# ent

id: cord-104485-3anla664
type: GGP
entity:
  Cronbach coefficient alpha 0 81 0 93 and strong content validity and reliability 16 In addition three openended free text questions


id: cord-285277-8w03car3
type: ORG
entity:
  Centers for Disease Control and Prevention Department of Health and Human Services Office of Inspector General Hospital


id: cord-285277-8w03car3
type: ORG
entity:
  The Center for Connected Health Policy National Policy Informed Consent Effectiveness of Population Health Management


id: cord-285277-8w03car3
type: ORG
entity:
  The Department of Health and Human Services National 679 Telecommunications and Information Administration American College of Allergy


id: cord-285277-8w03car3
type: WORK_OF_ART
entity:
  the Treatment of Opioid Use Disorder Under the Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment


id: cord-265934-wjdxqj8h
type: WORK_OF_ART
entity:
  A Review of Telemedicine Applications in Otorhinolaryngology Considerations During the Coronavirus Disease


id: cord-270153-krhkqcev
type: DISEASE
entity:
  cord_uid krhkqcev Synchronous telemedicine allows clinicians to expand their reach by using technology to take care of patients who otherwise


id: cord-259395-ytj21cit
type: FAC
entity:
  TECCU Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa or Telemonitoring of Crohn s Disease and Ulcerative Colitis


id: cord-300620-scauefiv
type: WORK_OF_ART
entity:
  The Nuts and Bolts of Utilizing Telemedicine in Nursing HomesdThe GeriCare North Experience Virtually perfect Telemedicine for COVID 19 Physicians


id: cord-301083-nnh95i0k
type: ORG
entity:
  the American Telemedicine Association Center for Telemedicine and eHealth Law Health Resource and Services


id: cord-301083-nnh95i0k
type: ORG
entity:
  the American Academy of Pediatrics Section on Telehealth Care and Council on Clinical Information Technologies


id: cord-267400-3mrqiofw
type: ORG
entity:
  Data Resource Center for Child Adolescent Health National Survey of Children s Health Interactive Data


id: cord-267400-3mrqiofw
type: WORK_OF_ART
entity:
  A Telehealth Enhanced Referral Process in Pediatric Primary Care A Cluster Randomized Trial Electronic


id: cord-271573-qsr3ka5p
type: EVENT
entity:
  the Pediatric Population Community Triage of Otology Patients Using a Store and Forward Telemedicine Device


id: cord-323273-q53wf6au
type: WORK_OF_ART
entity:
  Home Monitoring of Retinal 2382 Sensitivity on a Tablet Device in Intermediate Age Related Macular Degeneration


id: cord-323273-q53wf6au
type: ORG
entity:
  the National Program for the 2398 Prevention of Blindness in Childhood by Retinopathy of Prematurity


id: cord-323273-q53wf6au
type: EVENT
entity:
  Optic Cup Segmentation Methodologies for Glaucoma Image Detection A Survey Telemedicine 2404 for Ophthalmology Information Statement


id: cord-323273-q53wf6au
type: WORK_OF_ART
entity:
  Promising Artificial Intelligence Machine Learning Deep 2433 Learning Algorithms in Ophthalmology Validation of


id: cord-323273-q53wf6au
type: WORK_OF_ART
entity:
  Development and Validation of a Smartphone Based Visual Acuity 2438 Test Peek Acuity for Clinical Practice and Community Based Fieldwork Artificial Intelligence Screening for 2442 Diabetic Retinopathy the Real World Emerging Application Representation Learning A Review


id: cord-323273-q53wf6au
type: ORG
entity:
  the Eye HOME study Development and Validation of a Deep Learning Algorithm for 2703 Detection of Diabetic Retinopathy


id: cord-323273-q53wf6au
type: ORG
entity:
  Undiagnosed Symptomatic Dry Eye Using a Smartphone Application International Committee for the Classification of Retinopathy of Prematurity International Council of Ophthalmology Cost


id: cord-323273-q53wf6au
type: WORK_OF_ART
entity:
  Hyderabad A Novel Tele 2991 Eye Protocol for Ocular Disease Detection and Access to Eye Care Services 2992 Telemedicine and E Health 2994


id: cord-323273-q53wf6au
type: ORG
entity:
  Automated Diabetic Retinopathy Image Assessment 3358 Software Diagnostic Accuracy and Cost Effectiveness Compared with Human 3359 Graders


id: cord-343205-zjw4fbfd
type: CELL_LINE
entity:
  ValCrònic Quasi Experimental study Impact of telemonitoring home care patients with heart failure or chronic lung disease from primary care


id: cord-343205-zjw4fbfd
type: GGP
entity:
  Parkinson s disease PD also require ongoing multidisciplinary care 43 Established programs such as the Ontario Telemedicine Network the ParkinsonNet infrastructure in the Netherlands and that of Kaiser Permanente in the US all display the ability to integrate telehealth into PD patient care 44 Areas for growth include the reimbursement of nursing homes


id: cord-343205-zjw4fbfd
type: ORG
entity:
  the Transregional Network for Stroke Intervention with Telemedicine TRANSIT Stroke Impact of Statewide Telestroke Network


id: cord-330017-t14o7rua
type: ORG
entity:
  the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology Cardiovascular


id: cord-337338-7uj2r0gy
type: ORG
entity:
  Otolaryngology An Assessment of Telemedicine Eligibility among Otolaryngology Diagnoses Otolaryngology


id: cord-337338-7uj2r0gy
type: WORK_OF_ART
entity:
  An Evolutionary Examination of Telemedicine A Health and Computer Mediated Communication Perspective Telemedicine


id: cord-316414-1dho7mmd
type: EVENT
entity:
  the Medical Response to Disasters Global Telemedicine Implementation and Integration Within Health Systems


id: cord-322394-b18fv3r3
type: WORK_OF_ART
entity:
  Telemedicine in Neurosurgery Lessons Learned from a Systematic Review of the Literature for the COVID 19 Era


id: cord-354885-fkgr2o9i
type: ORG
entity:
  the National Medical Insurance Bureau on Promoting the Internet Medical Insurance Service During the Prevention and Control of the New Coronary Pneumonia Outbreak Ministry of Health and Family Welfare Government


id: cord-345949-6aehkrsm
type: CELL_LINE
entity:
  SPROUT CTSA Collaborative Telehealth Research Network a National Institutes of Healthefunded program


# bib

id: cord-029848-dj5xqlz1
title: Using Telemedicine During the COVID-19 Pandemic
author: Mahajan, Vidushi
date: 2020-05-14
txt: ./txt/cord-029848-dj5xqlz1.txt
cache: ./cache/cord-029848-dj5xqlz1.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387251/
doi: 10.1007/s13312-020-1895-6
summary:
  Telemedicine is defined as the delivery of health care services, where distance is a critical factor, by all healthcare professionals using information or communication technology. Telemedicine aims to ensure equitable services to everyone, is costeffective, provides safety to both patient and doctors during pandemics, and offers timely and faster care. Telemedicine can be classified on the basis of mode of communication as (i) audio, video or text-based (video mode is preferred as it allows limited examination as well); (ii) timing of information transmitted as real time or asynchronous exchange; (iii) purpose of consult as first time or follow up (in non-emergent cases or emergency consultation); and (iv) according to individuals involved as patient to medical practitioner, caregiver to medical practitioner, medical practitioner to medical practitioner or health worker to medical practitioner [2] . Doctors should avoid giving advice in such cases and the patient must be referred for an urgent in-person visit to the nearest hospital.

abstract:
  Telemedicine is the delivery of health care services using information or communication technology. In the current pandemic scenario, telemedicine can supplement health-care delivery in the absence of in-person visit. The Government of India has recently launched the e-sanjeevani OPD, a National teleconsultation service, which has been adopted by many state governments as mandatory for health-care providers. With Indian Medical Association issuing an advisory against the use of telemedicine except in few situations, a lot of confusion exists in the mind of a pediatrician. Despite the uncertain situation, we have to remember that other diseases shall not stall in the face of a pandemic. Since telemedicine is an evolving subject, training of medical professionals, clear guidelines and good quality internet service systems will go a long way in increasing the acceptability of telemedicine in the Indian population. We herein discuss issues related to using telemedicine during the SARS-CoV-2 pandemic.


id: cord-104485-3anla664
title: Utilizing Telemedicine for Group Visit Provider Encounters: A Feasibility and Acceptability Study
author: Patel, Tushar A
date: 2020-08-02
txt: ./txt/cord-104485-3anla664.txt
cache: ./cache/cord-104485-3anla664.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7514109/
doi: nan
summary:
  The objective of this study was to evaluate the feasibility and acceptability of group visit provider encounters conducted via telemedicine while CHWs led the educational sections in-person for a low-income, Latino(a) population. We conducted a prospective, feasibility and acceptability study of provider-patient telemedicine encounters in diabetes group visits at a 501(c)(3) community clinic that serves low-income (≤250% federal poverty level), uninsured individuals in Houston, Texas. We also evaluated eight focal areas of feasibility: acceptability (how participates reacted to telemedicine), adaptation (changing program (if applicable)), demand for intervention (attendance), expansion (potential success within a different population or setting), limitedefficacy testing (i.e., TUQ, clinical outcomes), implementation (likelihood telemedicine could be conducted as proposed), integration (level of change needed to initiate telemedicine), and practicality (extent telemedicine could be delivered) [21] . This study evaluated patient-provider telemedicine encounters during group visits and found that they were feasible and acceptable as evidenced by systematic positive findings on the TUQ and no negative clinical impact during the virtual months.

