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Holzman SA, Davis-Dao CA, Khoury AE, Fortier MA, N Kain Z. Telemedicine and patient satisfaction during the COVID-19 pandemic: A case-control study of outpatient pediatric urology patients. J Child Health Care 2023; 27:351-359. [PMID: 34865548 DOI: 10.1177/13674935211058272] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Telemedicine has increased during the coronavirus disease 2019 pandemic. Our objective was to determine if patient satisfaction with telemedicine differed from in-person visits in an academic pediatric urology clinic. Following outpatient telemedicine and in-person pediatric urology visits, the validated NRC Health© Patient Survey was used to assess patient experience. Patient satisfaction was assessed on a 10-point scale with scores of 9-10 considered "satisfied" and 1-8 considered "not satisfied." Satisfaction scores between telemedicine and in-person groups were compared using McNemar's test, Wilcoxon signed rank test, and conditional logistic regression. Fifty-one patients had urology telemedicine visits during April-August 2020 and completed the NRC Health© Patient Survey. Propensity score matching was used to identify 102 in-person controls between January 2019 and March 2020. Ninety-two percent of telemedicine patients were satisfied compared to 87% of in-person patients (OR 1.7 95% CI [0.53-5.6]). Regression analysis adjusting for matching variables demonstrated that patient satisfaction was higher for telemedicine compared to in-person visits but was not statistically significant (OR 1.5 95% CI [0.43-5.6]). Patient satisfaction with telemedicine was similar to in-person visits in the pediatric urology clinic. Reduced waiting time and convenience associated with telemedicine visits provide an opportunity for telemedicine as a useful modality for pediatric urology.
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Affiliation(s)
- Sarah A Holzman
- Division of Pediatric Urology, CHOC Children's, Orange, CA, USA
- Department of Urology, University of California, Irvine, CA, USA
| | - Carol A Davis-Dao
- Division of Pediatric Urology, CHOC Children's, Orange, CA, USA
- Department of Urology, University of California, Irvine, CA, USA
| | - Antoine E Khoury
- Division of Pediatric Urology, CHOC Children's, Orange, CA, USA
- Department of Urology, University of California, Irvine, CA, USA
| | - Michelle A Fortier
- Center on Stress & Health, University of California School of Medicine, Irvine, CA, USA
- Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
- Department of Pediatric Psychology, Children's Hospital of Orange County, Orange, CA, USA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA
| | - Zeev N Kain
- Center on Stress & Health, University of California School of Medicine, Irvine, CA, USA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
- Health Policy Research Institute, University of California, Irvine, CA, USA
- Department of Pediatrics, CHOC Children's, Orange, CA, USA
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2
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Hurvitz N, Ilan Y. The Constrained-Disorder Principle Assists in Overcoming Significant Challenges in Digital Health: Moving from "Nice to Have" to Mandatory Systems. Clin Pract 2023; 13:994-1014. [PMID: 37623270 PMCID: PMC10453547 DOI: 10.3390/clinpract13040089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023] Open
Abstract
The success of artificial intelligence depends on whether it can penetrate the boundaries of evidence-based medicine, the lack of policies, and the resistance of medical professionals to its use. The failure of digital health to meet expectations requires rethinking some of the challenges faced. We discuss some of the most significant challenges faced by patients, physicians, payers, pharmaceutical companies, and health systems in the digital world. The goal of healthcare systems is to improve outcomes. Assisting in diagnosing, collecting data, and simplifying processes is a "nice to have" tool, but it is not essential. Many of these systems have yet to be shown to improve outcomes. Current outcome-based expectations and economic constraints make "nice to have," "assists," and "ease processes" insufficient. Complex biological systems are defined by their inherent disorder, bounded by dynamic boundaries, as described by the constrained disorder principle (CDP). It provides a platform for correcting systems' malfunctions by regulating their degree of variability. A CDP-based second-generation artificial intelligence system provides solutions to some challenges digital health faces. Therapeutic interventions are held to improve outcomes with these systems. In addition to improving clinically meaningful endpoints, CDP-based second-generation algorithms ensure patient and physician engagement and reduce the health system's costs.
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Affiliation(s)
| | - Yaron Ilan
- Hadassah Medical Center, Department of Medicine, Faculty of Medicine, Hebrew University, POB 1200, Jerusalem IL91120, Israel;
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3
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Marin L, Ambrosini G, Fantò FM, Della Vella M, Massaro A, Dessole F, Capobianco G, Andrisani A. Telemedicine for Virtual Consultations During COVID-19 Pandemic in a Medically Assisted Reproduction Center: Patients' Perspective. Telemed J E Health 2023; 29:459-465. [PMID: 35833792 DOI: 10.1089/tmj.2021.0509] [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: Restrictive measures imposed to prevent COVID-19 contagion have caused an increase in waiting times for other health procedures. During the pandemic, utilization of telemedicine has increased to ensure patient care safely. The aim of this study was to evaluate the perspective of infertile patients who underwent virtual consultations for infertility. Materials and Methods: This was an observational study. A survey was submitted to patients who attended a virtual consultation at a single in vitro fertilization (IVF) unit between March 2020 and July 2021. The survey concerned their experience with telemedicine assessing the experience of video consulting and the software characteristics. Results: The survey response rate was 50.3% (n = 159). In total, 98.8% of patients positively rated the experience of telemedicine. Regarding the software itself, it was defined as intuitive and easy to use by 87.4% of patients. A majority (92.5%) of interviewed patients reported that they were able to receive the information and clear any doubts they had and 85.5% of interviewed patients would repeat the experience of video consultation. Conclusions: The acceptance of telemedicine was very high among infertile patients. However, IVF treatments have a strong emotional component and face-to-face consultation with medical staff might help to create the right climate of trust, and the empathy that can be demonstrated during a vis-à-vis meeting cannot be achieved through a screen. The use of telemedicine should be considered in those situations where it is not possible to attend an in-person consultation or when couples prefer it.
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Affiliation(s)
- Loris Marin
- Department of Women's and Children's Health, University of Padua, Padova, Italy
| | - Guido Ambrosini
- Department of Women's and Children's Health, University of Padua, Padova, Italy
| | | | - Manuela Della Vella
- Department of Women's and Children's Health, University of Padua, Padova, Italy
| | - Alberto Massaro
- Information Technology Department, Padua Hospital, Padova, Italy
| | - Francesco Dessole
- Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
| | - Giampiero Capobianco
- Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
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4
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Jung OS, Graetz I, Dorner SC, Hayden EM. Implementing a COVID-19 Virtual Observation Unit in Emergency Medicine: Frontline Clinician and Staff Experiences. Med Care Res Rev 2023; 80:79-91. [PMID: 35815570 PMCID: PMC9806199 DOI: 10.1177/10775587221108750] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic pushed hospitals to deliver care outside of their four walls. To successfully scale virtual care delivery, it is important to understand how its implementation affects frontline workers, including their teamwork and patient-provider interactions. We conducted in-depth interviews of 17 clinicians and staff involved with the COVID-19 Virtual Observation Unit (CVOU) in the emergency department (ED) of an academic hospital. The program leveraged remote patient monitoring and mobile integrated health care. In the CVOU (vs. the ED), participants observed increases in interactions among clinicians and staff, patient participation in care delivery, attention to nonmedical factors, and involvement of coordinators and paramedics in patient care. These changes were associated with unintended, positive consequences for staff, namely, feeling heard, experience of meaningfulness, and positive attitudes toward virtual care. This study advances research on reconfiguration of roles following implementation of new practices using digital tools, virtual work interactions, and at-home care delivery.
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Affiliation(s)
- Olivia S. Jung
- Emory University, Atlanta, GA,
USA,Harvard University, Cambridge, MA,
USA,Massachusetts General Hospital, Boston,
USA,Olivia S. Jung, Department of Health Policy
and Management, Rollins School of Public Health, Emory University, 1518 Clifton
Road, Atlanta, GA 30322, USA.
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5
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Mudd A, Feo R, Pinero de Plaza MA, Tieu M, Paia SY, Cleland J, Windle A, George S, Thompson MQ, Ambagtsheer RC, Muller A, Hall A, Lange B. The Use of Digital Technologies in the Inpatient Setting to Promote Communication During the Early Stage of an Infectious Disease Outbreak: A Scoping Review. Telemed J E Health 2023; 29:172-197. [PMID: 35758765 DOI: 10.1089/tmj.2021.0615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Infectious disease outbreaks disrupt inpatient clinical care and have an impact on staff and patients' ability to communicate with each other and with the wider community. Digital technology may offer opportunities for communication in the inpatient setting during infectious disease outbreaks. Aim: This scoping review aimed to investigate the use of digital technology in the inpatient setting to promote communication in the early stages of an infectious disease outbreak. Methods: There were three aspects to this scoping review: (1) a database search of Ovid MEDLINE (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Association for Computing Machinery Digital Library (ACM) and IEEE Xplore (IEEE) exploring peer-reviewed articles, (2) a gray literature search, and (3) a media search. Results: Results focused on the early stages of the COVID-19 pandemic. Thirty-eight peer-reviewed articles were extracted from the database search. There were three main areas of investigation: study characteristics, technology features, and benefits and barriers. Forty-four websites were searched for the gray literature search focusing on policy and guidance. Eighteen media articles were retrieved focusing on patients' use of technology and community involvement. Conclusion: Results demonstrate the diverse use of digital technology in the inpatient setting to facilitate communication during the early stages of the COVID-19 pandemic. However, the articles provide limited data to allow readers to fully understand and reproduce described actions. Furthermore, there was limited guidance to support clinicians to communicate using digital technology to create trusting therapeutic relationships. Areas for future development include standard reporting process for technology hardware, software, and content; and structured reporting and evaluation of the implementation of technologies.
