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Tipre M, Scarinci IC, Pandya VN, Kim YI, Bae S, Peral S, Hardy C, Baskin ML. Attitudes toward telemedicine among urban and rural residents. J Telemed Telecare 2024; 30:722-730. [PMID: 35578537 DOI: 10.1177/1357633x221094215] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Adoption of telemedicine by healthcare facilities has dramatically increased since the start of coronavirus pandemic; yet, major differences exist in universal acceptance of telemedicine across different population groups. The goal of this study was to examine population-based factors associated with current and/or future use of telemedicine in Alabama. METHODS A cross-sectional survey was administered to 532 participants online or by phone, in four urban and eight rural counties in Alabama. Data were collected on: demographics, health insurance coverage, medical history, access to technology, and its use in accessing healthcare services. Generalized logit regression models were used to estimate the odds of choosing "virtual visit" and "phone communication" compared to "in-person visit" for the preferred choice of visit with the healthcare provider; as well as odds for willingness to participate in "virtual visit" in the future. RESULTS Our study sample had a mean age of 43 (±15) years, 72.9% women, 45.9% Black or African American; 59.4% population living in an urban county. The odds of "phone communication" were higher compared to the odds of "in-person visit", with a unit increase in age (odds ratio: 1.02, 95% confidence interval: 1.00-1.03), after adjusting for other covariates. Among participants with past experience of virtual communications, the odds for choosing "virtual visit" were significantly higher compared to choice of in-person visit (odds ratio for virtual visit: 3.23, 95% confidence interval: 2.01-5.18), adjusted for other covariates. Further, people with college or more education were 71% less likely to choose "No" compared to those with high school or lower general education development education for future virtual visit [odds ratio for college or more: 0.29, 95% confodence interval: 0.10-0.87). Likewise, participants residing in rural counties were 57% less likely to choose "No" compared to urban counties for future virtual visit (odds ratio for rural participants: 0.43, 95% confidence interval:0.19-0.97). DISCUSSION Our study found notable differences in age, education, and rurality for use and/or preference for telemedicine. Medical institutions and healthcare providers will need to account for these differences to ensure that the implementation of telemedicine does not exacerbate existing health disparities.
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Affiliation(s)
- Meghan Tipre
- Division of Preventive Medicine, Office of the Outreach and Engagement, O'Neal Comprehensive Cancer Center, School of Medicine, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
| | - Isabel C Scarinci
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Obstetrics and Gynecology, UAB, Birmingham, AL, USA
| | - Vishruti N Pandya
- Division of Preventive Medicine, Office of the Outreach and Engagement, O'Neal Comprehensive Cancer Center, School of Medicine, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Young-Il Kim
- Division of Preventive Medicine, Office of the Outreach and Engagement, O'Neal Comprehensive Cancer Center, School of Medicine, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
| | - Sejong Bae
- Division of Preventive Medicine, Office of the Outreach and Engagement, O'Neal Comprehensive Cancer Center, School of Medicine, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
| | - Sylvia Peral
- Division of Preventive Medicine, Office of the Outreach and Engagement, O'Neal Comprehensive Cancer Center, School of Medicine, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Claudia Hardy
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
| | - Monica L Baskin
- Division of Preventive Medicine, Office of the Outreach and Engagement, O'Neal Comprehensive Cancer Center, School of Medicine, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
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Patel M, Berlin H, Rajkumar A, Krein SL, Miller R, DeVito J, Roy J, Punch M, Ellimootti C, Peahl AF. Barriers to Telemedicine Use: Qualitative Analysis of Provider Perspectives During the COVID-19 Pandemic. JMIR Hum Factors 2023; 10:e39249. [PMID: 37358887 PMCID: PMC10337245 DOI: 10.2196/39249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 02/28/2023] [Accepted: 04/13/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Though telemedicine is a promising approach for removing barriers to care and improving access for patients, telemedicine use for many medical specialties has decreased from its peak during the acute COVID-19 public health crisis. Understanding the barriers and facilitators to the maintenance of web-based visits-one key component of telemedicine-is critical for ensuring the continuous availability of this service for patients. OBJECTIVE The purpose of this study is to describe medical providers' perceived barriers and facilitators to the continued use of web-based visits to inform quality improvement efforts and promote sustainability. METHODS We performed a qualitative content analysis of free-text responses from a survey of medical providers administered from February 