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1.
Artículo en Inglés | MEDLINE | ID: mdl-32635422

RESUMEN

Psychotherapists around the world are facing an unprecedented situation with the outbreak of the novel coronavirus disease (COVID-19). To combat the rapid spread of the virus, direct contact with others has to be avoided when possible. Therefore, remote psychotherapy provides a valuable option to continue mental health care during the COVID-19 pandemic. The present study investigated the fear of psychotherapists to become infected with COVID-19 during psychotherapy in personal contact and assessed how the provision of psychotherapy changed due to the COVID-19 situation and whether there were differences with regard to country and gender. Psychotherapists from three European countries: Czech Republic (CZ, n = 112), Germany (DE, n = 130) and Slovakia (SK, n = 96), with on average 77.8% female participants, completed an online survey. Participants rated the fear of COVID-19 infection during face-to-face psychotherapy and reported the number of patients treated on average per week (in personal contact, via telephone, via internet) during the COVID-19 situation as well as (retrospectively) in the months before. Fear of COVID-19 infection was highest in SK and lowest in DE (p < 0.001) and was higher in female compared to male psychotherapists (p = 0.021). In all countries, the number of patients treated on average per week in personal contact decreased (p < 0.001) and remote psychotherapies increased (p < 0.001), with more patients being treated via internet than via telephone during the COVID-19 situation (p < 0.001). Furthermore, female psychotherapists treated less patients in personal contact (p = 0.036), while they treated more patients via telephone than their male colleagues (p = 0.015). Overall, the total number of patients treated did not differ during COVID-19 from the months before (p = 0.133) and psychotherapy in personal contact remained the most common treatment modality. Results imply that the supply of mental health care could be maintained during COVID-19 and that changes in the provision of psychotherapy vary among countries and gender.


Asunto(s)
Infecciones por Coronavirus/psicología , Neumonía Viral/psicología , Psicoterapia/estadística & datos numéricos , Telemedicina/estadística & datos numéricos , Adulto , Betacoronavirus , Coronavirus , República Checa , Miedo , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Psicoterapia/métodos , Eslovaquia , Encuestas y Cuestionarios
2.
Artículo en Inglés | MEDLINE | ID: mdl-32640652

RESUMEN

The COVID-19 pandemic forced physicians to quickly adapt and find ways to provide their usual offline services by using online tools. We aimed to understand how physicians adapted to the sudden need for telehealth and if their perception of telehealth changed due to their experience during the COVID-19 pandemic. We conducted an exploratory sequential mixed-methods study. We interviewed five Lebanese physicians and thematically analyzed the interviews. We developed a questionnaire based on the analysis results and administered it online to physicians in Lebanon. In total, 140 responses were collected. We found that, during the COVID-19 pandemic, physicians engaged in more telehealth activities in the realms of telemedicine, public awareness, continuing medical education, research, administration, and teaching. They also expanded their repertoire of information-technology tools. Our results also show that there was a significant shift in the physicians' perceptions, indicating greater openness and willingness to adopt telehealth services. However, a significant amount of skepticism and uncertainty regarding telemedicine remains, especially concerning its efficiency, safety, and the adequacy of existing regulations. Based on our findings, we offer recommendations for health IT policy makers, developers, and researchers, to sustain the continuity of telehealth activities beyond the COVID-19 pandemic.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Médicos/psicología , Neumonía Viral , Telemedicina/estadística & datos numéricos , Actitud del Personal de Salud , Betacoronavirus , Educación Médica Continua , Humanos , Líbano , Encuestas y Cuestionarios , Telemedicina/métodos
3.
Rev Saude Publica ; 54: 65, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32609277

RESUMEN

OBJECTIVE: To point out challenges and opportunities for the Brazilian Unified Health System (SUS) with the use of telemonitoring to face the increasing costs of non-communicable chronic diseases, based on its general panorama in Brazil, business dynamics and reapplication of data from American studies. METHODS: Quali-quantitative approach with exploratory research. The field work focused on the analysis of the national market from private companies, since no experiences or studies related to this theme were identified in the SUS. To analyze the panorama and market dynamics, we investigated the offer of this technology based on the products and services available and their demand by reference hospitals the ten largest private health plan companies. To support the central discussion, we analyzed the reduction of costs with hospital admissions by the SUS due to chronic non-communicable diseases sensitive to telemonitoring (HCDST), using data from Datasus and some American studies from the MEDLINE/PubMed database. RESULTS: Although in the embryonic phase, business agents search for new business opportunities, whereas public initiatives for the use of telemonitoring in collective health seem inexistent. The reapplication of U.S. data would reduce spending on HCDST and provide benefits, such as the reduction in emergency room care, acute hospitalizations, readmissions and home care time, among others, which point to even greater economic gains. CONCLUSIONS: The development of a major project to reduce HCDST using this technology has the potential to advance in a comprehensive network of primary care, contribute to a greater dynamism of the national productive and innovative base and induce innovations along the chain of this emerging industry.