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Affiliation(s)
- Alexandra Mudd
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Rebecca Feo
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Maria A Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia
| | - Matthew Tieu
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Shila Y Paia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Jenny Cleland
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Alice Windle
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Stacey George
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,Northern Adelaide Local Health Network, Allied Health Division, Lyell McEwin Hospital, Adelaide, Australia
| | - Mark Q Thompson
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia.,Adelaide Geriatrics Training & Research with Aged Care Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Rachel C Ambagtsheer
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia.,Health Vertical, Torrens University Australia, Adelaide, Australia
| | - Amanda Muller
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Anna Hall
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Belinda Lange
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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6
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Koopirom P, Wiriyaamornchai P, Santeerapharp A. Telemedicine in Thai-otorhinolaryngology patients in COVID-19 situation; primary surveys. Digit Health 2022; 8:20552076221147795. [PMID: 36601287 PMCID: PMC9806494 DOI: 10.1177/20552076221147795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/08/2022] [Indexed: 12/28/2022] Open
Abstract
Introduction COVID-19 pandemic has put a strain on various aspects of hospital management due to high rates of infection and increased preventive measures around the world. Physicians and patients alike are susceptible to the ongoing virus causing concern leading to loss or postpone of follow up. Thailand has just start integration of digital solutions such as telemedicine which expected similar level of medical care and efficiency while reducing risk of exposure during the COVID-19 pandemic. Objective Evaluation the willingness to accept telemedicine in otorhinolaryngology patients during the peak COVID-19 outbreaks in our institution. Methods Collected data from all patients who had a schedule follow up for otorhinolaryngology department between the months of June to August, 2021 at out-patient Center. Results Total of 299 otorhinolaryngology patients included, 213 patients (71.2%) denied a virtual medical visit whereas 86 patients (28.8%) accepted. The obstructive sleep apnea (OSA) was the only group to have more acceptance of telemedicine, 79.5% than denying 20.5% with statistical significance (p < 0.01). Age difference between the accepting and declining group also showed statistical significance, 48.5 years and 56 years respectively (p < 0.01). Main Reasons for their decision, 48% of patients accepted due to experiencing clinical improvement and stability. The main reason for not accepting telemedicine was 80% of patients preferred a special otorhinolaryngologic examination on follow up. Conclusions This primary surveys among Thai otorhinolaryngology patients about telemedicine. The greater number of patients not interested in telemedicine due to requirement of otorhinolaryngologic examination. Which OSA follow-up patients have more attention in telemedicine.
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Affiliation(s)
| | | | - Alena Santeerapharp
- Alena Santeerapharp, Department of
Otolaryngology-Head & Neck Surgery, Faculty of Medicine, Srinakharinwirot
University, Bangkok, Thailand.
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7
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Oliveira CRAD, Etges APBDS, Marcolino MS, Paixão MC, Mendes MS, Ribeiro LB, Alkmim MBM, Polanczyk CA, Ribeiro ALP. COVID-19 Telehealth Service Can Increase Access to the Health Care System and Become a Cost-Saving Strategy. Telemed J E Health 2022. [DOI: 10.1089/tmj.2022.0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Clara Rodrigues Alves de Oliveira
- Department of Internal Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, University Hospital and Telehealth Network of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana Paula Beck da Silva Etges
- Institute for Health Technology Assessment (IATS/CNPq), Porto Alegre, Brazil
- School of Technology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Epidemiology Program, Medical School, Federal University Rio Grande do Sul, Porto Alegre, Brazil
| | - Milena Soriano Marcolino
- Department of Internal Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, University Hospital and Telehealth Network of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Institute for Health Technology Assessment (IATS/CNPq), Porto Alegre, Brazil
| | - Maria Cristina Paixão
- Telehealth Center, University Hospital and Telehealth Network of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Mayara Santos Mendes
- Telehealth Center, University Hospital and Telehealth Network of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Leonardo Bonisson Ribeiro
- Telehealth Center, University Hospital and Telehealth Network of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Maria Beatriz Moreira Alkmim
- Telehealth Center, University Hospital and Telehealth Network of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Carisi Anne Polanczyk
- Institute for Health Technology Assessment (IATS/CNPq), Porto Alegre, Brazil
- Graduate Epidemiology Program, Medical School, Federal University Rio Grande do Sul, Porto Alegre, Brazil
| | - Antonio Luiz Pinho Ribeiro
- Department of Internal Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, University Hospital and Telehealth Network of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Institute for Health Technology Assessment (IATS/CNPq), Porto Alegre, Brazil
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8
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Park HS, Jeong S, Chung HY, Soh JY, Hyun YH, Bang SH, Kim HS. Use of video-based telehealth services using a mobile app for workers in underserved areas during the COVID-19 pandemic: A prospective observational study. Int J Med Inform 2022; 166:104844. [PMID: 36007433 PMCID: PMC9381936 DOI: 10.1016/j.ijmedinf.2022.104844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/06/2022] [Accepted: 08/07/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic has limited face-to-face treatment, triggering a change in the structure of existing healthcare services. Unlike other groups, workers in underserved areas have relatively poor access to healthcare. OBJECTIVE This study aimed to investigate the effects of video-based telehealth services using a mobile personal health record (PHR) app for vulnerable workers with metabolic risk factors. METHODS A prospective observational study was conducted with 117 participants and 27 healthcare professionals for 16 weeks. Participants visited the research institution three times (at weeks 1, 8, and 16) and underwent health check-ups and used various features of the mobile PHR app. Healthcare professionals observed the participants's data using the monitoring system and performed appropriate interventions. The primary outcome measures were to evaluate the effects of services on changes in the participants' metabolic risk factors, and secondary outcome measures were to analyze changes in the participants' lifestyle and service satisfaction, and to observe service use through usage logs. One-way repeated measures ANOVA and Scheffé's test were performed to observe changes in participants' health status and lifestyle, and a paired t-test was performed to analyze changes in service satisfaction. Finally, in-depth interviews with healthcare professionals were performed using semi-structured questionnaires to understand service providers' perspectives after the end of the study. RESULTS Systolic blood pressure (F = 7.32, P <.001), diastolic blood pressure (F = 11.30, P <.001), body weight (F = 29.53, P <.001), BMI (F = 17.31, P <.001), waist circumference (F = 17.33, P <.001), fasting blood glucose (F = 5.11, P =.007), and triglycerides (F = 4.66, P =.01) showed significant improvements with time points, whereas high-density lipoprotein cholesterol (F = 3.35, P =.067) did not. The dietary score (F = 3.26, P =.04) showed a significant improvement with time points, whereas physical activity (F = 1.06, P =.34) did not. In terms of service satisfaction, only lifestyle improvement (P <.001) showed a significant difference. COVID-19 has affected the performance of healthcare professionals, thereby changing the perspectives toward healthcare technology services. CONCLUSIONS We evaluated the effectiveness of video-based telehealth services supporting workers' health status and lifestyle interventions using healthcare technologies such as the mobile PHR app, tele-monitoring, and video teleconsultation. Our results indicate that as a complementary means, its utility can be expanded in the field of occupational safety and health to overcome the limitations of face-to-face treatment due to COVID-19 in the future.