5-14, 2021, at a large, midwestern academic institution, including all providers from medical professions that offered telemedicine (eg, physicians, residents or fellows, nurse practitioners, physicians assistants, or nurses) who completed at least 1 web-based visit from March 20, 2020, to February 14, 2021. The primary outcome was the experience of providing web-based visits, including barriers and facilitators to continued usage of web-based visits. Survey questions included 3 major domains: quality of care, technology, and satisfaction. Responses were coded using qualitative content analysis and further analyzed through a matrix analysis to understand the providers' perspectives and elucidate key barriers and facilitators of web-based visit usage. RESULTS Of 2692 eligible providers, 1040 (38.6%) completed the survey, of whom 702 were providers from medical professions that offered telemedicine. These providers spanned 7 health care professions and 47 clinical departments. The most common professions represented were physicians (486/702, 46.7%), residents or fellows (85/702, 8.2%), and nurse practitioners (81/702, 7.8%), while the most common clinical departments were internal medicine (69/702, 6.6%), psychiatry (69/702, 6.6%), and physical medicine and rehabilitation (67/702, 6.4%). The following 4 overarching categories of provider experience with web-based visits emerged: quality of care, patient rapport, visit flow, and equity. Though many providers saw web-based visits as a tool for improving care access, quality, and equity, others shared how appropriate selection of web-based visits, support (eg, patient training, home devices, and broadband access), and institutional and nationwide optimization (eg, relaxation of licensing requirements across state borders and reimbursement for phone-only modalities) were needed to sustain web-based visits. CONCLUSIONS Our findings demonstrate key barriers to the maintenance of telemedicine services following the acute public health crisis. These findings can help prioritize the most impactful methods of sustaining and expanding telemedicine availability for patients who prefer this method of care delivery.
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Affiliation(s)
- Milan Patel
- Department of Urology, Loyola University Medical Center, Maywood, IL, United States
| | - Hanna Berlin
- University of Michigan Medical School, Ann Arbor, MI, United States
| | - Abishek Rajkumar
- University of Michigan Medical School, Ann Arbor, MI, United States
| | - Sarah L Krein
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
| | - Rebecca Miller
- Virtual Health, Michigan Medicine, Ann Arbor, MI, United States
| | - Jessie DeVito
- Virtual Health, Michigan Medicine, Ann Arbor, MI, United States
| | - Jake Roy
- Virtual Health, Michigan Medicine, Ann Arbor, MI, United States
| | - Margaret Punch
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Chad Ellimootti
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
- Department of Urology, University of Michigan, Ann Arbor, MI, United States
| | - Alex F Peahl
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
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Pandit AA, Eswaran H, Bogulski CA, Rabbani M, Allison M‘K, Dawson L, Hayes CJ. Factors Associated with Remote Patient Monitoring Services Provision by Hospitals and Health Care Systems in the United States. Telemed J E Health 2022. [DOI: 10.1089/tmj.2022.0266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Ambrish A. Pandit
- Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Hari Eswaran
- Rural Telehealth Evaluation Center, Institute of Digital Health and Innovation, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Department of Obstetrics and Gynecology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Cari A. Bogulski
- Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Maysam Rabbani
- Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Rural Telehealth Evaluation Center, Institute of Digital Health and Innovation, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mary ‘Katy’ Allison
- Rural Telehealth Evaluation Center, Institute of Digital Health and Innovation, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Leah Dawson
- Rural Telehealth Evaluation Center, Institute of Digital Health and Innovation, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Corey J. Hayes
- Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
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Ftouni R, AlJardali B, Hamdanieh M, Ftouni L, Salem N. Challenges of Telemedicine during the COVID-19 pandemic: a systematic review. BMC Med Inform Decis Mak 2022; 22:207. [PMID: 35922817 PMCID: PMC9351100 DOI: 10.1186/s12911-022-01952-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/22/2022] [Indexed: 01/12/2023] Open
Abstract
Background The COVID-19 pandemic has prompted the decrease of in-person visits to reduce the risk of virus transmission. Telemedicine is an efficient communication tool employed between healthcare providers and patients that prevents the risk of exposure to infected persons. However, telemedicine use is not infallible; its users reported multiple issues that complicated the expansion of this technology. So, this systematic review aimed to explore the barriers and challenges of telemedicine use during the pandemic and to propose solutions for improving future use.