abstract:
  BACKGROUND: The value of telemedicine has been underscored during the coronavirus pandemic. Utilizing telemedicine could markedly enhance group visit scalability and sustainability. However, there are limited data demonstrating telemedicine use for group visits. OBJECTIVE: To evaluate the feasibility and acceptability of provider encounters conducted via telemedicine in group visits. MATERIALS AND METHODS: We conducted a 6-month diabetes group visit program and compared in-person (months 1–3) versus telemedicine (videoconferencing) (months 4–6) patient-provider encounters. Participants completed the Telehealth Usability Questionnaire (TUQ) at 6-months (primary outcome). To ensure telemedicine did not negatively affect clinical outcomes, we compared in-person versus telemedicine differences in HbA1c, blood pressure, body mass index (BMI), and attendance. RESULTS: The TUQ revealed that participants (N=19) found telemedicine useful and easy to use (4.9/5.0, 4.4/5.0, respectively) and with excellent interface (4.3/5.0), interaction (4.6/5.0), reliability (4.2/5.0), and satisfaction (4.4/5.0). There were no significant differences in clinical outcomes between arms: HbA1c (in-person: −0.60%, telemedicine: −0.52%, p=0.86), blood pressure (systolic: p=0.475, diastolic: p=0.683), weight (p=0.982), BMI (p=0.981), attendance (in-person: 75.44%, telemedicine: 70.12%, p=0.551). CONCLUSION: Provider telemedicine encounters in group visits are feasible and acceptable. This is a promising model to address provider limitations in group visits and increase access to care. Larger studies are needed to further evaluate these findings.


id: cord-254040-s3k51rkk
title: Telemedicine for management of patients with amyotrophic lateral sclerosis through COVID-19 tail
author: Bombaci, Alessandro
date: 2020-10-06
txt: ./txt/cord-254040-s3k51rkk.txt
cache: ./cache/cord-254040-s3k51rkk.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33025327/
doi: 10.1007/s10072-020-04783-x
summary:
  In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk to be lost at follow-up, leading to a higher risk of morbidity and mortality. In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk of being lost at follow-up with a consequently higher morbidity and mortality. Neurological examination and ALS Functional Rating Scale revised (ALSFRSr) are the most important tools to monitor disease progression. In a recent randomized trial comparing remote nutritional counseling with or without mobile health technology in ALS patients, Nu Planit application was an acceptable and useful mobile app to check nutritional status [17] . In conclusion, implementing telemedicine services for patients with ALS is necessary to allow direct clinical evaluation during COVID-19 pandemic, in order to plan the appropriate medical and nursing care, avoiding hospitalizations or urgent interventions. Telemedicine for patients with amyotrophic lateral sclerosis during COVID-19 pandemic: an Italian ALS referral center experience

abstract:
  Over the last months, due to coronavirus disease (COVID-19) pandemic, containment measures have led to important social restriction. Healthcare systems have faced a complete rearrangement of resources and spaces, with the creation of wards devoted to COVID-19 patients. In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk to be lost at follow-up, leading to a higher risk of morbidity and mortality. Telemedicine may allow meet the needs of these patients. In this commentary, we briefly discuss the digital tools to remotely monitor and manage ALS patients. Focusing on detecting disease progression and preventing life-threatening conditions, we propose a toolset able to improve ALS management during this unprecedented situation.


id: cord-257229-5ml5ceu0
title: Telemedicine After Upper Extremity Surgery: A Prospective Study of Program Implementation
author: Grandizio, Louis C.
date: 2020-07-18
txt: ./txt/cord-257229-5ml5ceu0.txt
cache: ./cache/cord-257229-5ml5ceu0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32693989/
doi: 10.1016/j.jhsa.2020.06.002
summary:
  We aimed to compare travel burden, visit time, and patient satisfaction between an initial postoperative telemedicine visit and a second conventional in-clinic visit. METHODS: Telemedicine guidelines established by our hospital system were used as inclusion criteria for this prospective study, which included patients indicated for surgery in the outpatient clinic during a 3-month period. CONCLUSIONS: A telemedicine program for postoperative care after hand and upper extremity surgery decreases travel burdens associated with conventional in-clinic appointments. CLINICAL RELEVANCE: Telemedicine after hand and upper extremity surgery results in high levels of patient satisfaction and decreases visit times and the travel burdens associated with conventional in-clinic appointments. We aimed to compare travel burden, visit time, patient satisfaction, and ease of use between an initial postoperative telemedicine visit and the second conventional inclinic visit. A telemedicine program for postoperative care after hand and upper extremity surgery decreases travel burdens associated with conventional in-clinic appointments.

abstract:
  PURPOSE: Our purpose was to evaluate the implementation of a postoperative hand and upper extremity telemedicine program. We aimed to compare travel burden, visit time, and patient satisfaction between an initial postoperative telemedicine visit and a second conventional in-clinic visit. METHODS: Telemedicine guidelines established by our hospital system were used as inclusion criteria for this prospective study, which included patients indicated for surgery in the outpatient clinic during a 3-month period. Patients were excluded if they had wounds closed with nonabsorbable suture, remained admitted to the hospital, or required a custom orthosis at their first postoperative visit. Baseline demographics and patient-reported outcome measures were collected prior to surgery. Information pertaining to technology usage was collected for the telemedicine visit and travel information was obtained for the in-clinic visit. Patient satisfaction was recorded for both visits. RESULTS: Fifty-seven of 87 patients (66%) who met the inclusion criteria elected to participate in the study. A cell phone was utilized by 89% of patients and 88% of visits were performed from the patient’s home. There were 4 technological complications during the study period (7%). Mean round-trip travel distance for the in-clinic visit was 60 miles with an average drive time of 85 minutes. Visit times were significantly shorter with telemedicine (7 minutes vs 38 minutes). Telemedicine was preferred by 90% of patients for subsequent encounters. All 4 clinical complications were recognized during the telemedicine visit. CONCLUSIONS: A telemedicine program for postoperative care after hand and upper extremity surgery decreases travel burdens associated with conventional in-clinic appointments. Telemedicine significantly decreases visit times without decreasing patient satisfaction for patients who elect to participate in remote video visits. The ability to recognize early postsurgical complications was not compromised by utilizing this technology, even during our early experience. CLINICAL RELEVANCE: Telemedicine after hand and upper extremity surgery results in high levels of patient satisfaction and decreases visit times and the travel burdens associated with conventional in-clinic appointments.


id: cord-259395-ytj21cit
title: Implementing Telemedicine in Inflammatory Bowel Disease: is COVID-19 the definitive trigger?
author: Hoyo, Javier Del
date: 2020-05-15
txt: ./txt/cord-259395-ytj21cit.txt
cache: ./cache/cord-259395-ytj21cit.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0210570520301370
doi: 10.1016/j.gastrohep.2020.05.002
abstract: nan
summary:
  the pandemic, we already lived times of overwhelmed consultations with financial constraints, and the promise of telemedicine for improving access to better health services at lower costs drew attention to its use. Moreover, the efficacy of telemedicine on health outcomes is inconsistent across different programs used in inflammatory bowel disease (IBD), and their value is difficult to establish when only few economic data are available. In a previous pilot trial, TECCU showed to be a safe strategy to improve health outcomes of complex IBD patients [3] , with a high probability of being more cost-effective in the short term compared to standard care and telephone care [4] . Maybe the pandemic has reduced reluctance amongst physicians to use telemedicine, but funders, policy-makers, providers and patients need to align their interests to implement remote healthcare successfully. In spite of the use of telephone and e-mail in many centers, the development of mature telemedicine programs integrated with electronic health records requires further collaborative efforts between different investigators.


id: cord-265934-wjdxqj8h
author: Singh, Amrita K.
date: 2020-10-01
txt: ./txt/cord-265934-wjdxqj8h.txt
cache: ./cache/cord-265934-wjdxqj8h.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32942340/
doi: 10.1002/lary.29131
summary:
  21 Recent studies on remote free flap monitoring provide clear examples of how telemedicine can not only expedite care, but also improve patient outcomes. There is a further need for controlled studies comparing telemedicine to in-person assessment of head and neck cancer patients in terms of cost, safety, surveillance adherence, and oncologic outcomes. published clinical practice guidelines for the management of dysphagia in the COVID-19 pandemic, suggesting use of telemedicine for triage and remote evaluation. 63 High levels of patient satisfaction were also achieved with smartphone-based follow-up of facial cosmetic surgery and reviewing images remotely. Telemedicine has a wide applicability in pediatric ORL for obtaining patient history and assessing need for common surgeries such as obstructive sleep apnea, recurrent tonsillitis, and recurrent otitis media (Table VII) . Utilization of SAF techniques have already proven useful in head and neck oncology consultations, remote otologic and audiologic evaluation, cochlear implant and hearing aid management, laryngeal ultrasonography, nasolaryngoscopy, as well as CT sinus review.

