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Der-Martirosian C, Hou C, Hovsepian S, Diarra Carter M, Heyworth L, Dobalian A, Leung L. Implementation of Video-Based Care in Interdisciplinary Primary Care Settings at the Veterans Health Administration: Qualitative Study. JMIR Form Res 2024; 8:e52830. [PMID: 38592760 PMCID: PMC11040435 DOI: 10.2196/52830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 02/13/2024] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND With the rapid shift to telehealth, there remains a knowledge gap in how video-based care is implemented in interdisciplinary primary care (PC) settings. OBJECTIVE The objective of this study was to gain an in-depth understanding of how video telehealth services were implemented in PC from the perspectives of patients and interdisciplinary PC team members at the Veterans Health Administration (VHA) 2 years after the onset of the COVID-19 pandemic. METHODS We applied a positive and negative deviance approach and selected the 6% highest (n=8) and the 6% lowest (n=8) video-using PC sites in 2022 from a total of 130 VHA medical centers nationally. A total of 12 VHA sites were included in the study, where 43 PC interdisciplinary team members (August-October 2022) and 25 patients (February-May 2023) were interviewed. The 5 domains from the diffusion of innovation theory and the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework guided the development of the 2 study interview guides (provider and patient). We identified themes that emerged across all interviews that were associated with the implementation of video-based care in interdisciplinary PC settings, using directed-content rapid analysis of the interview transcripts. The analysis was guided by 5 a priori NASSS domains: (1) patient condition or characteristic, (2) technology, (3) adopter system, (4) health care organization, and (5) adaptation over time. RESULTS The study findings include the following common themes and factors, organized by the 5 NASSS domains: (1) patient condition or characteristic-visit type or purpose (eg, follow-up visits that do not require physical examination), health condition (eg, homebound or semihomebound patients), and sociodemographic characteristic (eg, patients who have a long commute time); (2) technology-key features (eg, access to video-enabled devices), knowledge (eg, how to use videoconferencing software), and technical support for patients and providers; (3) adopter system-changes in staff roles and clinical practice (eg, coordination of video-based care), provider and patient preference or comfort to use video-based care, and caregiver's role (eg, participation of caregivers during video visits); (4) health care organization-leadership support and access to resources, scheduling for video visits (eg, schedule or block off digital half or full days), and training and telehealth champions (eg, hands-on or on-site training for staff, patients, or caregivers); (5) adaptation over time-capacity to improve all aspects of video-based care and provide continued access to resources (eg, effective communication about updates). CONCLUSIONS This study identified key factors associated with the implementation of video-based services in interdisciplinary PC settings at the VHA from the perspectives of PC team members and patients. The identified multifaceted factors may inform recommendations on how to sustain and improve the provision of video-based care in VHA PC settings as well as non-VHA patient-centered medical homes.
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Affiliation(s)
- Claudia Der-Martirosian
- Veterans Affairs Greater Los Angeles Healthcare System Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, United States
- Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CA, United States
| | - Cynthia Hou
- Veterans Affairs Greater Los Angeles Healthcare System Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, United States
| | - Sona Hovsepian
- Veterans Affairs Greater Los Angeles Healthcare System Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, United States
| | - Maia Diarra Carter
- Office of Primary Care/Patient Care Services, Veterans Health Administration, Washington, DC, United States
| | - Leonie Heyworth
- Office of Connected Care/Telehealth Services, Veterans Health Administration, Washington, DC, United States
- Department of Medicine, University of California San Diego School of Medicine, San Diego, CA, United States
| | - Aram Dobalian
- Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CA, United States
- Division of Health Services Management and Policy, The Ohio State University College of Public Health, Columbus, OH, United States
| | - Lucinda Leung
- Veterans Affairs Greater Los Angeles Healthcare System Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, United States
- Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA David Geffen School of Medicine, Los Agneles, CA, United States
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2
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Homsi K, Ramachandran V, Del Campo DM, Del Campo LM, Kusnoto B, Atsawasuwan P, Viana G, Oubaidin M, Allareddy V, Elnagar MH. The use of teleorthodontics during the COVID-19 pandemic and beyond - perspectives of patients and providers. BMC Oral Health 2023; 23:490. [PMID: 37454048 PMCID: PMC10349415 DOI: 10.1186/s12903-023-03215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly impacted dental services, resulting in reduced staff availability, limited appointments, and some dental clinics even being forced to close their doors. Despite these challenges, the need for dental consultants remained present, particularly in emergency situations. One area of orthodontics that had seen a surge in demand during the pandemic is Teleorthodontics. With the help of Teleorthodontics, orthodontic consultations, assessments, and even treatment monitoring could be conducted remotely, making it a safe and convenient option for patients during those challenging times. AIM This survey aimed to evaluate the acceptance of patients and their orthodontists on the use of different modes of communication through Teleorthodontics during the COVID-19 pandemic and their willingness to continue using this in the future. METHODS An online survey instrument in Qualtrics was distributed to orthodontic patients at the University of Illinois, Chicago. The survey was available on a rolling basis for up to 6 months. A total number of 364 partients voluntarily participated in the survey. The Faculty and Residents were also asked to participate in a survey through recruitment via their UIC email addresses. RESULTS According to our survey, both patients and providers showed acceptance of Teleorthodontics and have used it in different forms during orthodontic treatment. The application is easy-to-use, convenient, and not at all time-consuming. Overall satisfaction with using this application was recorded at 92%, with 66% of patients stating that it saved them time by eliminating the need to travel to the orthodontic clinic. 30% of providers found that the interaction with patients using Teleorthodontics was a positive experience and would recommend it in future. CONCLUSION Teleorthodontics has shown great potential, particularly in follow-up cases, and holds promise as a valuable tool for online remote dental consultations in the future.