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Affiliation(s)
- Hyun Sang Park
- Digital Healthcare Department, BIT Computer Co. Ltd., Seoul, Republic of Korea; Department of Medical Informatics, Kyungpook National University, Daegu, Republic of Korea
| | - Sungmoon Jeong
- Department of Medical Informatics, Kyungpook National University, Daegu, Republic of Korea
| | - Ho-Young Chung
- Department of Medical Informatics, Kyungpook National University, Daegu, Republic of Korea; Department of Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
| | - Jae Young Soh
- Digital Healthcare Department, BIT Computer Co. Ltd., Seoul, Republic of Korea
| | - Young Ho Hyun
- Digital Healthcare Department, BIT Computer Co. Ltd., Seoul, Republic of Korea
| | - Seong Hwan Bang
- Digital Healthcare Department, BIT Computer Co. Ltd., Seoul, Republic of Korea
| | - Hwa Sun Kim
- Elecmarvels Co. Ltd., Daegu, Republic of Korea
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9
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Sud E, Anjankar A. Applications of Telemedicine in Dermatology. Cureus 2022; 14:e27740. [PMID: 36106261 PMCID: PMC9445412 DOI: 10.7759/cureus.27740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022] Open
Abstract
Telemedicine is a technological tool that enhances well-being all around the globe. Practicing medicine or performing a clinical examination from a distance was a mere thought until this decade's pandemic hit the world. Telemedicine is practicing medicine sitting on one side of a globe and diagnosing and treating a different individual from the opposite part of the world. There is a long way to go for medical practitioners to execute an entire clinical examination analogous to an accurate clinical examination. Telemedicine is a supplement to a patient's total care, not a replacement for in-person doctor visits. Family doctors can easily access specialists using telemedicine, which enables them to monitor their patients closely. Numerous telemedicine systems, including store and forward, real-time and remote, or self-monitoring, are used worldwide for education, healthcare delivery and control, sickness screening, and disaster management. Even if telemedicine cannot solve every issue, it can significantly lessen the strain on the healthcare system. Nevertheless, investigations performed via telemedicine have started incorporating various medical instruments called telemedicine peripherals, including electronic stethoscopes, teleophthalmoscopes, and video-otoscopes. The prevailing disease around the globe of coronavirus has remarkably debilitated the medical infrastructure in providing diagnosis, treatment, monitoring, and follow-ups. As a result, there is a significant change in the way of practicing medicine and managing patients. Telemedicine provides timely patient care and reduces the risk of exposure to various communicable diseases offered to medical practitioners. The development of imaging technologies has significantly impacted dermatology, a specialty that relies on visual signals. Reviewing dermatology's existing situation and potential digital future, in brief, is the goal of this study. This study provides brief information on telemedicine, its application and scope in dermatology, and how it can alter the healthcare system.
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10
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Fung BM, Markarian E, Serper M, Tabibian JH. Current Applications of Telemedicine in Gastroenterology. Am J Gastroenterol 2022; 117:1072-1079. [PMID: 35385404 DOI: 10.14309/ajg.0000000000001761] [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] [Received: 10/27/2021] [Accepted: 03/29/2022] [Indexed: 12/11/2022]
Abstract
Telemedicine generally refers to the use of technology to communicate with patients and provide health care from a distance. Advances in technology, specifically computers, cellphones, and other mobile devices, have facilitated healthcare providers' growing ability to virtually monitor and mentor patients. There has been a progressive expansion in the use of telemedicine in the field of gastroenterology (GI), which has been accelerated by the COVID-19 pandemic. In this review, we discuss telemedicine-its history, various forms, and limitations-and its current applications in GI. Specifically, we focus on telemedicine in GI practice in general and specific applications, including the management of inflammatory bowel disease, celiac disease, and colorectal cancer surveillance and its use as an aid in endoscopic procedures.
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Affiliation(s)
- Brian M Fung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
- Banner-University Medical Center Phoenix, Phoenix, Arizona, USA
| | - Eric Markarian
- Academy of Science and Medicine, Crescenta Valley High School, Los Angeles, California, USA
| | - Marina Serper
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - James H Tabibian
- Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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11
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Bogin MH, Chandra A, Manggaard J, Thorsteinsdottir B, Hanson GJ, Takahashi PY. Telehealth Use and Hospital Readmission Rates in Long-term Care Facilities in Southeastern Minnesota During the COVID-19 Pandemic. MAYO CLINIC PROCEEDINGS: INNOVATIONS, QUALITY & OUTCOMES 2022; 6:186-192. [PMID: 35281694 PMCID: PMC8904139 DOI: 10.1016/j.mayocpiqo.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective To determine whether the length of a telehealth visit predicted the risk of hospital readmission at 30 days in skilled nursing facilities (SNFs) in southeastern Minnesota during the coronavirus disease 2019 pandemic. Patients and Methods This was a retrospective cohort study conducted in SNFs located in southeastern Minnesota from March 1, 2020 through July 15, 2020. The primary outcomes included hospitalization within 30 days of a video visit, and the secondary outcome was the number of provider video visits during the stay at an SNF. The primary predictor was the duration of video visits, and we collected the data regarding other known predictors of hospitalization. We used the χ2 test for categorical variables and multivariate conditional logistic regression. Results We included 722 patients (mean age, 82.8 years [SD, 10.8 years]). Of those, 76 SNF residents (10.5%) were rehospitalized within 30 days. The average length of a video visit was 34.0 minutes (SD, 22.7 minutes) in admitted residents compared with 30.0 minutes (SD, 15.9 minutes) in nonadmitted residents. After full adjustment, there was no difference in the video visit duration between admitted and nonadmitted residents (odds ratio, 1.01; 95% CI, 0.99-1.03). The number of subsequent provider video visits was 2.26 (SD, 1.9) in admitted residents vs 1.58 (SD, 1.6), which was significant after adjustment (odds ratio, 1.17; 95% CI, 1.02-1.34). Conclusion There was no difference in the length of video visits for hospitalized SNF residents vs those who were not hospitalized within 30 days of a video visit. There were more visits in residents with hospital readmission. This may reflect the acuity of care for patients requiring a hospital stay. More research is needed to determine the ideal use of telehealth during the coronavirus disease 2019 pandemic in the postacute and long-term care environment.
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Affiliation(s)
| | - Anupam Chandra
- Department of Internal Medicine, Division of Community Internal Medicine, Mayo Clinic, Rochester, MN
| | - Jennifer Manggaard
- Department of Internal Medicine, Division of Community Internal Medicine, Mayo Clinic, Rochester, MN
| | - Bjoerg Thorsteinsdottir
- Department of Internal Medicine, Division of Community Internal Medicine, Mayo Clinic, Rochester, MN
| | - Gregory J Hanson
- Department of Internal Medicine, Division of Community Internal Medicine, Mayo Clinic, Rochester, MN
| | - Paul Y Takahashi
- Department of Internal Medicine, Division of Community Internal Medicine, Mayo Clinic, Rochester, MN
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12
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Rahman MM, Khatun F, Sami SI, Uzzaman A. The evolving roles and impacts of 5G enabled technologies in healthcare: The world epidemic COVID-19 issues. ARRAY 2022; 14:100178. [PMID: 35571870 PMCID: PMC9085442 DOI: 10.1016/j.array.2022.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022] Open
Abstract
The latest 5G technology is being introduced the Internet of Things (IoT) Era. The study aims to focus the 5G technology and the current healthcare challenges as well as to highlight 5G based solutions that can handle the COVID-19 issues in different arenas. This paper provides a comprehensive review of 5G technology with the integration of other digital technologies (like AI and machine learning, IoT objects, big data analytics, cloud computing, robotic technology, and other digital platforms) in emerging healthcare applications. From the literature, it is clear that the promising aspects of 5G (such as super-high speed, high throughput, low latency) have a prospect in healthcare advancement. Now healthcare is being adopted 5G-based technologies to aid improved health services, more effective medical research, enhanced quality of life, better experiences of medical professionals and patients in anywhere–anytime. This paper emphasizes the evolving roles of 5G technology for handling the epidemiological challenges. The study also discusses various technological challenges and prospective for developing 5G powered healthcare solutions. Further works will incorporate more studies on how to expand 5G-based digital society as well as to resolve the issues of safety–security–privacy and availability–accessibility–integrity in future health crises.
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Affiliation(s)
- Md Mijanur Rahman
- Department of Computer Science and Engineering, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh 2224, Bangladesh
| | - Fatema Khatun
- Department of Electrical and Electronic Engineering, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh
| | - Sadia Islam Sami
- Department of Computer Science and Engineering, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh 2224, Bangladesh
| | - Ashik Uzzaman
- Department of Computer Science and Engineering, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh 2224, Bangladesh
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Ostberg N, Ip W, Brown I, Li R. Impact of telemedicine on clinical practice patterns for patients with chest pain in the emergency department. Int J Med Inform 2022; 161:104726. [PMID: 35228006 PMCID: PMC8864961 DOI: 10.1016/j.ijmedinf.2022.104726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
Background The outbreak of the COVID-19 pandemic has led to the rapid adoption of novel telemedicine programs within the emergency department (ED) to minimize provider exposure and conserve personal protective equipment (PPE). In this study, we sought to assess how the adoption of telemedicine in the ED impacted clinical order patterns for patients with chest pain. We hypothesize that clinicians would rely more on imaging and laboratory workup for patients receiving telemedicine due to limitation in physical exams. Methods A single-center, retrospective, propensity score matched study was designed for patients presenting with chest pain at an ED. The study period was defined between April 1st, 2020 and September 30th, 2020. The frequency of the most frequent lab, imaging, and medication orders were compared. In addition, poisson regression analysis was performed to compare the overall number of orders between the two groups. Results 455 patients with chest pain who received telemedicine were matched to 455 similar patients without telemedicine with standardized mean difference < 0.1 for all matched covariates. The proportion of frequent lab, imaging, and medication orders were similar between the two groups. However, telemedicine patients received more orders overall (RR, 1.19, 95% CI, 1.11, 1.28, p-value < 0.001) as well as more imaging, lab, and nursing orders. The number of medication orders between the two groups remained similar. Conclusions Frequent labs, imaging, and medications were ordered in similar proportions between the two cohorts. However, telemedicine patients had more orders placed overall. This study is an important objective assessment of the impact that telemedicine has upon clinical practice patterns and can guide future telemedicine implementation after the COVID-19 pandemic.
