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Muller E, Huysmans MA, van Rijssen HJ, Anema JR. Needs, expectations, facilitators, and barriers among insurance physicians related to the use of eHealth in their work: results of a survey. Disabil Rehabil 2024; 46:2374-2384. [PMID: 37357317 DOI: 10.1080/09638288.2023.2224083] [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: 07/11/2022] [Accepted: 05/25/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE To determine needs, expectations, facilitators, and barriers of insurance physicians (IPs) for using eHealth in their work. Also, we investigated differences between age groups. MATERIALS AND METHODS All insurance physicians employed at the Dutch Social Security Institute (SSI) received an online anonymous survey in July 2020. RESULTS Three hundred and fifteen IPs (31%) responded. According to these IPs, the most important need for using eHealth was to collect medical information more effectively and efficiently (71%).Main facilitators were that eHealth could make IPs' work more effectively and efficiently (61%) and more future-proof (60%). Main barriers were losing human interaction (54%) and security issues (51%). Younger IPs saw more options for using eHealth, compared to older IPs. CONCLUSIONS The majority of IPs (in particular younger IPs) had a positive view towards using eHealth in their daily work. Nevertheless, differences in needs, expectations, facilitators and barriers between the age groups should be taken into account for the successful development and implementation of interventions using eHealth in insurance medicine.
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Affiliation(s)
- Elza Muller
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
- Dutch Social Security Institute, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - H Jolanda van Rijssen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
- Dutch Social Security Institute, Amsterdam, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
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Fu R, Sutradhar R, Li Q, Eskander A. Virtual and in-person visits by Ontario physicians in the COVID-19 era. J Telemed Telecare 2024; 30:706-714. [PMID: 35296163 PMCID: PMC11027436 DOI: 10.1177/1357633x221086447] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 02/21/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION We examined the coronavirus disease 2019 (COVID-19) pandemic impact on weekly trends in the billing of virtual and in-person physician visits in Ontario, Canada. METHODS In this retrospective cohort study, physician billing records from Ontario were aggregated on a weekly basis for in-person and virtual visits from 3 January 2016 to 27 March 2021. For each type of visit, a segmented negative binomial regression analysis was performed to estimate the weekly pre-pandemic trend in billing volume per thousand adults (3 January 2016 to 14 March 2020), the immediate change in mean volume at the start of the pandemic, and additional change in weekly volume in the pandemic era (15 March 2020 to 27 March 2021). RESULTS Before the start of the pandemic, the weekly volume of virtual visits per thousand adults was low with a 0.5% increase per week (rate ratio [RR]: 1.0053, 95% confidence interval [CI]: 1.0050-1.0056). A dramatic 65% reduction in in-person visits (RR: 0.35, 95% CI: 0.32-0.39) occurred at the start of the pandemic while virtual visits grew by 21-fold (RR: 21.3, 95% CI: 19.6-23.0). In the pandemic era, in-person visits rose by 1.4% per week (RR: 1.014, 95% CI: 1.011-1.017) but no change was observed for virtual visits (p-value = 0.31). Overall, we noted a 57.6% increase in total weekly physician visits volume after the start of the pandemic. DISCUSSION These results are meaningful for virtual care reimbursement models. Future study needs to assess the quality of care and whether the increase in virtual care volume is cost-effective to society.
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Affiliation(s)
- Rui Fu
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology – Head and Neck Surgery, Michael Garron Hospital and Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Qing Li
- ICES, Toronto, Ontario, Canada
| | - Antoine Eskander
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology – Head and Neck Surgery, Michael Garron Hospital and Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Civelek Y, Oakes A, Robinson M, Chi W. Distribution of a Remote Medical Exam Device Associated with an Increase in Telehealth Use. Telemed J E Health 2024; 30:e1197-e1202. [PMID: 38016132 DOI: 10.1089/tmj.2023.0492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
Background: The COVID-19 pandemic accelerated telehealth adoption, but its effects on care quality and costs remain unclear. This study evaluates a remote patient monitoring device's impact on utilization and spending. Methods: A large insurer launched a pilot program involving 2,880 households, representing 6,731 members in three states. Administrative claims data compared participant households to a matched group lacking necessary contact information for participation. Results: Participants had a 0.19 per member (p = 0.03) increase in telehealth visits and a 0.19 per member (p = 0.08) decrease in outpatient in-person visits relative to nonparticipants during the post 6-month period. No significant differences were observed in total outpatient and emergency department visits or total spending. Subgroup analyses revealed a significant reduction in telehealth visits followed by in-person outpatient visits in households with younger children (-9.1%; p < 0.05). Conclusion: This evaluation suggests that remote devices may boost telehealth utilization without increasing costs.
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Affiliation(s)
- Yasin Civelek
- Enterprise Analytics Core, Elevance Health Inc., Wilmington, Delaware, USA
| | - Allison Oakes
- Enterprise Analytics Core, Elevance Health Inc., Wilmington, Delaware, USA
| | - Michael Robinson
- Enterprise Analytics Core, Elevance Health Inc., Wilmington, Delaware, USA
| | - Winnie Chi
- Enterprise Analytics Core, Elevance Health Inc., Wilmington, Delaware, USA
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Smith Malm C, Klecki J, Lisovska K, Zelano J. Survey of an online system for information to women with epilepsy of childbearing age and management during pregnancy: A 3-year evaluation. Epilepsia Open 2024; 9:558-567. [PMID: 38135910 PMCID: PMC10984308 DOI: 10.1002/epi4.12893] [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: 12/27/2022] [Revised: 11/16/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE We developed an online tool for women with epilepsy consisting of two modules: one with information on pregnancy-related issues (information module) and one for reminders about blood test and communication about dose changes (pregnancy module). Our aim was to assess perceived value, user-friendliness and improvement of patient knowledge in users. METHODS The system was launched in 2019 and patients invited by epilepsy nurses were asked to participate in a survey 1 month after the invitation for the information module, and 1 month postnatally for the pregnancy module. RESULTS By November 2022, the system had been used by 96 individuals out of 100 invited in the pregnancy module, in a total of 114 pregnancies. One hundred and eleven women had been invited to the information module, and 70 of these accessed it. The survey received 96 answers (44 information, 52 pregnancy). User-friendliness was rated as good or very good by a little over half of the users; 55% in the information module and 52% in the pregnancy module. Among pregnant women, 83% found the TDM part useful and most would prefer a similar system in future pregnancies. Sixty-four percent of users of the information module and 48% of the pregnancy module found that the system had increased their knowledge. Two knowledge questions were answered correctly by a significantly higher proportion of those that had accessed the online information. SIGNIFICANCE There was great demand for online communication during pregnancy and our experiences of implementation can hopefully assist digitalization of epilepsy care elsewhere. Online information also seems to increase knowledge about pregnancy-related issues, but our invitation-only method of inclusion was not effective for widespread dissemination. Patient-initiated access with optional epilepsy-team contact if questions arise could be an alternative. PLAIN LANGUAGE SUMMARY We have performed a survey of users of a new Internet-based tool for information to women of childbearing age and communication about dose changes during pregnancy. Users were overall satisfied with the tool and answered some knowledge questions more accurately after accessing the information.
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Affiliation(s)
| | - Judith Klecki
- Department of NeurologySahlgrenska university hospitalGothenburgSweden
| | - Kristina Lisovska
- Department of NeurologySahlgrenska university hospitalGothenburgSweden
| | - Johan Zelano
- Department of NeurologySahlgrenska university hospitalGothenburgSweden
- Institute of neuroscience and physiology, Department of clinical neuroscience, Sahlgrenska AcademyGothenburg UniversityGothenburgSweden
- Wallenberg Center of Molecular and Translational MedicineGothenburg UniversityGothenburgSweden
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Byrnes M, Thompson NR, Hantus ST, Fesler JR, Ying Z, Ayub N, Rubinos C, Zafar S, Sivaraju A, Punia V. Characteristics and Attendance of Patients Eligible for the PASS Clinic: A Transition of Care Model After Acute Symptomatic Seizures. Neurol Clin Pract 2024; 14:e200232. [PMID: 38213398 PMCID: PMC10781564 DOI: 10.1212/cpj.0000000000200232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/04/2023] [Indexed: 01/13/2024]
Abstract
Background and Objectives Most acute symptomatic seizure (ASyS) patients stay on antiseizure medications (ASM) long-term, despite low epilepsy development risk. The Post-Acute Symptomatic Seizure (PASS) clinic is a transition of care model for ASyS patients who individualize ASM management with the goal of a safe deprescription. We evaluated patients discharged on ASMs after a witnessed or suspected ASyS to analyze their PASS clinic visit attendance and its predictors. Methods A single-center, retrospective cohort study of adults without epilepsy who were discharged from January 1, 2019, to September 30, 2019, on first-time ASMs due to witnessed or suspected ASyS (PASS clinic-eligible). We fit a cause-specific Cox proportional hazards model to analyze factors associated with PASS clinic attendance, which depends on survival in this patient population that has a high early postdischarge mortality (a competing risk). We checked for multicollinearity and the assumption of proportional hazards. Results Among 307 PASS clinic-eligible patients, 95 (30.9%) attended the clinic and 136 (44.3%) died during a median follow-up of 14 months (interquartile range = 2-34). ASyS occurred in 60.2% (convulsive 47%; electrographic 26.7%) of patients. ASMs were continued in the absence of ASyS or epileptiform abnormalities (EAs) in 27% of patients. Multivariable analysis revealed that the presence of EAs (HR = 1.69, 95% CI 1.10-2.59), PASS clinic appointments provided before discharge (HR = 3.39, 95% CI 2.15-5.33), and less frequently noted ASyS etiologies such as autoimmune encephalitis (HR = 2.03, 95% CI 1.07-3.86) were associated with an increased clinic attendance rate. Medicare/Medicaid insurance (HR = 0.43, 95% CI 0.24-0.78, p = 0.005) and the presence of progressive brain injury (i.e., tumors; HR = 0.55, 95% CI 0.32-0.95, p = 0.032) were associated with reduced rate of PASS clinic attendance. Discussion Our real-world data highlight the need for appropriate postdischarge follow-up of ASyS patients, which can be fulfilled by the PASS clinic model. Modest PASS clinic attendance can be significantly improved by adhering to a structured discharge planning process whereby appointments are provided before discharge. Future research comparing patient outcomes, specifically safe ASM discontinuation in a PASS clinic model to routine clinical care, is needed.
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Affiliation(s)
- MarieElena Byrnes
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Nicolas R Thompson
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Stephen T Hantus
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Jessica R Fesler
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Zhong Ying
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Neishay Ayub
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Clio Rubinos
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Sahar Zafar
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Adithya Sivaraju
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
| | - Vineet Punia
- Epilepsy Center (MB, STH, JRF, ZY, VP), Neurological Institute; Department of Quantitative Health Sciences (NRT), Lerner Research Institute; Center for Outcomes Research and Evaluation (NRT), Neurological Institute, Cleveland Clinic, OH; Rhode Island Hospital (NA), Brown University; University of North Carolina (CR), Chapel Hill; Massachusetts General Hospital (SZ), Harvard University; Yale New Haven Hospital (AS), Yale University
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Roslan N, Yusof N, Md Bohari NF, Md Sabri BA, Mohd Radzi NA, Bakri NN, Mohd Yani AA. Virtual counselling of tobacco cessation during the COVID-19 pandemic: A qualitative study on the experiences and perceptions of Malaysian dental undergraduates and their patients. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:28-40. [PMID: 37132218 DOI: 10.1111/eje.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/09/2023] [Accepted: 04/16/2023] [Indexed: 05/04/2023]
Abstract
INTRODUCTION When dental institutions had to close down during the Movement Control Order (MCO) implementation due to the COVID-19 pandemic, dental students were faced with delays in completing their tobacco cessation schedule. An alternative was to allow students to conduct virtual counselling (VC) for smoking cessation for their patients to address their clinical requirements. This study aimed to explore Malaysian dental undergraduates' and patients' experiences undergoing smoking cessation counselling through virtual platforms. MATERIALS AND METHODS The study consisted of qualitative, semi-structured Focus Group Discussions (for students, n = 23) and in-depth interviews (for patients, n = 9); to phenomenologically describe the perceptions of participants involved in the VC. Each session was recorded with the participants' permission. The recorded session was transcribed verbatim and thematically analysed using the qualitative data analysis software, NVivo™. RESULTS The major themes that emerged were: (1) General opinions and experiences, (2) Content of VCs, (3) Remote access to counselling, (4) Patient-clinician relationships, (5) Technical issues, (6) Changes after VCs, and (7) Future application. Most students and patients were quite comfortable with VC as it is convenient, allowing students to be creative and avoid the hassle of transport and traffic. However, some of the students felt that it lacked the personal touch and guidance from lecturers who would normally be present during physical class. CONCLUSION Virtual counselling enables remote access to counselling, but it is also subjected to some limitations, especially regarding lack of clinical assessments, human touch and internet issues. Though participants were optimistic about adapting it in the future, multiple factors must be considered. Ultimately, the behavioural change will depend on the patient's motivation in making a difference.