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Affiliation(s)
- Karen Homsi
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Vinitha Ramachandran
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA.
| | | | - Laura Martin Del Campo
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Budi Kusnoto
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Phimon Atsawasuwan
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Grace Viana
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Maysaa Oubaidin
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | | | - Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
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Broffman L, Harrison S, Zhao M, Goldman A, Patnaik I, Zhou M. The Relationship Between Broadband Speeds, Device Type, Demographic Characteristics, and Care-Seeking Via Telehealth. Telemed J E Health 2023; 29:425-431. [PMID: 35867048 DOI: 10.1089/tmj.2022.0058] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study sought to examine the complex relationship between individual and environmental characteristics, broadband access, device type (computer or smartphone), and telehealth utilization as it relates to the digital divide. Methods: We analyzed a combination of electronic health record and publicly available zip code-level data for 2,770 men seeking treatment on a large, nationally available, direct-to-consumer telehealth platform. Using logistic regression, we determined the likelihood of accessing the platform through a smartphone (vs. a computer) based on key features of the environment, including broadband access and income, and demographic characteristics, including age and race. Results: We found that living in areas with higher rates of broadband adoption significantly decreased the likelihood of accessing virtual care using a smartphone (odds ratio [OR] = 0.17, p < 0.001). Compared with the 18-29 age category, the odds of accessing virtual care using a smartphone decreased for men between the age categories of 40-59 (OR = 0.63, p < 0.01) and over 60 (OR = 0.29, p < 0.001) years. Belonging to historically marginalized communities of color (Black, Hispanic, and Native American) almost doubled the odds of using a smartphone to access the platform (OR = 1.8, p < 0.001). Broadband availability and median area income were not significantly associated with mobile use. Conclusions: Telehealth platform design and policy solutions intended to expand access to virtual care should be flexible enough to accommodate the sometimes competing needs of patients who are at the greatest risk of being left behind.
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Affiliation(s)
| | | | - Michael Zhao
- Roman Health Ventures, Inc., New York, New York, USA
| | - Alex Goldman
- Roman Health Ventures, Inc., New York, New York, USA
| | - Ira Patnaik
- Roman Health Ventures, Inc., New York, New York, USA
| | - Megan Zhou
- Roman Health Ventures, Inc., New York, New York, USA
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Cardona M, Fien S, Myooran J, Hunter C, Dillon A, Lewis E, Browning M, Lewis L, Ní Chróinín D. Clinical and cost-effectiveness of telehealth for Indigenous and culturally and linguistically diverse (CALD) people: a scoping review. ETHNICITY & HEALTH 2023; 28:114-135. [PMID: 34983256 DOI: 10.1080/13557858.2021.2023111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To examine the modalities and clinical and non-clinical effectiveness of telehealth services available to people from Indigenous and culturally and linguistically diverse backgrounds (CALD). MATERIALS AND METHODS A scoping review of peer-reviewed publications (2000-2021) on the effectiveness of telehealth interventions for Indigenous and CALD groups based on searches of Medline, CINAHL, and PsycInfo and manual searches from reference lists of captured literature reviews. RESULTS Of the initial 601 articles, 10 met the inclusion criteria (seven of clinical effectiveness and three of non-clinical effectiveness), with participants from the USA, Australia, New Zealand, and Canada, with sample sizes ranging from 19 to 1,665 participants (overall 327 Indigenous and 2,030 CALD patients). Telehealth was delivered via telephone or by videoconference-with or without data uploads-and follow-up ranging from 6 months to 5 years. DISCUSSION The findings suggest that telehealth shows some promise in: diabetes, depression, neuro/cognitive assessment, and health program adherence/service utilisation/cost. However, our confidence in the accuracy of the results is undermined by the mixed quality of designs and outcome measurements, and the high risk of bias derived from not proper random selections and small sample sizes. CONCLUSIONS The available literature suggests acceptable clinical and non-clinical effectiveness of telehealth against usual care in Indigenous and/or CALD groups but methodological limitations diminish their value in informing practice. Therefore, we consider it is premature to use the findings of these primary studies to draw conclusive recommendations about clinical or other effectiveness of telehealth for the two target groups. Further randomised trials with adequate sampling frames and objective outcome assessments are warranted.