title:
  A Review of Telemedicine Applications in Otorhinolaryngology: Considerations During the Coronavirus Disease of 2019 Pandemic

abstract:
  OBJECTIVE/HYPOTHESIS: Review the published literature of telemedicine's use within otorhinolaryngology (ORL), highlight its successful implementation, and document areas with need of future research. STUDY DESIGN: State of the Art Review. METHODS: Three independent, comprehensive searches for articles published on the subject of telemedicine in ORL were conducted of literature available from January 2000 to April 2020. Search terms were designed to identify studies which examined telemedicine use within ORL. Consensus among authors was used to include all relevant articles. RESULTS: While several, small reports document clinical outcomes, patient satisfaction, and the cost of telemedicine, much of the literature on telemedicine in ORL is comprised of preliminary, proof‐of‐concept reports. Further research will be necessary to establish its strengths and limitations. CONCLUSIONS: Particularly during the coronavirus disease of 2019 pandemic, telemedicine can, and should, be used within ORL practice. This review can assist in guiding providers in implementing telemedicine that has been demonstrated to be successful, and direct future research. Laryngoscope, 2020


id: cord-266371-eynmgvbd
title: The future of Telemedicine Cabin? The case of the French students’ acceptability()
author: Baudier, Patricia
date: 2020-06-13
url: https://www.sciencedirect.com/science/article/pii/S0016328720300859?v=s5
doi: 10.1016/j.futures.2020.102595
abstract:
  Telemedicine could solve the problem of the lack of infrastructure and insufficient number of qualified healthcare staff in many countries/regions. The aim of this research is to investigate the futures of such solution by having a better understanding of the acceptance of the Telemedicine Cabin by high-educated Millennials. To reach this goal, a survey was built using specific dimensions to measure the perception of Telemedicine Cabin, the Unified-Theory-of-Acceptance-and-Use-of-Technology 2(nd) version (UTAUT2) and finally the Personal Innovativeness and the Privacy Concern scales. Our sample was composed of 158 students from different Business Schools and data were analysed using a Partial Least Approach. Findings highlight the key role of all Telemedicine Cabin dimensions (Accessibility, Availability and Compatibility) on Performance Expectancy, the importance of three UTAUT2 constructs (Performance Expectancy, Price Value and Habit) and the negative impact of Privacy Concern on the Intention to Use a Telemedicine Cabin. In addition, results demonstrate that Personal Innovativeness does not affect the Intention to Use Telemedicine Cabin.


id: cord-267400-3mrqiofw
title: Telemedicine and Outpatient Subspecialty Visits among Pediatric Medicaid Beneficiaries
author: Ray, Kristin N
date: 2020-04-08
txt: ./txt/cord-267400-3mrqiofw.txt
cache: ./cache/cord-267400-3mrqiofw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32278078/
doi: 10.1016/j.acap.2020.03.014
summary:
  Among children cared for by telemedicine-using and non-using subspecialists, we compared visit rates across child characteristics by assessing negative binomial regression interaction terms. Compared to children receiving care from telemedicine non-using subspecialists, matched children receiving care from telemedicine-using subspecialists had larger differences in visit rates by distance to care, county rurality, ZIP code median income, and child race/ethnicity (p<0.001 for interaction terms). We matched on child age group, gender, race, Medicaid eligibility category and plan type, ZIP code median income level, county rurality, distance to care, months enrolled, subspecialist characteristics, and state. Compared to children receiving care from telemedicine non-using subspecialists, matched children receiving care from telemedicine-using subspecialists had larger variation in incident rate ratios by distance to care, county rurality, ZIP code median income, and child race/ethnicity (p<0.001 for each interaction term). In conclusion, we found low use of telemedicine among subspecialists caring for pediatric Medicaid beneficiaries in 2014, but increased likelihood of telemedicine use among children in rural communities and at distance to subspecialty care.

abstract:
  OBJECTIVE: Live-interactive telemedicine is increasingly covered by state Medicaid programs, but whether telemedicine is improving equity in utilization of subspecialty care is not known. We examined patterns of telemedicine use for outpatient pediatric subspecialty care within state Medicaid programs. METHODS: We identified children ≤17 years old in 2014 Medicaid Analysis eXtract data for 12 states. We identified telemedicine-using and telemedicine non-using medical and surgical subspecialists. Among children cared for by telemedicine-using subspecialists, we assessed child and subspecialist characteristics associated with any telemedicine visit using logistic regression with subspecialist-level random effects. Among children cared for by telemedicine-using and non-using subspecialists, we compared visit rates across child characteristics by assessing negative binomial regression interaction terms. RESULTS: Of 12,237,770 pediatric Medicaid beneficiaries, 2,051,690 (16.8%) had ≥1 subspecialist visit. Of 42,695 subspecialists identified, 146 (0.3%) had ≥1 telemedicine claim. Among children receiving care from telemedicine-using subspecialists, likelihood of any telemedicine use was increased for rural children (OR 10.4, 95%CI 6.3-17.1 compared to large metropolitan referent group) and those >90 miles from the subspecialist (OR 13.4, 95% CI 10.2-17.7 compared to 0-30 mile referent group). Compared to children receiving care from telemedicine non-using subspecialists, matched children receiving care from telemedicine-using subspecialists had larger differences in visit rates by distance to care, county rurality, ZIP code median income, and child race/ethnicity (p<0.001 for interaction terms). CONCLUSION: Children in rural communities and at distance to subspecialists had increased likelihood of telemedicine use. Use overall was low, and results indicated that early telemedicine policies and implementation did not close disparities in subspecialty visit rates by child geographic and sociodemographic characteristics.


id: cord-270153-krhkqcev
title: Implementation of Synchronous Telemedicine into Clinical Practice
author: Khosla, Seema
date: 2020-08-04
url: https://api.elsevier.com/content/article/pii/S1556407X20300424
doi: 10.1016/j.jsmc.2020.05.002
abstract:
  Synchronous telemedicine allows clinicians to expand their reach by using technology to take care of patients who otherwise may not be seen. Establishing a telemedicine practice can be daunting. This article outlines how to implement a synchronous telemedicine practice into an existing workflow. Telemedicine-specific considerations are discussed, as well as guidance regarding practice assessment, financial feasibility, technical considerations, and clinical guidance to translate in-person visit skills into an effective virtual visit.


id: cord-271573-qsr3ka5p
title: Telemedicine in Pediatric Otolaryngology: Ready for Prime Time?
author: Schafer, Austin
date: 2020-09-24
txt: ./txt/cord-271573-qsr3ka5p.txt
cache: ./cache/cord-271573-qsr3ka5p.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0165587620305425
doi: 10.1016/j.ijporl.2020.110399
summary:
  In a 2008 study, Smith and colleagues 5 attempted to determine concordance between pediatric otolaryngology diagnoses and surgical management plans made via a live videoconference and a subsequent, in-office consultation. 11, 12, 14 More recently, Gupta and colleagues 7 published a study in 2020 that examined the feasibility of equipping trained health workers with a store and forward telemedicine device to triage underserved otology patients in India. While much of the literature focuses on store and forward telemedicine in the context of providing care to remote or underserved populations, its benefits should be considered by all ENT practices during the COVID-19 era, as advances in technology have improved its cost effectiveness and convenience. Both of these studies indicate that smartphone otoscopy can be performed by parents; however, the diagnostic reliability of the captured media must improve for this technology to be widely implemented.

abstract:
  The purpose of this paper is to explore the current literature on telemedicine in otolaryngology, focusing on the potential for telemedicine in the field and the major modalities available. Ultimately, the goal is to summarize telemedicine implementation in otolaryngology during the COVID-19 pandemic and potential long term applications. This paper analyzes a variety of studies that have evaluated the efficacy of different telemedicine approaches in otolaryngology, with commentary on what these results mean for the potential of telemedicine during the COVID-19 pandemic. Otolaryngology is well-suited for telemedicine, and this technology is viewed favorably by both patients and physicians. However, its application cannot be generalized to such a wide-ranging specialty. Furthermore, store and forward technology, which has been traditionally used to provide care to remote and underserved populations, and synchronous technology both have the potential to limit unnecessary in-person visits—ultimately keeping both patients and providers safe as social distancing continues.


id: cord-281796-sutgyaep
title: Orthopedic telemedicine encounter during the COVID-19 pandemic: A cautionary tale
author: Bluman, Eric M.
date: 2020-06-27
txt: ./txt/cord-281796-sutgyaep.txt
cache: ./cache/cord-281796-sutgyaep.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S2352644020300479?v=s5
doi: 10.1016/j.tcr.2020.100323
summary:
  The COVID-19 pandemic has necessitated increased use of telemedicine for diagnosis and management of musculoskeletal disorders. J o u r n a l P r e -p r o o f Summary The COVID-19 pandemic has necessitated increased use of telemedicine for diagnosis and management of musculoskeletal disorders. We describe the initial virtual/telemedicine encounter and management of a patient with knee pain initially diagnosed as gonarthrosis but that actually resulted from an impending pathologic fracture of the femur. We describe the initial virtual/telemedicine encounter and management of a patient with knee pain initially diagnosed as gonarthrosis but that actually resulted from an impending pathologic fracture of the femur. One obvious drawback to using telemedicine visits is the limitation placed in conducting a physical examination. Physical examinations through the video component of eVisits are also limited, albeit less so than with telephonic encounters. Some locales have services that provide mobile imaging at the home of the patient.

abstract:
  The COVID-19 pandemic has necessitated increased use of telemedicine for diagnosis and management of musculoskeletal disorders. We describe the initial virtual/telemedicine encounter and management of a patient with knee pain initially diagnosed as gonarthrosis but that actually resulted from an impending pathologic fracture of the femur. Definitive diagnosis and treatment occurred only after completion of the impending fracture. The multiple factors making telemedicine encounters challenging which contributed to this outcome are highlighted. Orthopedists need awareness of these challenges and must take steps to mitigate the risk of complications possible with continued increased utilization of telemedicine during this pandemic and beyond.