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Taha BA, Al-Jubouri Q, Al Mashhadany Y, Zan MSDB, Bakar AAA, Fadhel MM, Arsad N. Photonics enabled intelligence system to identify SARS-CoV 2 mutations. Appl Microbiol Biotechnol 2022; 106:3321-3336. [PMID: 35484414 PMCID: PMC9050350 DOI: 10.1007/s00253-022-11930-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 12/13/2022]
Abstract
Abstract The COVID-19, MERS-CoV, and SARS-CoV are hazardous epidemics that have resulted in many deaths which caused a worldwide debate. Despite control efforts, SARS-CoV-2 continues to spread, and the fast spread of this highly infectious illness has posed a grave threat to global health. The effect of the SARS-CoV-2 mutation, on the other hand, has been characterized by worrying variations that modify viral characteristics in response to the changing resistance profile of the human population. The repeated transmission of virus mutation indicates that epidemics are likely to occur. Therefore, an early identification system of ongoing mutations of SARS-CoV-2 will provide essential insights for planning and avoiding future outbreaks. This article discussed the following highlights: First, comparing the omicron mutation with other variants; second, analysis and evaluation of the spread rate of the SARS-CoV 2 variations in the countries; third, identification of mutation areas in spike protein; and fourth, it discussed the photonics approaches enabled with artificial intelligence. Therefore, our goal is to identify the SARS-CoV 2 virus directly without the need for sample preparation or molecular amplification procedures. Furthermore, by connecting through the optical network, the COVID-19 test becomes a component of the Internet of healthcare things to improve precision, service efficiency, and flexibility and provide greater availability for the evaluation of the general population. Key points • A proposed framework of photonics based on AI for identifying and sorting SARS-CoV 2 mutations. • Comparative scatter rates Omicron variant and other SARS-CoV 2 variations per country. • Evaluating mutation areas in spike protein and AI enabled by photonic technologies for SARS-CoV 2 virus detection.
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Affiliation(s)
- Bakr Ahmed Taha
- UKM-Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600, UKM Bangi, Malaysia
| | - Qussay Al-Jubouri
- Department of Communication Engineering, University of Technology, Baghdad, 00964, Iraq
| | - Yousif Al Mashhadany
- Department of Electrical Engineering, College of Engineering, University of Anbar, Anbar, 00964, Iraq
| | - Mohd Saiful Dzulkefly Bin Zan
- UKM-Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600, UKM Bangi, Malaysia
| | - Ahmad Ashrif A Bakar
- UKM-Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600, UKM Bangi, Malaysia
| | - Mahmoud Muhanad Fadhel
- UKM-Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600, UKM Bangi, Malaysia
| | - Norhana Arsad
- UKM-Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600, UKM Bangi, Malaysia.
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15
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Kang E, Song N, Ju H. Contents and sentiment analysis of newspaper articles and comments on telemedicine in Korea: Before and after of COVID-19 outbreak. Health Informatics J 2022; 28:14604582221075549. [PMID: 35212233 PMCID: PMC8883126 DOI: 10.1177/14604582221075549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Telemedicine is rapidly growing to meet the increased needs for high-quality health care during the COVID-19 pandemic. However, telemedicine is still a sensitive issue as it is related to medical privatization. The use of telemedicine after the COVID-19 outbreak might be influenced by public opinion, and this may be an important key in implementing telemedicine. In this study, we aimed to assess if telemedicine-related newspaper articles and comments changed positively during the COVID-19 pandemic. From January 1, 2019, to March 1, 2020 (before COVID-19), a total of 1073 telemedicine-related articles were found in the Korean news network. Although the post-COVID-19 article collection period (from March 2, 2020, to September 30, 2020) was about half that of the pre-COVID-19, about twice the number (1934) of telemedicine-related articles were collected. And telemedicine-related news articles had a more positive tone post-COVID-19 than pre-COVID-19 (52.9% after vs 40.4% before). In conclusion, this study presented the association between the COVID-19 outbreak and changes in the media's perception of telemedicine in Korea. This study presented that, as telemedicine begins to be utilized due to COVID-19, news media and readers who embrace it are beginning to view telemedicine positively, suggesting that COVID-19 has a positive foundation for the spread of telemedicine.
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Affiliation(s)
- EunKyo Kang
- National Cancer Control Institute, 70317National Cancer Center, Goyang-si, Korea.,Department of Family Medicine, 105922National Cancer Center, Goyang-si, Korea
| | - Narae Song
- Ministry of Environment, 58927Government of South Korea, Sejong, Korea
| | - HyoRim Ju
- Department of Family Medicine, 58927Seoul National University Hospital, Korea
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16
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Alajwari HA, Alfayez A, Alsalman D, Alanezi F, Alhodaib H, Al-Rayes S, Aljaffary A, AlThani B, AlNujaidi H, Al-Saif AK, Attar R, Aljabri D, Al-Mubarak S, Al-Juwair MM, Alrawiai S, Alakrawi Z, Alanzi TM. Knowledge and attitude of Saudi Arabian citizens towards telemedicine during the COVID-19 pandemic. Int Health 2021; 14:604-609. [PMID: 34893850 PMCID: PMC8689698 DOI: 10.1093/inthealth/ihab082] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/10/2021] [Accepted: 11/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background The objective of this study was to investigate the knowledge and attitudes of Saudi Arabian citizens towards telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. Methods A cross-sectional survey was designed to carry out this study. The electronic survey, prepared using Google Forms, was distributed to 1500 randomly selected citizens of Saudi Arabia. A total of 330 participants completed and returned the questionnaire. Basic statistics were used to describe the data. Results The majority of the respondents (73.9%) were female. More than half of them (54.8%) were >35 y of age and had graduate or postgraduate degrees (65.5%). A total of 96.7% of the respondents were Saudis. Most of the participants (70.0%) were familiar with the term ‘telemedicine’ and thought that telemedicine (92.1%) could reduce transportation costs. Of the respondents, 58.8% had not seen a telemedicine system before and 67.0% indicated that they had not previously used telemedicine services. A total of 87.3% of the participants agreed or strongly agreed that telemedicine was a useful tool during the COVID-19 pandemic. Also, more than half of the participants agreed or strongly agreed that telemedicine facilitates the diagnosis of people (58.8%), increases communication (58.2%), reduces clinic visits (85.9%) and performs tasks quickly (70.3%). Also, 51.5% of the respondents disagreed or strongly disagreed that telemedicine affects patient privacy. Conclusions The outcomes indicated that most of the participants had a positive attitude towards the use of telemedicine as a response to the COVID-19 pandemic in Saudi Arabia. They believed that telemedicine saves time, labour and costs and is an effective tool to treat coronavirus patients at a safe distance. However, the government should develop programs to raise awareness in the population about the use of telemedicine for the treatment of various diseases that afflict the Saudi Arabian people. Likewise, a legal framework must be implemented to protect the privacy of patients and healthcare providers.
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Affiliation(s)
- Hadeel Abdullah Alajwari
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Asma Alfayez
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Demah Alsalman
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Fahad Alanezi
- College of Business Administration, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hala Alhodaib
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University
| | - Saja Al-Rayes
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Afnan Aljaffary
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Bashair AlThani
- College of Business Administration, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Heba AlNujaidi
- College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Atheer K Al-Saif
- College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Razaz Attar
- Princess Nourah Bint Abdul Rahman University, Saudi Arabia
| | - Duaa Aljabri
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Sama'a Al-Mubarak
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Mona M Al-Juwair
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Sumaiah Alrawiai
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Zahraa Alakrawi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Turki M Alanzi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
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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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Payvandi L, Parsons C, Bourgeois FC, Hron JD. Inpatient telehealth experience of limited English proficient patients: a cross-sectional survey and semi-structured interview (Preprint). JMIR Form Res 2021; 6:e34354. [PMID: 35438641 PMCID: PMC9066319 DOI: 10.2196/34354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/17/2022] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
Abstract
Background Patients with limited English proficiency (LEP) are at a higher risk of poor health outcomes and are less likely to use telehealth than English-speaking patients. To date, there is no formal evaluation of inpatient (IP) telehealth user experience of patients and their families by language preference during visits with their clinicians. Objective This study aims to compare the experiences of English- and Spanish-speaking patients and their families using IP telehealth, as well as to evaluate the experience of Spanish interpreters providing services through IP telehealth. Methods We prospectively administered a survey to English- and Spanish-speaking patients and their families who used IP telehealth from October 1, 2020, to March 31, 2021. We performed semistructured phone interviews of hospital-based Spanish interpreters who provided services through IP telehealth. Results A total of 661 surveys were administered, with completion rates of 18% (112/621) in English and 62% (25/40) in Spanish. On a 10-point scale, the overall satisfaction of Spanish speakers (median 10, IQR 10-10) was higher than that of English speakers (median 9, IQR 8-10; P=.001). Both English- and Spanish-speaking patients used IP telehealth for visits with their primary IP care team, subspecialty consultants, and other clinicians. Hospital tablets were used more often than personal devices, and only English-speaking patients used personal laptops. Patients and their families encountered challenges with log-in, team coordination with multiple users, and equipment availability. Interpreters encountered challenges with audio and video quality, communication, safety, and Wi-Fi access. Conclusions Both English- and Spanish-speaking patients reported high satisfaction using IP telehealth across multiple disciplines despite the workflow challenges identified by interpreters. Significant investment is needed to provide robust infrastructure to support use by all patients, especially the integration of multiple users to provide interpreter services for patients with LEP.