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Affiliation(s)
- Nurliyana Roslan
- Centre of Population Oral Health & Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - Norashikin Yusof
- Centre of Population Oral Health & Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - Nor Faezah Md Bohari
- Centre of Population Oral Health & Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - Budi Aslinie Md Sabri
- Centre of Population Oral Health & Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - Nawwal Alwani Mohd Radzi
- Centre of Population Oral Health & Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - Noor Nazahiah Bakri
- Centre of Population Oral Health & Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
- Department of Oral Sciences, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Azri Aliah Mohd Yani
- Centre of Population Oral Health & Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
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Manes MR, Burnfield JM, Boersma K, Peoples J, Davis A, Beneciuk JM, Bialosky J, Jordan K, Osborne R. Virtual Rehabilitation and COVID-19: Varied Adoption and Satisfaction Among Patients and Providers Participating in a Multi-Site Survey Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580231222334. [PMID: 38166514 PMCID: PMC10768633 DOI: 10.1177/00469580231222334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 01/04/2024]
Abstract
The COVID-19 pandemic compelled rapid healthcare adaptations including increased use of telehealth (TH) and virtual care (VC) to provide rehabilitation services. This multi-site cross-sectional survey study examined rehabilitation patients' and providers' experiences with service delivery during the COVID-19 pandemic, including the use of TH/VC. Patients and providers who received or provided rehabilitation services were recruited from 1 of 3 large, post-acute rehabilitation systems located in the Southeastern and Midwestern United States during the COVID-19 pandemic. Participants rated personal satisfaction with rehabilitation services received or rendered during the pandemic and willingness to use TH/VC in the future. Questions also addressed accessibility, ease of use, and perceived barriers to TH/VC use. The adoption and personal satisfaction of TH/VC for rehabilitation care varied between patients and providers. Patients reported higher levels of satisfaction compared to providers (P < .001). Patients who did not use TH/VC had higher satisfaction than those who did (P < .05). Patients were less willing than providers to use TH/VC (P < .001). Those who used TH/VC prior to the pandemic were more willing to use post-pandemic (P < .001). Patients reported TH/VC was useful in increasing health services accessibility yet were neutral as to the ability of TH/VC to improve outcomes. Patients and providers agreed that TH/VC was easy to learn and use. Medical providers found TH/VC more useful than therapy providers. Participants who used TH/VC during the pandemic are more willing to use the service again in the future. Understanding patient and provider preferences and perspectives is key to the continued use of TH/VC in rehabilitation care.
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Affiliation(s)
- Mindi R. Manes
- Brooks Rehabilitation, Brooks Center for Research Analytics and Outcomes, Jacksonville, FL, USA
| | - Judith M. Burnfield
- Madonna Rehabilitation Hospitals, Institute for Rehabilitation Science and Engineering, Lincoln, NE, USA
| | - Kelsey Boersma
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Jason Peoples
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Anita Davis
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
| | - Jason M. Beneciuk
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of Florida, Department of Physical Therapy, Gainesville, FL, USA
| | - Joel Bialosky
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of Florida, Department of Physical Therapy, Gainesville, FL, USA
| | - Katelyn Jordan
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
| | - Raine Osborne
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of North Florida, Department of Physical Therapy, Jacksonville, FL, USA
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Ejezie CL, Cuccaro P, Durand C, Savas L, Shegog R. Parent-reported provider recommendation of HPV vaccination among minority adolescents before and during the COVID-19 pandemic: Findings from the National Immunization Survey-Teen, 2019-2021. Prev Med Rep 2023; 35:102286. [PMID: 37361924 PMCID: PMC10282928 DOI: 10.1016/j.pmedr.2023.102286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/05/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Provider recommendation of human papillomavirus (HPV) vaccination among adolescents has steadily improved over the years, however, limited research has been conducted to examine if the COVID-19 pandemic disrupted this positive trend in parent-reported provider recommendation among minority adolescents. Therefore, we conducted the present study to determine if there is an association between the pandemic and parent-reported provider recommendation of HPV vaccine among non-Hispanic black and Hispanic adolescents. We also examined whether any changes in parent-reported provider recommendation in the years 2019, 2020, and 2021 differed by race or ethnicity. Using a cross-sectional design to examine data from the National Immunization Survey-Teen (2019-2021), a moderation analysis and logistic regression analysis were performed to model race-specific variation in parent-reported provider recommendation (n = 50,739). We found that Hispanic parents had lower odds (aOR = 0.80 [0.71, 0.91]) of reporting receiving a recommendation compared to non-Hispanic white parents. We also found that the odds of parent-reported provider recommendation were higher in 2020 (aOR = 1.15 [1.03-1.29]) than in 2019. Other variables-age, region, sex, health insurance status, and poverty status-were all associated with parent-reported provider recommendation. These findings demonstrated that the pandemic may not have triggered any race-related gap in the recommendation of HPV vaccines, however, more pandemic-resilient public health efforts are needed to improve parent and provider communication regarding HPV vaccination of adolescents.
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Affiliation(s)
- Chinenye Lynette Ejezie
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
- Department of Radiation Oncology, The University of MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
| | - Lara Savas
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
| | - Ross Shegog
- Department of Health Promotion and Behavioral Sciences, UThealth School of Public Health, Houston, TX 77030, USA
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Fang JL, Umoren R, Whyte H, Limjoco J, Makkar A, Yankanah R, McCoy M, Lo MD, Colby CE, Herrin J, Jacobson RM, Demaerschalk BM. Provider Perspectives on the Acceptability, Appropriateness, and Feasibility of Teleneonatology. Am J Perinatol 2023; 40:1521-1528. [PMID: 34583392 DOI: 10.1055/a-1656-6363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to measure provider perspectives on the acceptability, appropriateness, and feasibility of teleneonatology in neonatal intensive care units (NICUs) and community hospitals. STUDY DESIGN Providers from five academic tertiary NICUs and 27 community hospitals were surveyed using validated implementation measures to assess the acceptability, appropriateness, and feasibility of teleneonatology. For each of the 12 statements, scale values ranged from 1 to 5 (1 = strongly disagree; 5 = strongly agree), with higher scores indicating greater positive perceptions. Survey results were summarized, and differences across respondents assessed using generalized linear models. RESULTS The survey response rate was 56% (203/365). Respondents found teleneonatology to be acceptable, appropriate, and feasible. The percent of respondents who agreed with each of the twelve statements ranged from 88.6 to 99.0%, with mean scores of 4.4 to 4.7 and median scores of 4.0 to 5.0. There was no difference in the acceptability, appropriateness, and feasibility of teleneonatology when analyzed by professional role, years of experience in neonatal care, or years of teleneonatology experience. Respondents from Level I well newborn nurseries had greater positive perceptions of teleneonatology than those from Level II special care nurseries. CONCLUSION Providers in tertiary NICUs and community hospitals perceive teleneonatology to be highly acceptable, appropriate, and feasible for their practices. The wide acceptance by providers of all roles and levels of experience likely demonstrates a broad receptiveness to telemedicine as a tool to deliver neonatal care, particularly in rural communities where specialists are unavailable. KEY POINTS · Neonatal care providers perceive teleneonatology to be highly acceptable, appropriate, and feasible.. · Perceptions of teleneonatology do not differ based on professional role or years of experience.. · Perceptions of teleneonatology are especially high in smaller hospitals with well newborn nurseries..
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Affiliation(s)
- Jennifer L Fang
- Division of Neonatal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Rachel Umoren
- Division of Neonatology, Department of Pediatrics, University of Washington & Seattle Children's Hospital, Seattle, Washington
| | - Hilary Whyte
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jamie Limjoco
- Division of Neonatology, University of Wisconsin, Madison, Wisconsin
| | - Abhishek Makkar
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Rosanna Yankanah
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mike McCoy
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Mark D Lo
- Division of Emergency Medicine, Department of Pediatrics, University of Washington & Seattle Children's Hospital, Seattle, Washington
| | - Christopher E Colby
- Division of Neonatal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Jeph Herrin
- Division of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Bart M Demaerschalk
- Department of Neurology and Center for Connected Care, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona
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Luzuriaga MG, Lieberman M, Ma R, Casula S, Lagari-Libhaber V, Messinger S, Li H, Miranda B, Baidal DA, Mizrachi EB, Iacobellis G, Garg R, Vendrame F. Comparison of Glycemic Control Between In-Person and Virtual Diabetes Consults in Hospitalized Patients With Diabetes. J Diabetes Sci Technol 2023:19322968231199470. [PMID: 37727950 DOI: 10.1177/19322968231199470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND There is limited evidence that the diabetes in-person consult in hospitalized patients can be replaced by a virtual consult. During COVID-19 pandemic, the diabetes in-person consult service at the University of Miami and Miami Veterans Affairs Healthcare System transitioned to a virtual model. The aim of this study was to assess the impact of telemedicine on glycemic control after this transition. METHODS We retrospectively analyzed glucose metrics from in-person consults (In-person) during January 16 to March 14, 2020 and virtual consults during March 15 to May 14, 2020. Data from virtual consults were analyzed by separating patients infected with COVID-19, who were seen only virtually (Virtual-COVID-19-Pos), and patients who were not infected (Virtual-COVID-19-Neg), or by combining the two groups (Virtual-All). RESULTS Patient-day-weighted blood glucose was not significantly different between In-person, Virtual-All, and Virtual-COVID-19-Neg, but Virtual-COVID-19-Pos had significantly higher mean ± SD blood glucose (mg/dL) compared with others (206.7 ± 49.6 In-person, 214.6 ± 56.2 Virtual-All, 206.5 ± 57.2 Virtual-COVID-19-Neg, 229.7 ± 51.6 Virtual-COVID-19-Pos; P = .015). A significantly less percentage of patients in this group also achieved a mean ± SD glucose target of 140 to 180 mg/dL (23.8 ± 22.5 In-person, 21.5 ± 20.5 Virtual-All, 25.3 ± 20.8 Virtual-COVID-19-Neg, and 14.4±18.1 Virtual-COVID-19-Pos, P = .024), but there was no significant difference between In-person, Virtual-All, and Virtual-COVID-19-Neg. The occurrence of hypoglycemia was not significantly different among groups. CONCLUSIONS In-person and virtual consults delivered by a diabetes team at an academic institution were not associated with significant differences in glycemic control. These real-world data suggest that telemedicine could be used for in-patient diabetes management, although additional studies are needed to better assess clinical outcomes and safety.
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Affiliation(s)
- Maria Gracia Luzuriaga
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Endocrinology, Diabetes and Metabolism, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | | | - Ruixuan Ma
- Division of Biostatistics, Department of Epidemiology and Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Sabina Casula
- Endocrinology Section, Miami Veterans Affairs Healthcare System, Miami, FL, USA
| | - Violet Lagari-Libhaber
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
- Endocrinology Section, Miami Veterans Affairs Healthcare System, Miami, FL, USA
| | - Shari Messinger
- Department of Endocrinology, Diabetes and Metabolism, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Hua Li
- Department of Endocrinology, Diabetes and Metabolism, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Bresta Miranda
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - David A Baidal
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ernesto Bernal Mizrachi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
- Endocrinology Section, Miami Veterans Affairs Healthcare System, Miami, FL, USA
| | - Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Rajesh Garg
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
- Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Francesco Vendrame
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
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11
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Gong W, Liu J. Investigating the Predictors of Telemedicine Service Usage Intention in China During the COVID-19 Pandemic: An Extended Technology Acceptance Perspective. Telemed J E Health 2023; 29:1390-1398. [PMID: 37010406 DOI: 10.1089/tmj.2022.0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Introduction: In China, digital health and telemedicine services grew particularly rapidly during the COVID-19 pandemic. The goal of this study was to examine the effects of technology acceptance model (TAM) predictors, previous social media health service exposure, and telemedicine experience on individual telemedicine service usage intention within the extended theoretical framework of TAM and TAM2. Methods: The study adopted a cross-sectional survey to collect data (N = 1,088) through a Chinese online panel provider (wenjuan.com). Structural equation modeling was performed to examine relationships between the variables in the proposed model. Results: Our results indicated that technology anxiety (TA) was negatively related to perceived ease of use (PEOU) and usage intention. PEOU mediated the relationship between TA and usage intention. Social media health information consumption was positively associated with perceived usefulness (PU). Previous telemedicine satisfaction was positively related to PEOU and PU, but the direct relationship between satisfaction with telemedicine and usage intention was not found to be significant. Besides, PEOU and PU mediated the relationship between previous telemedicine satisfaction and usage intention. Conclusions: Findings of the study not only contribute to literature pertaining to telemedicine promotion by identifying important mediation relationships but also help identify potential users and provide a convenient internet-based promotion channel since they reveal that social media health information consumption is positively related to PU of telemedicine services.
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Affiliation(s)
- Wanqi Gong
- Department of Network and New Media, School of Journalism and Communication, Guangdong University of Foreign Studies, Guangzhou, China
| | - Jiawei Liu
- Department of Journalism, School of Journalism and Communication, Jinan University, Guangzhou, China
- China's National Cohesion Research Center, Jinan University, Guangzhou, China
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12
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Sociodemographic factors and family use of remote infant viewing in neonatal intensive care. J Perinatol 2023; 43:350-356. [PMID: 36088494 PMCID: PMC9464058 DOI: 10.1038/s41372-022-01506-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We aimed to determine whether the use of remote infant viewing (RIV) in a neonatal intensive care unit (NICU) differed based on maternal sociodemographic factors. METHODS The number of RIV camera views and view duration were obtained for NICU patients between 10/01/2019 and 3/31/2021 and standardized relative to patient days. Maternal sociodemographic and neonatal characteristics were obtained from institutional databases. RESULTS Families in which mothers were unmarried (aOR 1.42, 95% CI 1.03-1.95), did not require an interpreter (aOR 2.86, 95% CI 1.54-5.32), were multiparous (aOR 1.56, 95% CI 1.16-2.10), delivered prior to 37 weeks' gestation (aOR 1.57, 95% CI 1.17-2.12), or resided ≥50 miles from the NICU (aOR 1.38, 95% CI 1.02-1.87) were significantly more likely to use RIV. CONCLUSION Family use of RIV in the NICU varied by multiple sociodemographic factors. Further investigation to understand and to address potential equity gaps revealed or created by RIV are warranted.