id: cord-282730-pawasfh4
title: Telemedicine: Patient-Provider Clinical Engagement During the COVID-19 Pandemic and Beyond
author: Contreras, Carlo M.
date: 2020-05-08
txt: ./txt/cord-282730-pawasfh4.txt
cache: ./cache/cord-282730-pawasfh4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32385614/
doi: 10.1007/s11605-020-04623-5
summary:
  RESULTS: At many institutions, the number of telemedicine visits dramatically increased within days following the institution of novel coronavirus pandemic restrictions on in-person clinical encounters. To minimize interruption of crucial clinical services and the associated revenue, a rapid transition from in-person outpatient visits to telemedicine encounters was implemented by many academic medical centers and adopted by surgery departments throughout the country. The Centers for Medicare and Medicaid Services (CMS) sought to decrease in-person medical visits by issuing a temporary and emergency relaxation of telemedicine rules via the 1135 waiver and the Coronavirus Preparedness and Response Supplemental Appropriations Act. Enacted on March 6, 2020, this act allowed Original Medicare enrollees the same telemedicine benefits that had been extended to Medicare Advantage enrollees in January 2020. In addition, on March 13, 2020 the FCC funded the Rural Health Care Program that aims to make telemedicine services available to geographically remote patients.

abstract:
  BACKGROUND: The novel coronavirus pandemic has drastically affected healthcare organizations across the globe. METHODS: We sought to summarize the current telemedicine environment in order to highlight the important changes triggered by the novel coronavirus pandemic, as well as highlight how the current crisis may inform the future of telemedicine. RESULTS: At many institutions, the number of telemedicine visits dramatically increased within days following the institution of novel coronavirus pandemic restrictions on in-person clinical encounters. Prior to the pandemic, telemedicine utilization was weak throughout surgical specialties due to regulatory and reimbursement barriers. As part of the pandemic response, the USA government temporarily relaxed various telemedicine restrictions and provided additional telemedicine funding. DISCUSSION: The post-pandemic role of telemedicine is dependent on permanent regulatory solutions. In the coming decade, telemedicine and telesurgery are anticipated to mature due to the proliferation of interconnected consumer health devices and high-speed 5G data connectivity.


id: cord-285277-8w03car3
title: COVID-19: Unmasking Telemedicine.
author: Hare, Nathan
date: 2020-06-27
url: https://doi.org/10.1016/j.jaip.2020.06.038
doi: 10.1016/j.jaip.2020.06.038
abstract:
  Abstract Telemedicine adoption has rapidly accelerated since the onset of the COVID-19 pandemic.1 Telemedicine provides increased access to medical care and helps to mitigate risk by conserving personal protective equipment and providing for social/physical distancing in order to continue to treat patients with a variety of allergic and immunologic conditions. During this time, many allergy and immunology clinicians have needed to adopt telemedicine expeditiously in their practices while studying the complex and variable issues surrounding its regulation and reimbursement. Some concerns have been temporarily alleviated since March 2020 to aid with patient care in the setting of COVID-19. Other changes are ongoing at the time of this publication. Members of the Telemedicine Work Group in the American Academy of Allergy, Asthma & Immunology (AAAAI) completed a telemedicine literature review of online and Pub Med resources through May 9, 2020 to detail Pre-COVID-19 telemedicine knowledge and outline up to date telemedicine material. This work group report was developed to provide guidance to allergy/immunology clinicians as they navigate the swiftly evolving telemedicine landscape.


id: cord-287350-xj2i6fgd
title: Telehealth Training Is Essential to Care for Underserved Populations: a Medical Student Perspective
author: Camhi, Stephanie S.
date: 2020-06-15
url: https://doi.org/10.1007/s40670-020-01008-w
doi: 10.1007/s40670-020-01008-w
abstract:
  Telehealth is an area of medicine which has magnified the ability to treat patients remotely. Presently the education of medical professionals pertaining to the value, use, and implementation of telehealth is not adequate to harness the potential of available technologies. Patients engaging in telehealth experience time and cost savings, improved disease management through remote monitoring programs, and high-quality care regardless of geographic location. Despite this, medical education has been slow to evolve. It is therefore imperative that medical curricula incorporate training for this rapidly advancing mode of healthcare delivery to enable students to best care for their future patient population.


id: cord-294487-hcuzxhb3
author: Shenoi, Susan
date: 2020-10-31
txt: ./txt/cord-294487-hcuzxhb3.txt
cache: ./cache/cord-294487-hcuzxhb3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33129319/
doi: 10.1186/s12969-020-00476-z
summary:
  The current COVID 19 global pandemic has forced a paradigm shift with many centers rapidly adopting virtual visits to conduct care resulting in rapid expansion of use of telemedicine amongst practices. BODY: This commentary discusses practical tips for physicians including guidance around administrative and governance issues, preparation for telemedicine, involving the multidisciplinary care team, and teaching considerations. CONCLUSION: This commentary provides a starting framework for telemedicine use in pediatric rheumatology and further work on validation and acceptability is needed. Virtual care models with remote clinics and video visits (e-visits or telemedicine) have become widespread practice overnight. This commentary describes practical creative approaches based on our experiences and discusses the potential for telemedicine to address unmet needs in the wider context of pediatric rheumatology. Young patients (< 3 years) are more challenging to keep on task with a virtual joint exam, but a care-giver only visit to discuss symptoms or medication side effects is often feasible. Decreasing patient cost and travel time through pediatric rheumatology telemedicine visits

title:
  Telemedicine in pediatric rheumatology: this is the time for the community to embrace a new way of clinical practice

abstract:
  BACKGROUND: The use of telemedicine in pediatric rheumatology has been historically low. The current COVID 19 global pandemic has forced a paradigm shift with many centers rapidly adopting virtual visits to conduct care resulting in rapid expansion of use of telemedicine amongst practices. BODY: This commentary discusses practical tips for physicians including guidance around administrative and governance issues, preparation for telemedicine, involving the multidisciplinary care team, and teaching considerations. We also outline a standard proforma and smart phrases for the electronic health record. A proposed variation of the validated pediatric gait arms legs spine examination (pGALS) called the video pGALS (VpGALS) as a means of conducting virtual pediatric rheumatology physical examination is presented. CONCLUSION: This commentary provides a starting framework for telemedicine use in pediatric rheumatology and further work on validation and acceptability is needed.


id: cord-301083-nnh95i0k
title: Telemedicine and Medical Education in the Age of COVID-19
author: Jumreornvong, Oranicha
date: 2020-09-10
url: https://www.ncbi.nlm.nih.gov/pubmed/32889946/
doi: 10.1097/acm.0000000000003711
abstract:
  The COVID-19 pandemic has offered medical schools an opportunity to incorporate telemedicine training into the curricula in a timely and practical manner. Telemedicine has grown exponentially in the United States, and the shift toward remote care to align with social distancing guidelines is fueling this growth. Training medical students to deliver high-quality, secure, and personalized health care through telemedicine will prepare the next generation of physicians to conscientiously use these technologies and meet a growing need for telehealth services. Telemedicine-specific educational goals can be incorporated into curricula and integrated with existing clinical experiences to provide students with core telemedicine and clinical skills to prepare them for current and future pandemics. Medical educators could explore 5 major telemedicine domains: (1) access to care, (2) cost, (3) cost-effectiveness, (4) patient experience, and (5) clinician experience. Schools could use the following learning vehicles to help medical students explore these domains: (1) asynchronous lectures covering telehealth history; (2) discussions on applications, ethics, safety, etiquette, and patient considerations; (3) faculty-supervised standardized patient telehealth encounters; and (4) hands-on diagnostic or therapeutic procedures using telehealth equipment. Incorporating telemedicine into the medical school curriculum exposes students to the application of telemedicine across specialties as well as its limitations.


id: cord-306293-miyc5kok
author: Sherman, Courtney B
date: 2020-08-09
txt: ./txt/cord-306293-miyc5kok.txt
cache: ./cache/cord-306293-miyc5kok.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/lt.25868
doi: 10.1002/lt.25868
summary:
  During the COVID-19 pandemic, among 55 of the 73 original responding programs (75%) from all 11 OPTN regions, telemedicine use increased from 16% to 98% and was used throughout all phases of transplant care. We conducted a national survey of all liver and intestinal adult and pediatric transplant programs active in 2018 in UNOS to assess practice patterns of in-person outreach clinics and telemedicine from January to March 2019. We assessed the use of outreach clinics as well as live video and asynchronous telemedicine (e.g. electronic consultation by review of medical records or imaging studies), including the frequency of telemedicine, duration of use, phase of transplant care in which it was used, providing care across state lines, and reimbursement. Given high clinical demands during the COVID-19 pandemic, our follow-up survey asked targeted questions limited to: 1) use of synchronous telemedicine modality (live video, telephone, both), 2) type of provider using telemedicine, 3) phase of transplant care for which telemedicine was used.

title:
  In‐Person Outreach and Telemedicine in Liver and Intestinal Transplant: A Survey of National Practices, Impact of COVID‐19 and Areas of Opportunity

abstract:
  Little is known about national practices and use of in‐person outreach clinics and telemedicine in transplantation. We initially aimed to assess contemporary use of in‐person outreach and telemedicine in liver and intestinal transplantation in the U.S. We conducted a national survey of liver and intestinal transplant programs to assess use of outreach and telemedicine from January to March of 2019. Given the coronavirus disease 2019 (COVID‐19) pandemic, we distributed a second survey wave in April 2020 to assess changes in telemedicine use. Of the 143 programs surveyed, the initial response rate was 51% (n=73) representing all 11 Organ Procurement and Transplantation Network (OPTN) regions and 29 states. Pre‐COVID‐19, a total of 42 (59%) surveyed programs had in‐person outreach clinics only while 12 (16%) programs in only 6 states used telemedicine. Centers with higher median MELD at transplant were more likely to utilize telemedicine (p=0.02). During the COVID‐19 pandemic, among 55 of the 73 original responding programs (75%) from all 11 OPTN regions, telemedicine use increased from 16% to 98% and was used throughout all phases of transplant care. Telemedicine utilization was very low prior to COVID‐19 and has increased rapidly across all phases of transplant care presenting an opportunity to advocate for sustained future use.