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Affiliation(s)
- Lily Payvandi
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
| | - Chase Parsons
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Fabienne C Bourgeois
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Jonathan D Hron
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
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Ohta R, Ueno A, Sano C. Changes in the Comprehensiveness of Rural Medical Care for Older Japanese Patients during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010772. [PMID: 34682516 PMCID: PMC8535374 DOI: 10.3390/ijerph182010772] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 12/11/2022]
Abstract
Help-seeking behaviors (HSBs) refer to how people use lay and medical care to address their symptoms and diseases. The COVID-19 pandemic may have changed older, rural patients’ preferences and experiences regarding HSBs, thereby, affecting the comprehensiveness of medical support for communities. This study identified changes in the comprehensiveness of medical care for older, rural patients, who are often dependent on others for accessing medical services. This observational study was performed with patients who lived in Unnan City. Patients’ dependency and changes in comprehensiveness of medical services were assessed and calculated. The total usage of medical care decreased from 2018 to 2020 at all medical care levels. The proportion of patients who received comprehensive care was higher in 2020 than in 2018, at all care levels. At care dependent levels 3 to 5, the differences in the proportions were statistically significant. This study illustrates an association between the COVID-19 pandemic and the proportion of comprehensiveness of medical care among older rural patients with a decrease in medical care usage. Moreover, an improved proportion of comprehensiveness of medical care leads to appropriate HSBs. Going forward, HSBs and patient-centered care should be promoted by policy makers.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, Daito-cho Iida, Unnan 699-1221, Japan
- Correspondence: ; Tel.: +81-9050605330
| | - Akinori Ueno
- Unnan Public Health Center, Unnan 699-1311, Japan;
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, Enya-cho, Izumo 693-8501, Japan;
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Bae YS, Kim KH, Choi SW, Ko T, Lim JS, Piao M. Satisfaction and Usability of an Information and Communications Technology-Based System by Clinically Healthy Patients With COVID-19 and Medical Professionals: Cross-sectional Survey and Focus Group Interview Study. JMIR Form Res 2021; 5:e26227. [PMID: 34254946 PMCID: PMC8396536 DOI: 10.2196/26227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/22/2020] [Accepted: 07/06/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Digital health care is an important strategy in the war against COVID-19. South Korea introduced living and treatment support centers (LTSCs) to control regional outbreaks and care for patients with asymptomatic or mild COVID-19. Seoul National University Hospital (SNUH) introduced information and communications technology (ICT)-based solutions to manage clinically healthy patients with COVID-19. OBJECTIVE This study aims to investigate satisfaction and usability by patients and health professionals in the optimal use of a mobile app and wearable device that SNUH introduced to the LTSC for clinically healthy patients with COVID-19. METHODS Online surveys and focus group interviews were conducted to collect quantitative and qualitative data. RESULTS Regarding usability testing of the wearable device, perceived usefulness had the highest mean score of 4.45 (SD 0.57) points out of 5. Regarding usability of the mobile app, perceived usefulness had the highest mean score of 4.62 (SD 0.48) points out of 5. Regarding satisfaction items for the mobile app among medical professionals, the "self-reporting" item had the highest mean score of 4.42 (SD 0.58) points out of 5. In focus group interviews of health care professionals, hospital information system interfacing was the most important functional requirement for ICT-based COVID-19 telemedicine. CONCLUSIONS Improvement of patient safety and reduction of the burden on medical staff were the expected positive outcomes. Stability and reliability of the device, patient education, accountability, and reimbursement issues should be considered as part of the development of remote patient monitoring. In responding to a novel contagious disease, telemedicine and a wearable device were shown to be useful during a global crisis.
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Affiliation(s)
- Ye Seul Bae
- Office of Hospital Information, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung Hwan Kim
- Department of Thoracic & Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Thoracic & Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sae Won Choi
- Office of Hospital Information, Seoul National University Hospital, Seoul, Republic of Korea
| | - Taehoon Ko
- Department of Medical Informatics, Catholic University of Korea, Seoul, Republic of Korea
| | - Jun Seo Lim
- Office of Hospital Information, Seoul National University Hospital, Seoul, Republic of Korea
| | - Meihua Piao
- Office of Hospital Information, Seoul National University Hospital, Seoul, Republic of Korea
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Khoshrounejad F, Hamednia M, Mehrjerd A, Pichaghsaz S, Jamalirad H, Sargolzaei M, Hoseini B, Aalaei S. Telehealth-Based Services During the COVID-19 Pandemic: A Systematic Review of Features and Challenges. Front Public Health 2021; 9:711762. [PMID: 34350154 PMCID: PMC8326459 DOI: 10.3389/fpubh.2021.711762] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/21/2021] [Indexed: 01/11/2023] Open
Abstract
Background: As an ever-growing popular service, telehealth catered for better access to high-quality healthcare services. It is more valuable and cost-effective, particularly in the middle of the current COVID-19 pandemic. Accordingly, this study aimed to systematically review the features and challenges of telehealth-based services developed to support COVID-19 patients and healthcare providers. Methods: A comprehensive search was done for the English language and peer-reviewed articles published until November 2020 using PubMed and Scopus electronic databases. In this review paper, only studies focusing on the telehealth-based service to support COVID-19 patients and healthcare providers were included. The first author's name, publication year, country of the research, study objectives, outcomes, function type including screening, triage, prevention, diagnosis, treatment or follow-up, target population, media, communication type, guideline-based design, main findings, and challenges were extracted, classified, and tabulated. Results: Of the 5,005 studies identified initially, 64 met the eligibility criteria. The studies came from 18 countries. Most of them were conducted in the United States and China. Phone calls, mobile applications, videoconferencing or video calls, emails, websites, text messages, mixed-reality, and teleradiology software were used as the media for communication. The majority of studies used a synchronous communication. The articles addressed the prevention, screening, triage, diagnosis, treatment, and follow-up aspects of COVID-19 which the most common purpose was the patients' follow-up (34/64, 53%). Thirteen group barriers were identified in the literature, which technology acceptance and user adoption, concerns about the adequacy and accuracy of subjective patient assessment, and technical issues were the most frequent ones. Conclusion: This review revealed the usefulness of telehealth-based services during the COVID-19 outbreak and beyond. The features and challenges identified through the literature can be helpful for a better understanding of current telehealth approaches and pointed out the need for clear guidelines, scientific evidence, and innovative policies to implement successful telehealth projects.
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Affiliation(s)
- Farnaz Khoshrounejad
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Hamednia
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ameneh Mehrjerd
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Pichaghsaz
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Jamalirad
- Department of Computer Engineering, Ayatollah Amoli University, Science and Research Branch, Amol, Iran
| | - Mahdi Sargolzaei
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Benyamin Hoseini
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shokoufeh Aalaei
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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22
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Hassan H, Elazar A, Takabe K, Datta R, Takahashi H, Seitelman E. Scalp Leiomyosarcoma: Diagnosis and Treatment During a Global Pandemic With COVID-19. World J Oncol 2021; 12:132-136. [PMID: 34349859 PMCID: PMC8297053 DOI: 10.14740/wjon1393] [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: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 11/11/2022] Open
Abstract
Leiomyosarcoma is an aggressive, uncommon sarcoma effecting smooth muscle tissue. Prompt tissue diagnosis and staging workup are keys to preventing distant metastasis. Identification of this rare sarcoma has become increasingly difficult with decreased ability to seek out non-coronavirus disease 2019 (COVID-19) medical care. The pandemic has caused a widespread healthcare demand with providers reaching their full capacity causing care and resources to be shifted to the pandemic. We have experienced an 83-year-old male who significantly delayed to seek any medical attention for his scalp lesion for several months due to a combination of fear and decreased available appointments. Since the patient presented with a delayed scalp leiomyosarcoma, he required an extensive excision and flap reconstruction for the lesion. This case sheds light on the importance of weighing the risks and benefits associated with cancer management during the pandemic for both patients and healthcare providers. The healthcare system's response to the pandemic also played a role in this case as well, with shorter appointment times and decreased frequency of follow-up. As a result, the pandemic has had a catastrophic impact on the diagnostic pathway for cancer. This case report discusses the difficulties in diagnosing and treating a rare cancer such as scalp leiomyosarcoma amidst the global pandemic and the importance of telemedicine in improving future outcomes.
