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Spinos D, Coulson C, Beech T, Mehta N, Smith ME, Lee J, Nieto HR, Muzaffar J. Advances in remote otology and rhinology service delivery: A scoping review. Am J Otolaryngol 2024; 45:104399. [PMID: 39153399 DOI: 10.1016/j.amjoto.2024.104399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/16/2024] [Indexed: 08/19/2024]
Affiliation(s)
- Dimitrios Spinos
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust
| | - Christopher Coulson
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust
| | - Thomas Beech
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust
| | | | - Matthew E Smith
- Department of Clinical Neurosciences, University of Cambridge
| | - Jonathan Lee
- Department of Ear, Nose and Throat Surgery, Warwick Hospital, South Warwickshire University Hospitals NHS Foundation Trust
| | - Hannah Rachel Nieto
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust; Institute of Metabolism and Systems Research, University of Birmingham
| | - Jameel Muzaffar
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust
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Antezana LA, Xie KZ, Yin LX, Bowen AJ, Yeakel S, Nassiri AM, Moore EJ. Performing parotidectomy postoperative follow-ups via telemedicine: Experience at a tertiary care, multiple-surgeon otolaryngology center. J Telemed Telecare 2024; 30:739-746. [PMID: 35549759 DOI: 10.1177/1357633x221095319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION We examined the suitability of using a video visit platform to perform postoperative parotidectomy evaluation at a tertiary care, multiple-surgeon otolaryngology center. METHODS A retrospective case review was conducted of patients who underwent parotidectomy and postoperative video visits between November 2019 and December 2020. Success of video visit, plan if applicable, and post-visit outcomes were reviewed. Video visits were designated as successful if the physician could assess for complications in the postoperative course (e.g. first bite pain, Frey syndrome, ear numbness, unplanned visits to the emergency department, unplanned return to the operating room), perform examination of facial nerve function, and formulate care recommendations per clinical judgement without deferment of recommendations for a subsequent in-person visit. RESULTS There were 96 postoperative video visits with 91 unique parotidectomy patients. Demographics: 28/63 male/female; average age, 54y. All video visits were suitable for successful postoperative parotidectomy patient evaluation. Eight visits (8.3%) consisted of patients presenting with common postoperative complications (e.g. eye dryness, first bite pain) and warranted care recommendations. In only two cases did the patient require further in-person procedural (hematoma evacuation, seroma aspiration) follow-ups. For the other 91.7% of visits (n = 88), no additional recommendations were required as patients experienced uncomplicated postoperative courses. Of all the patients, 26.1% (n = 23) were instructed to follow-up for routine surveillance. All other patients, 73.9% (n = 65) were instructed to follow-up as needed. CONCLUSION Postoperative parotidectomy evaluation is highly amenable to being performed by video. A telemedicine option offers convenience for patients in the majority of cases without compromising clinical assessment and judgment for the physician.
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Affiliation(s)
- Luis A Antezana
- *Luis Antezana and Katherine Xie are equally contributed to this paper
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | - Katherine Z Xie
- *Luis Antezana and Katherine Xie are equally contributed to this paper
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | - Linda X Yin
- Department of Otolaryngology (ENT)/Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Andrew J Bowen
- Department of Otolaryngology (ENT)/Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Sarah Yeakel
- Department of Otolaryngology (ENT)/Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Ashley M Nassiri
- Department of Otolaryngology (ENT)/Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Eric J Moore
- Department of Otolaryngology (ENT)/Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
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Sargsyan N, Karunaratne D, Masani A, Howell L, Yousif M. ENT Telephone Clinics During the Coronavirus Pandemic: An Analysis of 400 Telephone Consultations at a District General Hospital. EAR, NOSE & THROAT JOURNAL 2023; 102:733-738. [PMID: 34167356 DOI: 10.1177/01455613211028091] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic led to the introduction of telephone consultations in order to provide specialist health care remotely. This study analyses the outcomes of ear, nose, and throat (ENT) telephone consultations. METHODS Retrospective analysis was undertaken of 400 ENT telephone consultations. RESULTS All 2-week-wait neck or face lump patients underwent imaging and 78% were successfully discharged. 80% of vertigo patients and 100% of 2-week-wait throat symptom patients were offered face-to-face consultations. All primary hyperparathyroidism patients were managed remotely, being discharged, or with telephone follow-up. The majority of routine referrals were managed without the need for face-to-face consultation. CONCLUSION Vertigo patients and 2-week-wait throat symptom patients should be offered a face-to-face consultation in the first instance. For patients with neck or face lumps, initial referral for imaging may improve patient flow and facilitate safe discharge. It is appropriate to continue with telephone consultations for all other patient groups.