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Jallal M, Berrada K, Bouaddi O, El Badisy I, Charaka H, Serhier Z, Bennani Othmani M, Nejjari C, Khalis M. How Physicians in a Moroccan Tertiary Care Center Perceive Teleconsultation During COVID-19 Pandemic? Telemed J E Health 2023; 29:284-292. [PMID: 36126680 DOI: 10.1089/tmj.2022.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Recent technological advances have paved the way for a new modality of medical practice known as teleconsultation. Positive perceptions about the benefits of teleconsultation and its acceptance by clinicians are key predictors of its uptake. The aim of this study was to assess knowledge, perceptions, and acceptability of teleconsultation among Moroccan physicians. Methods: This is a descriptive cross-sectional study conducted at the Cheikh Khalifa International University Hospital (HCK) of Casablanca, Morocco. Study participants answered an anonymous self-administered questionnaire designed based on similar studies. The questionnaire contained four sections related to demographic characteristics, knowledge about telemedicine and teleconsultation, perceptions about teleconsultation, and its acceptability by the study participants. Results: Of 486 eligible participants, a total of 212 completed the questionnaire. Approximately 96.7% had prior knowledge of teleconsultation. Most participants identified internet access (95.3%), data security (93.4%), and confidentiality (92.9%) as the main facilitators to the use of teleconsultation. The main barriers to the use of teleconsultation were internet access issues (98.6%), poor audio quality (96.2%), poor video quality (94.3%), and difficulty encountered by patients in expressing themselves and communicating with their physician (79.7%). The majority of participants (91.5%) believed that teleconsultation will be an integral part of future medical practice and about 70.8% thought that they would be able to allot time to teleconsultation in their current schedules. Conclusions: The findings of this study should be used by policy makers to remove barriers and promote enablers of teleconsultation use by physicians to bring health care closer to the Moroccan population.
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Affiliation(s)
- Manar Jallal
- Medical Informatics Laboratory, Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco
| | - Kenza Berrada
- Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Oumnia Bouaddi
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Imad El Badisy
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Hafida Charaka
- Department of Research and Development, Ibn Sina University Hospital Center, Rabat, Morocco
| | - Zineb Serhier
- Medical Informatics Laboratory, Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco
| | - Mohammed Bennani Othmani
- Medical Informatics Laboratory, Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco
| | - Chakib Nejjari
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Mohamed Khalis
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
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14
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Freund BE, Feyissa AM. EEG as an indispensable tool during and after the COVID-19 pandemic: A review of tribulations and successes. Front Neurol 2022; 13:1087969. [PMID: 36530612 PMCID: PMC9755176 DOI: 10.3389/fneur.2022.1087969] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/17/2022] [Indexed: 10/03/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, elective and non-emergent tests and procedures were delayed or suspended in lieu of diverting resources to more emergent treatment of critically ill patients and to avoid the spread and contraction of COVID-19. Further, the workforce was stretched thin, and healthcare facilities saw high turnover rates for full-time and contract employees, which strained the system and reduced the ability to provide clinical services. One of the casualties of these changes was electroencephalography (EEG) procedures, which have been performed less frequently throughout the world since the pandemic. Whether considered routine or emergent, the deferral of EEG studies can cause downstream effects, including a delay in diagnosis and initiation of treatment for epilepsy and non-epileptic seizures resulting in a higher risk of morbidity and mortality. Despite these limitations, the importance and utility of EEG and EEG technologists have been reinforced with the development of COVID-related neurological complications, including encephalopathy and seizures, which require EEG for diagnosis and treatment. Since the pandemic, reliance on remote telemonitoring has further highlighted the value and ease of using EEG. There has also been a heightened interest in rapid EEG devices that non-technologist professionals can attach quickly, allowing minimum patient contact to avoid exposure to COVID-19 and taking advantage of remote EEG monitoring. This review discusses the acute and potential long-term effects of the COVID-19 pandemic on the use and performance of EEG.
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Affiliation(s)
| | - Anteneh M. Feyissa
- Department of Neurology, Mayo Clinic Florida, Jacksonville, FL, United States
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15
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Donnelly C, Mills C, Gill S, Mehta K, Ashcroft R. The experience of primary care teams during the early phase of COVID-19: A qualitative study of primary care practice leaders in Ontario, Canada. BMC PRIMARY CARE 2022; 23:294. [PMID: 36418972 PMCID: PMC9682712 DOI: 10.1186/s12875-022-01907-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 08/22/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic has caused a rapid shift to virtual care in primary care practices around the globe. There has been little focus on the experiences of interprofessional teams through the lens of primary care practice leaders. The objective of this study was to examine the experience of primary care teams during the first wave of the COVID-19 pandemic from the perspective of primary care leadership. METHODS Qualitative study using qualitative description methods. Executive Directors of interprofessional primary care teams belonging to the Association of Family Health Teams of Ontario (AFHTO) were invited to participate. Executive Directors were interviewed and the interview transcripts were analyzed using thematic analysis. RESULTS Seventy-one Executive Directors from across all regions of Ontario were interviewed for the study, representing 37% of the AFHTO member clinics. Four themes were identified in the data: i) Complexities of Virtual Care, ii) Continuation of In-person Care, iii) Supporting Patients at Risk, and iv) Stepping up and into New Roles. CONCLUSIONS Primary care teams rapidly mobilized to deliver the majority of their care virtually, while continuing to provide in-person and home care as required. Major challenges to virtual care included technological infrastructure and unfamiliarity with virtual platforms. Advantages to virtual care included convenience and time savings. Virtual care will likely continue to be an important mode of primary care delivery moving forward.
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Affiliation(s)
- Catherine Donnelly
- grid.410356.50000 0004 1936 8331Queen’s University, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Christine Mills
- grid.410356.50000 0004 1936 8331Queen’s University, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Sandeep Gill
- Association of Family Health Teams of Ontario, 400 University Avenue, Suite 2100, Toronto, Ontario M5G 1S5 Canada
| | - Kavita Mehta
- Association of Family Health Teams of Ontario, 400 University Avenue, Suite 2100, Toronto, Ontario M5G 1S5 Canada
| | - Rachelle Ashcroft
- grid.17063.330000 0001 2157 2938University of Toronto, 246 Bloor Street, Toronto, Ontario M5S 1V4 Canada
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16
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Lavin B, Gray CL, Brodie M. Telemedicine and Epilepsy Care. Neurol Clin 2022; 40:717-727. [DOI: 10.1016/j.ncl.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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17
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Patel RK, Kreofsky BL, Morgan KM, Weaver AL, Brumbaugh JE, Fang JL. Family Use of Remote Infant Viewing in the Neonatal Intensive Care Unit: Impact of the COVID-19 Pandemic and Patient Room Type. Telemed J E Health 2022; 29:531-539. [PMID: 36036802 DOI: 10.1089/tmj.2022.0195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Background: Remote infant viewing (RIV) uses a bedside camera to allow families to view a livestream video of their neonate 24/7 from anywhere with internet access. Objective: The aim of this study was to evaluate family use of RIV for infants in the neonatal intensive care unit (NICU) during the COVID-19 pandemic and whether RIV use varied by patient room type. Study Design: Use of RIV was evaluated for NICU patients between October 1, 2019, and March 31, 2021. The date, time, and duration of every RIV were exported from the RIV database and linked to the patient's room type. Results: Among 980 patients, 721 (73.6%) were viewed using RIV. The median (interquartile range) number of views per patient-days was 12.5 (5.4-26.0). Based on monthly aggregate data, the proportion of patients with at least one RIV increased during the pandemic from 71.6% in April 2020 to 94.3% in March 2021 (p < 0.001). The monthly number of views and view duration per patient-days also increased (p = 0.003; p = 0.029, respectively). When evaluating patient-level data by room type, the median number of views per patient-days was higher for open-bay than single-family rooms (13.5 vs. 10.5; p < 0.001) and median view duration (minutes) per patient-days was longer (21.8 vs. 12.1; p < 0.001). Conclusions: Use of RIV in the NICU increased during the COVID-19 pandemic. RIV was used more frequently and for longer duration by families with newborns in an open-bay room. RIV allows families to observe their newborn when visitor restrictions are in place or when in-person visits may be less private or do not allow for physical distancing.
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Affiliation(s)
- Rahul K Patel
- Mayo Clinic Alix School of Medicine, Phoenix, Arizona, USA
| | - Beth L Kreofsky
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Katie M Morgan
- Division of Neonatal Medicine, Department of Nursing, Mayo Clinic, Rochester, Minnesota, USA
| | - Amy L Weaver
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Jane E Brumbaugh
- Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer L Fang
- Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Harahsheh E, English SW, Hrdlicka CM, Demaerschalk B. Telestroke’s Role Through the COVID-19 Pandemic and Beyond. Curr Treat Options Neurol 2022; 24:589-603. [PMID: 35999901 PMCID: PMC9388966 DOI: 10.1007/s11940-022-00737-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 11/25/2022]
Abstract
Purpose of review The goal of this paper is to discuss the role and utilization of telestroke services through the COVID-19 pandemic and to suggest future directions to sustain and increase patients’ access to stroke expertise. Recent findings Telestroke is an innovative and effective tool that has been shown to improve access, quality of care, and outcomes of patients with acute stroke syndromes in resource-limited areas for the last two decades. The COVID-19 pandemic posed a significant challenge and strained healthcare systems worldwide, but it created novel and unique opportunities to expand and increase the utilization of telehealth and telestroke services to deliver personalized healthcare across the continuum of stroke care outside of traditional settings. This rapid and widespread increase in telestroke use was facilitated by the removal of many legislative and regulatory barriers which have limited patients’ access to stroke expertise for many years. Summary As the public health emergency ends, there exists a unique opportunity to optimize and expand upon the pandemic-related rapid growth of telestroke care. Optimal utilization of telehealth and telestroke services will depend on maintaining and improving required infrastructure, laws, and regulations, particularly those governing reimbursement and licensing.
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Affiliation(s)
- Ehab Harahsheh
- Department of Neurology, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ 85259 USA
| | | | - Courtney M. Hrdlicka
- Department of Neurology, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ 85259 USA
| | - Bart Demaerschalk
- Department of Neurology, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ 85259 USA
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Ando H, Cousins R, Young CA. Flexibility to manage and enhance quality of life among people with motor neurone disease. Disabil Rehabil 2022; 44:2752-2762. [PMID: 33226867 DOI: 10.1080/09638288.2020.1846797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To identify influential factors for quality of life (QoL) among individuals with motor neurone disease (MND) and explore how regulatory flexibility and psychological flexibility may contribute towards maintaining and improving QoL. METHODS Semi-structured interviews were conducted with 26 individuals with MND. Thematic analysis, using both inductive and deductive analyses, was employed to examine subjective QoL in view of previous understanding of QoL. RESULTS Four factors were important for the QoL of participants: perceived illness prognosis, sense of self, concerns for significant others, and life to enjoy. These factors reflected psychological stress caused by MND, the participant's value system, and their beliefs about life. In optimising QoL, both regulatory flexibility and psychological flexibility were essential to maintain and enhance QoL. Often, regulatory flexibility was perceived among those employing a mindful approach, and psychological flexibility was found to involve savouring positive experiences. CONCLUSIONS People with MND reported that seeking ways to both maintain and enhance their QoL is crucial, and that this may be accomplished by increasing flexibility through mindfulness and savouring. (171/200 words)Implications for rehabilitationPeople with motor neurone disease (MND) seek to maintain quality of life (QoL) following changes caused by the condition, whilst attempting to enhance QoL by maximising their positive experiences.Regulatory flexibility is essential to maintain QoL and it was closely associated with mindful approach so that MND is not perceived as an inevitable threat to QoL.Psychological flexibility was found to enhance QoL and it involves savouring positive experiences, while abandoning fault-finding of the current situation.Positive inter-personal interactions can encourage people with MND to engage with mindfulness and savouring for favourable outcomes in terms of QoL; current support services should orient towards both mindfulness and savouring.