Methods A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. PubMed, Scopus, Web of Science, Academic Search Complete, CINAHL, Embase, and Science Direct were used to look for articles addressing barriers and challenges, in addition to articles proposing solutions. Studies were screened by title and abstract, followed by a full-text review. Risk of bias assessment was done using Critical Appraisal Skills Program for qualitative studies, Newcastle–Ottawa Scale for cross-sectional studies, and A MeaSurement Tool to Assess Systematic Reviews for systematic reviews. After the extraction of data, a narrative synthesis and analysis of the outcomes were performed. Results Among 1194 papers identified, only 27 studies were included. Barriers and challenges were assembled under 7 categories: technical aspects, privacy, data confidentiality and reimbursement, physical examination and diagnostics, special populations, training of healthcare providers and patients, doctor-patient relationship, and acceptability. Poor internet connection and lack of universal access to technology were among the technical barriers. Concerns about patient privacy and reimbursement hindered the use of telemedicine too. Physical examination and certain procedures were impossible to perform via telemedicine. Training both healthcare providers and patients was deficient. The doctor-patient relationship was troubled by telemedicine, and both healthcare providers and patients were reluctant to use telemedicine. Conclusion Widespread use of telemedicine is still hampered by various barriers and challenges. Healthcare providers should work with various stakeholders to implement the proposed solutions. More research and policy changes are essential to optimize telemedicine utilization. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-022-01952-0.
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Affiliation(s)
- Racha Ftouni
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.,Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Baraa AlJardali
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.,Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Hamdanieh
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Louna Ftouni
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.,Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nariman Salem
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
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Formea CM, Schultz AJ, Empey PE. Pharmacists Closing Health Disparity Gaps through Pharmacogenomics. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Christine M. Formea
- Intermountain Healthcare, Department of Pharmacy Services Salt Lake City Utah
- Intermountain Precision Genomics, Intermountain Healthcare St. George Utah
| | - April J. Schultz
- Sanford Imagenetics, Sanford Health Sioux Falls South Dakota
- Sanford USD School of Medicine University of South Dakota Sioux Falls South Dakota
| | - Philip E. Empey
- School of Pharmacy University of Pittsburgh Pittsburgh Pennsylvania
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Teraura H, Iguchi S, Maeda T, Koike S, Matsumoto M, Haruyama S, Kotani K. The use of information and communication technology in Japanese rural clinics. J Rural Med 2021; 16:298-300. [PMID: 34707743 PMCID: PMC8527613 DOI: 10.2185/jrm.2021-026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/25/2021] [Indexed: 11/27/2022] Open
Abstract
High-speed information and communication technology (ICT) networks stretch all over Japan. However, their utility in facilitating rural healthcare remains uncharacterized. A nationwide questionnaire survey was sent by mail to 1,018 rural clinics constructed in a public manner in municipalities throughout Japan. ICT use was classified by type, including a doctor-to-doctor manner. Only 19% of the 303 clinics surveyed (with a response rate of 30%) used ICT. Specifically, 50% used it in a doctor-to-doctor manner, while 35% used it to obtain electronic medical records. Differences in proficiency levels among ICT users were cited by 21% of the respondents as a major problem associated with ICT use. In Japan, the prevalence of ICT use for rural healthcare appeared low. We suggest a policy reform to facilitate ICT use in rural healthcare.