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Affiliation(s)
- Narek Sargsyan
- Department of Otolaryngology, Eastbourne District General Hospital, Eastbourne, East Sussex, United Kingdom
| | - Dilhara Karunaratne
- Department of Otolaryngology, Eastbourne District General Hospital, Eastbourne, East Sussex, United Kingdom
| | - Alisha Masani
- Department of Otolaryngology, Eastbourne District General Hospital, Eastbourne, East Sussex, United Kingdom
| | - Lauren Howell
- Department of Otolaryngology, Eastbourne District General Hospital, Eastbourne, East Sussex, United Kingdom
| | - Madi Yousif
- Department of Otolaryngology, Eastbourne District General Hospital, Eastbourne, East Sussex, United Kingdom
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Tolvi M, Lahti T, Aaltonen LM. Otorhinolaryngology Virtual Visits During the COVID-19 Pandemic: A 2-Year Follow-Up Study. Telemed J E Health 2022; 29:665-673. [PMID: 36112177 DOI: 10.1089/tmj.2022.0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To clarify how successful virtual visits were in different age groups and subspecialties of otorhinolaryngology during the COVID-19 pandemic, with a 2-year follow-up. Methods: We examined the progress of treatment and need for face-to-face follow-ups in a retrospective setting. Case records of all the visits marked as virtual between March and June 2020 in Helsinki University Hospital Department of Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) were reviewed. Results: Among 865 virtual visits, 71.2% (n = 616) clearly advanced treatment, 53.8% (n = 465) needed no face-to-face follow-up, and only 9.0% (n = 78) were followed by an unplanned visit within 6 months. Statistically significant differences were detected among different subspecialties and age groups. Virtual visits achieved clear progress of treatment most frequently in laryngology (119/149 visits, 79.9%) and in head and neck surgery (69/83 visits, 83.1%). Laryngology patients required the least face-to-face follow-ups (n = 38 scheduled, 25.5% of laryngology visits). Most visits with clear progress involved 18-29-year-olds (n = 100, 80.0%) and they also required least face-to-face follow-ups (n = 39, 31.2%). During the 6-month to 2-year follow-up, 82 patients (9.6%) contacted our clinic directly for outpatient treatment, 28 patients (3.3%) called or visited the emergency department, and 37 patients (4.3%) were referred to the ORL-HNS clinic again for the same issue. Conclusion: Virtual visits were beneficial for treatment of otorhinolaryngology patients, and unplanned visits afterward were rare. Differences in effectiveness among subspecialties suggest that the utility of telemedicine applications can be enhanced by examining more closely which patient and ailment characteristics favor virtual visits.
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Affiliation(s)
- Morag Tolvi
- Department of Otorhinolaryngology—Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Tiitu Lahti
- Department of Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology—Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
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Mohan B, Singh B, Singh K, Naik N, Roy A, Goyal A, SIngh G, Aggarwal S, Saini A, Tandon R, Chhabra ST, Aslam N, Wander GS, Prabhakaran D. Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study. BMJ Open 2022; 12:e056408. [PMID: 35798525 PMCID: PMC9263376 DOI: 10.1136/bmjopen-2021-056408] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic necessitated the use of telemedicine to maintain continuity of care for patients with cardiovascular diseases (CVDs). This study aimed to demonstrate the feasibility of implementing a nurse-led teleconsultation strategy for CVD management during the COVID-19 pandemic in India and evaluated the impact of nurse-led teleconsultations on patient treatment satisfaction. DESIGN, SETTING AND PARTICIPANTS We developed a two-stage teleconsultation strategy and tested the feasibility of implementing a nurse-led teleconsultation strategy to manage CVD in a northern state (Punjab) in India. A multidisciplinary team of experts developed the treatment protocol used for teleconsultations to manage CVD. Nurses were trained to provide teleconsultation, triaging of patients and referrals to the physicians. Patients with CVD who had an outpatient visit or hospitalisation between September 2019 and March 2020 at the Dayanand Medical College Hospital, Ludhiana, India, were contacted by phone and offered teleconsultations. Telemedicine strategy comprised: stage 1 nurse-led teleconsultations and stage 2 physician-led teleconsultations. Descriptive analysis was performed to report the proportion of patients triaged by the two-stage telemedicine strategy, and patient's clinical characteristics, and treatment satisfaction between the nurse-led versus physician-led teleconsultations. RESULTS Overall, nurse-led stage 1 teleconsultations were provided to 12 042 patients with CVD. The mean (SD) age of the participants was 58.9 years (12.8), and men were 65.4%. A relatively small proportion of patients (6.3%) were referred for the stage-2 physician-led teleconsultations and of these only 8.4% required hospitalisations. During stage 1 nurse-led teleconsultations, patients were referred to the physicians due to uncontrolled diabetes (24.9%), uncontrolled hypertension (18.7%) and congestive heart failure (16.2%). The patient's treatment satisfaction was similar between the nurse-led versus physician-led teleconsultations (p=0.07). CONCLUSION This study showed that a nurse-led telemedicine strategy is feasible to implement in a resource-constraint setting for triaging patients with CVD and reduces physician's burden.
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Affiliation(s)
- Bishav Mohan
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Bhupinder Singh
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Kavita Singh
- Centre for Chronic Conditions and Injuries, Public Health Foundation, Gurugram, India
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Nitish Naik
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Abhishek Goyal
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Gurbhej SIngh
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Shivaansh Aggarwal
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Aftabh Saini
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Rohit Tandon
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, India
| | | | - Naved Aslam
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, India
| | | | - Dorairaj Prabhakaran
- Centre for Chronic Conditions and Injuries, Public Health Foundation, Gurugram, India
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Patel R, Fang CH, Grube JG, Eloy JA, Hsueh WD. COVID-19 and rhinological surgery. OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY--HEAD AND NECK SURGERY 2022; 33:103-111. [PMID: 35502266 PMCID: PMC9046134 DOI: 10.1016/j.otot.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Coronavirus-19 (COVID-19) pandemic has caused disruptions in the normal patient care workflow, necessitating adaptations within the healthcare profession. The objective of this article is to outline some of these adaptations and considerations necessitated by COVID-19 within the subspeciality of rhinology and endoscopic skull base surgery.