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Affiliation(s)
- Magnolia Cardona
- Evidence-Based Practice Professorial Unit, Gold Coast University Hospital, Southport, Australia
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Samantha Fien
- Faculty of Health, Medical and Applied Sciences, Central Queensland University, Mackay, Australia
| | - Jananee Myooran
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
| | - Carol Hunter
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
- UNSW Medicine, University of New South Wales, Kensington, Australia
- South Western Sydney Clinical School, UNSW Medicine, Kensington, Australia
| | - Anne Dillon
- UNSW Medicine, University of New South Wales, Kensington, Australia
| | - Ebony Lewis
- School of Psychology, Faculty of Science, University of New South Wales, Kensington, Australia
- School of Population Health, Faculty of Medicine & Health, University of New South Wales Kensington, Sydney, Australia
| | - Melissa Browning
- Aboriginal and Torres Strait Islander Health Service, Gold Coast Hospital and Health Service, Southport, Australia
| | - Lou Lewis
- Matraville Medical Centre, Sydney, Australia
| | - Danielle Ní Chróinín
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
- South Western Sydney Clinical School, UNSW Medicine, Kensington, Australia
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Sołomacha S, Sowa P, Kiszkiel Ł, Laskowski PP, Alimowski M, Szczerbiński Ł, Szpak A, Moniuszko-Malinowska A, Kamiński K. Patient's Perspective of Telemedicine in Poland-A Two-Year Pandemic Picture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:115. [PMID: 36612438 PMCID: PMC9819744 DOI: 10.3390/ijerph20010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/10/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The outbreak of the COVID-19 pandemic caused the healthcare system to drastically reduce in-person visits and suddenly switch to telemedicine services to provide clinical care to patients. The implementation of teleconsultation in medical facilities was a novelty for most Polish patients. In Poland, the main telehealth services were provided in the form of telephone consultations. The aim of this study is to determine patients' perceptions of telemedicine in the context of their experiences with the healthcare system during the COVID-19 pandemic. In this study, we presented how the evaluation of telemedicine services from the perspective of patients in Poland changed in the context of the ongoing pandemic. We conducted two surveys (year by year) on a representative quota sample of the Polish population (N = 623). This ensured that our observations took into account the evolution of views on telemedicine over time. We confirmed the well-known relationship that innovations introduced in the healthcare sector require a longer period of adaptation. We also identified significant concerns that limit the positive perception of telemedicine and compared them with experiences described in other countries.
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Affiliation(s)
- Sebastian Sołomacha
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 13A, 15-089 Białystok, Poland
- Doctoral School, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Paweł Sowa
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 13A, 15-089 Białystok, Poland
| | - Łukasz Kiszkiel
- Society and Cognition Unit, University of Bialystok, 15-403 Bialystok, Poland
| | | | - Maciej Alimowski
- Doctoral School of Social Sciences, University of Bialystok, 15-403 Bialystok, Poland
| | - Łukasz Szczerbiński
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
- Clinical Research Centre, Medical University of Bialystok, 15-276 Białystok, Poland
| | - Andrzej Szpak
- Witold Chodźko Institute of Rural Medicine, 20-090 Lublin, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Karol Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 13A, 15-089 Białystok, Poland
- Department of Cardiology, University Hospital of Bialystok, 15-276 Białystok, Poland
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Helleman J, Johnson B, Holdom C, Hobson E, Murray D, Steyn FJ, Ngo ST, Henders A, Lokeshappa MB, Visser-Meily JMA, van den Berg LH, Hardiman O, Beelen A, McDermott C, van Eijk RPA. Patient perspectives on digital healthcare technology in care and clinical trials for motor neuron disease: an international survey. J Neurol 2022; 269:6003-6013. [PMID: 35849154 PMCID: PMC9294855 DOI: 10.1007/s00415-022-11273-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
Introduction To capture the patient’s attitude toward remote monitoring of motor neuron disease (MND) in care and clinical trials, and their concerns and preferences regarding the use of digital technology. Methods We performed an international multi-centre survey study in three MND clinics in The Netherlands, the United Kingdom, and Australia. The survey was co-developed by investigators and patients with MND, and sent to patients by e-mail or postal-mail. The main topics included: patients’ attitude towards remote care, participating in decentralized clinical trials, and preferences for and concerns with digital technology use. Results In total, 332 patients with MND participated. A majority of patients indicated they would be happy to self-monitor their health from home (69%), be remotely monitored by a multidisciplinary care team (75%), and would be willing to participate in clinical trials from home (65%). Patients considered respiratory function and muscle strength most valuable for home-monitoring. The majority of patients considered the use of at least three devices/apps (75%) once a week (61%) to be acceptable for home-monitoring. Fifteen percent of patients indicated they would not wish to perform home-measurements; reporting concerns about the burden and distress of home-monitoring, privacy and data security. Conclusion Most patients with MND exhibited a positive attitude toward the use of digital technology in both care and clinical trial settings. A subgroup of patients reported concerns with home-monitoring, which should be addressed in order to improve widespread adoption of remote digital technology in clinical MND care. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11273-x.
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Affiliation(s)
- Jochem Helleman
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Barbara Johnson
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Cory Holdom
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Australia.,UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Esther Hobson
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Deirdre Murray
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland.,Physiotherapy Department, Beaumont Hospital, Dublin, Ireland
| | - Frederik J Steyn
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia.,The Royal Brisbane and Women's Hospital, Herston, Australia.,Wesley Medical Research, The Wesley Hospital, Auchenflower, Australia.,Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Shyuan T Ngo
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Australia.,The Royal Brisbane and Women's Hospital, Herston, Australia.,Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Anjali Henders
- Institute for Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Madhura B Lokeshappa
- Institute for Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Leonard H van den Berg
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
| | - Orla Hardiman
- Department of Neurology, National Neuroscience Centre, Beaumont Hospital, Dublin, Ireland.,FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anita Beelen
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Chris McDermott
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Ruben P A van Eijk
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands. .,Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
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Lee G, Chang A, Pal A, Tran TA, Cui X, Quach T. Understanding and Addressing the Digital Health Literacy Needs of Low-Income Limited English Proficient Asian American Patients. Health Equity 2022; 6:494-499. [PMID: 36186613 PMCID: PMC9518790 DOI: 10.1089/heq.2022.0045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction: During the pandemic, Asian Health Services (AHS), a federally qualified health center serving patients in 14 Asian languages, transformed rapidly to provide telehealth visits, developed an intensive remote patient monitoring program, and conducted a digital health literacy survey. Method: This article describes how AHS collected and utilized descriptive data on our patient population to inform our rapid adoption of telehealth and assess our patients' response to these changes. Results: Our experiences show that audio visits are invaluable for our patients. In addition, our remote monitoring program resulted in 96% of patients improving their blood pressure control. Conclusion: Many barriers to widespread adoption of telehealth exist, including low digital literacy and the need for in-language digital training. Disaggregated data by ethnicity and language are needed to inform future work.