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Affiliation(s)
- Hiroyuki Teraura
- Division of Community and Family Medicine, Center for
Community Medicine, Jichi Medical University, Japan
| | - Seitaro Iguchi
- Department of Community Medicine, Niigata University
Graduate School of Medicine and Dental Sciences, Japan
| | - Takahiro Maeda
- Department of General Medicine, Nagasaki University Graduate
School of Biomedical Science, Japan
| | - Soichi Koike
- Division of Health Policy and Management, Center for
Community Medicine, Jichi Medical University, Japan
| | - Masatoshi Matsumoto
- Department of Community-Based Medical Systems, Hiroshima
University Graduate School of Biomedical and Health Sciences, Japan
| | | | - Kazuhiko Kotani
- Division of Community and Family Medicine, Center for
Community Medicine, Jichi Medical University, Japan
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Reeves JJ, Pageler NM, Wick EC, Melton GB, Tan YHG, Clay BJ, Longhurst CA. The Clinical Information Systems Response to the COVID-19 Pandemic. Yearb Med Inform 2021; 30:105-125. [PMID: 34479384 PMCID: PMC8416224 DOI: 10.1055/s-0041-1726513] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The year 2020 was predominated by the coronavirus disease 2019 (COVID-19) pandemic. The objective of this article is to review the areas in which clinical information systems (CIS) can be and have been utilized to support and enhance the response of healthcare systems to pandemics, focusing on COVID-19. METHODS PubMed/MEDLINE, Google Scholar, the tables of contents of major informatics journals, and the bibliographies of articles were searched for studies pertaining to CIS, pandemics, and COVID-19 through October 2020. The most informative and detailed studies were highlighted, while many others were referenced. RESULTS CIS were heavily relied upon by health systems and governmental agencies worldwide in response to COVID-19. Technology-based screening tools were developed to assist rapid case identification and appropriate triaging. Clinical care was supported by utilizing the electronic health record (EHR) to onboard frontline providers to new protocols, offer clinical decision support, and improve systems for diagnostic testing. Telehealth became the most rapidly adopted medical trend in recent history and an essential strategy for allowing safe and effective access to medical care. Artificial intelligence and machine learning algorithms were developed to enhance screening, diagnostic imaging, and predictive analytics - though evidence of improved outcomes remains limited. Geographic information systems and big data enabled real-time dashboards vital for epidemic monitoring, hospital preparedness strategies, and health policy decision making. Digital contact tracing systems were implemented to assist a labor-intensive task with the aim of curbing transmission. Large scale data sharing, effective health information exchange, and interoperability of EHRs remain challenges for the informatics community with immense clinical and academic potential. CIS must be used in combination with engaged stakeholders and operational change management in order to meaningfully improve patient outcomes. CONCLUSION Managing a pandemic requires widespread, timely, and effective distribution of reliable information. In the past year, CIS and informaticists made prominent and influential contributions in the global response to the COVID-19 pandemic.