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Affiliation(s)
- Rushi Patel
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Christina H Fang
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York
| | - Jordon G Grube
- Division of Otolaryngology, Albany Medical College, Albany, New York
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey
- Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center - RWJ Barnabas Health, Livingston, New Jersey
| | - Wayne D Hsueh
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
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Payne T, Kevric J, Stelmach W, To H. The Use of Electronic Consultations in Outpatient Surgery Clinics: Synthesized Narrative Review. JMIR Perioper Med 2022; 5:e34661. [PMID: 35436223 PMCID: PMC9052035 DOI: 10.2196/34661] [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: 11/04/2021] [Revised: 01/20/2022] [Accepted: 03/18/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Electronic consultations (eConsults) are an increasingly used form of telemedicine that allows a nonspecialist clinician to seek specialist advice remotely without direct patient-specialist communication. Surgical clinics may see benefits from such forms of communication but face challenges with the need for intervention planning. OBJECTIVE We aimed to use the Quadruple Aim Framework to integrate published knowledge of surgical outpatient eConsults with regard to efficacy, safety, limitations, and evolving use in the era of COVID-19. METHODS We systematically searched for relevant studies across four databases (Ovid MEDLINE, Embase, Scopus, and Web of Science) on November 4, 2021, with the following inclusion criteria: English language, published in the past 10 years, and data on the outcomes of outpatient surgical eConsults. RESULTS A total of 363 studies were screened for eligibility, of which 33 (9.1%) were included. Most of the included studies were from the United States (23/33, 70%) and Canada (7/33, 21%), with a predominant multidisciplinary focus (9/33, 27%). Most were retrospective audits (16/33, 48%), with 15% (5/33) of the studies having a prospective component. CONCLUSIONS The surgical eConsult studies indicated a possible benefit for population health, promising safety results, enhanced patient and clinician experience, and cost savings compared with the traditional face-to-face surgical referral pathway. Their use appeared to be more favorable in some surgical subspecialties, and the overall efficacy was similar to that of medical subspecialties. Limited data on their long-term safety and use during the COVID-19 pandemic were identified, and this should be the focus of future research.
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Affiliation(s)
- Thomas Payne
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Surgery, The Northern Hospital, Melbourne, Australia
| | - Jasmina Kevric
- Department of Surgery, The Northern Hospital, Melbourne, Australia
| | - Wanda Stelmach
- Department of Surgery, The Northern Hospital, Melbourne, Australia
| | - Henry To
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Surgery, The Northern Hospital, Melbourne, Australia
- Department of Surgery, Werribee Mercy Hospital, Melbourne, Australia
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Yang A, Kim D, Hwang PH, Lechner M. Telemedicine and Telementoring in Rhinology, Otology, and Laryngology: A Scoping Review. OTO Open 2022; 6:2473974X211072791. [PMID: 35274073 PMCID: PMC8902203 DOI: 10.1177/2473974x211072791] [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: 10/22/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Objective Telemedicine and telementoring have had a significant boost across
all medical and surgical specialties over the last decade and
especially during the COVID-19 pandemic. The aim of this scoping
review is to synthesize the current use of telemedicine and
telementoring in otorhinolaryngology and head and neck
surgery. Data Sources PubMed and Cochrane Library. Review Methods A scoping review search was conducted, which identified 469
articles. Following full-text screening by 2 researchers, 173
articles were eligible for inclusion and further categorized via
relevant subdomains. Conclusions Virtual encounters and telementoring are the 2 main applications of
telemedicine in otolaryngology. These applications can be
classified into 7 subdomains. Different ear, nose, and throat
subspecialties utilized certain telemedicine applications more
than others; for example, almost all articles on patient
engagement tools are rhinology based. Overall, telemedicine is
feasible, showing similar concordance when compared with
traditional methods; it is also cost-effective, with high
patient and provider satisfaction. Implications for Practice Telemedicine in otorhinolaryngology has been widely employed during
the COVID-19 pandemic and has a huge potential, especially with
regard to its distributing quality care to rural areas. However,
it is important to note that with current exponential use, it is
equally crucial to ensure security and privacy and integrate
HIPAA-compliant systems (Health Insurance Portability and
Accountability Act) in the big data era. It is expected that
many more applications developed during the pandemic are here to
stay and will be refined in years to come.
