis (ie, mobile ultrasound and endoscopy) have the greatest potential to reduce stone recurrence and expedite treatment. Social media and online communities have also been rapidly adopted by patients and providers to promote education and support.
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Affiliation(s)
- Alexander C Small
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USA
| | - Samantha L Thorogood
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USA
| | - Ojas Shah
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USA
| | - Kelly A Healy
- Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USA.
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Sherwood BG, Nepple KG, Erickson BA. Managing the High Incidence of Testicular Pain and Pathology in Prisoners with Telemedicine. UROLOGY PRACTICE 2018. [DOI: 10.1016/j.urpr.2017.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zholudev V, Safir IJ, Painter MN, Petros JA, Filson CP, Issa MM. Comparative Cost Analysis: Teleurology vs Conventional Face-to-Face Clinics. Urology 2018; 113:40-44. [DOI: 10.1016/j.urology.2017.07.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 07/18/2017] [Accepted: 07/25/2017] [Indexed: 10/19/2022]
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Evaluating the Effectiveness, Efficiency and Safety of Telemedicine for Urological Care in the Male Prisoner Population. UROLOGY PRACTICE 2017; 5:44-51. [PMID: 29435485 DOI: 10.1016/j.urpr.2017.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction We reviewed the safety and effectiveness of our hospital's urologic telemedicine (TM) program that has been utilized for the Iowa prisoner population for over a decade. Methods A retrospective review of TM visits of male prisoners from 2007 to 2014 was performed. Effectiveness of TM visits was assessed by 1) concordance of TM and in-person diagnoses, 2) compliance with radiologic and medication orders and 3) in-person visits saved with TM. Safety was assessed by analyzing the number of patients in which an ED visit was required after TM visit and missed or delayed cases of malignancy. Estimates were then made of the number of patients that could safely be managed with TM alone. Results The most common diagnosis was voiding dysfunction (24%) followed by genitourinary pain (23%). Diagnoses were concordant in 90% of patients; compliance was high (radiology 91%, medications 89%); in-person visits were estimated to be saved in 80-94%. No men required peri-TM ED visits and no cases of malignancy were missed in the population that returned for an in-person visit. We estimated that over 50% of urologic complaints in this cohort could have been managed with TM alone. Conclusions TM was shown to be a safe and effective method to provide general urologic care that obviated the initial in-person visits in nearly 90% of patients. It is likely that TM could safely replace in-person visits for many urologic conditions, especially in younger men and those in which access to specialized care may be limited.
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