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Affiliation(s)
- Hebah Hassan
- Department of Surgery, Mount Sinai South Nassau, Oceanside, NY, USA.,New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Amit Elazar
- Department of Surgery, Mount Sinai South Nassau, Oceanside, NY, USA
| | - Kazuaki Takabe
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.,Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, NY, USA.,Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo, Japan.,Department of Surgery, Yokohama City University, Yokohama, Japan.,Department of Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Rajiv Datta
- Department of Surgery, Mount Sinai South Nassau, Oceanside, NY, USA
| | - Hideo Takahashi
- Department of Surgery, Mount Sinai South Nassau, Oceanside, NY, USA
| | - Eric Seitelman
- Department of Surgery, Mount Sinai South Nassau, Oceanside, NY, USA
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23
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Kyriakoulis KG, Poulakou G, Nitsotolis T, Syrigos KN. Clinical examination practices and perceptions in the era of COVID-19. Expert Rev Respir Med 2021; 15:967-971. [PMID: 34109904 DOI: 10.1080/17476348.2021.1941884] [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: 01/08/2023]
Abstract
Introduction The art of clinical examination has been the cornerstone of medical practices since ancient years. Recent technological achievements and their overuse have led falsely to underestimation of their significance, which has been further questioned during the coronavirus disease 2019 (COVID-19) pandemic, due to concerns regarding exposure risk and use of personal protective equipment.Areas covered The role of clinical examination (namely chest examination) during the pandemic is discussed. Emerging evidence is being accumulated concerning alternatives to traditional practices. Telemedicine stands out as a promising tool, allowing inspection and interaction between physicians and patients, proved to be useful for many medical specialties but not enough for some others. Medical practices cannot remain the same in the era of the COVID-19 pandemic, yet realistic strategies should be adopted for their optimal and safe implementation.Expert opinion The experiences of a dedicated Reference Center for COVID-19 along with a suggested algorithm for conducting clinical examinations are presented. According to our experience, an initial detailed clinical examination upon admission of each COVID-19 patient appears to be necessary. Then, vital signs and signs of respiratory distress using inspection should be checked frequently. A focused examination approach should be adopted, in case of new onset clinical problems.
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Affiliation(s)
- Konstantinos G Kyriakoulis
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Garyphallia Poulakou
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Thomas Nitsotolis
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos N Syrigos
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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24
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Jaffe TA, Hayden E, Uscher‐Pines L, Sousa J, Schwamm LH, Mehrotra A, Zachrison KS. Telehealth use in emergency care during coronavirus disease 2019: a systematic review. J Am Coll Emerg Physicians Open 2021; 2:e12443. [PMID: 33969356 PMCID: PMC8087945 DOI: 10.1002/emp2.12443] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/21/2021] [Accepted: 03/31/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 pandemic has presented emergency departments (EDs) with many challenges to address the acute care needs of patients. Many EDs have leveraged telehealth to innovatively respond to these challenges. This review describes the landscape of telehealth initiatives in emergency care that have been described during the coronavirus disease 2019 pandemic. METHODS We conducted a comprehensive, systematic review of the literature using PubMed, supplemented by a review of the gray literature (ie, non-peer reviewed), with input from subject matter experts to identify telehealth initiatives in emergency care during coronavirus disease 2019. We categorized types of telehealth use based on purpose and user characteristics. RESULTS We included 27 papers from our review of the medical literature and another 8 sources from gray literature review. The vast majority of studies (32/35) were descriptive in nature, with the additional inclusion of 2 cohort studies and one randomized clinical trial. There were 5 categories of ED telehealth use during the pandemic: (1) pre-ED evaluation and screening, (2) within ED (including as a means of limiting staff and patient exposure and facilitating consultation with specialists), (3) post-ED discharge monitoring and treatment, (4) educating trainees and health care workers, and (5) coordinating resources and patient care. CONCLUSION Telehealth has been used in a variety of manners during the coronavirus disease 2019 pandemic, enabling innovation in emergency care delivery. The findings from this study can be used by institutions to consider how telehealth may address challenges in emergency care during the coronavirus disease 2019 pandemic and beyond. Because few studies included cost data and given the variability in institutional resources, how organizations implement telehealth programs will likely vary. Future work should further explore barriers and facilitators of innovation, and the impact on care delivery and patient outcomes.
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Affiliation(s)
- Todd A. Jaffe
- Harvard Affiliated Emergency Medicine ResidencyMassachusetts General Hospital and Brigham and Women's HospitalBostonMassachusettsUSA
| | - Emily Hayden
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | | | | | - Lee H. Schwamm
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Ateev Mehrotra
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Kori S. Zachrison
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
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25
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Legler S, Diehl M, Hilliard B, Olson A, Markowitz R, Tignanelli C, Melton GB, Broccard A, Kirsch J, Usher M. Evaluation of an Intrahospital Telemedicine Program for Patients Admitted With COVID-19: Mixed Methods Study. J Med Internet Res 2021; 23:e25987. [PMID: 33872187 PMCID: PMC8086788 DOI: 10.2196/25987] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/30/2021] [Accepted: 04/11/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The increasing incidence of COVID-19 infection has challenged health care systems to increase capacity while conserving personal protective equipment (PPE) supplies and minimizing nosocomial spread. Telemedicine shows promise to address these challenges but lacks comprehensive evaluation in the inpatient environment. OBJECTIVE The aim of this study is to evaluate an intrahospital telemedicine program (virtual care), along with its impact on exposure risk and communication. METHODS We conducted a natural experiment of virtual care on patients admitted for COVID-19. The primary exposure variable was documented use of virtual care. Patient characteristics, PPE use rates, and their association with virtual care use were assessed. In parallel, we conducted surveys with patients and clinicians to capture satisfaction with virtual care along the domains of communication, medical treatment, and exposure risk. RESULTS Of 137 total patients in our primary analysis, 43 patients used virtual care. In total, there were 82 inpatient days of use and 401 inpatient days without use. Hospital utilization and illness severity were similar in patients who opted in versus opted out. Virtual care was associated with a significant reduction in PPE use and physical exam rate. Surveys of 41 patients and clinicians showed high rates of recommendation for further use, and subjective improvements in communication. However, providers and patients expressed limitations in usability, medical assessment, and empathetic communication. CONCLUSIONS In this pilot natural experiment, only a subset of patients used inpatient virtual care. When used, virtual care was associated with reductions in PPE use, reductions in exposure risk, and patient and provider satisfaction.
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Affiliation(s)
- Sean Legler
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Matthew Diehl
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Brian Hilliard
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Andrew Olson
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Rebecca Markowitz
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Christopher Tignanelli
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Genevieve B Melton
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Alain Broccard
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Jonathan Kirsch
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Michael Usher
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
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26
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Manteghinejad A, Javanmard SH. Challenges and opportunities of digital health in a post-COVID19 world. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2021; 26:11. [PMID: 34084190 PMCID: PMC8103966 DOI: 10.4103/jrms.jrms_1255_20] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/01/2020] [Accepted: 12/25/2020] [Indexed: 12/12/2022]
Abstract
Digital health as a rapidly growing medical field relies comprehensively on human health data. Conventionally, the collection of health data is mediated by officially diagnostic instruments, operated by health professionals in clinical environments and under strict regulatory conditions. Mobile health, telemedicine, and other smart devices with Internet connections are becoming the future choices for collecting patient information. Progress of technologies has facilitated smartphones, wearable devices, and miniaturized health-care devices. These devices allow the gathering of an individual's health-care information at the patient's home. The data from these devices will be huge, and by integrating such enormous data using Artificial Intelligence, more detailed phenotyping of disease and more personalized medicine will be realistic. The future of medicine will be progressively more digital, and recognizing the importance of digital technology in this field and pandemic preparedness planning has become urgent.
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Affiliation(s)
- Amirreza Manteghinejad
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh Haghjooy Javanmard
- Applied Physiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Science, Isfahan, Iran
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27
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Dhahri AA, Ahmad R, Shaikh BF, Sajinyan O, Warrag I, Patel M, Ivanov B. Hybrid Surgical Hot Clinic (HSHC): Evaluation of Surgical Hot Clinic Services during COVID-19 Lockdown. World J Surg 2021; 45:955-961. [PMID: 33554298 PMCID: PMC7868112 DOI: 10.1007/s00268-021-05981-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2021] [Indexed: 12/20/2022]
Abstract
Background Surgical Hot Clinic (SHC) is an acute, ambulatory service for management provided on an outpatient basis. Following the start of global Novel Coronavirus (COVID-19) pandemic and as per the statement released by the Association of Surgeons of Great Britain and Ireland (ASGBI), we also modified our services to hybrid SHC (HSHC) by mainly providing telephonic follow-up with an occasional face-to-face (F2F) service. We conducted a service evaluation to assess the effectiveness and serviceability of HSHC during a pandemic. Methods This service evaluation was conducted from 30th March till 26th May 2020. The pathway was developed to mostly telephonic consultation with selective face-to-face consultation at a designated area in the medical ambulatory unit. The analysis then performed using SPSS version 21. Results As the overall attendance fell in hospital, 149 patients, including 54(36.2%) male, and 95(63.8%) females, attended SHC during COVID-19 lockdown. Out of these 149, 87(58.3%) were referred from Accident & Emergency (A&E), 2(1.3%) from GP, 9(6.04%) after scan through radiology department, while 51(34.2%) after discharge from hospital. Out of those who have telephonic consultation (n = 98), 12 patients were called in for review with either blood tests or further clinical examination. In total, only 10 out of 149 patients required admission to the hospital, for either intervention or symptomatic treatment. Conclusion Hybrid Surgical Hot Clinic (HSHC) with both telephonic & face-to-face consultation, as per requirement, is flexible, effective and safe patient-focused acute surgical service during COVID-19 like crisis.