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Affiliation(s)
- Angela Yang
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Dayoung Kim
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Peter H. Hwang
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Matt Lechner
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
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Hentati F, Cabrera CI, D'Anza B, Rodriguez K. Patient satisfaction with telemedicine in rhinology during the COVID-19 pandemic. Am J Otolaryngol 2021; 42:102921. [PMID: 33508592 PMCID: PMC7834232 DOI: 10.1016/j.amjoto.2021.102921] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 12/29/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The COVID-19 pandemic has forced the rapid integration of telemedicine services across several specialties, especially in Otolaryngology where risk of transmission is very high. Studies before and during the COVID-19 pandemic have shown that Otolaryngology is generally amenable to telemedicine. However, few studies have assessed patient satisfaction with telemedicine during the COVID-19 pandemic, and fewer have focused on patient satisfaction with telehealth in Rhinology. OBJECTIVES To determine if patients believe the benefits of virtual live synchronous telemedicine visits out-weigh the drawbacks when compared to in-person clinical visits. METHODS Single center retrospective case series and survey study of patients presenting to a tertiary care Rhinology practice between 3/15/2020 and 6/1/2020. All patients had previous in-person encounters with Rhinology (n = 45). RESULTS Twenty-nine participants (64.4%) had audio-video visits while 16 (35.6%) had audio visits. 36 (80%) patients stated that their needs were met during their telemedicine visit while 32 (71.1%) patients felt that nothing was missed or not addressed during the virtual visit. The most commonly cited advantage to telemedicine visits was convenience (22.2%) and provider availability (20.0%). While most participants did not disclose a disadvantage to a virtual visit besides the lack of a physical exam (68.9%), the most commonly cited disadvantage to a virtual visit was technological difficulties (17.8%). CONCLUSIONS Virtual telemedicine visits were shown to effectively meet the needs of established patients and address concerns in a convenient time efficient manner. However, patients indicated that limited technology and a less personalized feel hindered the telemedicine experience in Rhinology.
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Gupta T, Gkiousias V, Bhutta MF. A systematic review of outcomes of remote consultation in ENT. Clin Otolaryngol 2021; 46:699-719. [PMID: 33754458 DOI: 10.1111/coa.13768] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/11/2021] [Accepted: 03/14/2021] [Indexed: 12/18/2022]
Abstract
AIMS Remote or tele-consultation has become an emerging modality of consultation in many specialities, including ENT. Advantages include increasing accessibility, potential to reduce costs and, during the COVID-19 pandemic, reduced risk of infection transmission. Here, we systematically collate and synthesise the evidence base on outcomes from remote consultation in adult and paediatric ENT services. METHODS We performed a review in accordance with PRISMA guidelines. We searched Medline and Embase for relevant articles. Outcomes include specific patient pathway efficiency measures (including number of healthcare visits, lead time, touch time and handoff), patient/clinician satisfaction, cost analysis and safety implications. RESULTS From 6325 articles screened, 53 met inclusion criteria. Publications included studies on remote consultation for initial, preoperative and follow-up assessment (including postoperative). In most instances, remote consultation reduced costs and time from referral to assessment and was associated with high patient satisfaction. However, a face-to-face follow-up appointment was required in 13%-72% of initial consultations, suggesting that remote consultation is only appropriate in selected cases. CONCLUSION Remote consultation is appropriate and preferable for ENT consultation in specific conditions and circumstances. Future research should look to better define those conditions and circumstances, and report using recognised quality standards and outcome measures.
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Affiliation(s)
- Tanya Gupta
- Ear, Nose and Throat Department, Royal Sussex County Hospital, Brighton, UK
| | | | - Mahmood F Bhutta
- Ear, Nose and Throat Department, Royal Sussex County Hospital, Brighton, UK.,Brighton & Sussex Medical School, Falmer, Brighton, UK
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Qi M, Cui J, Li X, Han Y. Perceived Factors Influencing the Public Intention to Use E-Consultation: Analysis of Web-Based Survey Data. J Med Internet Res 2021; 23:e21834. [PMID: 33470934 PMCID: PMC7857952 DOI: 10.2196/21834] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/24/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Background Unbalanced distribution of medical resources is becoming a major challenge, particularly in the selection of doctors. e-Consultation could provide patients with more choices of doctors and break the constraints of time and space. However, the acceptance of e-consultation is still poor and the mechanism of adoption is unclear. Objective The aim of this study was to identify the factors influencing the public intention to use e-consultation and explore the effect path of the factors and behavior intention. Methods The hypotheses of our research model were developed based on the technology acceptance model and perceived risk theory. A web-based survey was conducted by an electronic questionnaire collection platform; this survey that consisted of a 29-item questionnaire with 5-point Likert scales was completed by 934 respondents. Structural equation modeling was used to analyze the data. Item evaluation and reliability, validity, path loading, goodness of fit, and multiple group analysis were used to check the moderation effects. Results The standardized factor loadings of the items were between 0.551 and 0.873. The composite reliability of 9 constructs ranged from 0.706 to 0.840. The average variance extracted ranged from 0.387 to 0.640. The fitness indices showed that the collected data fitted well with the research model. Perceived usefulness was the strongest positive factor effecting behavior intention (β=.399, P<.001). Perceived ease of use had a positive effect on behavior intention but it was not statistically significant (β=.117, P=.07) and it had a positive effect on perceived usefulness (β=.537, P<.001). Perceived risk could be well explained by financial risk (β=.972, P<.001), privacy risk (β=.774, P<.001), social risk (β=.871, P<.001), time risk (β=.894, P<0.001), and psychological risk (β=.774, P<.001). Perceived risk had negative effects on perceived usefulness (β=–.375, P<.001) and behavior intention (β=–.297, P<.001). Personal innovativeness had a positive influence on perceived ease of use (β=.241, P<.001) and a slight effect on behavior intention (β=.124, P=.001). Age (χ258=133.5, P<.001) and usage experience (χ258=82.5, P=.02) had a slight moderation effect on the paths. Conclusions Perceived usefulness and perceived risk have significant effects on public intention to use e-consultation. Therefore, platform and manufacturer must improve the function of e-consultation, which will promote the public intention to use e-consultation fundamentally. In order to control the perceived risk of public, government should play an important role in enforcing management of e-consultation markets and approving corresponding medical insurance policies. Besides, personal innovativeness had an effect on behavior intention. Moreover, the paths of factors had some heterogeneity among people with different characteristics. Therefore, it is necessary to adjust the strategies to fit more groups better.