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Affiliation(s)
- Hikari Ando
- The Walton Centre NHS Foundation Trust, Liverpool, UK.,Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Rosanna Cousins
- Department of Psychology, Liverpool Hope University, Liverpool, UK
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Hatef E, Lans D, Bandeian S, Lasser EC, Goldsack J, Weiner JP. Outcomes of In-Person and Telehealth Ambulatory Encounters During COVID-19 Within a Large Commercially Insured Cohort. JAMA Netw Open 2022; 5:e228954. [PMID: 35471570 PMCID: PMC9044109 DOI: 10.1001/jamanetworkopen.2022.8954] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/07/2022] [Indexed: 12/27/2022] Open
Abstract
Importance Since the start of the COVID-19 pandemic, few studies have assessed the association of telehealth with outcomes of care, including patterns of health care use after the initial encounter. Objective To assess the association of telehealth and in-person visits with outcomes of care during the COVID-19 pandemic. Design, Setting, and Participants This cohort study assessed continuously enrolled members in private health plans of the Blue Cross and Blue Shield Association from July 1, 2019, to December 31, 2020. Main Outcomes and Measures Main outcomes were ambulatory encounters per enrollee stratified by characteristics derived from enrollment files, practitioner claims, and community characteristics linked to the enrollee's zip code. Outcomes of care were assessed 14 days after the initial encounters and included follow-up encounters of any kind, emergency department encounters, and hospitalizations after initial telehealth or in-person encounters. Results In this cohort study of 40 739 915 individuals (mean [SD] age, 35.37 [18.77] years; 20 480 768 [50.3%] female), ambulatory encounters decreased by 1.0% and the number of in-person encounters per enrollee decreased by 17.0% from 2019 to 2020; however, as a proportion of all ambulatory encounters, telehealth encounters increased substantially from 0.6% (n = 236 220) to 14.1% (n = 5 743 718). For members with an initial telehealth encounter for a new acute condition, the adjusted odds ratio was 1.44 (95% CI, 1.42-1.46) for all follow-ups combined and 1.11 (95% CI, 1.06-1.16) for an emergency department encounter. For members with an initial telehealth encounter for a new chronic condition, the adjusted odds ratios were 0.94 (95% CI, 0.92-0.95) for all follow-ups combined and 0.94 (95% CI, 0.90-0.99) for in-patient admissions. Conclusions and Relevance In this cohort study of 40.7 million commercially insured adults, telehealth accounted for a large share of ambulatory encounters at the peak of the pandemic and remained prevalent after infection rates subsided. Telehealth encounters for chronic conditions had similar rates of follow-up to in-person encounters for these conditions, whereas telehealth encounters for acute conditions seemed to be more likely than in-person encounters to require follow-up. These findings suggest a direction for future work and are relevant to policy makers, payers, and practitioners as they manage the use of telehealth during the COVID-19 pandemic and afterward.
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Affiliation(s)
- Elham Hatef
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel Lans
- Blue Health Intelligence, an independent licensee of the Blue Cross and Blue Shield Association, Chicago, Illinois
| | - Stephen Bandeian
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elyse C. Lasser
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Jonathan P. Weiner
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Greenwood H, Krzyzaniak N, Peiris R, Clark J, Scott AM, Cardona M, Griffith R, Glasziou P. Telehealth Versus Face-to-face Psychotherapy for Less Common Mental Health Conditions: Systematic Review and Meta-analysis of Randomized Controlled Trials. JMIR Ment Health 2022; 9:e31780. [PMID: 35275081 PMCID: PMC8956990 DOI: 10.2196/31780] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/16/2021] [Accepted: 01/12/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Mental disorders are a leading cause of distress and disability worldwide. To meet patient demand, there is a need for increased access to high-quality, evidence-based mental health care. Telehealth has become well established in the treatment of illnesses, including mental health conditions. OBJECTIVE This study aims to conduct a robust evidence synthesis to assess whether there is evidence of differences between telehealth and face-to-face care for the management of less common mental and physical health conditions requiring psychotherapy. METHODS In this systematic review, we included randomized controlled trials comparing telehealth (telephone, video, or both) versus the face-to-face delivery of psychotherapy for less common mental health conditions and physical health conditions requiring psychotherapy. The psychotherapy delivered had to be comparable between the telehealth and face-to-face groups, and it had to be delivered by general practitioners, primary care nurses, or allied health staff (such as psychologists and counselors). Patient (symptom severity, overall improvement in psychological symptoms, and function), process (working alliance and client satisfaction), and financial (cost) outcomes were included. RESULTS A total of 12 randomized controlled trials were included, with 931 patients in aggregate; therapies included cognitive behavioral and family therapies delivered in populations encompassing addiction disorders, eating disorders, childhood mental health problems, and chronic conditions. Telehealth was delivered by video in 7 trials, by telephone in 3 trials, and by both in 1 trial, and the delivery mode was unclear in 1 trial. The risk of bias for the 12 trials was low or unclear for most domains, except for the lack of the blinding of participants, owing to the nature of the comparison. There were no significant differences in symptom severity between telehealth and face-to-face therapy immediately after treatment (standardized mean difference [SMD] 0.05, 95% CI -0.17 to 0.27) or at any other follow-up time point. Similarly, there were no significant differences immediately after treatment between telehealth and face-to-face care delivery on any of the other outcomes meta-analyzed, including overall improvement (SMD 0.00, 95% CI -0.40 to 0.39), function (SMD 0.13, 95% CI -0.16 to 0.42), working alliance client (SMD 0.11, 95% CI -0.34 to 0.57), working alliance therapist (SMD -0.16, 95% CI -0.91 to 0.59), and client satisfaction (SMD 0.12, 95% CI -0.30 to 0.53), or at any other time point (3, 6, and 12 months). CONCLUSIONS With regard to effectively treating less common mental health conditions and physical conditions requiring psychological support, there is insufficient evidence of a difference between psychotherapy delivered via telehealth and the same therapy delivered face-to-face. However, there was no includable evidence in this review for some serious mental health conditions, such as schizophrenia and bipolar disorders, and further high-quality research is needed to determine whether telehealth is a viable, equivalent treatment option for these conditions.
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Affiliation(s)
- Hannah Greenwood
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Natalia Krzyzaniak
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
- School of Pharmacy, University of Queensland, Brisbane, Australia
| | - Ruwani Peiris
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Magnolia Cardona
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
- Gold Coast University Hospital Evidence-Based Practice Professorial Unit, Southport, Australia
| | | | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
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22
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Tilahun BBS, Thompson NR, Bautista JF, Sankary LR, Stanton S, Punia V. Telepsychology May Improve Treatment Adherence in Patients with Psychogenic Nonepileptic Seizures. Telemed J E Health 2021; 28:1159-1165. [PMID: 34962145 DOI: 10.1089/tmj.2021.0463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Access to mental health care is a significant challenge in patients with psychogenic nonepileptic seizures (PNES). Telepsychology can curb the access barriers and improve adherence but the role of telepsychology in improving adherence has not been well investigated. The current study examines the utility of telepsychology during the COVID-19 pandemic and treatment adherence in PNES patients. Materials and Methods: Patients with PNES admitted to a 12-week counseling program were offered two visit types: telepsychology and in-office. Visit type, visit status, and demographic information were obtained from department database. Follow-up visits in 6 months were used to examine the effect of visit type on visit status. Adherence to treatment was measured by higher attendance of scheduled visits and less cancellation and no-show rates. Results: Two hundred fifty-seven (n) patients who scheduled virtual or telepsychology visits were included in the study. After adjusting for demographic variables, and accounting for repeated measures, telepsychology visits were significantly more likely to be attended (odds ratio [OR] = 2.40, 95% confidence interval [CI] = 1.69-3.41, p < 0.001) and were significantly less likely to be canceled (OR = 0.43, 95% CI = 0.29-0.64, p < 0.001). The regression model showed patients in the telepsychology visit group attended more than three times as many visits as in-office patients (incidence rate ratios = 3.16, 95% CI = 2.13-4.73, p < 0.001). Conclusions: Patients with PNES have logistical and psychological barriers that can impede their ability to attend counseling treatment. Receiving care remotely may have been associated with higher engagement with mental health treatment compared to having to travel to counseling clinics. Considering the symptom-related restrictions patients with PNES have and the barriers presented by the COVID-19 pandemic, telepsychology played a key role for continuation of mental health treatment.
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Affiliation(s)
| | - Nicolas R Thompson
- Department of Quantitative Health Sciences, Neurological Institute, Center for Outcomes Research and Evaluation, Cleveland, Ohio, USA
| | - Jocelyn F Bautista
- The Charles Shor Epilepsy Center, Neurological Institute, Cleveland, Ohio, USA
| | - Lauren R Sankary
- Neuro-ethics Program, Center for Bioethics, Cleveland Clinic, Cleveland, Ohio, USA
| | - Susan Stanton
- The Charles Shor Epilepsy Center, Neurological Institute, Cleveland, Ohio, USA
| | - Vineet Punia
- The Charles Shor Epilepsy Center, Neurological Institute, Cleveland, Ohio, USA
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23
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A review of audiovisual telemedicine utilization and satisfaction assessment during the COVID-19 pandemic. Int J Technol Assess Health Care 2021; 38:e2. [PMID: 34924067 DOI: 10.1017/s026646232100060x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The use of telemedicine has broadened as technology that both restores continuity of care during disruptions in healthcare delivery and routinely provides primary care alone or in combination with in-person care. During the Covid-19 outbreak, the use of telemedicine as a routine care modality further accelerated. METHODS A review of scientific studies that used telemedicine to provide care from December 2019 to December 2020 is presented. From an initial set of 2,191 articles, 36 studies are analyzed. Evidence is organized and evaluated according to the country of study, the clinical specialty, the technology platform used, and satisfaction and utilization outcomes. RESULTS Thirty-one studies reported high patient satisfaction scores. Eight studies reported satisfaction from both providers and patients with no uniformly accepted assessment instrument. Eight studies conducted a descriptive analysis of telemedicine use and patient adoption patterns. Less than one-third of studies were controlled before/after studies. Most studies were conducted in the USA followed by Europe. CONCLUSIONS Reported satisfaction rates are high, consistent with previously documented research, whereas utilization rates increased significantly compared with the prepandemic period. Future work in developing standardized uniform assessment instruments, embedded with each telemedicine system, would increase versatility and agility in the assessment, boosting statistical power and the interpretation of results.
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24
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Martos-Pérez F, Martín-Escalante MD, Olalla-Sierra J, Prada-Pardal JL, García-de-Lucas MD, González-Vega R, Jiménez-Puente A, García-Alegría J. The value of telephone consultations during COVID-19 pandemic. An observational study. QJM 2021; 114:715-720. [PMID: 33533911 PMCID: PMC7928558 DOI: 10.1093/qjmed/hcab024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Many Spanish hospitals converted scheduled in-person visits to telephone visits during the COVID-19 lockdown. There is scarce information about the performance of those visits. AIM To compare telephone visits during the COVID-19 lockdown period with previous in-person visits. DESIGN Retrospective descriptive study. METHODS Telephone visits from 15 March to 31 May 2020 were compared with in-person visits during the same period in 2019. MAIN MEASURES The proportions of both groups were compared in term of failure to contact patient, requested diagnostic tests/referrals, discharges, admissions and emergency visits within 30-60 days. A sample of patients, and all participating physicians completed surveys. Z-score test was used (statistical significance P<0.05). RESULTS A total of 5602 telephone visits were conducted. In comparison to in-person visits, telephone visits showed higher rates of visit compliance (95.9% vs. 85.2%, P<0.001) and discharges (22.12% vs. 11.82%; P<0.001), and lower number of ancillary tests and referrals. During the 30- and 60-day periods following the telephone visit, a reduction of 52% and 47% in the combined number of emergency department visits and hospital admissions was observed compared to in-person visits (P<0.01). Of the 120 patients surveyed, 95% were satisfied/very satisfied with the telephone visits. Of the 26 physicians, 84.6% considered telephone visits were useful to prioritize patients. CONCLUSIONS During health emergencies, previously scheduled outpatient in-person visits can be converted to telephone visits, reducing absenteeism, increasing the rate of discharges and reducing ancillary tests and referrals without increasing the rate of hospital admissions or emergency department visits.
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Affiliation(s)
- F Martos-Pérez
- Department of Internal Medicine, Hospital Costa del Sol, Autovía A-7 Km 187, 29603 Marbella, Spain
| | - M D Martín-Escalante
- Department of Internal Medicine, Hospital Costa del Sol, Autovía A-7 Km 187, 29603 Marbella, Spain
| | - J Olalla-Sierra
- Department of Internal Medicine, Hospital Costa del Sol, Autovía A-7 Km 187, 29603 Marbella, Spain
| | - J L Prada-Pardal
- Department of Internal Medicine, Hospital Costa del Sol, Autovía A-7 Km 187, 29603 Marbella, Spain
| | - M D García-de-Lucas
- Department of Internal Medicine, Hospital Costa del Sol, Autovía A-7 Km 187, 29603 Marbella, Spain
| | - R González-Vega
- Department of Internal Medicine, Hospital Costa del Sol, Autovía A-7 Km 187, 29603 Marbella, Spain
| | - A Jiménez-Puente
- Evaluation Department, Hospital Costa del Sol, Autovía A-7 Km 187, 29603 Marbella, Spain
| | - J García-Alegría
- Department of Internal Medicine, Hospital Costa del Sol, Autovía A-7 Km 187, 29603 Marbella, Spain
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25
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Ali A, Dindoust D, Grant J, Clarke D. Delivering epilepsy care in low-resource settings: the role of technology. Expert Rev Med Devices 2021; 18:13-23. [PMID: 34851222 DOI: 10.1080/17434440.2021.2013198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The implementation of technology in the field of epileptology has traditionally focused on its use for diagnosis and treatment and has, unsurprisingly, been capital-intensive, making it therefore mainly implementable in advanced high-income countries. Because of technological innovations over the past 20 years there has been almost a paradigm shift, particularly in access to and the potential for implementing relevant technology in lesser developed environments. Nearly 80% of people living with epilepsy live in low and middle-income countries. AREAS COVERED The challenge and the purpose of this paper is to discuss how technology can be implemented into lesser-resourced contexts not only cost-effectively but in a cost-saving way while also building capacity and thus sustainability. EXPERT OPINION The rate of technological advancement presents the risk of progressive widening of the technology and care gaps between advanced and lesser developed regions. Implementing technology is both about finding relevant appropriate technologies for the individual contexts of a diverse range of countries but also about repurposing low-tech technologies for application in epilepsy care in these areas. Finally exciting advances such as autonomous driving, digital twinning and robotic surgery will likely transform epilepsy care in several lower-resourced settings in the next 5-10 years.