id: cord-307808-0t6sw0zp
title: Telemedicine — maintaining quality during times of transition
author: Romanick-Schmiedl, Sue
date: 2020-06-01
txt: ./txt/cord-307808-0t6sw0zp.txt
cache: ./cache/cord-307808-0t6sw0zp.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1038/s41572-020-0185-x
doi: 10.1038/s41572-020-0185-x
summary:
  To decrease transmission of SARS-CoV-2, the virus responsible for COVID-19, while maintaining health-care access, telehealth -particularly, virtual visits in place of traditional in-person visits -has expanded rapidly around the world. Telemedicine specifically addresses the diagnosis, treatment and monitoring of patients (including history taking and appropriate physical examination) by means of electronic technology. In the midst of these major changes, clinicians are still responsible for ensuring patients receive the care they need, as well as understand the limitations of telemedicine visits. However, we feel strongly that complex medical problems involving major decision-making, such as in follow-up of organ transplant recipients who are manifesting symptoms suggestive of infection or rejection, require in-person patient evaluation. Health-care providers should be prepared to interrupt digital visits or arrange timely follow-up as necessary, so that any patient identified as requiring in-person evaluation will be appropriately directed to receive timely medical attention.

abstract:
  The COVID-19 crisis has accelerated the adoption of telemedicine, presenting challenges and opportunities for clinicians trying to manage diverse, and not only pandemic-related, health conditions. Here, we consider some limitations of telemedicine and offer a perspective on how clinicians can adapt to working in different health-care delivery systems.


id: cord-308873-73zv5ned
title: Lessons from Temporary Telemedicine Initiated owing to Outbreak of COVID-19
author: Kim, Hun-Sung
date: 2020-04-30
txt: ./txt/cord-308873-73zv5ned.txt
cache: ./cache/cord-308873-73zv5ned.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32547813/
doi: 10.4258/hir.2020.26.2.159
abstract: nan
summary:
  To prepare clinical evidence in earlier telemedicine projects, various medical devices were used to check the patient''s condition and provide medical treatment through videotelephony [5] [6] [7] [8] . For this reason, it is true that the earlier telemedicine projects concentrated on medical devices and platforms to check health conditions of patient [9, 10] . Patients unfamiliar with telemedicine will be more interested in taking prescriptions for repeated medications without visiting the hospital, rather than using telemedicine for the purpose of healthcare. Unlike face-to-face medical treatment, which consists of inspection, palpitation, percussion, and auscultation, telemedicine consists only of inspection; hence, safety problems and accountability are inevitable (Currently, temporary telemedicine is a telephone consultation, without inspection. However, it is difficult to judge whether telemedicine should be adopted in the future based only on the experience of temporary telemedicine initiated during COVID-19.


id: cord-309074-pys4aa60
title: Telehealth in the times of SARS-CoV-2 infection for the Otolaryngologist
author: Huang, Victoria W.
date: 2020-05-30
url: https://www.sciencedirect.com/science/article/pii/S2095881120300676?v=s5
doi: 10.1016/j.wjorl.2020.04.008
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.


id: cord-310976-24b3c3a4
title: Time-Driven Activity-Based Costing Analysis of Telemedicine Services in Radiation Oncology
author: Parikh, Neil R.
date: 2020-10-01
txt: ./txt/cord-310976-24b3c3a4.txt
cache: ./cache/cord-310976-24b3c3a4.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ijrobp.2020.06.053
doi: 10.1016/j.ijrobp.2020.06.053
summary:
  We used time-driven activity-based costing to evaluate the change in resource use associated with transitioning to telemedicine in a radiation oncology department. CONCLUSIONS: A modified workflow incorporating telemedicine visits and work-from-home capability conferred savings to a department as well as significant time and costs to health care workers and patients alike. 5 In this study, using a patient undergoing a 28-fraction treatment course as an example, we used TDABC to evaluate the overall change in resource use associated with transitioning to telemedicine in a radiation oncology department. For each patient undergoing 28-fraction treatment, 6 OTVs, and 1 follow-up visit, transitioning to telemedicine workflow reduced provider costs by $586 compared with the traditional workflow (Table 1 )d comprising space/equipment ($347) and personnel ($239). Compared with a traditional workflow involving in-person visits, a modified workflow incorporating telemedicine visits and work-from-home capability confers provider savings of $586/patient, with number of OTVs and cost of nursing time as the most important model inputs in the specific amount saved.

abstract:
  PURPOSE: Health systems have increased telemedicine use during the SARS-CoV-2 outbreak to limit in-person contact. We used time-driven activity-based costing to evaluate the change in resource use associated with transitioning to telemedicine in a radiation oncology department. METHODS AND MATERIALS: Using a patient undergoing 28-fraction treatment as an example, process maps for traditional in-person and telemedicine-based workflows consisting of discrete steps were created. Physicians/physicists/dosimetrists and nurses were assumed to work remotely 3 days and 1 day per week, respectively. Mapping was informed by interviews and surveys of personnel, with cost estimates obtained from the department’s financial officer. RESULTS: Transitioning to telemedicine reduced provider costs by $586 compared with traditional workflow: $47 at consultation, $280 during treatment planning, $237 during on-treatment visits, and $22 during the follow-up visit. Overall, cost savings were $347 for space/equipment and $239 for personnel. From an employee perspective, the total amount saved each year by not commuting was $36,718 for physicians (7243 minutes), $19,380 for physicists (7243 minutes), $17,286 for dosimetrists (7210 minutes), and $5599 for nurses (2249 minutes). Patients saved $170 per treatment course. CONCLUSIONS: A modified workflow incorporating telemedicine visits and work-from-home capability conferred savings to a department as well as significant time and costs to health care workers and patients alike.


id: cord-311000-abntwzuy
title: Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak
author: Sommer, Adir C.
date: 2020-08-19
url: https://doi.org/10.1007/s00417-020-04879-2
doi: 10.1007/s00417-020-04879-2
abstract:
  PURPOSE: Technological advances in recent years have resulted in the development and implementation of various modalities and techniques enabling medical professionals to remotely diagnose and treat numerous medical conditions in diverse medical fields, including ophthalmology. Patients who require prolonged isolation until recovery, such as those who suffer from COVID-19, present multiple therapeutic dilemmas to their caregivers. Therefore, utilizing remote care in the daily workflow would be a valuable tool for the diagnosis and treatment of acute and chronic ocular conditions in this challenging clinical setting. Our aim is to review the latest technological and methodical advances in teleophthalmology and highlight their implementation in screening and managing various ocular conditions. We present them as well as potential diagnostic and treatment applications in view of the recent SARS-CoV-2 virus outbreak. METHODS: A computerized search from January 2017 up to March 2020 of the online electronic database PubMed was performed, using the following search strings: “telemedicine,” “telehealth,” and “ophthalmology.” More generalized complementary contemporary research data regarding the COVID-19 pandemic was also obtained from the PubMed database. RESULTS: A total of 312 records, including COVID-19-focused studies, were initially identified. After exclusion of non-relevant, non-English, and duplicate studies, a total of 138 records were found eligible. Ninety records were included in the final qualitative analysis. CONCLUSION: Teleophthalmology is an effective screening and management tool for a range of adult and pediatric acute and chronic ocular conditions. It is mostly utilized in screening of retinal conditions such as retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration; in diagnosing anterior segment condition; and in managing glaucoma. With improvements in image processing, and better integration of the patient’s medical record, teleophthalmology should become a more accepted modality, all the more so in circumstances where social distancing is inflicted upon us. [Image: see text]


id: cord-312947-ppc4w23a
title: Meeting the challenge of the 2019 novel coronavirus disease in patients with cancer
author: Spiess, Philippe E.
date: 2020-04-23
txt: ./txt/cord-312947-ppc4w23a.txt
cache: ./cache/cord-312947-ppc4w23a.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32324273/
doi: 10.1002/cncr.32919
summary:
  authors: Spiess, Philippe E.; Greene, John; Keenan, Robert J.; Paculdo, David; Letson, G. title: Meeting the challenge of the 2019 novel coronavirus disease in patients with cancer This commentary proposes a simple 5‐part strategy plus rapidly expanded use of telemedicine to anticipate and deal with COVID‐19 and, by extension, future epidemics in patients with cancer. Cancer Month 0, 2020 restrictions on telemedicine use, clinical trials be put into place for evaluating telemedicine''s clinical effectiveness, overall costs of care, diagnostic accuracy, and real and perceived effects on patient confidentiality. With these regulatory changes, however, providers need to be reassured that these changes and future regulatory changes, such as eliminating the need to first conduct an in-person visit before telemedicine is used, will encourage expanded use of telemedicine among oncologists to reduce COVID-19 infections today and improve access to care tomorrow. Infection in cancer patients: a continuing association

abstract:
  The alarming situation of the 2019 novel coronavirus disease (COVID‐19) is contrasted by the limited efforts to curb the spread and impact of the disease among patients with cancer. This commentary proposes a simple 5‐part strategy plus rapidly expanded use of telemedicine to anticipate and deal with COVID‐19 and, by extension, future epidemics in patients with cancer.