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Affiliation(s)
- Miaojie Qi
- School of Public Health, Capital Medical University, Beijing, China
| | - Jiyu Cui
- School of Public Health, Capital Medical University, Beijing, China
| | - Xing Li
- School of Public Health, Capital Medical University, Beijing, China
| | - Youli Han
- School of Public Health, Capital Medical University, Beijing, China
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Yuen E, Gudis DA, Rowan NR, Nguyen SA, Schlosser RJ. Viral Infections of the Upper Airway in the Setting of COVID-19: A Primer for Rhinologists. Am J Rhinol Allergy 2021; 35:122-131. [PMID: 32762250 PMCID: PMC8685738 DOI: 10.1177/1945892420947929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Viral respiratory tract infections are associated with a significant burden of disease and represent one of the leading causes of mortality worldwide. The current Coronavirus Disease 2019 (COVID-19) pandemic highlights the devastating toll that respiratory viruses have on humanity and the desperate need to understand the biological characteristics that define them in order to develop efficacious treatments and vaccines. To date, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected nearly 600 times more people and resulted in 200 times more deaths relative to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) combined. OBJECTIVE Through this review, we aim to summarize the key characteristics of respiratory viruses that hold global significance, with a focus on SARS-CoV-2. Our goal is to disseminate our current knowledge of these infectious agents to otolaryngologists, in particular rhinologists, practicing in the COVID-19 era. METHODS The general and clinical characteristics of selected respiratory viruses along with available viral treatments and vaccines are reviewed. RESULTS There has been significant progress in our understanding of the epidemiology and pathogenesis of various respiratory viruses. However, despite the advancement in knowledge, efficacious vaccines and antiviral treatments remain elusive for most respiratory viruses. The dire need for these scientific discoveries is highlighted by the recent COVID-19 pandemic, which has prompted investigators worldwide to conduct clinical trials at an accelerated timeline in an effort to reduce the morbidity and mortality associated with SARS-CoV-2 infection. Rhinologists will continue to remain on the front-lines of pandemics associated with respiratory viruses. CONCLUSION In light of these unprecedented times, the need to understand the nuances of these viral respiratory pathogens, especially SARS-CoV-2, cannot be overemphasized. This knowledge base is of particular importance to otolaryngologists, whose expertise in the upper airway coincides with the anatomic tropism of these infectious agents.
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Affiliation(s)
- Erick Yuen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, New York
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Kinberg EC, Kirke DN, Trosman SJ. Modernizing the Otolaryngology Referral Workflow: The Impact of Electronic Consultation. Laryngoscope 2020; 131:E1792-E1796. [PMID: 33320360 DOI: 10.1002/lary.29333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/19/2020] [Accepted: 12/08/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the impact of electronic consultation on the otolaryngology clinic workflow at our high-volume public hospital. STUDY DESIGN Retrospective Observational Study. METHODS This is a retrospective observational analysis study. Operational data regarding clinic volume, referral patterns, and scheduling efficiency were assessed over a 9-month period in 2018 prior to implementation of electronic consultation. The same data were collected for the 9-month period immediately following implementation of electronic consultation in 2019. RESULTS During the pre-implementation (pre-EC) period, 3,243 otolaryngology referrals were made as compared to 4,249 post-implementation (post-EC). 86% of referrals were scheduled for a clinic appointment pre-EC, compared to 61% post-EC (P < .00001) 24.5% of patients were evaluated within 30 days pre-EC compared to 53.6% post-EC (P < .00001). The average time to be seen by an otolaryngology provider declined from 60.8 days pre-EC to 42.8 days post-EC (P = .0029). There was a 50% decline in the percentage of appointments canceled by patients in the post-EC period as compared to pre-EC. CONCLUSIONS In our experience, implementation of electronic consultation significantly reduced both wait times for a clinic appointment and the percentage of no-show or canceled appointments. Electronic consultation may be a valuable tool in improving the efficiency and yield of the modern otolaryngology clinic. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1792-E1796, 2021.