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Affiliation(s)
- Amza Ali
- Departments of Medicine, Kingston Public Hospital and University of the West Indies, Mona, Jamaica
| | | | - Justin Grant
- Rotman School of Management, University of Toronto, Toronto, Canada
| | - Dave Clarke
- Dell Medical School, University of Texas, Austin, Texas, USA
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26
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Benis A, Banker M, Pinkasovich D, Kirin M, Yoshai BE, Benchoam-Ravid R, Ashkenazi S, Seidmann A. Reasons for Utilizing Telemedicine during and after the COVID-19 Pandemic: An Internet-Based International Study. J Clin Med 2021; 10:jcm10235519. [PMID: 34884221 PMCID: PMC8658517 DOI: 10.3390/jcm10235519] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic challenges healthcare services. Concomitantly, this pandemic had a stimulating effect on technological expansions related to telehealth and telemedicine. We sought to elucidate the principal patients' reasons for using telemedicine during the COVID-19 pandemic and the propensity to use it thereafter. Our primary objective was to identify the reasons of the survey participants' disparate attitudes toward the use of telemedicine. We performed an online, multilingual 30-question survey for 14 days during March-April 2021, focusing on the perception and usage of telemedicine and their intent to use it after the pandemic. We analyzed the data to identify the attributes influencing the intent to use telemedicine and built decision trees to highlight the most important related variables. We examined 473 answers: 272 from Israel, 87 from Uruguay, and 114 worldwide. Most participants were women (64.6%), married (63.8%) with 1-2 children (52.9%), and living in urban areas (84.6%). Only a third of the participants intended to continue using telemedicine after the COVID-19 pandemic. Our main findings are that an expected substitution effect, technical proficiency, reduced queueing times, and peer experience are the four major factors in the overall adoption of telemedicine. Specifically, (1) for most participants, the major factor influencing their telemedicine usage is the implicit expectation that such a visit will be a full substitute for an in-person appointment; (2) another factor affecting telemedicine usage by patients is their overall technical proficiency and comfort level in the use of common web-based tools, such as social media, while seeking relevant medical information; (3) time saving as telemedicine can allow for asynchronous communications, thereby reducing physical travel and queuing times at the clinic; and finally (4) some participants have also indicated that telemedicine seems more attractive to them after watching family and friends (peer experience) use it successfully.
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Affiliation(s)
- Arriel Benis
- Faculty of Industrial Engineering and Technology Management, Holon Institute of Technology, Holon 5810201, Israel; (M.B.); (D.P.); (M.K.); (B.-e.Y.)
- Faculty of Digital Technologies in Medicine, Holon Institute of Technology, Holon 5810201, Israel
- Correspondence:
| | - Maxim Banker
- Faculty of Industrial Engineering and Technology Management, Holon Institute of Technology, Holon 5810201, Israel; (M.B.); (D.P.); (M.K.); (B.-e.Y.)
| | - David Pinkasovich
- Faculty of Industrial Engineering and Technology Management, Holon Institute of Technology, Holon 5810201, Israel; (M.B.); (D.P.); (M.K.); (B.-e.Y.)
| | - Mark Kirin
- Faculty of Industrial Engineering and Technology Management, Holon Institute of Technology, Holon 5810201, Israel; (M.B.); (D.P.); (M.K.); (B.-e.Y.)
| | - Bat-el Yoshai
- Faculty of Industrial Engineering and Technology Management, Holon Institute of Technology, Holon 5810201, Israel; (M.B.); (D.P.); (M.K.); (B.-e.Y.)
| | | | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel 4070000, Israel;
| | - Abraham Seidmann
- Department of Information Systems, Questrom Business School, Boston University, Boston, MA 02215, USA;
- Health Analytics and Digital Health, Digital Business Institute, Boston University, Boston, MA 02215, USA
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27
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Pagaling GT, Espiritu AI, Dellosa MAA, Leochico CFD, Pasco PMD. The practice of teleneurology in the Philippines during the COVID-19 pandemic. Neurol Sci 2021; 43:811-819. [PMID: 34729643 PMCID: PMC8563298 DOI: 10.1007/s10072-021-05705-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/27/2021] [Indexed: 01/15/2023]
Abstract
Background and objectives The practice of teleneurology provided an accessible and safe method of consultation during the COVID-19 pandemic. We aimed to describe the practice of teleneurology among Filipino neurologists and determine the factors affecting its adoption using the unified theory of acceptance and use of technology (UTAUT) model and its constructs, namely performance expectancy, effort expectancy, social influence, and facilitating conditions. Methods This was a cross-sectional survey conducted online last October 2020 involving adult and pediatric neurologists in the Philippines. The internal consistency of the questionnaire adapted from UTAUT model was determined using Cronbach’s alpha. We performed logistic regression analysis to determine which constructs of the UTAUT model were significant factors on the intent to practice teleneurology. Results The study yielded a 28.8% response rate. Among the respondents (n1 = 147), 95.2% (n2 = 140) practiced teleneurology during the pandemic, and 77.6% (n1 = 147) planned to continue it after the pandemic. Teleneurology was mostly done on an outpatient basis on social media platforms via videoconferencing due to easier access for both end-users. The UTAUT model explained 80.9% (95% CI 0.76, 0.86a) of the total variation. Performance expectancy and facilitating conditions affect the intent to use teleneurology. Conclusions Due to the limited resources and knowledge of its practice, infrastructural support and benefit awareness campaigns would be beneficial to increase its adoption, especially in developing countries.
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Affiliation(s)
- Gerald T Pagaling
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
| | - Adrian I Espiritu
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,Department of Clinical Epidemiology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | | | - Carl Froilan D Leochico
- Department of Rehabilitation Medicine, College of Medicine and Philippine General Hospital, University of the Philippines, Manila, Philippines.,Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Global and Quezon City, Philippines
| | - Paul Matthew D Pasco
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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28
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Escobar MF, Henao JF, Prieto D, Echavarria MP, Gallego JC, Nasner D, Martínez-Ruíz DM, Velasco JE, Alarcón J. Teleconsultation for outpatient care of patients during the Covid-19 pandemic at a University Hospital in Colombia. Int J Med Inform 2021; 155:104589. [PMID: 34592540 PMCID: PMC8453779 DOI: 10.1016/j.ijmedinf.2021.104589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND During the COVID 19 pandemic, direct-to-consumer telehealth (DTC) services allowed patients real-time virtual access to healthcare providers, especially those with an established relationship. In Colombia, this care modality was implemented between 2019 and 2020, under national considerations, it was implemented for outpatient care in a highly complex university hospital in Cali, Colombia. METHODS A descriptive study with prospective information collection was used to describe the implementation of the outpatient teleconsultation care model for patients. We constructed the clinical and process indicators with which we evaluated the model. FINDINGS A total of 56,560 patients from our institution were treated by virtual outpatient consultation during the first nine months of the health emergency declared by COVID 19 in Colombia. The strategy made it possible to achieve coverage more significant than 100% in Cali and the departments of Colombia. Attention by teleconsultation was 19% of the total ambulatory care. The effectiveness in carrying out scheduled teleconsultations had an overall result of 91.5%. The accessibility results demonstrated the need to strengthen connectivity and accessibility to payments and strengthen technology adoption in the institution, health personnel, and patients. INTERPRETATION Implementing an outpatient teleconsultation model allowed the continuity of the management with comprehensive coverage nationwide from a highly complex hospital in southwestern Colombia. The indicators' analysis should help strengthen the policies of access to telemedicine, especially with the consequences of the pandemic in low- and middle-income countries. Latin American evidence is necessary to establish the safety profile of telemedicine and the costs associated with the provision.
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Affiliation(s)
- María Fernanda Escobar
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia; Department of Telemedicine, Fundación Valle del Lili, Cali, Colombia.
| | - Juan Fernando Henao
- Department of Information Technology, Fundación Valle del Lili, Cali, Colombia
| | - Diana Prieto
- Department of Outpatient Medical Care, Fundación Valle del Lili, Cali, Colombia
| | | | | | - Daniela Nasner
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | | | | | - Juliana Alarcón
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
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Garfan S, Alamoodi AH, Zaidan BB, Al-Zobbi M, Hamid RA, Alwan JK, Ahmaro IYY, Khalid ET, Jumaah FM, Albahri OS, Zaidan AA, Albahri AS, Al-Qaysi ZT, Ahmed MA, Shuwandy ML, Salih MM, Zughoul O, Mohammed KI, Momani F. Telehealth utilization during the Covid-19 pandemic: A systematic review. Comput Biol Med 2021; 138:104878. [PMID: 34592585 PMCID: PMC8450049 DOI: 10.1016/j.compbiomed.2021.104878] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 12/27/2022]
Abstract
During the coronavirus disease (COVID-19) pandemic, different technologies, including telehealth, are maximised to mitigate the risks and consequences of the disease. Telehealth has been widely utilised because of its usability and safety in providing healthcare services during the COVID-19 pandemic. However, a systematic literature review which provides extensive evidence on the impact of COVID-19 through telehealth and which covers multiple directions in a large-scale research remains lacking. This study aims to review telehealth literature comprehensively since the pandemic started. It also aims to map the research landscape into a coherent taxonomy and characterise this emerging field in terms of motivations, open challenges and recommendations. Articles related to telehealth during the COVID-19 pandemic were systematically searched in the WOS, IEEE, Science Direct, Springer and Scopus databases. The final set included (n = 86) articles discussing telehealth applications with respect to (i) control (n = 25), (ii) technology (n = 14) and (iii) medical procedure (n = 47). Since the beginning of the pandemic, telehealth has been presented in diverse cases. However, it still warrants further attention. Regardless of category, the articles focused on the challenges which hinder the maximisation of telehealth in such times and how to address them. With the rapid increase in the utilization of telehealth in different specialised hospitals and clinics, a potential framework which reflects the authors' implications of the future application and opportunities of telehealth has been established. This article improves our understanding and reveals the full potential of telehealth during these difficult times and beyond.
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Affiliation(s)
- Salem Garfan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A H Alamoodi
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia.
| | - B B Zaidan
- Future Technology Research Centre, National Yunlin University of Science and Technology, 123 University Road, Section 3, Douliou, Yunlin, 64002, Taiwan, ROC
| | | | - Rula A Hamid
- College of Business Informatics, University of Information Technology and Communications (UOITC), Baghdad, Iraq
| | - Jwan K Alwan
- Biomedical Informatics College, University of Information Technology and Communications (UOITC), Baghdad, Iraq; Faculty of Computer Science and Information Technology, University of Malaya (UM), Malaysia
| | - Ibraheem Y Y Ahmaro
- Computer Science Department, College of Information Technology, Hebron University, Hebron, Palestine
| | - Eman Thabet Khalid
- Department of Computer Sciences, College of Education for Pure Sciences, University of Basrah, Basrah, Iraq
| | - F M Jumaah
- Department of Computer and Software Engineering, Polytechnique Montréal, Canada
| | - O S Albahri
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A A Zaidan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A S Albahri
- Informatics Institute for Postgraduate Studies (IIPS), Iraqi Commission for Computers and Informatics (ICCI), Baghdad, Iraq
| | - Z T Al-Qaysi
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - M A Ahmed
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Moceheb Lazam Shuwandy
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Mahmood M Salih
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Omar Zughoul
- Computer Information System, Ahmed Bin Mohammed Military College, Al Shahaniya, Qatar
| | - K I Mohammed
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - Fayiz Momani
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
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30
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Fang JL, Umoren R, Whyte H, Limjoco J, Makkar A, Yankanah R, McCoy M, Lo MD, Colby CE, Herrin J, Jacobson RM, Demaerschalk BM. Provider Perspectives on the Acceptability, Appropriateness, and Feasibility of Teleneonatology. Am J Perinatol 2021. [PMID: 34666395 DOI: 10.1055/s-0041-1736587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to measure provider perspectives on the acceptability, appropriateness, and feasibility of teleneonatology in neonatal intensive care units (NICUs) and community hospitals. STUDY DESIGN Providers from five academic tertiary NICUs and 27 community hospitals were surveyed using validated implementation measures to assess the acceptability, appropriateness, and feasibility of teleneonatology. For each of the 12 statements, scale values ranged from 1 to 5 (1 = strongly disagree; 5 = strongly agree), with higher scores indicating greater positive perceptions. Survey results were summarized, and differences across respondents assessed using generalized linear models. RESULTS The survey response rate was 56% (203/365). Respondents found teleneonatology to be acceptable, appropriate, and feasible. The percent of respondents who agreed with each of the twelve statements ranged from 88.6 to 99.0%, with mean scores of 4.4 to 4.7 and median scores of 4.0 to 5.0. There was no difference in the acceptability, appropriateness, and feasibility of teleneonatology when analyzed by professional role, years of experience in neonatal care, or years of teleneonatology experience. Respondents from Level I well newborn nurseries had greater positive perceptions of teleneonatology than those from Level II special care nurseries. CONCLUSION Providers in tertiary NICUs and community hospitals perceive teleneonatology to be highly acceptable, appropriate, and feasible for their practices. The wide acceptance by providers of all roles and levels of experience likely demonstrates a broad receptiveness to telemedicine as a tool to deliver neonatal care, particularly in rural communities where specialists are unavailable. KEY POINTS · Neonatal care providers perceive teleneonatology to be highly acceptable, appropriate, and feasible.. · Perceptions of teleneonatology do not differ based on professional role or years of experience.. · Perceptions of teleneonatology are especially high in smaller hospitals with well newborn nurseries..