id: cord-314028-sf8zt9r9
title: Telemedicine for management of paediatric infectious diseases during COVID-19 outbreak
author: Esposito, Susanna
date: 2020-06-23
txt: ./txt/cord-314028-sf8zt9r9.txt
cache: ./cache/cord-314028-sf8zt9r9.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S138665322030264X
doi: 10.1016/j.jcv.2020.104522
abstract: nan
summary:
  From March 7 to May 3, during the lockdown phase, 61 requests of telemedicine consultation (28, 45.9%, males; mean age ± standard deviation, 4.69 ± 3.22 years) to the paediatric infectious disease specialist in the hospital by the primary care paediatricians were made. A total of 55 (90.2%) paediatric problems that without telemedicine support could have led the patient to the emergency room of the hospital were solved in the community: 30 (54.5%) children with fever of unknown origin, 20 (36.4%) with skin rash, 3 (5.5%) with suspected primary immunodeficiency and 2 (3.6%) with acrocyanosis. This experience shows that during the COVID-19 outbreak, the use of telemedicine for the management of paediatric infectious diseases permitted us to avoid hospital access J o u r n a l P r e -p r o o f in 90% of the cases, favouring reduction of the pressure on the hospitals. Our experience shows that telemedicine may be an easy and effective measure to solve many paediatric problems in the community during COVID-19 outbreak, reducing emergency room visits.


id: cord-316414-1dho7mmd
title: The role of telemedicine in the delivery of healthcare in the COVID‐19 Pandemic
author: Valentino, Leonard.A.
date: 2020-05-12
url: https://doi.org/10.1111/hae.14044
doi: 10.1111/hae.14044
abstract:
  On 11 March 2020, the World Health Organization declared the coronavirus disease 2019 (COVID‐19) a pandemic. Recently, Hermans, et.al., outlined the challenges the COVID‐19 pandemic pose for the bleeding disorders community (1). The general response to the pandemic has included increased measures focused on personal hygiene, social distancing, symptom monitoring, early diagnosis, patient isolation, shelter in place, and public health quarantine. Accordingly, such measures have led to concerns over how to maintain access to haemophilia treatment products and to the specialized integrated care medical follow up within the haemophilia treatment centers (HTCs). As part of the medical response to disasters such as a world‐wide pandemic, telemedicine has emerged as one proposed solution to address this type of global challenge (2).


id: cord-321030-isc3p46t
title: Telemedicine and Smart Working: Recommendations of the European Association of Urology
author: Rodriguez Socarrás, Moises
date: 2020-07-10
txt: ./txt/cord-321030-isc3p46t.txt
cache: ./cache/cord-321030-isc3p46t.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32654801/
doi: 10.1016/j.eururo.2020.06.031
summary:
  EVIDENCE SYNTHESIS: Telemedicine refers to the use of electronic information and telecommunications tools to provide remote clinical health care support. It is time for us to formalize the place of telemedicine in routine urological practice, and it is our responsibility to adapt and learn about all the tools and possible strategies for their optimal implementation during the pandemic to ensure that the quality of care received by patients and the outcomes of patients and their families are of the highest standard. CONCLUSIONS: Telemedicine facilitates specialized urological clinical support at a distance, solves problems of limitations in mobility, reduces unnecessary visits to clinics, and is useful for reducing the risk of viral transmission in the current COVID-19 outbreak. As telemedicine has been used in previous epidemic outbreaks, it has rapidly been incorporated into solutions to manage COVID-19 patients and in several countries for continuation of specialty care such as urology.

abstract:
  CONTEXT: Telemedicine provides remote clinical support using technological tools. It may facilitate health care delivery while reducing unnecessary visits to the clinic. The coronavirus disease 2019 (COVID-19) outbreak has caused an abrupt change in our daily urological practice, converting many of us to be reliant on telehealth. OBJECTIVE: To provide practical recommendations for effective use of technological tools in telemedicine. EVIDENCE ACQUISITION: A Medline-based and gray literature search was conducted through April 2020. We selected the most relevant articles related to “telemedicine” and “smart working” that could provide important information. EVIDENCE SYNTHESIS: Telemedicine refers to the use of electronic information and telecommunications tools to provide remote clinical health care support. Smart working is a model of work that uses new or existing technologies to improve performance. Telemedicine is becoming a useful invaluable tool during and even beyond the COVID-19 pandemic. It is time for us to formalize the place of telemedicine in routine urological practice, and it is our responsibility to adapt and learn about all the tools and possible strategies for their optimal implementation during the pandemic to ensure that the quality of care received by patients and the outcomes of patients and their families are of the highest standard. CONCLUSIONS: Telemedicine facilitates specialized urological clinical support at a distance, solves problems of limitations in mobility, reduces unnecessary visits to clinics, and is useful for reducing the risk of viral transmission in the current COVID-19 outbreak. Furthermore, both personal and societal considerations may favor continued use of telemedicine, even beyond the COVID-19 pandemic. PATIENT SUMMARY: Telemedicine in urology offers specialized remote clinical support to patients, similar to face-to-face visits. It is very useful for reducing unnecessary visits to the clinic, as well as reducing the risk of contagion in the current coronavirus disease 2019 (COVID-19) pandemic.


id: cord-321594-x5wv9p7n
title: Equal Access to Telemedicine during COVID‐19 Pandemic: A Pediatric Otolaryngology Perspective
author: Jiang, Wen
date: 2020-10-05
txt: ./txt/cord-321594-x5wv9p7n.txt
cache: ./cache/cord-321594-x5wv9p7n.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32969043/
doi: 10.1002/lary.29164
summary:
  Due to the technology requirement, our concern is that telemedicine 7 In a recently published article by Nouri et al, the authors found that, in a primary care practice managing chronic diseases, a significantly smaller proportion of the visits after scaled-up telemedicine implementation was observed for vulnerable patients: age 65+ years, non-English language preference, and those insured by Medicare or Medicaid. Using a self-administered survey, DeMartini et al reported a high level of digital technology access among parents in an urban pediatric primary care clinic setting with a high percentage of African American and Medicaid-insured families in a low socioeconomic area. To provide a sustainable level of telemedicine care beyond the COVID-19 pandemic era and well into the future, we need to be cognizant of the language barrier and consciously structure future encounters with increased staff support and longer allotted time and examine more efficient ways to provide digital education and translational services to this population.

abstract:
  OBJECTIVES/HYPOTHESIS: During the current COVID‐19 pandemic, the demand for direct‐to‐home telemedicine services has risen to an unprecedented level. Equal access to specialty care was assessed to identify potential barriers that may negatively impact telemedicine utilization. STUDY DESIGN: Retrospective case series. METHODS: We examined the 6‐week period between March and May 2020 when the only access to nonurgent pediatric otolaryngology service was through telemedicine and compared it to in‐person visits during the same period in 2019. We compared patient demographics, including age, gender, preferred language, zip code of residence, and primary insurance plan. RESULTS: A total of 1,495 visits were conducted through telemedicine from March 23, 2020 to May 1, 2020, and 1983 in‐person visits were completed in 2019. There was no difference in patient age and gender. The proportions of Spanish‐speaking families were similar (15.8% in 2019 vs. 14.4% in 2020, P = .96). The percentage of Medi‐Cal‐insured patients (51.4% in 2019 vs. 49.8% in 2020, P = .73) and the mean poverty level (12.6% in 2019 vs. 12.2% in 2020, P = .38) also remained the same. Spanish‐speaking families were statistically more likely to require rescheduling of their telemedicine visits (17.2%) when compared to the overall rescheduling rate of 11.9% (P = .0083). CONCLUSIONS: We were able to successfully provide access to telemedicine services to our vulnerable populations during the current COVID‐19 pandemic. Telemedicine is likely to remain an essential mode of delivering patient care going forward. It is important to evaluate and identify potential disparities to telemedicine access and proactively implement changes to address these barriers. LEVEL OF EVIDENCE: 4. Laryngoscope, 2020


id: cord-322394-b18fv3r3
author: Eichberg, Daniel G
date: 2020-07-20
url: https://www.ncbi.nlm.nih.gov/pubmed/32687191/
doi: 10.1093/neuros/nyaa306
title:
  Telemedicine in Neurosurgery: Lessons Learned from a Systematic Review of the Literature for the COVID-19 Era and Beyond

abstract:
  BACKGROUND: Evolving requirements for patient and physician safety and rapid regulatory changes have stimulated interest in neurosurgical telemedicine in the COVID-19 era. OBJECTIVE: To conduct a systematic literature review investigating treatment of neurosurgical patients via telemedicine, and to evaluate barriers and challenges. Additionally, we review recent regulatory changes that affect telemedicine in neurosurgery, and our institution's initial experience. METHODS: A systematic review was performed including all studies investigating success regarding treatment of neurosurgical patients via telemedicine. We reviewed our department's outpatient clinic billing records after telemedicine was implemented from 3/23/2020 to 4/6/2020 and reviewed modifier 95 inclusion to determine the number of face-to-face and telemedicine visits, as well as breakdown of weekly telemedicine clinic visits by subspecialty. RESULTS: A total of 52 studies (25 prospective and 27 retrospective) with 45 801 patients were analyzed. A total of 13 studies were conducted in the United States and 39 in foreign countries. Patient management was successful via telemedicine in 99.6% of cases. Telemedicine visits failed in 162 cases, 81.5% of which were due to technology failure, and 18.5% of which were due to patients requiring further face-to-face evaluation or treatment. A total of 16 studies compared telemedicine encounters to alternative patient encounter mediums; telemedicine was equivalent or superior in 15 studies. From 3/23/2020 to 4/6/2020, our department had 122 telemedicine visits (65.9%) and 63 face-to-face visits (34.1%). About 94.3% of telemedicine visits were billed using face-to-face procedural codes. CONCLUSION: Neurosurgical telemedicine encounters appear promising in resource-scarce times, such as during global pandemics.