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Affiliation(s)
- Eliezer C Kinberg
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Diana N Kirke
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, New York City Health and Hospital System, Elmhurst Hospital, New York, New York, U.S.A
| | - Samuel J Trosman
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, New York City Health and Hospital System, Elmhurst Hospital, New York, New York, U.S.A
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Incorporation of telemedicine by rhinologists: The COVID-19 pandemic and beyond. Am J Otolaryngol 2020; 41:102567. [PMID: 32920475 PMCID: PMC7264942 DOI: 10.1016/j.amjoto.2020.102567] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/15/2022]
Abstract
Objectives The current analysis queries rhinologists' attitudes about the use of telemedicine, including the degree to which it has impacted practice patterns during the COVID-19 pandemic. Our objective was to survey rhinologists and understand the extent to which telemedicine serves as a rejoinder to in-person consultation: appreciation of relevant factors may be important in planning for present and future considerations. Methods A 14-question anonymous survey sent out to the American Rhinologic Society (ARS) membership in April 2020. It included demographic factors and detailed questions examining the extent of telemedicine use. Numerous topics including the degree of use, satisfaction with services, and utility of services were evaluated. Results There were 134 respondents. Most reported seeing ≤30% of typical in-person volume, with 14.8% not seeing any patients at all. 88.1% used telemedicine; 82.0% reported some level of satisfaction with telemedicine. The vast majority utilized platforms employing audio and video (83.3%), and a plurality reported spending 5–15 min on calls. Numerous reasons were cited for the use of telemedicine, including significant public health benefits amid the crisis (89.7%). Only 12.0% of respondents reported using telemedicine for hospital consultation. Conclusion Rhinologists have embraced telemedicine during the COVID-19 pandemic in an attempt to improve accessibility, patient satisfaction, and revenue stream. When utilized appropriately, this technology obviates the need for seeing at-risk patients and performing procedures such as nasal endoscopy. Only a minority of rhinologists was dissatisfied, viewing this as a temporary fix during the pandemic.
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15
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Setzen M, Svider PF, Setzen S, Setzen G, Eloy JA, Johnson AP. The novel corona virus and rhinology: Impact on practice patterns and future directions. Am J Otolaryngol 2020; 41:102569. [PMID: 32683188 PMCID: PMC7263239 DOI: 10.1016/j.amjoto.2020.102569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
Objectives To evaluate the impact of the novel coronavirus pandemic on practice patterns, clinical behavior, personal health, and emotional/psychological concerns of rhinologists. Methods A 15-question survey was sent out to the American Rhinologic Society's (ARS) membership to determine the impact of COVID-19 during the crisis. Demographic factors and practice patterns were collected and evaluated. Results There were 224 total respondents out of 835 ARS members queried (26.8% response rate). Study queries were sent in April 2020. Notably, 17.8% reported illness in themselves or their staff and 74.4% noted a psychological/emotional impact. A plurality of rhinologists noted their practice volume and in-office procedure volume has become 20.0% and 0.0% of their prior volumes, respectively. In addition, 96.2% were noted to be using telemedicine in our subspecialty. Conclusion In addition to severely impacting volume and the perception of future decreases in patients and revenue, the COVID-19 pandemic has had a physical and emotional impact on rhinologists in ways that need to be further studied. These data include significantly novel and objective information. The COVID-19 crisis also reveals the important role of telemedicine in rhinology. Guidelines regarding personal protective equipment for in-office visits, nasal endoscopy, and other in-office and operating room procedures would be particularly helpful as future waves are expected.
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Fieux M, Duret S, Bawazeer N, Denoix L, Zaouche S, Tringali S. Téléconsultation en ORL : enquête de satisfaction en période pandémique COVID-19. ANNALES FRANÇAISES D'OTO-RHINO-LARYNGOLOGIE ET DE PATHOLOGIE CERVICO-FACIALE 2020. [PMCID: PMC7298459 DOI: 10.1016/j.aforl.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
But Étudier l’intérêt de la téléconsultation en période de pandémie liée au COVID-19. Matériel et méthodes Étude prospective comportant une enquête de satisfaction réalisée au sein d’un service d’ORL d’un centre hospitalo-universitaire où la téléconsultation a été mise en place pour remplacer les consultations programmées. Les patients étaient répartis en deux groupes selon leur niveau de satisfaction pour en identifier les facteurs prédictifs. Une valeur de p < 0,005 était considérée statistiquement significative. L’objectif principal était d’évaluer le taux de satisfaction des patients à la suite d’une téléconsultation en ORL pendant le confinement mondial. L’objectif secondaire était d’identifier des facteurs prédictifs de la satisfaction globale des patients. Résultats 125 patients ont été vu en téléconsultation sur une période de 7 jours d’inclusion et 100 patients ont complété le questionnaire. Le taux de satisfaction globale était de 87 %. Aucun facteur prédictif cliniquement pertinent n’était associé de façon statistiquement significative avec la satisfaction. Respectivement 76 et 61 % des patients avaient jugé satisfaisante la qualité du son et de la vidéo sans impact significatif sur leur satisfaction globale (respectivement OR = 3,40 ; valeur de p = 0,049 et OR = 3,79 ; valeur de p = 0,049). L’absence d’examen physique n’était pas significativement corrélée à une diminution de la satisfaction globale (OR = 0,30 ; valeur de p = 0,027). Conclusion La téléconsultation ne permettait pas une prise en charge médicale complète mais en situation de pandémie, elle a été bien accueillie par les patients. Elle représentait un moyen simple de maintenir la continuité des soins médicaux tout en réduisant le risque de contamination par contact direct entre les patients et le personnel soignant.
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Muraleedharan M, Kaur S, Arora K, Virk RS. Otolaryngology Practice in Covid 19 Era: A Road-Map to Safe Endoscopies. Indian J Otolaryngol Head Neck Surg 2020; 73:101-103. [PMID: 32837946 PMCID: PMC7397970 DOI: 10.1007/s12070-020-02019-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 07/27/2020] [Indexed: 11/22/2022] Open
Abstract
Covid-19 has changed the way medical services are being delivered all around the world. Otolaryngology as a speciality is anecdotally associated with high risk of infection. Endoscopies can be associated with aerosolization of particles due to cough or sneeze which may be induced. An overhaul of endoscopy and associated procedures is necessary keeping in mind the prevailing situations. This paper aims at a review of the on-going research and development of a road map for safe endoscopies—both for patients and heath care workers.
