1
|
King L, Alexander-Gabbadon K, Chin N, Hammond-Gabbadon C, Simmonds-Brooks P, Harris J, Martin H, Witter K, Bartlett R, Knight-Madden J, Asnani M. Telehealth: Navigating the COVID-19 Pandemic and Beyond: The Sickle Cell Unit Experience. Telemed J E Health 2023; 29:1781-1791. [PMID: 37092975 DOI: 10.1089/tmj.2023.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
Introduction: To examine the use of telehealth for delivery of health care in persons with sickle cell disease in a resource-constrained country during the COVID-19 pandemic. Methods: This study was a retrospective review of patient encounters at the Sickle Cell Unit (SCU), Jamaica during a 3-year period, March 10, 2019 to March 9, 2022 and a comparison of endpoints between 1 year before and 2 years during the pandemic. Primary endpoints of registration numbers, day-care admissions, and study visits were obtained from logbooks and the electronic medical records. Additional endpoints included well visits, hydroxyurea (HU) visits, and bone pain crisis. Results: Patients registered at the clinic on 17,295 occasions, with 7,820 in the pre-pandemic year decreasing by 43.8% and 35% in the 2 subsequent pandemic years. Overall, study visits increased by 4.9% and 1.3% in the pandemic years. They increased in adults by 13.1% and 8.9% but fell by 3.2% and 6.2% in children. Fewer people were seen in the pandemic years, with children showing a 20.7% decline in numbers. Tele-visits accounted for 31.4% of all study visits during the pandemic years and increased by 23.6% between the pandemic years. There were more well-visits and HU visits, but fewer pain visits and day-care admissions in the pandemic years. Conclusions: The SCU maintained health care delivery for a high-risk population during the pandemic, with tele-visits mitigating the short-fall from in-person visits. Tele-visits may be more acceptable to adults with a chronic illness and may be a suitable alternative for delivering health care.
Collapse
Affiliation(s)
- Lesley King
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Kesha Alexander-Gabbadon
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Nicki Chin
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Christine Hammond-Gabbadon
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Patrice Simmonds-Brooks
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - June Harris
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Hopelyn Martin
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Krystal Witter
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Rachel Bartlett
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Jennifer Knight-Madden
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Monika Asnani
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| |
Collapse
|
2
|
Foster AA, Walls TA, Alade KH, Brown K, Gausche‐Hill M, Lin SD, Rose EA, Ruttan T, Shahid S, Sorrentino A, Stoner MJ, Waseem M, Saidinejad M. Review of pediatric emergency care and the COVID-19 pandemic. J Am Coll Emerg Physicians Open 2023; 4:e13073. [PMID: 38045015 PMCID: PMC10691296 DOI: 10.1002/emp2.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic posed new challenges in health care delivery for patients of all ages. These included inadequate personal protective equipment, workforce shortages, and unknowns related to a novel virus. Children have been uniquely impacted by COVID-19, both from the system of care and socially. In the initial surges of COVID-19, a decrease in pediatric emergency department (ED) volume and a concomitant increase in critically ill adult patients resulted in re-deployment of pediatric workforce to care for adult patients. Later in the pandemic, a surge in the number of critically ill children was attributed to multisystem inflammatory syndrome in children. This was an unexpected complication of COVID-19 and further challenged the health care system. This article reviews the impact of COVID-19 on the entire pediatric emergency care continuum, factors affecting ED care of children with COVID-19 infection, including availability of vaccines and therapeutics approved for children, and pediatric emergency medicine workforce innovations and/or strategies. Furthermore, it provides guidance to emergency preparedness for optimal delivery of care in future health-related crises.
Collapse
Affiliation(s)
- Ashley A. Foster
- Department of Emergency MedicineUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Theresa A. Walls
- Division of Emergency Medicine, Department of PediatricsThe Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Kiyetta H. Alade
- Division of Emergency Medicine, Department of PediatricsTexas Children's HospitalHoustonTexasUSA
| | - Kathleen Brown
- Division of Emergency Medicine, Department of PediatricsChildren's National HospitalWashington, DCUSA
| | - Marianne Gausche‐Hill
- Departments of Emergency Medicine and Pediatrics, David Geffen School of Medicine at University of CaliforniaLos AngelesCaliforniaUSA
- Department of Emergency MedicineHarbor‐University of California Los Angeles Medical CenterLos AngelesCaliforniaUSA
- Department of PediatricsHarbor‐University of California Los Angeles Medical CenterLos AngelesUSA
- The Lundquist Institute for Biomedical Innovation at Harbor University of CaliforniaLos AngelesCaliforniaUSA
| | - Sophia D. Lin
- Departments of Emergency Medicine and PediatricsWeill Cornell Medical CollegeNew YorkNew YorkUSA
| | - Emily A. Rose
- Department of Emergency MedicineLos Angeles County + University of Southern California Medical CenterLos AngelesCaliforniaUSA
| | - Timothy Ruttan
- Department of Pediatrics, Dell Medical SchoolThe University of Texas at AustinUS Acute Care SolutionsCantonOhioUSA
| | - Sam Shahid
- Department of Clinical AffairsAmerican College of Emergency PhysiciansIrvingTexasUSA
| | - Annalise Sorrentino
- Department of Pediatrics, Division of Emergency MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Michael J Stoner
- Division of Emergency MedicineDepartment of PediatricsNationwide Children's HospitalColumbusOhioUSA
| | - Muhammad Waseem
- Division of Emergency MedicineLincoln Medical CenterBronxNew YorkUSA
| | - Mohsen Saidinejad
- Departments of Emergency Medicine and Pediatrics, David Geffen School of Medicine at University of CaliforniaLos AngelesCaliforniaUSA
- Department of Emergency MedicineHarbor‐University of California Los Angeles Medical CenterLos AngelesCaliforniaUSA
- The Lundquist Institute for Biomedical Innovation at Harbor University of CaliforniaLos AngelesCaliforniaUSA
| | | |
Collapse
|