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Affiliation(s)
- George Lee
- Asian Health Services, Oakland, California, USA
| | - Anita Chang
- Asian Health Services, Oakland, California, USA
| | - Agnita Pal
- Asian Health Services, Oakland, California, USA
| | - Thu-An Tran
- Asian Health Services, Oakland, California, USA
| | - Xinyue Cui
- Asian Health Services, Oakland, California, USA
| | - Thu Quach
- Asian Health Services, Oakland, California, USA
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Bin Noon G, Hanjahanja-Phiri T, Dave H, Fadrique LX, Morita PP, Teague J. Exploring the Role of Active Assisted Living in the Continuum of Care for Older Adults: Thematic Analysis (Preprint). JMIR Aging 2022; 6:e40606. [DOI: 10.2196/40606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 01/30/2023] [Accepted: 03/05/2023] [Indexed: 03/07/2023] Open
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Lavric A, Petrariu AI, Mutescu PM, Coca E, Popa V. Internet of Things Concept in the Context of the COVID-19 Pandemic: A Multi-Sensor Application Design. SENSORS (BASEL, SWITZERLAND) 2022; 22:503. [PMID: 35062463 PMCID: PMC8778479 DOI: 10.3390/s22020503] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 12/13/2022]
Abstract
In this paper, we present the design, development and implementation of an integrated system for the management of COVID-19 patient, using the LoRaWAN communication infrastructure. Our system offers certain advantages when compared to other similar solutions, allowing remote symptom and health monitoring that can be applied to isolated or quarantined people, without any external interaction with the patient. The IoT wearable device can monitor parameters of health condition like pulse, blood oxygen saturation, and body temperature, as well as the current location. To test the performance of the proposed system, two persons under quarantine were monitored, for a complete 14-day standard quarantine time interval. Based on the data transmitted to the monitoring center, the medical staff decided, after several days of monitoring, when the measured values were outside of the normal parameters, to do an RT-PCR test for one of the two persons, confirming the SARS-CoV2 virus infection. We have to emphasize the high degree of scalability of the proposed solution that can oversee a large number of patients at the same time, thanks to the LoRaWAN communication protocol used. This solution can be successfully implemented by local authorities to increase monitoring capabilities, also saving lives.
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Affiliation(s)
- Alexandru Lavric
- Computers, Electronics and Automation Department, Stefan Cel Mare University of Suceava, 720229 Suceava, Romania; (A.I.P.); (P.-M.M.); (E.C.); (V.P.)
| | - Adrian I. Petrariu
- Computers, Electronics and Automation Department, Stefan Cel Mare University of Suceava, 720229 Suceava, Romania; (A.I.P.); (P.-M.M.); (E.C.); (V.P.)
- MANSiD Research Center, Stefan Cel Mare University of Suceava, 720229 Suceava, Romania
| | - Partemie-Marian Mutescu
- Computers, Electronics and Automation Department, Stefan Cel Mare University of Suceava, 720229 Suceava, Romania; (A.I.P.); (P.-M.M.); (E.C.); (V.P.)
| | - Eugen Coca
- Computers, Electronics and Automation Department, Stefan Cel Mare University of Suceava, 720229 Suceava, Romania; (A.I.P.); (P.-M.M.); (E.C.); (V.P.)
| | - Valentin Popa
- Computers, Electronics and Automation Department, Stefan Cel Mare University of Suceava, 720229 Suceava, Romania; (A.I.P.); (P.-M.M.); (E.C.); (V.P.)