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Affiliation(s)
- Manjul Muraleedharan
- Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Shwinder Kaur
- Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Kanika Arora
- Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Ramandeep Singh Virk
- Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
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Layfield E, Triantafillou V, Prasad A, Deng J, Shanti RM, Newman JG, Rajasekaran K. Telemedicine for head and neck ambulatory visits during COVID-19: Evaluating usability and patient satisfaction. Head Neck 2020; 42:1681-1689. [PMID: 32476228 PMCID: PMC7300847 DOI: 10.1002/hed.26285] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/11/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In light of the COVID-19 pandemic, there has been a rapid increase in telemedicine visits. Otolaryngology patient satisfaction with these visits has not yet been extensively studied using a validated survey. METHODS All patients who had telemedicine visits with three head and neck surgeons, by phone or video-based platform, between March 25, 2020 and April 24, 2020. Retrospective chart reviews were conducted to determine demographic, disease, and treatment information. Patients who had a video visit were contacted by telephone and, if they could be reached and consented, were administered the telehealth usability questionnaire (TUQ). RESULTS Hundred surveys were completed. The average score across all questions was 6.01 on a scale from 1 to 7, where 7 indicated the highest level of patient agreement. The highest scores were for questions related to satisfaction with telehealth (6.29), while the lowest were related to reliability (4.86). CONCLUSIONS Patients are generally highly satisfied with telemedicine.
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Affiliation(s)
- Eleanor Layfield
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Vasiliki Triantafillou
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Aman Prasad
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Jie Deng
- School of NursingUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Rabie M. Shanti
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Jason G. Newman
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Fieux M, Duret S, Bawazeer N, Denoix L, Zaouche S, Tringali S. Telemedicine for ENT: Effect on quality of care during Covid-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:257-261. [PMID: 32624390 PMCID: PMC7306717 DOI: 10.1016/j.anorl.2020.06.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIMS To assess the benefit of telemedicine consultation during the Covid-19 pandemic. MATERIAL AND METHODS A prospective study of patient satisfaction with telemedicine consultation was carried out in the ENT department of a university hospital center where telemedicine consultations were set up to replace scheduled out-patient consultations. Patients were divided into two groups according to overall satisfaction, in order to identify predictive factors. The significance threshold was set at P<0.005. The main endpoint was patient satisfaction after an ENT telemedicine consultation during global lockdown. The secondary endpoint comprised predictive factors for overall satisfaction. RESULTS One hundred of the 125 patients with telemedicine consultation over a 7-day inclusion period completed the questionnaire. Overall satisfaction was 87%. There were no clinically relevant predictive factors significantly associated with satisfaction. Sound and video quality was satisfactory for 76% and 61% of patients respectively, without significant impact on overall satisfaction (respectively: OR=3.40, P-value=0.049; and OR=3.79, P-value=0.049). Lack of physical examination did not significantly correlate with reduced overall satisfaction (OR=0.30, P-value=0.027). CONCLUSION Telemedicine consultation did not allow complete medical care but, in a difficult time like the global pandemic, was well accepted by patients. It is a simple way to maintain continuity of care while reducing contamination risk by avoiding direct contact between patients and healthcare professionals.
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Affiliation(s)
- M Fieux
- Service d'Otologie et d'Otoneurologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France.
| | - S Duret
- Service d'Otologie et d'Otoneurologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
| | - N Bawazeer
- Service d'Otorhinolaryngologie et Chirurgie Cervico-Faciale, Umm Al Qura University, Mecca, Saudi Arabia
| | - L Denoix
- Service d'Otologie et d'Otoneurologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
| | - S Zaouche
- Service d'Otologie et d'Otoneurologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
| | - S Tringali
- Service d'Otologie et d'Otoneurologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
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Hagge D, Knopf A, Hofauer B. [Telemedicine in the fight against SARS-COV-2-opportunities and possible applications in otorhinolaryngology : Narrative review]. HNO 2020; 68:433-439. [PMID: 32300823 PMCID: PMC7160613 DOI: 10.1007/s00106-020-00864-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Hintergrund Die COVID-19-Pandemie bringt Gesundheitssysteme weltweit bisweilen an die Belastungsgrenze. Ein Grund dafür ist die rasant steigende Anzahl von Neuinfizierten. Zum anderen verschärfen die hohen Ausfallquoten bei Ärzten und Pflegern insbesondere in der HNO-Heilkunde zusätzlich die Situation. Telemedizin kann dabei ein sinnvolles Mittel sein, um die Anzahl von Arzt-Patienten-Kontakten zu reduzieren. Dadurch könnten Infektionsketten unterbrochen werden und das Infektionsrisiko für Ärzte minimiert werden. Methoden Zur Erstellung des Reviews wurde eine selektive Literaturrecherche unter www.pubmed.com mit den einschlägig verwendeten englischen Fachtermini für Telemedizin und HNO durchgeführt. Zudem wurde eine Recherche unter www.news.google.com zu aktuellen Entwicklungen der COVID-19-Pandemie mit den Suchbegriffen Telemedizin und COVID-19 betrieben. Ergebnisse Telemedizin kann sowohl im direkten Patientenkontakt als auch bei der konsiliarischen Unterstützung von Allgemeinmedizinern hilfreich sein. Die vorliegenden Studien zeigen, dass im Durchschnitt mehr als 50 % der Arztbesuche telemedizinisch durchführbar wären. Sowohl Ärzte als auch Patienten bewerten den Einsatz von Telemedizin als positiv. Weder die Bildqualität noch die Handhabung der Technik stellen relevante Hindernisse bei der sicheren Diagnosestellung dar. Patienten gaben an, dass der telemedizinische Arztbesuch nicht länger dauerte als ein traditioneller Arztbesuch. Zudem wurde von den Patienten die schnellere und bessere Verfügbarkeit von medizinischer Versorgung durch Telemedizin hervorgehoben. Schlussfolgerung Telemedizin kann einen entscheidenden Beitrag zur Bewältigung der aktuellen COVID-19-Pandemie leisten. Zudem kann die Etablierung von Telemedizin dabei helfen, auf zukünftige Pandemien besser vorbereitet zu sein.
