Telemedicine in the Wake of COVID-19: A Statewide Demographic Study on Provider Utilization and Perspective In South Dakota.

INTRODUCTION: The COVID-19 pandemic has ushered in a rapid evolution of regulations surrounding telemedicine and the public's need for affordable, accessible, high-quality care at a distance. This necessity led to a rise in telemedicine demand that forced health systems to adapt, and for providers to witness the potential benefits and limitations of such services. METHODS: In this analysis, Sanford Health EMR data was evaluated from Q2 of 2019 to Q2 of 2020 to compare specialty utilization of telemedicine and quantify percentage change within the midst of the COVID-19 pandemic. A survey was conducted to evaluate provider opinion within the Sanford Health system regarding demographics, usage, perceived benefits, and perceived barriers to this rapid adoption. RESULTS: Results suggest that Sanford Health experienced a significant, 1,600 percent increase of telemedicine usage. Additionally, with this increased usage of telemedicine, provider opinion of telemedicine and its potential has improved. During the pandemic, a greater percentage of providers believe telemedicine is highly beneficial to their practice and a majority believe telemedicine will continue to play a vital role in their practice in the future. However, the barriers found within the survey included limited patient access, technical difficulties, reimbursement, and insurance coverage. CONCLUSIONS: With the rapid increase in provider usage and the subsequent approval of providers, telemedicine has the potential to facilitate higher quality healthcare going forward. The COVID-19 pandemic has necessitated evolution and adoption of virtual media in medicine and has provided a unique glimpse into telemedicine's limitations and exceptional potential.

Intracranial Hemorrhage Secondary to Vitamin K Deficiency Bleeding in a Newborn.

We present a case of a 6-week-old infant who presented with seizure-like activity. Workup revealed abnormal coagulation and imaging confirmed intracranial hemorrhage. Parental refusal of vitamin K treatment at birth suggested vitamin K deficiency bleeding (VKDB) in this newborn. Though VKDB is rare in developed countries, rates have been rising which coincides with an increasing trend of parental refusal of vitamin K prophylaxis at birth.

Infant With Acute Bilateral Pneumothorax During Air Transport.

In rural settings, medically complicated patients may require air transport to facilities that are capable of providing higher levels of care. Extra consideration must be given to pulmonary pathologies when considering this mode of transport. Altitude changes impact both air pressure and volume as described by Boyle's law. These changes can complicate the care of these patients in several ways. We present a case of patient with respiratory failure secondary to viral infection who developed acute bilateral pneumothorax (PTX) while mechanically ventilated during a transport on a fixed-wing aircraft. In this article we outline the unique risks of air travel on the development and progression of PTX as well as the unique challenges with diagnosis and treatment during air transport.