id: cord-323273-q53wf6au
author: Olivia Li, Ji-Peng
date: 2020-09-06
txt: ./txt/cord-323273-q53wf6au.txt
cache: ./cache/cord-323273-q53wf6au.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32898686/
doi: 10.1016/j.preteyeres.2020.100900
summary:
  These digital innovations include artificial intelligence (AI), 5th generation (5G) telecommunication networks and the Internet of Things (IoT), creating an inter-dependent ecosystem offering opportunities to develop new models of eye care addressing the challenges of COVID-19 and beyond. This article reviews how countries across the world have utilised these digital innovations to tackle diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, glaucoma, refractive error correction, cataract and other anterior segment disorders. Several advanced techniques that assess refractive error accurately have been 1432 developed, and Patients were found to be sufficiently motivated to report their symptoms at least 1598 once a month with a good correlation between the two dry eye questionnaires 1599 (r=0.67), underscoring the potential utility of a tele-health approach for monitoring telemedicine presents different challenges in comparison to screening.

title:
  Digital technology, tele-medicine and artificial intelligence in ophthalmology: A global perspective

abstract:
  The simultaneous maturation of multiple digital and telecommunications technologies in 2020 has created an unprecedented opportunity for ophthalmology to adapt to new models of care using tele-health supported by digital innovations. These digital innovations include artificial intelligence (AI), 5th generation (5G) telecommunication networks and the Internet of Things (IoT), creating an inter-dependent ecosystem offering opportunities to develop new models of eye care addressing the challenges of COVID-19 and beyond. Ophthalmology has thrived in some of these areas partly due to its many image-based investigations. Tele-health and AI provide synchronous solutions to challenges facing ophthalmologists and healthcare providers worldwide. This article reviews how countries across the world have utilised these digital innovations to tackle diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, glaucoma, refractive error correction, cataract and other anterior segment disorders. The review summarises the digital strategies that countries are developing and discusses technologies that may increasingly enter the clinical workflow and processes of ophthalmologists. Furthermore as countries around the world have initiated a series of escalating containment and mitigation measures during the COVID-19 pandemic, the delivery of eye care services globally has been significantly impacted. As ophthalmic services adapt and form a “new normal”, the rapid adoption of some of telehealth and digital innovation during the pandemic is also discussed. Finally, challenges for validation and clinical implementation are considered, as well as recommendations on future directions.


id: cord-323980-rcyjthze
author: Willems, Laurent M.
date: 2020-10-06
url: https://www.ncbi.nlm.nih.gov/pubmed/33181898/
doi: 10.1016/j.yebeh.2020.107483
title:
  SARS-CoV-2-related rapid reorganization of an epilepsy outpatient clinic from personal appointments to telemedicine services: A German single-center experience

abstract:
  INTRODUCTION: When the SARS-CoV-2 pandemic reached Europe in 2020, a German governmental order forced clinics to immediately suspend elective care, causing a problem for patients with chronic illnesses such as epilepsy. Here, we report the experience of one clinic that converted its outpatient care from personal appointments to telemedicine services. METHODS: Documentations of telephone contacts and telemedicine consultations at the Epilepsy Center Frankfurt Rhine-Main were recorded in detail between March and May 2020 and analyzed for acceptance, feasibility, and satisfaction of the conversion from personal to telemedicine appointments from both patients' and medical professionals' perspectives. RESULTS: Telephone contacts for 272 patients (mean age: 38.7 years, range: 17–79 years, 55.5% female) were analyzed. Patient-rated medical needs were either very urgent (6.6%, n = 18), urgent (23.5%, n = 64), less urgent (29.8%, n = 81), or nonurgent (39.3%, n = 107). Outpatient service cancelations resulted in a lack of understanding (9.6%, n = 26) or anger and aggression (2.9%, n = 8) in a minority of patients, while 88.6% (n = 241) reacted with understanding, or relief (3.3%, n = 9). Telemedicine consultations rather than a postponed face-to-face visit were requested by 109 patients (40.1%), and these requests were significantly associated with subjective threat by SARS-CoV-2 (p = 0.004), urgent or very urgent medical needs (p = 0.004), and female gender (p = 0.024). Telemedicine satisfaction by patients and physicians was high. Overall, 9.2% (n = 10) of patients reported general supply problems due to SARS-CoV-2, and 28.4% (n = 31) reported epilepsy-specific problems, most frequently related to prescriptions, or supply problems for antiseizure drugs (ASDs; 22.9%, n = 25). CONCLUSION: Understanding and acceptance of elective ambulatory visit cancelations and the conversion to telemedicine consultations was high during the coronavirus disease 2019 (COVID-19) lockdown. Patients who engaged in telemedicine consultations were highly satisfied, supporting the feasibility and potential of telemedicine during the COVID-19 pandemic and beyond.


id: cord-330017-t14o7rua
title: The Importance of Telemedicine during COVID-19 Pandemic: A Focus on Diabetic Retinopathy
author: Galiero, Raffaele
date: 2020-10-14
url: https://www.ncbi.nlm.nih.gov/pubmed/33123599/
doi: 10.1155/2020/9036847
abstract:
  Recently, telemedicine has become remarkably important, due to increased deployment and development of digital technologies. National and international guidelines should consider its inclusion in their updates. During the COVID-19 pandemic, mandatory social distancing and the lack of effective treatments has made telemedicine the safest interactive system between patients, both infected and uninfected, and clinicians. A few potential evidence-based scenarios for the application of telemedicine have been hypothesized. In particular, its use in diabetes and complication monitoring has been remarkably increasing, due to the high risk of poor prognosis. New evidence and technological improvements in telemedicine application in diabetic retinopathy (DR) have demonstrated efficacy and usefulness in screening. Moreover, despite an initial increase for devices and training costs, teleophthalmology demonstrated a good cost-to-efficacy ratio; however, no national screening program has yet focused on DR prevention and diagnosis. Lack of data during the COVID-19 pandemic strongly limits the possibility of tracing the real management of the disease, which is only conceivable from past evidence in normal conditions. The pandemic further stressed the importance of remote monitoring. However, the deployment of device and digital application used to increase screening of individuals and monitor progression of retinal disease needs to be easily accessible to general practitioners.


id: cord-330545-jrmott3i
title: Telemedicine in the Care of Kidney Transplant Recipients with COVID-19: Case Reports
author: Abuzeineh, Mohammad
date: 2020-07-16
url: https://api.elsevier.com/content/article/pii/S0041134520326294
doi: 10.1016/j.transproceed.2020.07.009
abstract:
  Abstract Kidney transplant recipients who develop symptoms consistent with COVID-19 are bringing unique challenges to health care professionals. Telemedicine has surged dramatically since the pandemic in efforts to maintain patient care and reduce the risk of COVID-19 exposure to patients, healthcare workers, and the public. Herein we present reports of three kidney transplant recipients with COVID-19 that were managed using telemedicine via synchronous video visits integrated with an electronic medical records system, from home to inpatient settings. We demonstrate how telemedicine helped assess, diagnose, triage, and treat patients with COVID-19 while avoiding an emergency room or outpatient clinic visit. While there is limited information about the duration of viral shedding for immunosuppressed patients, our findings underscore the importance of using telemedicine in the follow-up care for kidney transplant recipients with COVID-19 who have recovered from symptoms but might have persistently positive NAT tests. Our experience emphasizes the opportunities of telemedicine in the management of kidney transplant recipients with COVID-19 and in the maintenance of uninterrupted follow-up care for such immunosuppressed patients with prolonged viral shedding. Telemedicine may help increase access to care for kidney transplant recipients during and beyond the pandemic as it offers a prompt, safe, and convenient platform in the delivery of care for these patients. Yet in order to advance the practice of telemedicine in the field of kidney transplantation, barriers to increasing the widespread implementation of telemedicine should be removed, and research studies to assess the effectiveness of telemedicine in the care kidney transplant recipients are needed.


id: cord-333003-t1lo5jpv
title: Navigating telemedicine for facial trauma during the COVID‐19 pandemic
author: Said, Mena
date: 2020-07-09
txt: ./txt/cord-333003-t1lo5jpv.txt
cache: ./cache/cord-333003-t1lo5jpv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838033/
doi: 10.1002/lio2.428
summary:
  As some telemedicine and telecommunication support tools have been incorporated into the otolaryngology practice in response to safety and access demands, it is essential to review how these tools and services can help facilitate facial trauma evaluation during a time when clinical resources are limited. OBJECTIVE: To review applications of telemedicine for the evaluation of facial trauma to better direct utilization of these methods and technologies during times of limited access to clinical resources such as the COVID‐19 pandemic. Telemedicine may provide a potential useful tool in the evaluation and triage of facial injuries and patient engagement. 11 As technologies developed and internet access improved over the years, however, some physicians envisioned telemedicine''s practical potential for facilitating medical care, such as implementing tele-tools for consultation to the underserved, proctored surgery, treatment, education, and research. Two studies explored the potential for using telemedicine tools to engage the patient in participating in their own facial trauma evaluation and follow up.

abstract:
  IMPORTANCE: The COVID‐19 pandemic is changing how health care providers practice. As some telemedicine and telecommunication support tools have been incorporated into the otolaryngology practice in response to safety and access demands, it is essential to review how these tools and services can help facilitate facial trauma evaluation during a time when clinical resources are limited. OBJECTIVE: To review applications of telemedicine for the evaluation of facial trauma to better direct utilization of these methods and technologies during times of limited access to clinical resources such as the COVID‐19 pandemic. METHODS: A systematic review was conducted using PubMed, Embase, and Web of Science. RESULTS: After screening 158 titles and abstracts, we identified 16 eligible studies involving facial trauma evaluation using telemedicine. Telemedicine opportunities for facial trauma evaluation have the potential to be developed in the areas of multidisciplinary remote consultations, facial trauma triage, patient engagement, and postoperative follow‐up. CONCLUSION: The COVID‐19 pandemic is posing obstacles for both providers and patients in the delivery of health care at a time of limited clinical resources. Telemedicine may provide a potential useful tool in the evaluation and triage of facial injuries and patient engagement.