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Affiliation(s)
- Daniel Hagge
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - Andreas Knopf
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - Benedikt Hofauer
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland.
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Huang VW, Imam SA, Nguyen SA. Telehealth in the times of SARS-CoV-2 infection for the otolaryngologist. World J Otorhinolaryngol Head Neck Surg 2020; 6:S49-S53. [PMID: 32837759 PMCID: PMC7260481 DOI: 10.1016/j.wjorl.2020.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 01/08/2023] Open
Abstract
Objective In response to the American Academy of Otolaryngology – Head and Neck Surgery's recommendations to limit patient care activities in the times of SARS-CoV-2, many elective surgeries have been canceled without patient clinics transitioning to virtual visits. With regulations for telemedicine loosened, new possibilities for the practice of otolaryngology have opened. To address the uncertain duration of this pandemic, a review was conducted of current literature on use of telemedicine services in the current SARS-CoV-2 pandemic and in previous national emergencies to reveal the role telemedicine can play for otolaryngology practices. Data sources Pubmed articles with an independent search query were utilized. Methods Literature review performed by one author searched for all published English-language literature on telehealth in the SARS-CoV-2 era. Articles were considered for discussion if they provided relevant developments for telemedicine in the context of the SARS-CoV-2 pandemic. Results Telemedicine can be up-scaled in the current SARS-CoV-2 pandemic where exposure containment is of the utmost priority. With patient interaction possible through virtual communication, telemedicine allows continued patient care while minimizing the risk of viral spread. In the realm of otolaryngology, telemedicine has been used in the past during disasters with other studies demonstrating high diagnostic concordance with inpatient visits. Many institutions have recognized the potential for such care as they begin utilize both virtual visits and in-person care during this pandemic. Conclusion To limit the spread of SARS-CoV-2, we support the AAO-HNS recommendation for the adoption of novel ways to employ telemedicine in this era. Many emergency departments and health care systems have the infrastructure necessary for synchronous video telemedicine visits that can be leveraged to provide quality care with patients. With the continued need to socially distance, telemedicine can protect both physicians and patients from unnecessary exposure to the virus.
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Affiliation(s)
| | - Sarah A Imam
- Department of Health and Human Performance, The Citadel, Charleston, SC, USA
| | - Shaun A Nguyen
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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Popescu B, Oașă ID, Bălălău C, Scăunașu R, Manole F, Domuța M, Oancea ALA. Fibroscopic examination on ENT patients in COVID-19 era. JOURNAL OF CLINICAL AND INVESTIGATIVE SURGERY 2020. [DOI: 10.25083/2559.5555/5.2/63.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Patients benefit from the use of telescopes and flexible fiber optics when are examined by the ENT specialist. It is not mandatory in all situations but in most cases, some form of optical endoscopic examination of the nasal cavities, pharynx or larynx is needed. There is some reluctance to use this kind of method in patients in COVID 19 era since this is a maneuver that can generate aerosols and thus increase the chance of transmitting SARS-Cov-2 virus. There are several precautions that can be considered and we offer an insight on how fibroscopic examination can be performed with smaller risk for the physician. The question that we address is whether it is safe or not to perform this procedure and in what conditions.
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Abstract
The novel Coronavirus (COVID-19) has created a deadly pandemic that is now significantly impacting the United States. Otolaryngologists are considered high risk for contracting disease, as the virus resides in the nasal cavity, nasopharynx, and oropharynx. While valuable work has been publicized regarding several topics in Rhinology, we discuss other aspects of our specialty in further detail. There are several issues regarding Rhinologic practice that need to be clarified both for the current epidemic as well as for future expected “waves.” In addition, as the pandemic dies down, guidelines are needed to optimize safe practices as we start seeing more patients again. These include protocols pertinent to safety, in-office Rhinologic procedures, the substitution of imaging for endoscopy, and understanding the appropriate role of telemedicine. We discuss these aspects of Rhinology as well as practical concerns relating to telemedicine and billing, as these issues take on increasing importance for Rhinologists both in the present and the future.
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