ABSTRACT
The organisation of a military health system (MHS) differs from the civilian system due to the role of the armed forces, the unique nature of the supported population and their occupational health requirements. A previously published review of the Military Medical Corps Worldwide Almanac demonstrated the value of a standardised framework for evaluation and comparison of MHSs. This paper proposes such a framework which highlights the unique features of MHSs not covered by health services research of national health systems. These include: national context and summary; organisational structure; firm base facilities, healthcare beneficiaries and medical research; operational capabilities, overseas deployments, collaborations and alliances; personnel including recruitment, training and education; and history and culture. This common framework can help facilitate international collaboration between military medical services including capability development, training exercises and mutual support during military operations. It can also inform national contributions to future editions of the Almanac.
ABSTRACT
Background: Social distancing restrictions resulted in increased utilization of virtual visits (VVs) for arrhythmia care in 2020. Over time, there has been a return to in-person visits (IPVs);however, utilization of VVs may continue to offer advantages for patients. Objective: To assess characteristics of patients durably adopting virtual care. Methods: All appointments in our arrhythmia clinics from March 2020 through November 2021 were analyzed. Completed appointments by EP providers were categorized as VV or IPV. The VV rate was calculated as number of VVs divided by total Visits (IPVs and VVs). Pt characteristics collected included self-identified race and ethnicity as well as age, gender, and insurance status. We compared VV rates amongst patients of different ethnicity, race, and insurance status. We also assessed enrollment in an internet-based patient portal that interfaces with the electronic medical record (EMR) and allows for communication with providers. Results: A total of 6,084 VVs and 10,942 IPVs were included in the analysis. In 2020, 3,550 VVs comprised the majority (52.8% of 6,723) of all outpatient visits, whereas in 2021, this proportion dropped to 24.6% (2,534/10,303) as IPVs became more common. The largest reduction in VV utilization was amongst Black patients (65.2% reduction to a 19% VV rate) followed by Hispanics (62.3% reduction to a 15.8% VV rate). Both groups had a significantly reduced VV utilization rate compared to others in 2021 (P<0.01). There was no significant difference in VV rates for underinsured patients in 2020 or 2021, indicating social but not economic influence on telehealth adoption. Enrollment in the EMR patient portal during the study period was significantly reduced for Black and Hispanic patients (67.4% and 63.1% vs 80.6%;P<0.01) but did not significantly change over time. Conclusion: There was a large reduction in the overall use of VVs for arrhythmia care from 2020 to 2021. The largest reductions in VV utilization were observed in the Black and Hispanic communities, where digital health resources appeared to be underutilized. [Formula presented]
ABSTRACT
The COVID-19 pandemic introduced many challenges for research scientists: reduction of lab and field observation collection and in-person meetings. These new constraints forced researchers to remote work and virtual networking, dramatically influencing scientific inquiry. Such challenges are compounded for those in early stages of their career, where data collection and networking are vital to be seen as productive. However, during this trying time of remote work, we, as a collective of early-career oceanographers, were actively developing and improving on an already-existent hybrid community of practice. Through our experiences, we believe this type of framework can enhance virtual collaboration to the point that it outlasts the pandemic and helps create new synergies that will diversify and enhance scientific inquiry within the ocean science community. We describe a hybrid community of practice and an example workflow that models effective collaboration. We have found that three components to this model are necessary for effective collaboration, inspiration, and communication: 1) openly accessible data, 2) software, computational, and professional-development resources, and 3) a team science approach. In our experience, both the in-person and remote aspects of the model are important. In person collaboration is key to expanding the community of practice and invigorating those already within the community. Remote collaboration has been critical for effective collaborations between in-person activities and has proven to maximize outputs during in-person collaborations. While the three components of this model are not new to the scientific community, we believe that utilizing them strategically post-pandemic will diversify and expand scientific collaboration in oceanography.