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BACKGROUND: Telemedicine is the use of electronic information to communicate technologies to provide and support healthcare when distance separates the participants. Satisfaction and engagement of patients are key resource indicators for any healthcare setup and healthcare provider for evolving the care continuum (a system that provides a comprehensive range of health services so that care can evolve with the patient over time) and ensuring continuous quality improvement in the systems. As the latest remarkable strategy to connect with patients for consultations and follow-up, telemedicine has been of pivotal importance, especially during the coronavirus disease 2019 (COVID-19), where medicinal services utilize digital sound, video, and information interchanges to remotely access and provide care. MATERIALS AND METHODS: A cross-sectional study was planned during the second wave of the COVID-19 pandemic from April 2021 to April 2022 to assess the impact of telemedicine in essential healthcare delivery by super specialty tertiary care healthcare setup, which is also a medical college, by three consultants and a physiotherapist. RESULTS: There was a significant improvement in satisfaction scores and an improvement in the approach of patients towards telemedicine was observed. Various other parameters, like readmission compliance with medications and a reduction in ED times, were also observed. Finally, clinical endpoints were captured, and the correlation between readmission and medicine adherence was found to be strongly correlated (r = 0.9). A p-value of the reduction in utilization times of ED (emergency department), readmission, and medicine adherence was found to be highly significant Conclusions: Telemedicine is the need of the hour and is now an essential part of healthcare. Its acceptance post-COVID-19 pandemic and adaptability into existing healthcare setups would deliver fruitful results.
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BACKGROUND: Estimation of age is of utmost importance in identifying the deceased. Research considering splenic morphometric parameters to determine the deceased's age is very rare in Haryana. The present study is done to find the correlation between the spleen's morphometric parameters and the deceased's age. The objective of the present study is to determine the changes in morphometry of the spleen with the age of the deceased. METHODS: The cross-sectional study was done in spleen specimens (56 males and 44 females) obtained from deceased adults aged 16-70 years belonging to North India from the Department of Forensic Medicine during autopsy from September 2021-June 2022. The data was analyzed using SPSS 20.0. Pearson's correlation test evaluated the association between splenic parameters and age. The correlation formula was derived to assess the significance of correlation. RESULTS: Correlation with age was negative and significant with splenic weight and splenic dimensions in both males and females. Mean splenic weight, length, breadth, and thickness were 113.83± 7.86 g, 10.2±1.04 cm, 6.53 ± 0.4 cm, 1.46 ± 0.074 cm respectively. Mean spleen weight, length, width, and thickness were 137 ±10.98g, 11.06 ± 1.28 cm, 6.9 ± 0.4cm, 1.66 ± 0.018 cm in males. Mean spleen weight, length, width, and thickness were 90.66 ± 4.74g, 9.34 ±0.8cm, 6.16 ±0.4cm, and 1.26 ±0.13cm in females. Conclusions: Spleen weight and dimensions were higher in males than in females, and all the morphometric parameters increased up to the age of 45 and later decreased. The correlation of morphometric parameters of the spleen was negative and significant with age.
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Background: The Medical Record (MR) contains the information which is needed to plan, provide, and evaluate the care given to the individual. It also serves as a pivotal tool for communicating information to all the health personnel who manage the patient, and it contributes to the continuity of patient care. There is an unmet need of identifying and correcting the issues faced with MR and Medical Records Departments (MRDs) so that higher efficiency can be achieved. This study was conducted to study the deficiencies and discrepancies found in MRD files during COVID management and to correlate the deficiencies with the facilities available and the workflow. Later Lean Management (LM) was applied to ensure compliance and efficiency in the system. Methods: An observational study was done on the audit of COVID 19 patient files and facilities in the care centres. Process mapping was done. The data for LM were collected by brainstorming, observation, interview, and workflow review of several processes, values, number of wastes, and suggestions were documented the MRD staff. Results: Area available was 400 m2 which is adequate against the norm of 350 m2. The existing staff of 30 was adequate as per norms. Deficiencies were observed in physical examination, history, radiology, and laboratory reports. The findings showed that the MRD units had 13 current processes, 26 wastes, and 10 values were identified. In addition, they were offered a total of 25 comments on eliminating the waste. Conclusion: Staff and equipment were adequate. Recommendations include regular staff training and usage of electronic medical records, focus on deficiency check by specific MRD staff on regular basis monitored by the administration and supported by the medical audit committee. The study also recommends that suggestions applied after LM should be implemented in letter and spirit and a repeat study of LM is advisable after regular intervals to maintain the quality standards and to maintain or further improve the efficiency.