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Affiliation(s)
- J. Jeffery Reeves
- Department of Surgery, University of California, San Diego, La Jolla, California, USA
| | - Natalie M. Pageler
- Department of Pediatrics, Division of Critical Care Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Elizabeth C. Wick
- Department of Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Genevieve B. Melton
- Department of Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Yu-Heng Gamaliel Tan
- Department of Orthopedics, Chief Medical Information Officer, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Brian J. Clay
- Department of Medicine, Division of Biomedical Informatics, University of California, San Diego, La Jolla, CA, USA
| | - Christopher A. Longhurst
- Department of Medicine, Division of Biomedical Informatics, University of California, San Diego, La Jolla, CA, USA
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Berland H, Hughes D. Is Rural Kansas Prepared? An Assessment of Resources Related to the COVID-19 Pandemic. Kans J Med 2021; 14:95-102. [PMID: 33903809 PMCID: PMC8060066 DOI: 10.17161/kjm.vol1414597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 01/29/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction This cross-sectional study investigated rural Kansas healthcare resources relevant to COVID-19 at the county level in the context of population characteristics. Methods The federal Area Health Resource File was used to assess system capacity and critical care-related resources and COVID-19-related risk factors at the county level. Data were described with summary statistics, cross-tabulations, and bivariate tests to discern differences across county rurality categories (2013 Rural-Urban Continuum Codes). Results Kansas has 105 counties. Metropolitan counties had an average of 1.5 physicians (M.D. or D.O., any specialty) per 1,000 people, while rural counties had 0.8. A total of 63.5% of rural counties had no anesthesia providers and 100.0% of rural counties had no pulmonary disease physicians. While 96 counties have at least one hospital, nearly 90% rural counties had no intensive care unit (ICU) services. The percent of the population estimated to be over 65 was higher among rural counties (24.2%) than metropolitan counties (19.3%). On average, rural counties had nearly twice as many deaths per 1,000 people by cardiovascular disease and more chronic obstructive pulmonary disease deaths than metropolitan and nonmetropolitan/urban adjacent counties. Conclusions Kansas faced limited ICU capabilities and physician workforce shortages in rural counties, both in primary care and specialties such as anesthesia and pulmonology. In addition, nonmetropolitan/urban adjacent and rural population age structures and mortality rates potentially demonstrated an increased risk to overwhelm local healthcare systems. This may have serious implications for rural health, particularly in the context of the COVID-19 pandemic.
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Affiliation(s)
- Hannah Berland
- University of Kansas School of Medicine-Salina, Salina, KS
| | - Dorothy Hughes
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS
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Boettcher AN, Hammoud DA, Weinberg JB, Agarwal P, Mendiratta-Lala M, Luker GD. Cancer Imaging and Patient Care during the COVID-19 Pandemic. Radiol Imaging Cancer 2020; 2:e200058. [PMID: 33778750 PMCID: PMC7706101 DOI: 10.1148/rycan.2020200058] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Patients with cancer have been negatively impacted during the coronavirus disease 2019 (COVID-19) pandemic, as many of these individuals may be immunosuppressed and of older age. Additionally, cancer follow-up or imaging appointments have been delayed in many clinics around the world. Postponement of routine screening exams will result in delays in new cancer diagnoses. Clinics are continuing to monitor and adapt their appointment schedules based on local outbreaks of COVID-19. Studies on COVID-19 in patients with cancer are limited, but consistently indicate that this population is at risk for more severe COVID-19 illness. Data from recent studies also suggest that pediatric patients with cancer have a lower risk of severe COVID-19 illness compared to adults. Certain features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection detected by lung, brain, and gastrointestinal imaging may confound radiologists' interpretation of cancer diagnosis, staging, and treatment response. Lastly, as clinics begin to re-open for routine appointments, protocols have been put in place to reduce SARS-CoV-2 exposure to patients during their visits. This review details different perspectives on the impact of the COVID-19 pandemic on patients with cancer and on cancer imaging. Keywords: Abdomen/GI, Cardiac, Infection, Nervous-Peripheral.