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Affiliation(s)
- Jennifer L. Fang
- Division of Neonatal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Rachel Umoren
- Division of Neonatology, Department of Pediatrics, University of Washington & Seattle Children's Hospital, Seattle, Washington
| | - Hilary Whyte
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jamie Limjoco
- Division of Neonatology, University of Wisconsin, Madison, WI
| | - Abhishek Makkar
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Rosanna Yankanah
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mike McCoy
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Mark D. Lo
- Division of Emergency Medicine, Department of Pediatrics, University of Washington & Seattle Children's Hospital, Seattle, Washington
| | - Christopher E. Colby
- Division of Neonatal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Jeph Herrin
- Division of Cardiovascular Medicine, Yale School of Medicine, New Haven Connecticut
| | - Robert M. Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Bart M. Demaerschalk
- Department of Neurology and Center for Connected Care, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona
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Cross JH, Kwon C, Asadi‐Pooya AA, Balagura G, Gómez‐Iglesias P, Guekht A, Hall J, Ikeda A, Kishk NA, Murphy P, Kissani N, Naji Y, Perucca E, Pérez‐Poveda JC, Sanya EO, Trinka E, Zhou D, Wiebe S, Jette N. Epilepsy care during the COVID-19 pandemic. Epilepsia 2021; 62:2322-2332. [PMID: 34428314 PMCID: PMC8652685 DOI: 10.1111/epi.17045] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 02/05/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected the care of all patients around the world. The International League Against Epilepsy (ILAE) COVID-19 and Telemedicine Task Forces examined, through surveys to people with epilepsy (PWE), caregivers, and health care professionals, how the pandemic has affected the well-being, care, and services for PWE. The ILAE included a link on their website whereby PWE and/or their caregivers could fill out a survey (in 11 languages) about the impact of the COVID-19 pandemic, including access to health services and impact on mental health, including the 6-item Kessler Psychological Distress Scale. An anonymous link was also provided whereby health care providers could report cases of new-onset seizures or an exacerbation of seizures in the context of COVID-19. Finally, a separate questionnaire aimed at exploring the utilization of telehealth by health care professionals since the pandemic began was available on the ILAE website and also disseminated to its members. Seventeen case reports were received; data were limited and therefore no firm conclusions could be drawn. Of 590 respondents to the well-being survey (422 PWE, 166 caregivers), 22.8% PWE and 27.5% caregivers reported an increase in seizure frequency, with difficulty in accessing medication and health care professionals reported as barriers to care. Of all respondents, 57.1% PWE and 21.5% caregivers had severe psychological distress (k score >13), which was significantly higher among PWE than caregivers (p<0.01). An increase in telemedicine use during the COVID-19 pandemic was reported by health care professionals, with 40% of consultations conducted by this method. Although 74.9% of health care providers thought that this impacted positively, barriers to care were also identified. As we move forward, there is a need to ensure ongoing support and care for PWE to prevent a parallel pandemic of unmet health care needs.
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Affiliation(s)
- J Helen Cross
- Programme of Developmental NeurosciencesUCL NIHR BRC Great Ormond Street Institute of Child HealthGreat Ormond Street Hospital for ChildrenLondon and Young Epilepsy LingfieldLondonUK
| | - Churl‐Su Kwon
- Division of Health Outcomes and Knowledge Translation ResearchDepartment of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Ali Akbar Asadi‐Pooya
- Epilepsy Research CenterShiraz University of Medical SciencesShirazIran
- Jefferson Comprehensive Epilepsy CenterDepartment of NeurologyThomas Jefferson UniversityPhiladelphiaUSA
| | - Ganna Balagura
- Department of Neurosciences, Rehabilitation, OphthalmologyGenetics, and Maternal and Child HealthPediatric Neurology and Muscular Diseases UnitIRCCS ‘G. Gaslini’ InstituteUniversity of GenoaGenoaItaly
| | - Patricia Gómez‐Iglesias
- Epilepsy Unit. Department of NeurologyHospital Clínico San CarlosHealth Research Institute “San Carlos” (IdISCC)Universidad Complutense de MadridMadridSpain
| | - Alla Guekht
- Moscow Research and Clinical Center for NeuropsychiatryMoscowRussia
- Department of Neurology, Neurosurgery and Medical GeneticsRussian National Research Medical UniversityMoscowRussia
| | - Julie Hall
- Executive DirectorInternational League Against EpilepsyFlower MoundTXUSA
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and PhysiologyKyoto University Graduate School of MedicineKyotoJapan
| | - Nirmeen A. Kishk
- Neurology DepartmentFaculty of MedicineCairo UniversityCairoEgypt
| | | | - Najib Kissani
- Neuroscience Research LaboratoryMarrakech Medical SchoolUniversity Cadi AyyadMarrakeshMorocco
- Neurology DepartmentUniversity Teaching Hospital Mohammed VIMarrakeshMorocco
| | - Yahya Naji
- Neuroscience Research LaboratoryMarrakech Medical SchoolUniversity Cadi AyyadMarrakeshMorocco
- Neurology DepartmentUniversity Teaching Hospital Mohammed VIMarrakeshMorocco
| | - Emilio Perucca
- Division of Clinical and Experimental PharmacologyDepartment of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly
- IRCCS Mondino Foundation (and member of the ERN EpiCARE)PaviaItaly
| | - Juan Carlos Pérez‐Poveda
- Neuroscience DepartmentFaculty of MedicineXavierian University, and Hospital Universitario San IgnacioBogotá D. CColombia
| | - Emmanuel O. Sanya
- Neurology division, Medicine DepartmentUniversity of Ilorin Teaching HospitalKwara StateNigeria
| | - Eugen Trinka
- Department of NeurologyCentre for Cognitive NeuroscienceChristian‐Doppler University HospitalParacelsus Medical UniversitySalzburgAustria
- Neuroscience Institute Christian‐Doppler University HospitalCentre for Cognitive NeuroscienceParacelsus Medical UniversitySalzburgAustria
- Institute of Public Health, Medical Decision‐Making and HTA, UMITMedical Informatics and TechnologyPrivate University for Health SciencesHall in TyrolAustria
| | - Dong Zhou
- Department of NeurologyWest China HospitalSichuan UniversityChengduChina
| | - Samuel Wiebe
- Departments of Clinical Neurosciences and Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Nathalie Jette
- Division of Health Outcomes and Knowledge Translation ResearchDepartment of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
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32
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Abd-Alrazaq A, Hassan A, Abuelezz I, Ahmed A, Alzubaidi MS, Shah U, Alhuwail D, Giannicchi A, Househ M. Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review. J Med Internet Res 2021; 23:e29136. [PMID: 34406962 PMCID: PMC8767979 DOI: 10.2196/29136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/28/2021] [Accepted: 06/20/2021] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Alaa Abd-Alrazaq
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Asmaa Hassan
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Israa Abuelezz
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Arfan Ahmed
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Mahmood Saleh Alzubaidi
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Uzair Shah
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Dari Alhuwail
- Information Science Department, Kuwait University, Kuwait, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Anna Giannicchi
- School of Professional Studies, Berkeley College, New York, NY, United States
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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Koh MY, Lim KS, Fong SL, Khor SB, Tan CT. Impact of COVID-19 pandemic on people with epilepsy: An interventional study using early physical consultation. Epilepsy Behav 2021; 122:108215. [PMID: 34325157 PMCID: PMC8270747 DOI: 10.1016/j.yebeh.2021.108215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Telehealth use is limited in developing countries. Therefore, a modified approach with early physical consultation was designed and applied in our hospital. This study aimed to determine the efficacy of this early physical consultation in reducing the clinical and psychological impacts of coronavirus disease-19 (COVID-19), which enabled insight into its global feasibility. METHOD Participants were contacted and offered early physical consultation with a neurologist. Patients who participated in the Phase 1 study on the impacts of the COVID-19 pandemic on people with epilepsy and treated in our hospital were recruited. Clinical and psychological outcomes of COVID-19 were assessed with the Hospital Anxiety Depression Scale (HADS) and Quality of Life in Epilepsy Inventory (QOLIE-31). RESULT A total of 312 patients completed this study with a mean age of 39.13 ± 16.13 years, majority female (51.0%), and experienced seizures at least once yearly (64.7%). There was 12.6% who experienced seizure worsening related to the COVID-19 pandemic. After receiving early clinical intervention, 30.8% achieved better seizure control with another 51.1% had no seizure occurrence. The mean HADS anxiety score improved immediately post-intervention (5.27 ± 4.32 vs. 4.79 ± 4.26, p < 0.01), and at 2-week post-intervention (5.58 ± 4.46 vs. 4.73 ± 3.95, p < 0.01). The mean HADS depression score also improved immediately post-intervention (4.12 ± 3.69 vs. 3.84 ± 3.76, p < 0.05) and at 2-week post-intervention (4.38 ± 3.81 vs. 3.73 ± 3.63, p < 0.05). The intervention resulted in significant improvement in energy-fatigue and social function subscales in QOLIE-31 but a reduction in cognitive and medication effects subscales. CONCLUSION Early physical consultation with stringent precautionary measures is feasible and effective in improving the psychological outcome during COVID-19 pandemic.
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Affiliation(s)
| | - Kheng-Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Patel NR, El-Karim GA, Mujoomdar A, Mafeld S, Jaberi A, Kachura JR, Tan KT, Oreopoulos GD. Overall Impact of the COVID-19 Pandemic on Interventional Radiology Services: A Canadian Perspective. Can Assoc Radiol J 2021; 72:564-570. [PMID: 32864995 PMCID: PMC7459179 DOI: 10.1177/0846537120951960] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The aim of this national survey was to assess the overall impact of the coronavirus disease 2019 (COVID-19) pandemic on the provision of interventional radiology (IR) services in Canada. METHODS An anonymous electronic survey was distributed via national and regional radiology societies, exploring (1) center information and staffing, (2) acute and on-call IR services, (3) elective IR services, (4) IR clinics, (5) multidisciplinary rounds, (6) IR training, (7) personal protection equipment (PPE), and departmental logistics. RESULTS Individual responses were received from 142 interventional radiologists across Canada (estimated 70% response rate). Nearly half of the participants (49.3%) reported an overall decrease in demand for acute IR services; on-call services were maintained at centers that routinely provide these services (99%). The majority of respondents (73.2%) were performing inpatient IR procedures at the bedside where possible. Most participants (88%) reported an overall decrease in elective IR services. Interventional radiology clinics and multidisciplinary rounds were predominately transitioned to virtual platforms. The vast majority of participants (93.7%) reported their center had disseminated an IR specific PPE policy; 73% reported a decrease in case volume for trainees by at least 25% and a proportion of trainees will either have a delay in starting their careers as IR attendings (24%) or fellowship training (35%). CONCLUSION The COVID-19 pandemic has had a profound impact on IR services in Canada, particularly for elective cases. Many centers have utilized virtual platforms to provide multidisciplinary meetings, IR clinics, and training. Guidelines should be followed to ensure patient and staff safety while resuming IR services.
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Affiliation(s)
- Neeral R. Patel
- Division of Interventional Radiology,
University
Health Network, Toronto, Ontario,
Canada
| | - Ghassan Awad El-Karim
- Division of Interventional Radiology,
University
Health Network, Toronto, Ontario,
Canada
| | - Amol Mujoomdar
- Division of Interventional Radiology,
London Health
Sciences Centre, London, Ontario,
Canada
| | - Sebastian Mafeld
- Division of Interventional Radiology,
University
Health Network, Toronto, Ontario,
Canada
| | - Arash Jaberi
- Division of Interventional Radiology,
University
Health Network, Toronto, Ontario,
Canada
| | - John R. Kachura
- Division of Interventional Radiology,
University
Health Network, Toronto, Ontario,
Canada
| | - Kong Teng Tan
- Division of Interventional Radiology,
University
Health Network, Toronto, Ontario,
Canada
| | - George D. Oreopoulos
- Division of Interventional Radiology,
University
Health Network, Toronto, Ontario,
Canada
- Division of Vascular Surgery, University Health
Network, Toronto, Ontario, Canada
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Aleboyeh S, Appireddy R, Winston GP, Boisse Lomax L, Shukla G. Virtual epilepsy clinics - A Canadian Comprehensive Epilepsy Center experience pre-COVID and during the COVID-19 pandemic period. Epilepsy Res 2021; 176:106689. [PMID: 34242903 PMCID: PMC8440323 DOI: 10.1016/j.eplepsyres.2021.106689] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/27/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
Objective The objective of this study is to assess the role of prior experience with virtual care (through e-visits) in maintaining continuity in ambulatory epilepsy care during an unprecedented pandemic situation, comparing in person versus e-visit clinic uptake. Methods This is an observational study on virtual epilepsy care (through e-visits) over two years, during a pre-COVID period (14 months) continuing into the COVID-19 pandemic period (10 months). For a small initial section of patients seen during the study period a physician survey and a patient satisfaction survey were completed (n = 53). Outcomes of eVisits were analyzed using descriptive statistics. Results Median numbers of epilepsy clinic visits conducted during the COVID-19 period (27.5 new and 113 follow up) remained similar to the median uptake during the pre-COVID period (28 new and 116 follow up). Prior experience with e-visits for epilepsy yielded smooth transition into the pandemic period, with several other advantages. The majority of eVisits were successful despite technical difficulties and major components of history and management were still easily implemented. Results from patient surveys supported that a significant amount of time and money were saved, which was in keeping with our health-economic analysis. Conclusion Our study is one of the first few reports of fully integrated virtual care in a comprehensive epilepsy clinic starting much before start of the COVID-19 pandemic. The results of our study support the feasibility of using virtual care to deliver specialized outpatient care in a comprehensive epilepsy center.