- MANSiD Research Center, Stefan Cel Mare University of Suceava, 720229 Suceava, Romania
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Marianayagam NJ, Premaratne ID, Buontempo MM, Villamater FN, Souweidane MM, Hoffman CE. Outcomes of a virtual craniofacial clinic for assessing plagiocephaly during the COVID-19 pandemic. J Neurosurg Pediatr 2021; 28:497-501. [PMID: 34388721 DOI: 10.3171/2021.4.peds20978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/02/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to carry out a quantitative analysis of a virtual craniofacial clinic during the COVID-19 pandemic. METHODS The charts of 90 patients from a single institution were reviewed. Of these patients, 45 visited the virtual clinic during the COVID-19 pandemic. The other 45 patients visited the clinic in the 3 months prior to COVID-19. Demographics including the mean age at the visit, chief complaint, visit diagnosis, appointment duration, helmet usage, accuracy of the diagnosis, need for a CT scan, and the need for a follow-up appointment were assessed. Diagnostic accuracy, the frequency of follow-up appointments, and patient satisfaction (via survey), as well as additional associated factors, were analyzed to determine the efficacy and satisfaction associated with the virtual clinic approach. RESULTS The mean patient age at time of the visit was 5.6 and 7.3 months (p = 0.244), and the mean time from referral to appointment was 19.2 and 19 days (p = 0.934), in the in-person and virtual cohorts, respectively. There was no significant difference in the variety of chief complaints between the in-person and virtual visits, with 97.8% and 93.3% of patients' parents reporting abnormal head shape, respectively, and the remainder reporting more infrequent complaints (p = 0.435). The visit diagnosis was plagiocephaly in 93.3% of the in-person cohort and 80.0% of the virtual cohort (p = 0.118). The final diagnosis exhibited a similar pattern, with 95.6% of the in-person cohort and 88.9% of the virtual cohort observed as positional plagiocephaly; the remaining diagnoses were more infrequent (p = 0.434). The most common alternative diagnosis in the virtual visit cohort was a metopic ridge (8.4%). In the in-person visit cohort, the most common alternative diagnosis was equally a benign enlargement of the subarachnoid space in infancy, scalp mass, and skull lesion (2.2% each). None of the patients in either cohort were diagnosed with synostosis. Eighty percent of the in-person visits were 15 to 30 minutes in duration, with the remaining 20% being 31 minutes or longer; virtual visits were all 30 minutes or less, with 95.6% being 15 to 30 minutes (p = 0.002). Helmets were prescribed for 2 patients in the in-person cohort and no patients in the virtual cohort (p = 0.494). Alterations in diagnosis were made in 2.2% of in-person visits and 6.7% of virtual visits (p = 0.616). Follow-up was required in 15.6% of the in-person visits and 31.1% of the virtual visits (p = 0.134). CT was only utilized twice, once in the in-person visit cohort and once in the virtual visit cohort. CONCLUSIONS Virtual clinic encounters resulted in comparable diagnostic accuracy. The trend toward frequent follow-up assessments and changes in the final diagnosis in the virtual clinic cohort has indicated a level of diagnostic uncertainty via the virtual interface, which required in-person assessment for confirmation. This finding did not contribute toward diagnostic inaccuracy with respect to missed synostosis. The study results have indicated that telemedicine can be an effective modality in assessing craniofacial pathology.
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11
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Graves JM, Abshire DA, Amiri S, Mackelprang JL. Disparities in Technology and Broadband Internet Access Across Rurality: Implications for Health and Education. FAMILY & COMMUNITY HEALTH 2021; 44:257-265. [PMID: 34269696 PMCID: PMC8373718 DOI: 10.1097/fch.0000000000000306] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Amidst the COVID-19 pandemic, interest in using telehealth to increase access to health and mental health care has grown, and school transitions to remote learning have heightened awareness of broadband inequities. The purpose of this study was to examine access and barriers to technology and broadband Internet service ("broadband") among rural and urban youth. Washington State public school districts were surveyed about youth's access to technology (ie, a device adequate for online learning) and broadband availability in spring 2020. Availability of and barriers to broadband (ie, geography, affordability, and smartphone-only connectivity) were assessed across rurality. Among responding districts, 64.2% (n = 172) were rural and 35.8% (n = 96) were urban. Rural districts reported significantly fewer students with access to an Internet-enabled device adequate for online learning (80.0% vs 90.1%, P < .01). Access to reliable broadband varied significantly across geography (P < .01). Compared with their urban peers, rural youth face more challenges in accessing the technology and connectivity needed for remote learning and telehealth. Given that inadequate broadband infrastructure is a critical barrier to the provision of telehealth services and remote learning in rural areas, efforts to improve policies and advance technology must consider geographical disparities to ensure health and education equity.
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Affiliation(s)
- Janessa M Graves
- College of Nursing (Dr Graves) and Elson S. Floyd College of Medicine (Dr Amiri), Washington State University, Spokane; College of Nursing, University of South Carolina, Columbia (Dr Abshire); and Swinburne University of Technology, School of Health Sciences, Melbourne, Victoria, Australia (Dr Mackelprang)
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12
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Al-Thani H, Mekkodathil A, Hussain A, Sharaf A, Sadek A, Aldakhl-Allah A, Awad A, Al-Abdullah N, Zitoun A, Paul J, Pillai P, John S, El-Menyar A. Implementation of vascular surgery teleconsultation during the COVID-19 pandemic: Insights from the outpatient vascular clinics in a tertiary care hospital in Qatar. PLoS One 2021; 16:e0257458. [PMID: 34591886 PMCID: PMC8483384 DOI: 10.1371/journal.pone.0257458] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/01/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has sparked a surge in the use of virtual communication tools for delivering clinical services for many non-urgent medical needs allowing telehealth or telemedicine, to become an almost inevitable part of the patient care. However, most of patients with vascular disease may require face-to-face interaction and are at risk of worse outcomes if not managed in timely manner. OBJECTIVE We aimed to describe the utilization of telemedicine services in the outpatient vascular surgery clinics in a tertiary hospital. METHODS A retrospective analysis of data on all vascular outpatient encounters during 2019 and 2020 was conducted and compared to reflect the pattern of practice prior to and during the COVID-19 pandemic. RESULTS The study showed that 61% of the total patient encounters in 2020 were reported through teleconsultation. Females were the majority of patients who sought the virtual vascular care. Consultations for the new cases decreased from 29% to 26% whereas, the follow-up cases increased from 71% to 74% in 2020 (p = 0.001). The number of procedures performed in the vascular outpatient clinics decreased by 46% in 2020 when compared to 2019. This decrease in procedures was more evident in the duration from February 2020 to April 2020 in which the procedures decreased by 97%. The proportion of procedures represented 22.6% of the total encounters in 2019 and 10.5% of the encounters during 2020, (p = 0.001). CONCLUSIONS Teleconsultation, along with supporting practice guidelines, can be used to maximize the efficiency of care in vascular surgery patients during the pandemic and beyond. Adoption of the 'hybrid care' which combines both virtual and in-person services as an ongoing practice requires evidence obtained through audits and studies on patients and healthcare providers levels. It is essential to establish a clear practice that ensures patient's needs.