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Affiliation(s)
- Adeline N. Boettcher
- From the Scientific Editor, RSNA (A.N.B.); Center for Infectious Disease Imaging, NIH Clinical Center, Bethesda, Maryland (D.A.H.); Departments of Pediatrics and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (J.B.W.); Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan (P.A.); Department of Radiology, Division of Abdominal imaging, University of Michigan, Ann Arbor, Michigan (M.M.); Department of Radiology, Biomedical Engineering, and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (G.D.L)
| | - Dima A. Hammoud
- From the Scientific Editor, RSNA (A.N.B.); Center for Infectious Disease Imaging, NIH Clinical Center, Bethesda, Maryland (D.A.H.); Departments of Pediatrics and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (J.B.W.); Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan (P.A.); Department of Radiology, Division of Abdominal imaging, University of Michigan, Ann Arbor, Michigan (M.M.); Department of Radiology, Biomedical Engineering, and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (G.D.L)
| | - Jason B. Weinberg
- From the Scientific Editor, RSNA (A.N.B.); Center for Infectious Disease Imaging, NIH Clinical Center, Bethesda, Maryland (D.A.H.); Departments of Pediatrics and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (J.B.W.); Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan (P.A.); Department of Radiology, Division of Abdominal imaging, University of Michigan, Ann Arbor, Michigan (M.M.); Department of Radiology, Biomedical Engineering, and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (G.D.L)
| | - Prachi Agarwal
- From the Scientific Editor, RSNA (A.N.B.); Center for Infectious Disease Imaging, NIH Clinical Center, Bethesda, Maryland (D.A.H.); Departments of Pediatrics and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (J.B.W.); Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan (P.A.); Department of Radiology, Division of Abdominal imaging, University of Michigan, Ann Arbor, Michigan (M.M.); Department of Radiology, Biomedical Engineering, and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (G.D.L)
| | - Mishal Mendiratta-Lala
- From the Scientific Editor, RSNA (A.N.B.); Center for Infectious Disease Imaging, NIH Clinical Center, Bethesda, Maryland (D.A.H.); Departments of Pediatrics and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (J.B.W.); Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan (P.A.); Department of Radiology, Division of Abdominal imaging, University of Michigan, Ann Arbor, Michigan (M.M.); Department of Radiology, Biomedical Engineering, and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (G.D.L)
| | - Gary D. Luker
- From the Scientific Editor, RSNA (A.N.B.); Center for Infectious Disease Imaging, NIH Clinical Center, Bethesda, Maryland (D.A.H.); Departments of Pediatrics and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (J.B.W.); Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan (P.A.); Department of Radiology, Division of Abdominal imaging, University of Michigan, Ann Arbor, Michigan (M.M.); Department of Radiology, Biomedical Engineering, and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan (G.D.L)
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Puro NA, Feyereisen S. Telehealth Availability in US Hospitals in the Face of the COVID-19 Pandemic. J Rural Health 2020; 36:577-583. [PMID: 32603017 PMCID: PMC7362065 DOI: 10.1111/jrh.12482] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Telehealth is likely to play a crucial role in treating COVID-19 patients. However, not all US hospitals possess telehealth capabilities. This brief report was designed to explore US hospitals' readiness with respect to telehealth availability. We hope to gain deeper insight into the factors affecting possession of these valuable capabilities, and how this varies between rural and urban areas. METHODS Based on 2017 data from the American Hospital Association survey, Area Health Resource Files and Medicare cost reports, we used logistic regression models to identify predictors of telehealth and eICU capabilities in US hospitals. RESULTS We found that larger hospitals (OR(telehealth) = 1.013; P < .01) and system members (OR(telehealth) = 1.55; P < .01) (OR(eICU) = 1.65; P < .01) had higher odds of possessing telehealth and eICU capabilities. We also found evidence suggesting that telehealth and eICU capabilities are concentrated in particular regions; the West North Central region was the most likely to possess capabilities, given that these hospitals had higher odds of possessing telehealth (OR = 1.49; P < .10) and eICU capabilities (OR = 2.15; P < .05). Rural hospitals had higher odds of possessing telehealth capabilities as compared to their urban counterparts, although this relationship was marginally significant (OR = 1.34, P < .10). CONCLUSIONS US hospitals vary in their preparation to use telehealth to aid in the COVID-19 battle, among other issues. Hospitals' odds of possessing the capability to provide such services vary largely by region; overall, rural hospitals have more widespread telehealth capabilities than urban hospitals. There is still great potential to expand these capabilities further, especially in areas that have been hard hit by COVID-19.
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Affiliation(s)
- Neeraj A Puro
- Department of Management Programs, Florida Atlantic University, Boca Raton, Florida
| | - Scott Feyereisen
- Department of Management Programs, Florida Atlantic University, Boca Raton, Florida
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