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Affiliation(s)
- Sallya Aleboyeh
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Ramana Appireddy
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Gavin P Winston
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Lysa Boisse Lomax
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Garima Shukla
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada.
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Howie F, Kreofsky BL, Ravi A, Lokken T, Hoff MD, Fang JL. Rapid Rise of Pediatric Telehealth During COVID-19 in a Large Multispecialty Health System. Telemed J E Health 2021; 28:3-10. [PMID: 33999718 DOI: 10.1089/tmj.2020.0562] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Before the COVID-19 pandemic, telemedicine use for outpatient pediatric specialty care was low. Stay-at-home orders (SHO) prompted rapid upscaling of telemedicine capabilities and upskilling of providers. This study compares telemedicine usage before and after the SHO and analyzes how a Children's Center addressed challenges associated with a rapid rise in telemedicine. Methods: Data on outpatient visits across 14 specialty divisions were abstracted from the institutional electronic medical record. The 12-week study period (March 9, 2020-May 29, 2020) spanned three epochs: pre-SHO; post-SHO; reopening to in-person visits. Changes in in-person visits, video visits, and completed, cancelled, and no-show appointments were compared between three epochs. Results: A total of 4,914 outpatient pediatric specialty visits were completed, including 67% (3,296/4,914) in-person and 33% (1,618/4,914) through video. During the first two epochs encompassing the SHO, video visits increased by 4,750%. During the third epoch when the SHO was lifted, video visits decreased by 66%, with 19.4% of visits conducted through video in week 12. Overall, for outpatient video appointments, 82.8% (1,618/1,954) were completed, 9.1% (178/1,954) were cancelled, and 8.1% (158/1,954) were no-shows. The percentage of completed and no-show appointments did not differ between epochs. However, the cancellation rate decreased significantly from Epochs 1 to 3 (p = 0.008). Conclusion: A SHO was associated with a large increase in pediatric specialty video visits. Post-SHO, the percentage of pediatric specialty visits conducted through video decreased but remained higher than before the SHO. Frequent, content-rich communications, self-directed tutorials, and individualized coaching may facilitate successful increases in telemedicine use.
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Affiliation(s)
- Flora Howie
- Division of Developmental and Behavioral Pediatrics, Mayo Clinic, Rochester, Minnesota, USA
| | - Beth L Kreofsky
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Anupama Ravi
- Division of Pediatric Allergy and Immunology, Mayo Clinic, Rochester, Minnesota, USA
| | - Troy Lokken
- Center for Connected Care, Mayo Clinic, Rochester, Minnesota, USA
| | - Mekenzie D Hoff
- Center for Connected Care, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer L Fang
- Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Rivest J, Caron D, Desbeaumes Jodoin V. Covid-19 pandemic: Will telemedicine be a new standard for mental health in cancer care? J Psychosoc Oncol 2021; 39:333-336. [PMID: 33900901 DOI: 10.1080/07347332.2021.1895948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jacynthe Rivest
- Psychiatry Department, CHUM, Integrated Cancer and Psychosocial Oncology Research Team, CRCHUM, Montreal, Canada
| | - David Caron
- Psychiatry Department, CHUM, Montreal, Canada
| | - Véronique Desbeaumes Jodoin
- Psychiatry Department, CHUM, Integrated Cancer and Psychosocial Oncology Research Team, CRCHUM, Montreal, Canada
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38
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Abd-alrazaq A, Hassan A, Abuelezz I, Ahmed A, Alzubaidi MS, Shah U, Alhuwail D, Giannicchi A, Househ M. 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] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
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.
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Empeslidis T, Tsaousis KT, Katopodis P, Tyradellis S. Patient's satisfactory outcomes after implementation of follow-up 'virtual clinics' in age-related macular degeneration treatment. Clin Exp Optom 2021; 105:94-95. [PMID: 33689648 DOI: 10.1080/08164622.2021.1878841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Theo Empeslidis
- Ophthalmology Department, Medical Retina, Leicester Royal Infirmary, Leicester, UK,
| | | | - Periklis Katopodis
- Ophthalmology Department, Medical Retina, Leicester Royal Infirmary, Leicester, UK,
| | - Straton Tyradellis
- Ophthalmology Department, Medical Retina, Leicester Royal Infirmary, Leicester, UK,
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40
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Heart Failure Care Delivery in the COVID-19 Era: The Patients' Perspective. Healthcare (Basel) 2021; 9:healthcare9030245. [PMID: 33804305 PMCID: PMC8001742 DOI: 10.3390/healthcare9030245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: The SARS-CoV-2 pandemic is changing healthcare delivery around the world with hospital systems experiencing a dramatic decline in patient volumes. Surveying our center’s heart failure (HF) clinic population, we aimed to understand our patients’ perception of coronavirus disease 2019 (COVID-19) and care delivery preferences. Methods: Patients with chronic HF presenting either in-person or virtually were approached to complete a ten question, anonymous, voluntary survey. Acutely decompensated patients and heart transplant recipients were excluded. Results: 109 patients completed the survey. Average age was 62 ± 14 years, 67% were male, and 59% had HF with reduced ejection fraction (HFrEF). Overall, patients were worried about contracting COVID-19 and believed they were prone to more severe infection given their underlying HF. However, they were not hesitant to initiate healthcare contact for symptoms and preferred in-person appointments over virtual visits. Although the difference did not reach statistical significance, female patients and those with HF with preserved ejection fraction (HFpEF) were more concerned. Conclusions: Patients with HF are concerned about their increased risk of contracting COVID-19. However, they are actively seeking healthcare contact and prefer in-person over virtual visits.
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41
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Weiner JP, Bandeian S, Hatef E, Lans D, Liu A, Lemke KW. In-Person and Telehealth Ambulatory Contacts and Costs in a Large US Insured Cohort Before and During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e212618. [PMID: 33755167 PMCID: PMC7988360 DOI: 10.1001/jamanetworkopen.2021.2618] [Citation(s) in RCA: 130] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/29/2021] [Indexed: 12/11/2022] Open
Abstract
Importance This study assesses the role of telehealth in the delivery of care at the start of the COVID-19 pandemic. Objectives To document patterns and costs of ambulatory care in the US before and during the initial stage of the pandemic and to assess how patient, practitioner, community, and COVID-19-related factors are associated with telehealth adoption. Design, Setting, and Participants This is a cohort study of working-age persons continuously enrolled in private health plans from March 2019 through June 2020. The comparison periods were March to June in 2019 and 2020. Claims data files were provided by Blue Health Intelligence, an independent licensee of the Blue Cross and Blue Shield Association. Data analysis was performed from June to October 2020. Main Outcomes and Measures Ambulatory encounters (in-person and telehealth) and allowed charges, stratified by characteristics derived from enrollment files, practitioner claims, and community characteristics linked to the enrollee's zip code. Results A total of 36 568 010 individuals (mean [SD] age, 35.71 [18.77] years; 18 466 557 female individuals [50.5%]) were included in the analysis. In-person contacts decreased by 37% (from 1.63 to 1.02 contacts per enrollee) from 2019 to 2020. During 2020, telehealth visits (0.32 visit per person) accounted for 23.6% of all interactions compared with 0.3% of contacts in 2019. When these virtual contacts were added, the overall COVID-19 era patient and practitioner visit rate was 18% lower than that in 2019 (1.34 vs 1.64 visits per person). Behavioral health encounters were far more likely than medical contacts to take place virtually (46.1% vs 22.1%). COVID-19 prevalence in an area was associated with higher use of telehealth; patients from areas within the top quintile of COVID-19 prevalence during the week of their encounter were 1.34 times more likely to have a telehealth visit compared with those in the lowest quintile (the reference category). Persons living in areas with limited social resources were less likely to use telehealth (most vs least socially advantaged neighborhoods, 27.4% vs 19.9% usage rates). Per enrollee medical care costs decreased by 15% between 2019 and 2020 (from $358.32 to $306.04 per person per month). During 2020, those with 1 or more COVID-19-related service (1 470 721 members) had more than 3 times the medical costs ($1701 vs $544 per member per month) than those without COVID-19-related services. Persons with 1 or more telehealth visits in 2020 had considerably higher costs than persons having only in-person ambulatory contacts ($2214.10 vs $1337.78 for the COVID-19-related subgroup and $735.87 vs $456.41 for the non-COVID-19 subgroup). Conclusions and Relevance This study of a large cohort of patients enrolled in US health plans documented patterns of care at the onset of COVID-19. The findings are relevant to policy makers, payers, and practitioners as they manage the use of telehealth during the pandemic and afterward.
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Affiliation(s)
- Jonathan P. Weiner
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Stephen Bandeian
- Blue Health Intelligence, LLC, an independent licensee of the Blue Cross and Blue Shield Association, Chicago, Illinois
| | - Elham Hatef
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel Lans
- Blue Health Intelligence, LLC, an independent licensee of the Blue Cross and Blue Shield Association, Chicago, Illinois
| | - Angela Liu
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Klaus W. Lemke
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Ganapathy A, Clough BA, Casey LM. Organizational and Policy Barriers to the Use of Digital Mental Health by Mental Health Professionals. Telemed J E Health 2021; 27:1332-1343. [PMID: 33646057 DOI: 10.1089/tmj.2020.0455] [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: 11/12/2022] Open
Abstract
Background: Digital mental health (DMH) provides effective methods of overcoming issues of time constraints, accessibility, and availability of mental health care. They can provide a valuable means to deliver mental health care in the present pandemic. However, adoption of these methods has been slow. Mental health professional (MHP) concerns at the organizational and policy level that influence this slow adoption need to be examined. Materials and Methods: A narrative review was conducted to identify the barriers. Searches using the databases Scopus, Embase, and PubMed were conducted to identify research focused on barriers reported by MHPs to use DMH. Results: The search resulted in 356 unique citations, and 21 papers met the inclusion and exclusion criteria. Forward and backward sampling resulted in identifying an additional 19 relevant papers. Discussion: Unmet needs for information, training, and infrastructure, challenges to the workflow and excessive workloads, and ambiguous policies serve as barriers to DMH use. This article recommends strategies for researchers, organizations, DMH designers, and governmental institutions to ensure efficient utilization of DMH. Conclusion: Concerted efforts at individual, organizational, and governmental levels are essential to ensure efficient utilization of DMH.
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Affiliation(s)
- Aarthi Ganapathy
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute, Mount Gravatt, Australia
| | - Bonnie A Clough
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute, Mount Gravatt, Australia
| | - Leanne M Casey
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute, Mount Gravatt, Australia
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Lisovska K, Gustafsson E, Klecki J, Edelvik Tranberg A, Zelano J. An online tool for information to women with epilepsy and therapeutic drug monitoring in pregnancy: Design and pilot study. Epilepsia Open 2021; 6:339-344. [PMID: 34033254 PMCID: PMC8166785 DOI: 10.1002/epi4.12473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/19/2021] [Accepted: 01/30/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Information to women with epilepsy on pregnancy-related antiseizure medication (ASM) issues and reliable tools for therapeutic drug monitoring (TDM) are important aspects of epilepsy care. We aimed to develop and test an online tool for patient education on pregnancy-related issues and communication with epilepsy nurses during pregnancy for women with epilepsy. METHODS An existing national platform for online communication (1177.se) was used, and an online tool was developed by two epilepsy nurses, two neurologists, and an IT technician. The tool was launched as a complement to standard care, and patients deciding to use it were invited to participate in a survey of user experiences and knowledge questions. RESULTS The online tool consists of two modules: one for patient education and one for TDM during pregnancy. The latter module allows scheduling of automatic reminders of blood tests that are sent to patients at set intervals. The epilepsy nurse can communicate results and suggested dose changes in the tool. A total of 48 women answered the survey: 28 had been invited to use the information module and 20 to use the TDM module. Patient experiences were generally good, and most users of the TDM module would prefer an online means of communication in future pregnancies. For epilepsy nurses, the tool provided good overview of patients currently pregnant and administrative advantages compared with traditional means of communication. SIGNIFICANCE Online patient education and communication about TDM during pregnancy are feasible and can be a valuable part of future digitalization efforts in epilepsy care.
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Affiliation(s)
- Kristina Lisovska
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva Gustafsson
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Judith Klecki
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Edelvik Tranberg
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Johan Zelano
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Wallenberg Center of Molecular and Translational Medicine, Gothenburg University, Gothenburg, Sweden
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Abbatemarco JR, Hartman J, McGinley M, Bermel RA, Boissy A, Chizmadia DT, Sullivan AB, Rensel MR. Providing Person-Centered Care via Telemedicine in the Era of COVID-19 in Multiple Sclerosis. J Patient Exp 2021; 8:2374373520981474. [PMID: 34179353 PMCID: PMC8205372 DOI: 10.1177/2374373520981474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has catalyzed the rapid adoption of telemedicine which encompasses synchronous and asynchronous interactions between patients and providers. In order to facilitate this rapid deployment, there has been numerous regulatory changes to ensure caregivers can effectively communicate with patients during this time. We illustrate a model where people, processes, and technology work together to address the comprehensive needs of multiple sclerosis (MS) patients. We provide a template for how multidisciplinary, academic practices can implement a rapid shift to virtual management during the pandemic using existing infrastructure that can be widely adopted to care for patients with chronic diseases. Telemedicine was incorporated into our entire practice, which encompasses neurology, rehabilitation, advanced practice providers, fellows, social work, and behavioral medicine. Our patient satisfaction results remained stable across almost all domains when compared to survey results from our typical, in-office visits. Our experience demonstrates telemedicine’s transformative potential in successfully managing a multidisciplinary MS clinic during the time of a pandemic and outlines a potential path for other practices to follow.