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Affiliation(s)
- Hassan Al-Thani
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Ahammed Mekkodathil
- Department of Surgery, Vascular Surgery, Clinical Research, HGH, Doha, Qatar
| | - Ahmed Hussain
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Ahmed Sharaf
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Ahmed Sadek
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Anas Aldakhl-Allah
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Ahmed Awad
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Nassar Al-Abdullah
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Ahmad Zitoun
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Jini Paul
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Pushpalatha Pillai
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Sara John
- Department of Surgery, Vascular Surgery, Hamad General Hospital (HGH), Doha, Qatar
| | - Ayman El-Menyar
- Department of Surgery, Vascular Surgery, Clinical Research, HGH, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
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13
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Dhaliwal JK, Hall TD, LaRue JL, Maynard SE, Pierre PE, Bransby KA. Expansion of telehealth in primary care during the COVID-19 pandemic: benefits and barriers. J Am Assoc Nurse Pract 2021; 34:224-229. [PMID: 34107501 DOI: 10.1097/jxx.0000000000000626] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/05/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT The novel coronavirus disease 2019 (COVID-19) pandemic remarkably accelerated the adoption of telemedicine in outpatient settings. Out of necessity, virtual care became a preferred and default modality of extending primary care services to health care consumers. Although telemedicine is not a new concept and had been used in many organizations and health systems, the COVID-19 pandemic scaled up its use in a variety of health care settings. Telehealth's use in primary care was particularly important because of the need to maintain continuity of care for successful coordination of chronic disease management. This article examines the benefits of telehealth, including continuity of care, convenience of access to care, screening and triaging, and social distancing and disease prevention. The utilization of telehealth and financial implications are discussed, including reimbursement and cost-effectiveness. Barriers and challenges are addressed, including methods for successful implementation of nurse practitioner (NP) in primary care practices as a response to the COVID-19 pandemic. The leadership role of the NP in telehealth is discussed and implementation guidance is provided.
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Affiliation(s)
| | - Tara D Hall
- Fay-West Community Practice, WVU Medicine, Scottdale, Pennsylvania
| | - Julie L LaRue
- UPMC Carlisle, Alexander Spring FamilyCare, Carlisle, Pennsylvania
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14
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High-Value Pediatric Home Health Care for Children With Medical Complexity. Am J Med Qual 2021; 36:284-286. [PMID: 34086633 DOI: 10.1097/01.jmq.0000741936.31159.3d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Littlewood SJ, Dalci O, Dolce C, Holliday LS, Naraghi S. Orthodontic retention: what's on the horizon? Br Dent J 2021; 230:760-764. [PMID: 34117435 PMCID: PMC8193167 DOI: 10.1038/s41415-021-2937-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/14/2020] [Indexed: 11/08/2022]
Abstract
Orthodontic retention remains one of the great challenges in orthodontics. In this article, we discuss what is on the horizon to help address this challenge, including biological approaches to reduce relapse, treating patients without using retainers, technological developments, personalised medicine and the impact of COVID-19 on approaches to orthodontic retention.
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Affiliation(s)
- Simon J Littlewood
- Consultant Orthodontist, Department of Orthodontics, St Luke's Hospital, Bradford, UK.
| | - Oyku Dalci
- Senior Lecturer, Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, University of Sydney, Australia
| | - Calogero Dolce
- Professor and Chairman, Department of Orthodontics, University of Florida, College of Dentistry, Gainesville, Florida, USA
| | - L Shannon Holliday
- Associate Professor, Department of Orthodontics, University of Florida, College of Dentistry, Gainesville, Florida, USA
| | - Sasan Naraghi
- Consultant Orthodontist, Orthodontic Clinic, Public Dental Health, Växjö, Sweden
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Abstract
Amyotrophic lateral sclerosis and multiple sclerosis are neurodegenerative diseases requiring interdisciplinary rehabilitation services to maximize function, manage symptoms, prevent complications, and promote higher quality of life. Distance and disability may pose barriers to access of subspecialized care. Telehealth is one solution to facilitate access and was rapidly expanded during the COVID-19 pandemic. This article details the utility of telehealth services across the disease spectrum-including to establish a diagnosis, monitor progression for ongoing management, and identify and manage symptoms and provide therapy interventions. The challenges and promise of telehealth services for clinical care and research will be explored.
