key: cord-1050500-gonp3reh
authors: Lawrentschuk, Nathan
title: Telehealth, virtual meetings and conferences in urology: ‘good’ COVID side effects
date: 2021-05-10
journal: BJU Int
DOI: 10.1111/bju.15381
sha: 8c1ba871ef93872e05509497710ea8070f205b19
doc_id: 1050500
cord_uid: gonp3reh

nan

Undoubtedly the legacy of COVID-19 will go beyond the medical; the social changes that accompany such pandemic events can be just as seismic. Hence, we are well aware that the scope and practice of medicine and urology has changed forever as we have adapted to COVID-19 [1] . Indeed, with the exception of a hotel quarantine disaster in the State of Victoria, Australia and New Zealand have largely avoided the catastrophic impact of the pandemic and we feel fortunate to be in this position. We feel for our colleagues overseas as they battle overstretched resources, illness and death in numbers that are almost incomprehensible.

Aside from all of the negative aspects of this pandemic, are there some positive 'side effects' that we can use and adapt to, not just for now but for the future? Let us focus on telehealth, virtual events and information technology.

Prior to COVID-19 many urologists were using telehealth and telephone consultations (even just as follow-ups) to the advantage of clinicians and patients. Out of necessity, the pandemic has accelerated the use of such tools to keep health systems moving forward [2] .

There does remain a balance that needs to be sought: trust in the doctor-patient relationship and 'the healing touch or hand' of medicine should never be forgotten. Telehealth potentially robs us of this opportunity and others: a familiar face with positive body language becomes unrecognizable, and more regimented and de-personalized admissions where visitations to hospital are restricted cannot be favoured.

Freedom of movement allowed relationships to flourishfellowship programmes, conferences and international committees benefited as well as the social context of making friends with common goals and interestswell beyond just urology. Virtual meetings will continue for the foreseeable future, yet the ability to be in multiple places without loss of travel time, either locally or internationally, has some advantages and these must remain when the pandemic has passed. The desire for face-to-face interaction will undeniably return but let us not abandon flexibility and new formats because inclusiveness can also create great relationships that can be nurtured in many ways over time.

Information technology in health has never been more important. Let's not stop with telehealth: let's make a single login to access all radiology and pathologynot an open medical record but trackable and necessary access for patient care. In the interests of wasted money and resources on repeated tests, including unnecessary exposure to radiation, we must act. Hundreds of millions of dollars are spent by individual hospitals on complex medical record systems designed to please the interests of cost centres and generate administrative graphs, but not the job of doctors and nurses who actually treat patients, and patients really do suffer as clinicians do from time wasted navigating such behemoths.

Have pharmacies also finally decided to exit the dark age of faxes? They are now proudly displaying signs 'e-script is here'. One may ask why has it taken so long to allow prescriptions to be emailed? This demonstrates the classic paradox where medicine can be cutting edge but processes remain mired in red tape and archaic beliefs and ideals. Again, this must change forever, with better ways to deliver accurate prescriptions in a timely fashion, linked to medical software.

In summary, opportunities have arisen due to the pandemic to rethink our practices from doctor, patient and even provider and governmental perspectives [3] . Just as we recognize that approaches to prostate cancer must vary [4] , so too should our individual approaches, with the focus always on timely and evidence-based care. The 'COVID catch-up' as is happening now, and will continue intermittently, particularly for cancer patients [5] needs everything in its favour for the health system to respond as it should.

Again, we hope this supplement provides stimulus away from the omnipotent and ever-present coronavirus. Of course, we once again would like to reach out and thank the contribution of health, emergency service and other workers and our colleagues who have put themselves at risk and allowed society to function in these difficult times.

A reflection on an adapted approach from faceto-face to telephone consultations in our urology outpatient department during the covid-19 pandemic -a pathway for change to future practice?

For men's problems, we need a women's approach: equality in treatment care planning

Not all prostate cancer is the same -patient perceptions: an Asia-Pacific region study

Cancer in lockdown: Impact of the COVID-19 pandemic on patients with cancer