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Affiliation(s)
| | | | | | | | | | | | - Bogdan Ivanov
- The Princess Alexandra Hospital NHS Trust, Harlow, UK
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28
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Al-Zyoud W, Oweis T, Al-Thawabih H, Al-Saqqar F, Al-Kazwini A, Al-Hammouri F. The Psychological Effects of Physicians' Communication Skills on COVID-19 Patients. Patient Prefer Adherence 2021; 15:677-690. [PMID: 33854302 PMCID: PMC8039207 DOI: 10.2147/ppa.s303869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has affected physician-patient communication (PPC) in multiple ways. This study aims to report on the impact of physician-patient communication (PPC) skills on COVID-19 patients' psychology in Jordan. SAMPLE AND METHODS In this study, two questionnaires were designed. The first questionnaire targeted physicians, with 72 responses, and the second questionnaire targeted patients, with 248 responses. Both questionnaires contained common sections covering nine aspects of communication such as empathy, honesty, optimism, simple and deliberateness. RESULTS This study found that the psychological effect of physicians' positive communication skills on COVID-19 patients is significant. There were almost statistical agreement between physicians' and patients' questionnaire responses that the physicians' communication skills have positively affected the patients' psychological status; all patients' responses confirmed this finding. CONCLUSION Based on this study's findings, appropriate and continuous training will advance physicians' communication skills in the form of exercises that could be as simple as class- or lecture-based activities, or using technology-based learning. Using a protocol or handbook to guide such communication is another essential strategy to enhance physician-patient communication (PPC). The study recommends that physicians must be aware that PPC skills required may vary depending on whether they are dealing with a pandemic or non-pandemic situation. Generally, appropriate or positive communication skills are considered one of the main factors effecting patients' psychological responses to their diagnosis.
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Affiliation(s)
- Walid Al-Zyoud
- School of Applied Medical Sciences, German Jordanian University, Amman, Jordan
- Correspondence: Walid Al-Zyoud German Jordanian University, Amman Madaba Street, P.O. Box 35247, Amman, 11180, JordanTel +962 6 429 4401Fax +962 6 430 0215 Email
| | - Thelal Oweis
- School of Basic Sciences and Humanities, German Jordanian University, Amman, Jordan
| | - Haytham Al-Thawabih
- School of Applied Humanities and Languages, German Jordanian University, Amman, Jordan
| | - Fawwaz Al-Saqqar
- School of Basic Sciences and Humanities, German Jordanian University, Amman, Jordan
| | - Akeel Al-Kazwini
- School of Applied Medical Sciences, German Jordanian University, Amman, Jordan
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29
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Almallah YZ, Doyle DJ. Telehealth in the time of Corona: 'doctor in the house'. Intern Med J 2020; 50:1578-1583. [PMID: 33354885 DOI: 10.1111/imj.15108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/12/2020] [Accepted: 09/10/2020] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic has led to many physicians working from home whenever possible. Although the concept of 'remote' patient care has been around for decades, present circumstances have provided a grand impetus in that direction with a view to protecting both patient and caregiver. In this article, we discuss some of the various challenges to moving forward with telemedicine, drawing in part on our own experiences in dealing with the COVID-19 pandemic. Clinical, technical, financial and cultural barriers to telemedicine are identified, along with a discussion concerning anticipated benefits. We conclude that the COVID-19 pandemic will likely forever change how healthcare is conducted as telemedicine figures increasingly prominently in the clinical landscape.
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Affiliation(s)
- Yahia Zaki Almallah
- Department of Urology, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, UAE
| | - Daniel John Doyle
- Department of Urology, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, UAE
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30
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Candel BGJ, Vaes SMM, van Bree EM, Groenen SMA, Derkx F, Mignot LAA, de Groot B. Telemedicine in the emergency department to decrease personal protective equipment use: a before-and-after study. Emerg Med J 2020; 38:224-228. [PMID: 33355305 DOI: 10.1136/emermed-2020-210292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/22/2020] [Accepted: 11/11/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Personal protective equipment (PPE) used by healthcare workers was scarce during the COVID-19 pandemic. The aim of this study was to assess whether telemedicine (using iPads) reduced PPE use in emergency department (ED) patients who were treated in contact isolation, and whether telemedicine had a positive effect on patient anxiety and satisfaction. METHODS We conducted a prospective single centre before-and-after study including ED patients ≥18 years who were treated in contact isolation. PPE use, the Hospital Anxiety Scale and the 15-item Picker Patient Experience Questionnaire were compared between the control period (8 April to 14 April 2020) and intervention period (15 April to 24 April 2020). RESULTS We included 25 patients in each period. PPE use per patient was higher for physicians in the control period (mean 1.7; 95% CI 1.5 to 1.9) compared with the intervention period (mean 1.2; 95% CI 1.0 to 1.3, p<0.01). Total PPE use per patient contact for ED physicians decreased from 42 out of 42 patient contacts in the control period, to 29 out of 66 patient contacts in the intervention period (difference 54.3%; 95% CI 50.1% to 58.6%, p<0.01). Reported anxiety and satisfaction were not significantly different. CONCLUSION PPE use by physicians can successfully be reduced by using telemedicine in the ED without increasing anxiety or dissatisfaction. This study was a first step to gain experience with telemedicine in the ED which has the potential to reduce PPE use in future pandemics or other patients with an indication for contact isolation.
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Affiliation(s)
- Bart G J Candel
- Department of Emergency Medicine, Máxima Medical Centre, Veldhoven, Noord-Brabant, The Netherlands
| | - Selma M M Vaes
- Department of Emergency Medicine, Máxima Medical Centre, Veldhoven, Noord-Brabant, The Netherlands
| | - Egid M van Bree
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Sophie M A Groenen
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Floor Derkx
- Department of Emergency Medicine, Máxima Medical Centre, Veldhoven, Noord-Brabant, The Netherlands
| | - Lisette A A Mignot
- Department of Emergency Medicine, Máxima Medical Centre, Veldhoven, Noord-Brabant, The Netherlands
| | - Bas de Groot
- Department of Emergency Medicine, Leiden University Medical Centre, Leiden, Zuid-Holland, The Netherlands
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31
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Abbas B, Wajahat M, Saleem Z, Imran E, Sajjad M, Khurshid Z. Role of Teledentistry in COVID-19 Pandemic: A Nationwide Comparative Analysis among Dental Professionals. Eur J Dent 2020; 14:S116-S122. [PMID: 33383589 PMCID: PMC7775233 DOI: 10.1055/s-0040-1722107] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To assess knowledge, awareness, and practice of health care workers about the role of teledentistry in coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS A prevalidated structured questionnaire was used to evaluate awareness of general dentists, postgraduate dental students, dental educators, and consultants with postgraduation degrees toward teledentistry. The acceptability, reliability, and language clarity were also pretested. A total of 510 dental professionals contributed to this study. STATISTICAL ANALYSIS A statistical analysis using SPSS (version 20.0) was performed. Responses were noted as yes or no. A p-value of ≤ 0.05 was considered to be significant. Frequencies described data. Chi-square test was performed for intergroup comparison to evaluate if the knowledge and attitude diverge with the increase in the level of seniority in the profession. RESULTS Awareness regarding teledentistry is high among general dentists with bachelor of dental surgery qualification in comparison to final-year students and postgraduate dental students. The majority of participants agreed with improvement in health care (88.20%), access to rural areas (82.90%), and general practicing dentist agreed with statistically significant difference (0.00) on saving time by teledentistry. CONCLUSION General practicing dentist was observed with high awareness of teledentistry as compared with postgraduate and undergraduate dental students.
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Affiliation(s)
- Beenish Abbas
- Department of Pediatric Dentistry, Foundation University, College of Dentistry, Rawalpindi, Pakistan
| | - Mehreen Wajahat
- Department of Dental Materials, Avicenna Dental College, Lahore, Pakistan
| | - Zakia Saleem
- Department of Dental Education, University College of Dentistry, Lahore, Pakistan
| | - Eisha Imran
- Department of Dental Materials, Dental College, HITEC-Institute of Medical Sciences, Rawalpindi, Pakistan
| | - Mehvish Sajjad
- Department of Dental Materials, Avicenna Dental College, Lahore, Pakistan
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
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32
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Brown HL. Emergency Care EMTALA Alterations During the COVID-19 Pandemic in the United States. J Emerg Nurs 2020; 47:321-325. [PMID: 33388166 PMCID: PMC7704064 DOI: 10.1016/j.jen.2020.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/02/2020] [Accepted: 11/23/2020] [Indexed: 11/24/2022]
Abstract
The coronavirus 2019 pandemic has affected almost every aspect of health care delivery in the United States, and the emergency medicine system has been hit particularly hard while dealing with this public health crisis. In an unprecedented time in our history, medical systems and clinicians have been asked to be creative, flexible, and innovative, all while continuing to uphold the important standards in the US health care system. To continue providing quality services to patients during this extraordinary time, care providers, organizations, administrators, and insurers have needed to alter longstanding models and procedures to respond to the dynamics of a pandemic. The Emergency Medicine Treatment and Active Labor Act of 1986, or EMTALA, is 1 example of where these alterations have allowed health care facilities and clinicians to continue their work of caring for patients while protecting both the patients and the clinicians themselves from infectious exposures at the same time.