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17
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Impact of COVID-19 on rheumatology practice in the UK-a pan-regional rheumatology survey. Clin Rheumatol 2021; 40:2499-2504. [PMID: 33495972 PMCID: PMC7832421 DOI: 10.1007/s10067-021-05601-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 12/01/2022]
Abstract
The COVID-19 pandemic has disrupted healthcare services and rheumatology staff were redeployed to the frontline. The purpose of this survey was to evaluate the impact of the COVID-19 pandemic on the provision of rheumatology services as viewed by rheumatologists in the UK. Survey monkey questionnaire weblink was sent to 804 clinicians including consultant rheumatologists, speciality trainees, nurse specialists, and allied health professionals in 4 regions of the UK to evaluate personal effects of COVID-19 and redeployment, impact on current out-patient clinic activity, immunosuppressive drug use, and future rheumatology care. Response rate was 21%. One-fifth of the responders reported that their rheumatology departments were functioning less than 50% capacity during the pandemic. Two-third of responders felt anxious about the ill-effects of COVID-19 on their health and well-being, and one-third of them were redeployed. During the peak of the pandemic, 75% of clinicians stopped intravenous biologics. Although access to video consultation was available for up to three-fourths of the clinicians, the majority (90%) used this modality in less than 1 in 4 consultations. This survey highlights rheumatologists’ perception in the delivery of future care and anxiety they faced. As demonstrated by this survey, the National Institute for Health and Care Excellence (NICE) guidance did not influence clinician decision making in some aspects of patient care. Underutilization of tele-rheumatology in this survey should be considered whilst planning the restoration of rheumatology services in the post-COVID era.Key points • COVID-19 has generated significant concerns among rheumatology community about their mental well-being. • In over 50% of cases, rheumatologists stopped IV biologic drugs as per patients’ wishes during the first wave of the pandemic. • Tele-rheumatology has been used more widely during the pandemic, but the extent of its use in the post-COVID era is less clear. Evolving evidence will determine its future wider use. |
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18
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Erben Y, Franco-Mesa C, Hamid O, Lin M, Stone W, Meltzer AJ, Hattery W, Palaj A, Wilshusen LL, Vista TL, Kalra M, Farres H, Bower TC, De Martino RR, Huang JF, Meschia JF, TerKonda SP. Telemedicine in vascular surgery during the coronavirus disease-2019 pandemic: A multisite healthcare system experience. J Vasc Surg 2020; 74:1-4. [PMID: 33338578 PMCID: PMC7738278 DOI: 10.1016/j.jvs.2020.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 12/06/2020] [Indexed: 01/15/2023]
Abstract
Objective To assess the introduction of telemedicine as an alternative to the traditional face-to-face encounters with vascular surgery patients in the era of the coronavirus disease 2019 (COVID-19) pandemic. Methods A retrospective review of prospectively collected data on face-to-face and telemedicine interactions was conducted at a multisite health care system from January to August 2020 in vascular surgery patients during the COVID-19 pandemic. The end point is direct patient satisfaction comparison between face-to-face and telemedicine encounters/interactions prior and during the pandemic. Results There were 6262 patient encounters from January 1, 2020, to August 6, 2020. Of the total encounters, 790 (12.6%) were via telemedicine, which were initiated on March 11, 2020, after the World Health Organization's declaration of the COVID-19 pandemic. These telemedicine encounters were readily adopted and embraced by both the providers and patients and remain popular as an option to patients for all types of visits. Of these patients, 78.7% rated their overall health care experience during face-to-face encounters as very good and 80.6% of patients rated their health care experience during telemedicine encounters as very good (P = .78). Conclusions Although the COVID-19 pandemic has produced unprecedented consequences to the practice of medicine and specifically of vascular surgery, our multisite health care system has been able to swiftly adapt and adopt telemedicine technologies for the care of our complex patients. Most important, the high quality of patient-reported satisfaction and health care experience has remained unchanged.
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Affiliation(s)
- Young Erben
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Fla.
| | - Camila Franco-Mesa
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Fla
| | - Osman Hamid
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Fla
| | - Michelle Lin
- Department of Neurology, Mayo Clinic, Jacksonville, Fla
| | - William Stone
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Scottsdale, Ariz
| | - Andrew J Meltzer
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Scottsdale, Ariz
| | - Wendy Hattery
- Center for Connected Care, Mayo Clinic, Jacksonville, Fla
| | - Arta Palaj
- Office of Access Management, Mayo Clinic, Jacksonville, Fla
| | | | - Tafi L Vista
- Patient Experience Research, Mayo Clinic, Jacksonville, Fla
| | - Manju Kalra
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | - Houssam Farres
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Fla
| | - Thomas C Bower
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | | | | | | | - Sarvam P TerKonda
- Center for Connected Care, Mayo Clinic, Jacksonville, Fla; Division of Plastic and Reconstructive Surgery, Mayo Clinic, Jacksonville, Fla
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19
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Nakamoto I, Jiang M, Zhang J, Zhuang W, Guo Y, Jin MH, Huang Y, Tang K. Evaluation of the Design and Implementation of a Peer-To-Peer COVID-19 Contact Tracing Mobile App (COCOA) in Japan. JMIR Mhealth Uhealth 2020; 8:e22098. [PMID: 33170801 PMCID: PMC7710388 DOI: 10.2196/22098] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/08/2020] [Accepted: 09/13/2020] [Indexed: 12/23/2022] Open
Abstract
We evaluate a Bluetooth-based mobile contact-confirming app, COVID-19 Contact-Confirming Application (COCOA), which is being used in Japan to contain the spread of COVID-19, the disease caused by the novel virus termed SARS-COV-2. The app prioritizes the protection of users' privacy from a variety of parties (eg, other users, potential attackers, and public authorities), enhances the capacity to balance the current load of excessive pressure on health care systems (eg, local triage of exposure risk and reduction of in-person hospital visits), increases the speed of responses to the pandemic (eg, automated recording of close contact based on proximity), and reduces operation errors and population mobility. The peer-to-peer framework of COCOA is intended to provide the public with dynamic and credible updates on the COVID-19 pandemic without sacrificing the privacy of their information. However, cautions must be exercised to address critical concerns, such as the rate of participation and delays in data sharing. The results of a simulation imply that the participation rate in Japan needs to be close 90% to effectively control the spread of COVID-19.