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Affiliation(s)
- Justin R Abbatemarco
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Jennifer Hartman
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Marisa McGinley
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Robert A Bermel
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Adrienne Boissy
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Desiree T Chizmadia
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Amy B Sullivan
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Mary R Rensel
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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Garg A, Goyal S, Thati R, Thati N. Implementation of Telemedicine in a Tertiary Hospital-Based Ambulatory Practice in Detroit During the COVID-19 Pandemic: Observational Study. JMIR Public Health Surveill 2021; 7:e21327. [PMID: 33400680 PMCID: PMC7801131 DOI: 10.2196/21327] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/04/2020] [Accepted: 12/12/2020] [Indexed: 12/11/2022] Open
Abstract
Background The COVID-19 pandemic, caused by SARS-CoV-2, has forced the health care delivery structure to change rapidly. The pandemic has further widened the disparities in health care and exposed vulnerable populations. Health care services caring for such populations must not only continue to operate but create innovative methods of care delivery without compromising safety. We present our experience of incorporating telemedicine in our university hospital–based outpatient clinic in one of the worst-hit areas in the world. Objective Our goal is to assess the adoption of a telemedicine service in the first month of its implementation in outpatient practice during the COVID-19 pandemic. We also want to assess the need for transitioning to telemedicine, the benefits and challenges in doing so, and ongoing solutions during the initial phase of the implementation of telemedicine services for our patients. Methods We conducted a prospective review of clinic operations data from the first month of a telemedicine rollout in the outpatient adult ambulatory clinic from April 1, 2020, to April 30, 2020. A telemedicine visit was defined as synchronous audio-video communication between the provider and patient for clinical care longer than 5 minutes or if the video visit converted to a telephone visit after 5 minutes due to technical problems. We recorded the number of telemedicine visits scheduled, visits completed, and the time for each visit. We also noted the most frequent billing codes used based on the time spent in the patient care and the number of clinical tasks (eg, activity suggested through diagnosis or procedural code) that were addressed remotely by the physicians. Results During the study period, we had 110 telemedicine visits scheduled, of which 94 (85.4%) visits were completed. The average duration of the video visit was 35 minutes, with the most prolonged visit lasting 120 minutes. Of 94 patients, 24 (25.54%) patients were recently discharged from the hospital, and 70 (74.46%) patients were seen for urgent care needs. There was a 50% increase from the baseline in the number of clinical tasks that were addressed by the physicians during the pandemic. Conclusions There was a high acceptance of telemedicine services by the patients, which was evident by a high show rate during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, a shortage of providers, and increased outpatient needs, telemedicine was successfully implemented in our practice.
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Affiliation(s)
- Alpana Garg
- Wayne State University, Detroit, MI, United States
| | - Sachin Goyal
- Wayne State University, Detroit, MI, United States
| | - Rohit Thati
- Georgia State University, Atlanta, GA, United States
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Implementation and Patient Satisfaction of Telemedicine in Spine Physical Medicine and Rehabilitation Patients During the COVID-19 Shutdown. Am J Phys Med Rehabil 2020; 99:1079-1085. [PMID: 32969967 DOI: 10.1097/phm.0000000000001600] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the implementation and patient satisfaction of telemedicine visits in a physical medicine and rehabilitation spine practice during COVID-19. DESIGN This is a prospective cohort study. RESULTS Of 172 patients, 97.6% were very satisfied or satisfied (83.7% of the patients were very satisfied) with their telemedicine appointment. In 44.4% of the cases, the physical medicine and rehabilitation physician prescribed medication to the patient, and in 21.6% of the cases, either an injection or radiofrequency ablation was ordered. Most patients (87%) did not have any issues during their encounter. Lastly, 64.5% of the patients preferred telemedicine over in-person appointments, whereas 56.1% of the patients who are 60 yrs and older responded the same. A total of 67.4% of those who had a follow-up visit would choose telemedicine over in-person. CONCLUSIONS The results of this study show that telemedicine can provide very effective and satisfactory care in a physical medicine and rehabilitation spine practice. This was especially notable with follow-up visits where imaging and treatment plan can easily be discussed over telemedicine. Stay-at-home orders and improved reimbursement during the COVID-19 pandemic have spurred adoption of telemedicine with high patient satisfaction. We hope that physical medicine and rehabilitation physicians will be able to continue expanding patient access in the postpandemic world.
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Asadi-Pooya AA, Simani L, Shahisavandi M, Barzegar Z. COVID-19, de novo seizures, and epilepsy: a systematic review. Neurol Sci 2020; 42:415-431. [PMID: 33237493 PMCID: PMC7686454 DOI: 10.1007/s10072-020-04932-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022]
Abstract
Objective We discuss the evidence on the occurrence of de novo seizures in patients with COVID-19, the consequences of this catastrophic disease in people with epilepsy (PWE), and the electroencephalographic (EEG) findings in patients with COVID-19. Methods This systematic review was prepared according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. MEDLINE, Scopus, and Embase from inception to August 15, 2020 were systematically searched. These key words were used: “COVID” AND “seizure” OR “epilepsy” OR “EEG” OR “status epilepticus” OR “electroencephalography”. Results We could identify 62 related manuscripts. Many studies were case reports or case series of patients with COVID-19 and seizures. PWE showed more psychological distress than healthy controls. Many cases with new-onset focal seizures, serial seizures, and status epilepticus have been reported in the literature. EEG studies have been significantly ignored and underused globally. Conclusion Many PWE perceived significant disruption in the quality of care to them, and some people reported increase in their seizure frequency since the onset of the pandemic. Telemedicine is a helpful technology that may improve access to the needed care for PWE in these difficult times. De novo seizures may occur in people with COVID-19 and they may happen in a variety of forms. In addition to prolonged EEG monitoring, performing a through metabolic investigation, electrocardiogram, brain imaging, and a careful review of all medications are necessary steps. The susceptibility of PWE to contracting COVID-19 should be investigated further.
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Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. .,Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Leila Simani
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Shahisavandi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Barzegar
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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von Wrede R, Moskau-Hartmann S, Baumgartner T, Helmstaedter C, Surges R. Counseling of people with epilepsy via telemedicine: Experiences at a German tertiary epilepsy center during the COVID-19 pandemic. Epilepsy Behav 2020; 112:107298. [PMID: 32801068 PMCID: PMC7422810 DOI: 10.1016/j.yebeh.2020.107298] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Driven by the challenges of alternative healthcare supply during the COVID-19 pandemic, acceptance and appreciation of telemedicine were assessed in a German tertiary epilepsy center. METHODS Two hundred thirty-nine patients with epilepsy (53% female, 35% seizure-free, 97% on antiseizure medication) answered a structured audit on telemedical counseling as part of individual outpatients' care. RESULTS Overall 82% of the participants were satisfied with the telemedical appointment. The telemedical appointment was rated equal to onsite appointments in means of time (91%), comprehensibility (94%), and opportunity to get answers to current questions (92%). It was evaluated as good as onsite appointments regarding comprehension of the disease (88%) and impact on following the physician's advice (82%). The participants considered immediate convenience and shortfall of travel expenses as advantages of telemedicine, whereas lack of personal contact and diagnostics (electroencephalogram [EEG] recordings, blood analysis) were seen as disadvantages. About 73% of the participants would appreciate the opportunity of future telemedical counseling, but the majority (75%) wished to have further appointments onsite. CONCLUSIONS Overall, people with epilepsy appear to be satisfied with telemedical counseling. However, patients greatly appreciate the medical services onsite and consider telemedicine as an add-on service rather than a substitute to visits onsite.
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Affiliation(s)
| | | | | | | | - Rainer Surges
- Department of Epileptology, University of Bonn Medical Center, Germany.
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Sanchez-Larsen A, Gonzalez-Villar E, Díaz-Maroto I, Layos-Romero A, Martínez-Martín Á, Alcahut-Rodriguez C, Grande-Martin A, Sopelana-Garay D. Influence of the COVID-19 outbreak in people with epilepsy: Analysis of a Spanish population (EPICOVID registry). Epilepsy Behav 2020; 112:107396. [PMID: 32911299 PMCID: PMC7476448 DOI: 10.1016/j.yebeh.2020.107396] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current COVID-19 outbreak, exploring the possible causes thereof. METHODS This is an observational, retrospective study based on prospective data collection of 100 successive patients who attended an epilepsy outpatient clinic either face-to-face or telephonically during the months of the COVID-19 outbreak and national state of emergency. RESULTS One hundred patients were included, 52% women, mean age 42.4 years. During the COVID-19 period, 27% of the patients presented an increase of >50% of seizure frequency. An increase of stress/anxiety (odds ratios (OR): 5.78; p = 0.008) and a prior higher seizure frequency (OR: 12.4; p = 0.001) were associated with worsening of seizures. Other risk factors were exacerbation of depression, sleep deprivation, less physical activity, and history of epilepsy surgery. Three patients had status epilepticus (SE) and one a cluster of seizures. Likewise, 9% of patients improved their seizure control. Reduction in stress/anxiety (OR: 0.05; p = 0.03) and recent adjustment of antiepileptics (OR: 0.07; p = 0.01) acted as protecting factors. CONCLUSIONS A high proportion of PWE suffered a significant worsening of their seizure control during the months of the COVID-19 pandemic. Emotional distress due to home confinement was the main factor for the change in seizure control. Promoting physical activity and adequate sleep may minimize the potential impact of the pandemic in PWE. Ensuring correct follow-up can prevent decompensation in those PWE at high risk.
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Affiliation(s)
- Alvaro Sanchez-Larsen
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, Albacete, Castilla-La Mancha, Spain.
| | - Esther Gonzalez-Villar
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, Albacete, Castilla-La Mancha, Spain
| | - Inmaculada Díaz-Maroto
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, Albacete, Castilla-La Mancha, Spain
| | - Almudena Layos-Romero
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, Albacete, Castilla-La Mancha, Spain
| | - Álvaro Martínez-Martín
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, Albacete, Castilla-La Mancha, Spain
| | - Cristian Alcahut-Rodriguez
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, Albacete, Castilla-La Mancha, Spain
| | - Alberto Grande-Martin
- Department of Clinical Neurophysiology Complejo, Hospitalario Universitario de Albacete, Albacete, Castilla-La Mancha, Spain
| | - David Sopelana-Garay
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, Albacete, Castilla-La Mancha, Spain
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Van Hees S, Siewe Fodjo JN, Wijtvliet V, Van den Bergh R, Faria de Moura Villela E, da Silva CF, Weckhuysen S, Colebunders R. Access to healthcare and prevalence of anxiety and depression in persons with epilepsy during the COVID-19 pandemic: A multicountry online survey. Epilepsy Behav 2020; 112:107350. [PMID: 32920373 PMCID: PMC7481834 DOI: 10.1016/j.yebeh.2020.107350] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/17/2020] [Accepted: 07/17/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of this study was to assess access to healthcare and to estimate the prevalence of depression and anxiety among persons with epilepsy (PWE) during the ongoing coronavirus disease 2019 (COVID-19) pandemic. METHODS We conducted a multicountry online survey among PWE. Persons with epilepsy were invited to participate through various social media channels. The Hospital Anxiety and Depression Scale (HADS) and 9-item Patient Health Questionnaire (PHQ-9) scale were used to score anxiety and depression. Logistic regression modeling was used to investigate factors associated with anxiety and depression. RESULTS Three hundred ninety-nine PWE were included (mean age: 38.22 ± 12.09 years), the majority were female (80.2%) and living in high-income countries (83.2%). Two hundred three PWE reported symptoms of a cold since January 2020. Nine (25%) of the 36 PWE tested for COVID were positive. A total of 72 PWE (19.6%) reported problems to obtain antiseizure medication (ASM), which in 25% of cases was directly COVID-related. Of the 399 PWE, 201 (50.4%) screened positive for anxiety according to the HADS; 159 (39.8%) and 187 (46.9%) PWE screened positive for depression based on the HADS and PHQ-9 scale, respectively. Female gender and financial problems were associated with both depression and anxiety. A planned follow-up consultation with the treating physician was associated with a lower risk of depression, whereas difficulties to access ASM treatment increased the odds of depression. In 65/137 (47.4%) PWE with a planned follow-up visit with the treating physician, this consultation was canceled. CONCLUSIONS Innovative approaches are needed to ensure continuity in access to ASM treatment. Healthcare workers should ensure continued follow-up, either through inperson or telehealth appointments, to timely identify symptoms of anxiety and depression and act accordingly.
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Affiliation(s)
- Stijn Van Hees
- Global Health Institute, University of Antwerp, Belgium; Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Belgium
| | | | - Veerle Wijtvliet
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Belgium
| | | | | | | | - Sarah Weckhuysen
- Department of Neurology, University Hospital Antwerp, Belgium; VIB-Center for Molecular Neurology, University of Antwerp, Belgium
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