id: cord-333123-pglsgi2f
title: Overview of Telemedicine and Sleep Disorders
author: Singh, Jaspal
date: 2020-07-02
url: https://api.elsevier.com/content/article/pii/S1556407X2030045X
doi: 10.1016/j.jsmc.2020.05.005
abstract:
  Telemedicine is about more than simply using audio-visual technology to care for patients, but rather an opportunity to fundamentally improve patient access, quality, efficiencies, and experience. Regarding sleep medicine, it has the potential to drive sleep medicine’s evolution. By enabling care across geographies and facilitating population-based management, sleep medicine is poised to take advantage of telemedicine capabilities. In this introductory chapter, we highlight issues related to sleep telemedicine, while providing a framework in which to approach this transformational journey thoughtfully. We thereby set the stage for the individual chapters in this edition of Sleep Medicine Clinics.


id: cord-334719-zl5mhuth
title: Telemedicine: Potential applications in epidemic situations
author: Ohannessian, R.
date: 2015-09-30
url: https://api.elsevier.com/content/article/pii/S2212764X15000308
doi: 10.1016/j.eurtel.2015.08.002
abstract:
  Summary Background Telemedicine has several applications regarding different medical specialties or clinical situations. However, telemedicine as a potential tool during epidemics is not as well considered. Methods In this paper, the application of telemedicine is conceptualised using five possible evidence-based epidemic situations. Results The first situation corresponds to asymptomatic individuals, mainly home-based, living in an epidemic-affected location. The application of telemedicine would be through the use of teleconsultation for emergency medical dispatching and would occur when suspicious symptoms are detected by an individual. The second situation for the application of telemedicine is principally home-based and corresponds to the follow-up telemonitoring of asymptomatic individuals identified as case contacts. Concrete applications of these concepts were used during the Ebola virus disease outbreak in Africa since 2014. The third situation links to symptomatic cases in need of isolation. Examples include patients isolated in Taiwan during SARS epidemic in 2003 and H1N1 pandemic influenza in 2009, as well as H7N9 influenza infected patients in 2013 in China. The fourth situation involves tele-expertise when local medical resources do not have the technical expertise for the diagnosis or treatment of a patient and support is required from reference centres. The fifth situation corresponds to a healthcare facility under quarantine that would use telemedicine to keep taking care of patients that cannot access the facility, as it was the case in June 2015 in Seoul during the Middle East Respiratory Syndrome Coronavirus epidemic. Conclusion The use of telemedicine in epidemic situations has a high potential in improving epidemiological investigations, disease control, and clinical case management. However, since it is a recent application, further research would be needed to gain an improved understanding of how telemedicine could be applied in epidemic situations.


id: cord-337338-7uj2r0gy
title: Telemedicine in Otolaryngology in the COVID‐19 Era: Initial Lessons Learned
author: Ohlstein, Jason F.
date: 2020-08-02
url: https://www.ncbi.nlm.nih.gov/pubmed/32740925/
doi: 10.1002/lary.29030
abstract:
  OBJECTIVES: The COVID‐19 pandemic has led to unprecedented global changes in the delivery of healthcare over a short period of time. With the implementation of “shelter in place” orders, otolaryngology clinic visits at our institution were transitioned to Telemedicine. This change enabled the rapid characterization of the patients who accepted and declined Telemedicine. METHODS: Review of 525 otolaryngology patients at a tertiary care referral center with scheduled visits requiring rescheduling to a future date or a Telemedicine visit. Visit, demographic information, and reason for deferring Telemedicine were collected for analysis. RESULTS: 72% of patients declined a Telemedicine visit with the most common reason being the lack of a physical exam (97%). There was an even distribution of demographics between those who accepted and declined visits. There was an association between declining Telemedicine with older age (P = 0.0004) and otology visits (P = 0.0003), while facial plastics patients were more likely to accept (P < 0.0001). Patients scheduled earlier during the pandemic were more likely to accept a visit with a median of 28 days from onset of “shelter in place” orders vs 35 for those who declined (P < 0.0001). CONCLUSIONS: We describe our initial experience with a transition to Telemedicine, where the majority of patients would decline a virtual visit due to the lack of a physical exam. While the future remains uncertain, Telemedicine will continue to play a vital role in healthcare delivery; we believe that understanding our patient base gives critical insights that will help guide and improve virtual care to meet patient's needs.


id: cord-343205-zjw4fbfd
author: Bhaskar, Sonu
date: 2020-09-07
txt: ./txt/cord-343205-zjw4fbfd.txt
cache: ./cache/cord-343205-zjw4fbfd.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3389/fpubh.2020.00410
doi: 10.3389/fpubh.2020.00410
summary:
  Due to the COVID-19 pandemic, the American College of Cardiology urgently updated its guidance on "Telehealth: Rapid Implementation for Your Cardiology Clinic, " in which it encouraged remote monitoring and virtual visits of patients with cardiac problems (16) . A program developed in Germany known as TRANSIT-stroke, in which rural hospitals established a telemedicine network, saw an improvement in patient outcomes as neurological assessment was made faster, treatments were issued within the required timeframe, and 24 h neurologist access was enabled (27) . The rapid move by various bodies, associations, and providers to use telemedicine in maintaining patient continuity while limiting COVID-19 risks of exposure to patients and healthcare workers will have a long-term impact well-beyond the current pandemic. Key Strategies for clinical management and improvement of healthcare services for cardiovascular disease and diabetes patients in the coronavirus (COVID-19) settings: recommendations from the REPROGRAM consortium

title:
  Telemedicine as the New Outpatient Clinic Gone Digital: Position Paper From the Pandemic Health System REsilience PROGRAM (REPROGRAM) International Consortium (Part 2)

abstract:
  Technology has acted as a great enabler of patient continuity through remote consultation, ongoing monitoring, and patient education using telephone and videoconferencing in the coronavirus disease 2019 (COVID-19) era. The devastating impact of COVID-19 is bound to prevail beyond its current reign. The vulnerable sections of our community, including the elderly, those from lower socioeconomic backgrounds, those with multiple comorbidities, and immunocompromised patients, endure a relatively higher burden of a pandemic such as COVID-19. The rapid adoption of different technologies across countries, driven by the need to provide continued medical care in the era of social distancing, has catalyzed the penetration of telemedicine. Limiting the exposure of patients, healthcare workers, and systems is critical in controlling the viral spread. Telemedicine offers an opportunity to improve health systems delivery, access, and efficiency. This article critically examines the current telemedicine landscape and challenges in its adoption, toward remote/tele-delivery of care, across various medical specialties. The current consortium provides a roadmap and/or framework, along with recommendations, for telemedicine uptake and implementation in clinical practice during and beyond COVID-19.


id: cord-344258-19zzumqf
author: Mustafa, S. Shahzad
date: 2020-06-22
url: https://www.sciencedirect.com/science/article/pii/S108112062030435X?v=s5
doi: 10.1016/j.anai.2020.06.027
abstract: nan
title:
  Patient Satisfaction with Telemedicine Encounters in an Allergy/Immunology Practice During the COVID-19 Pandemic


id: cord-345809-tevi0sup
title: Covid-19 and the ‘new normal’: are remote video consultations here to stay?
author: Bidmead, Elaine
date: 2020-08-22
url: https://doi.org/10.1093/bmb/ldaa025
doi: 10.1093/bmb/ldaa025
abstract:
  INTRODUCTION: During the UK Covid-19 lockdown, video consultations (telemedicine) were encouraged. The extent of usage, and to which concerns to earlier implementation were set aside, is unknown; this is worthy of exploration as data becomes available. SOURCES OF DATA: Sources of data are as follows: published case studies, editorials, news articles and government guidance. AREAS OF AGREEMENT: Video can be clinically effective, especially where patients cannot attend due to illness or infection risk. Patients are positive, and they can benefit from savings in time and money. Adoption of telemedicine is hindered by a range of known barriers including clinician resistance due to technological problems, disrupted routines, increased workload, decreased work satisfaction and organizational readiness. AREAS OF CONTROVERSY: Despite policy impetus and successful pilots, telemedicine has not been adopted at scale. GROWING POINTS: Increased use of telemedicine during the Covid-19 crisis presents opportunities to obtain robust evidence of issues and create service transformation effectively. AREAS TIMELY FOR DEVELOPING RESEARCH: Examination of telemedicine use during the Covid-19 crisis to ensure that the benefits and usage continue into the post-lockdown, ‘new normal’ world.


id: cord-354885-fkgr2o9i
author: Hoffer-Hawlik, Michael A.
date: 2020-09-15
url: https://doi.org/10.5334/gh.852
doi: 10.5334/gh.852
title:
  Leveraging Telemedicine for Chronic Disease Management in Low- and Middle-Income Countries During Covid-19

abstract:
  In response to the Covid-19 pandemic, many low- and middle-income countries (LMICs) expanded access to telemedicine to maintain essential health services. Although there has been attention to the accelerated growth of telemedicine in the United States and other high-income countries, the telemedicine revolution may have an even greater benefit in LMICs, where it could improve health care access for vulnerable and geographically remote patients. In this article, we survey the expansion of telemedicine for chronic disease management in LMICs and describe seven key steps needed to implement telemedicine in LMIC settings. Telemedicine can not only maintain essential medical care for chronic disease patients in LMICs throughout the Covid-19 pandemic, but also strengthen primary health care delivery and reduce socio-economic disparities in health care access over the long-term.