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Affiliation(s)
- Ichiro Nakamoto
- School of Internet Economics and Business, Fujian University of Technology, Fuzhou, China
| | - Ming Jiang
- School of Internet Economics and Business, Fujian University of Technology, Fuzhou, China
| | - Jilin Zhang
- School of Internet Economics and Business, Fujian University of Technology, Fuzhou, China
| | - Weiqing Zhuang
- School of Internet Economics and Business, Fujian University of Technology, Fuzhou, China
| | - Yan Guo
- School of Internet Economics and Business, Fujian University of Technology, Fuzhou, China
| | - Ming-Hui Jin
- School of Internet Economics and Business, Fujian University of Technology, Fuzhou, China
| | - Yi Huang
- School of Internet Economics and Business, Fujian University of Technology, Fuzhou, China
| | - Kuotai Tang
- School of Internet Economics and Business, Fujian University of Technology, Fuzhou, China
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20
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Macy ML, Huetteman P, Kan K. Changes in Primary Care Visits in the 24 Weeks After COVID-19 Stay-at-Home Orders Relative to the Comparable Time Period in 2019 in Metropolitan Chicago and Northern Illinois. J Prim Care Community Health 2020; 11:2150132720969557. [PMID: 33174495 PMCID: PMC7675908 DOI: 10.1177/2150132720969557] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE In this brief report, we characterize pediatric primary care service utilization in metropolitan Chicago over the first 24 weeks of the COVID-19 pandemic response in relation to the comparable time period in 2019. METHODS We examined retrospective visit and billing data, regardless of payer, from 16 independent pediatric practices that utilize a common electronic medical record platform within an Accountable Care Organization of 252 pediatricians in 71 offices throughout metropolitan Chicago. We categorized visits as Well-Child and Immunization-Only (WC-IO) or Other types and identified visits with a telemedicine billing modifier. Diagnoses for Other visits were tallied and categorized using the Agency for Healthcare Research and Quality Clinical Classification System. We summarized counts of visits and the proportion of visits with a telemedicine billing modifier in one-week epochs for 2020 compared with 2019. RESULTS There were 102 942 total visits (72 030 WC-IO; 30 912 Other) in 2020 and 144 672 visits (80 578 WC-IO; 64 094 Other) in 2019. WC-IO visits in 2020 were half of 2019 visits at the start of the Illinois Stay-at-Home Order and returned greater than 90% of 2019 visits in 8 weeks. Other visit types have remained below 70% of 2019 visits. A telemedicine billing modifier peaked in mid-April (21% of all visits) and declined to <10% of all visits in June (Phase 2 reopening). The top 10 most common diagnoses differed between years. CONCLUSIONS Recovery of well child and immunization visits suggests that practice-level efforts and policy change can ensure children receive recommended care as the pandemic evolves.
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Affiliation(s)
- Michelle L. Macy
- Department of Pediatrics, Northwestern
University, Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, IL, USA
- Michelle L. Macy, Department of Pediatrics,
Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago Ave,
Chicago, IL 60611, USA.
| | | | - Kristin Kan
- Department of Pediatrics, Northwestern
University, Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, IL, USA
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21
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Pickler RH, Abshire DA, Chao AM, Chlan LL, Stanfill AG, Hacker ED, Kawar LN, McCarthy AM, Talsma A. Nursing Science and COVID-19. Nurs Outlook 2020; 68:685-688. [PMID: 32980083 PMCID: PMC7511851 DOI: 10.1016/j.outlook.2020.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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22
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Jaffe DH, Lee L, Huynh S, Haskell TP. Health Inequalities in the Use of Telehealth in the United States in the Lens of COVID-19. Popul Health Manag 2020; 23:368-377. [PMID: 32816644 DOI: 10.1089/pop.2020.0186] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The use of remote health care services, or telehealth, is a promising solution for providing health care to those unable to access care in person easily and thus helping to reduce health inequalities. The COVID-19 pandemic and resulting stay-at-home orders in the United States have created an optimal situation for the use of telehealth services for non-life-threatening health care use. A retrospective cohort study was performed using Kantar's Claritis™ database, which links insurance claims encounters (Komodo Health) with patient-reported data (Kantar Health, National Health & Wellness Survey). Logistic regression models (odds ratios [OR], 95% confidence intervals [CI]) examined predictors of telehealth versus in-person encounters. Adults ages ≥18 years eligible for payer-complete health care encounters in both March 2019 and March 2020 were identified (n = 35,376). Telehealth use increased from 0.2% in 2019 to 1.9% in 2020. In adjusted models of respondents with ≥1 health care encounter (n = 11,614), age, marital status, geographic residence (region; urban/rural), and presence of anxiety or depression were significant predictors of telehealth compared with in-person use in March 2020. For example, adults 45-46 years versus 18-44 years were less likely to use telehealth (OR 0.684, 95% CI: 0.561-0.834), and respondents living in urban versus rural areas were more likely to use telehealth (OR 1.543, 95% CI: 1.153-2.067). Substantial increases in telehealth use were observed during the onset of the COVID-19 pandemic in the United States; however, disparities existed. These inequalities represent the baseline landscape that population health management must monitor and address during this pandemic.
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Affiliation(s)
| | - Lulu Lee
- Health Division, Kantar, San Mateo, California, USA
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