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33
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Rosen K, Patel M, Lawrence C, Mooney B. Delivering Telerehabilitation to COVID-19 Inpatients:A Retrospective Chart Review Suggests It Is a Viable Option. HSS J 2020; 16:64-70. [PMID: 32837409 PMCID: PMC7364751 DOI: 10.1007/s11420-020-09774-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023]
Abstract
Background Guidelines for physical therapy management of patients hospitalized with COVID-19 recommend limiting physical therapists' contact with patients when possible. Telehealth has been viewed as "electronic personal protective equipment" during the COVID-19 pandemic; although telerehabilitation has been shown to be effective with outpatients, it is unknown whether it is a viable option for hospitalized patients. Purpose Our facility developed an algorithm for the use of a physical therapy telerehabilitation program for inpatients with COVID-19. We sought to investigate the safety and viability of the program. Methods We conducted a retrospective chart review of patients admitted with a diagnosis of COVID-19 who received either telerehabilitation only or a combination of telerehabilitation and in-person rehabilitation. Based on the algorithm, COVID-19 inpatients were selected to receive telerehabilitation if they could ambulate independently, could use technology, had stable vital signs, required minimal supplemental oxygen, and were cognitively intact. We analyzed data of inpatients who received telerehabilitation only, which included patient education, therapeutic exercises, and breathing techniques. Results Of 33 COVID-19 inpatients who received telerehabilitation, in-person rehabilitation, or a combination of the two, 12 patients received telerehabilitation only (age range, 33 to 65 years; all but one male). They demonstrated independence with their individualized home exercise programs in one to two sessions, did not require an in-person rehabilitation consultation, did not require increased oxygen, experienced no exacerbation of symptoms, and were discharged home. Conclusions Inpatient telerehabilitation appears to be a viable option for selected hospitalized patients with COVID-19 and may be a safe way of delivering inpatient rehabilitation to isolated or at-risk populations. At our hospital, the use of inpatient telerehabilitation reduced staff exposure while providing important education and services to patients. To our knowledge, no studies have investigated the use of telerehabilitation for hospitalized patients, including those with COVID-19. Our findings suggest that this innovative approach warrants further study.
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Affiliation(s)
- Kelsey Rosen
- Rehabilitation Department, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10021 USA
| | - Monika Patel
- Rehabilitation Department, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10021 USA
| | - Cecelia Lawrence
- Rehabilitation Department, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10021 USA
| | - Brianne Mooney
- Rehabilitation Department, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10021 USA
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Rentrop V, Schneider JS, Bäuerle A, Junne F, Dörrie N, Skoda EM, Schedlowski M, Mallmann B, Benecke AV, Kohler H, Gerigk M, Teigelack P, Emler T, Scherbaum N, Gradl-Dietsch G, Scheer K, Teufel M. Psychosocial emergency care in times of COVID-19: the Essen University Hospital concept for corona-infected patients, their relatives, and medical staff. Int Arch Occup Environ Health 2020; 94:347-350. [PMID: 32964313 PMCID: PMC7508238 DOI: 10.1007/s00420-020-01580-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/04/2020] [Indexed: 11/27/2022]
Abstract
Due to the SARS CoV-2-virus (COVID-19), anxiety, distress, and insecurity occur more frequently. In particular, infected individuals, their relatives, and medical staff face an increased risk of high psychological distress as a result of the ongoing pandemic. Thus, structured psychosocial emergency concepts are needed. The University hospital of Essen has taken up this challenge by creating the PEC concept to reduce psychosocial long-term consequences for infected patients, relatives, and medical staff at the university hospital. The concept includes professional medical as well as psychological support to convey constructive coping strategies and the provision of adequate tools such as the low-threshold online training program (CoPE It), which is accessible via the webpage www.cope-corona.de.
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Affiliation(s)
- Vanessa Rentrop
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.
| | - Johanna Sophie Schneider
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Alexander Bäuerle
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, 72076, Tübingen, Germany
| | - Nora Dörrie
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Eva-Maria Skoda
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, 45147, Essen, Germany
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Bernhard Mallmann
- Palliative Medicine, University Hospital Essen, 45147, Essen, Germany
| | - Anke-Verena Benecke
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Hannah Kohler
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Monja Gerigk
- Institute of Patient Experience, University Hospital Essen, 45147, Essen, Germany
| | - Per Teigelack
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Tobias Emler
- Strategic Management, University Hospital Essen, 45147, Essen, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, LVR University Hospital Essen, Medical Faculty, University of Duisburg-Essen, 45147, Essen, Germany
| | - Gertraud Gradl-Dietsch
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR University Hospital, University of Duisburg-Essen, 45157, Essen, Germany
| | - Karin Scheer
- Hospice Care, University Hospital Essen, 45157, Essen, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
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35
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Bokolo Anthony Jnr. Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic. J Med Syst 2020; 44:132. [PMID: 32542571 PMCID: PMC7294764 DOI: 10.1007/s10916-020-01596-5] [Citation(s) in RCA: 321] [Impact Index Per Article: 80.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 12/18/2022]
Abstract
The current coronavirus disease 2019 (COVID-19) pandemic has caused significant strain on medical centers resources. Thus, concerns about the reducing and management of COVID-19 are on the rise, as there is need to provide diagnosis, treatment, monitoring, and follow-ups during the pandemic. Therefore, the COVID-19 pandemic has radically and quickly altered how medical practitioners provide care to patients. Medical centers are now responding to COVID-19 through rapid adoption of digital tools and technologies such as telemedicine and virtual care which refer to the delivery of healthcare services digital or at a distance using Information and Communications Technology (ICT) for treatment of patients. Telemedicine is expected to deliver timely care while minimizing exposure to protect medical practitioners and patients. Accordingly, a rapid literature review was conducted, and 35 research studies published from 2019 to May 2020 were employed to provide theoretical and practical evidence on the significance of using telemedicine and virtual care for remote treatment of patients during the COVID-19 pandemic. This article provides practical guide based on how to use telemedicine and virtual care during the COVID-19 pandemic. This study provides implication on the potentials of consolidating virtual care solutions in the near future towards contributing to integrate digital technologies into healthcare.
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Affiliation(s)
- Bokolo Anthony Jnr
- Department of Computer Science, Norwegian University of Science and Technology NTNU, NO-7491, Trondheim, Norway.
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36
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Cheruku S, Dave S, Goff K, Park C, Ebeling C, Cohen L, Styrvoky K, Choi C, Anand V, Kershaw C. Cardiopulmonary Resuscitation in Intensive Care Unit Patients With Coronavirus Disease 2019. J Cardiothorac Vasc Anesth 2020; 34:2595-2603. [PMID: 32620487 PMCID: PMC7286272 DOI: 10.1053/j.jvca.2020.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 01/25/2023]
Abstract
Cardiopulmonary resuscitation (CPR) in patients with severe acute respiratory syndrome coronavirus-2–associated disease (coronavirus disease 2019) poses a unique challenge to health- care providers due to the risk of viral aerosolization and disease transmission. This has caused some centers to modify existing CPR procedures, limit the duration of CPR, or consider avoiding CPR altogether. In this review, the authors propose a procedure for CPR in the intensive care unit that minimizes the number of personnel in the immediate vicinity of the patient and conserves the use of scarce personal protective equipment. Highlighting the low likelihood of successful resuscitation in high-risk patients may prompt patients to decline CPR. The authors recommend the preemptive placement of central venous lines in high-risk patients with intravenous tubing extensions that allow for medication delivery from outside the patients’ rooms. During CPR, this practice can be used to deliver critical medications without delay. The use of a mechanical compression system for CPR further reduces the risk of infectious exposure to health- care providers. Extracorporeal membrane oxygenation should be reserved for patients with few comorbidities and a single failing organ system. Reliable teleconferencing tools are essential to facilitate communication between providers inside and outside the patients' rooms. General principles regarding the ethics and peri-resuscitative management of coronavirus 2019 patients also are discussed.
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Affiliation(s)
- Sreekanth Cheruku
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX.
| | - Siddharth Dave
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX
| | - Kristina Goff
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX
| | - Caroline Park
- Department of Surgery, UT Southwestern Medical Center, Dallas, TX
| | - Callie Ebeling
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX
| | - Leah Cohen
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Kim Styrvoky
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Christopher Choi
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX
| | - Vikram Anand
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Corey Kershaw
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
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