Asunto(s)
Prestación de Atención de Salud , Costos de la Atención en Salud/estadística & datos numéricos , Hospitalización , Telemedicina/economía , Brasil , Comercio , Servicio de Urgencia en Hospital , Humanos , Enfermedades no Transmisibles , Telemedicina/estadística & datos numéricos
4.
Orthopedics ; 43(4): 228-232, 2020 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-32674173

RESUMEN

The SARS-CoV-2 (COVID-19) pandemic has had a global influence on health care. The authors examined the early effect of hospital- and state-mandated restrictions on an orthopedic surgery department and hypothesized that the volume of ambulatory clinic encounters, office and surgical procedures, and cases would dramatically decrease. A retrospective review was performed of all encounters in an orthopedic surgery department at a level I academic trauma center during a 4-week period, from March 16, 2020, to April 12, 2020. The results were compared with two control 4-week periods, February 17, 2020, to March 15, 2020, and March 16, 2019, to April 12, 2019. Weekly volume and work relative value units (RVUs) of clinic encounters, office and surgical procedures, and cases were assessed. The type of ambulatory visit also was recorded. Comparisons of mean weekly volume and RVUs between the study and control periods were performed with Student's t test. Surgical cases were categorized into fracture or dislocation, acute soft tissue or nerve injury, infection, oncology, and elective or nonurgent. After implementation of hospital- and state-mandated restrictions on elective health care, the volume of ambulatory orthopedic surgery clinic encounters decreased by 74% to 77%, the volume of clinic procedures decreased by 95%, and the volume of surgical cases decreased by 88%. The percentage of clinic visits performed via telemedicine increased from 0.3% to 81.2%. Elective surgical cases ceased, and the volume of nonelective surgical cases decreased by 51%. During the first 4 weeks after COVID-19-related restrictions were imposed, an immediate and dramatic effect was observed. Compared with the control periods, significant reductions were seen in the volume of ambulatory encounters, office-based procedures, and surgical cases. In addition, the volume of nonelective surgical cases decreased by 51%. [Orthopedics. 2020;43(4):228-232.].


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Procedimientos Ortopédicos/estadística & datos numéricos , Ortopedia/estadística & datos numéricos , Neumonía Viral/epidemiología , Telemedicina/estadística & datos numéricos , Centros Médicos Académicos , Instituciones de Atención Ambulatoria , Betacoronavirus , Humanos , Massachusetts/epidemiología , Pandemias , Estudios Retrospectivos , Centros Traumatológicos
5.
Neurol India ; 68(3): 595-602, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32643671

RESUMEN

Background: The COVID-19 pandemic has created an unprecedented challenge for medical professionals throughout the world to tackle the rapidly changing scenario. The objective of this survey was to analyze the change in neurosurgical practice in India following the COVID-19 outbreak and assess its impact on practising neurosurgeons. Materials and Methods: Between May 7th and 23rd, 2020, a validated questionnaire was circulated amongst practising neurosurgeons across the country by social media and e-mails, regarding changes in the patterns of patients seen, adaptations made in their practice, effect on surgeries performed, financial burden, and impact on their personal lives. The responses were kept anonymous and were analyzed for correlations between the changes observed and independent factors such as hospital affiliations, teaching professions, and neurosurgical experience. Results: Our survey showed a drastic fall in the number of neurosurgical patients seen in the outpatient department (OPD) as well as the number of surgeries performed. A drop of 76.25% was seen in OPD patients (P = 0.000) and that of 70.59% in surgeries performed (P = 0.000). There was no uniformity among the neurosurgeons in the number of COVID-19 tests being done before elective/emergency surgery and in the use of protective gear while examining patients. Private practitioners were more affected financially as compared to those in the government sector. The pandemic has affected the research work of 53.23% of all respondents, with those in the teaching profession (70.96%) more affected than those in the non-teaching profession (24.67%). Conclusions: Evidence-based policies, screening COVID-19 tests with better sensitivity, and better-quality personal protective equipment kits in adequate numbers are required to protect our medical professionals from COVID-19. Mental health issues among neurosurgeons may also be an issue, this being a high risk speciality and should be closely watched for.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Neurocirugia/estadística & datos numéricos , Procedimientos Neuroquirúrgicos/estadística & datos numéricos , Neumonía Viral/epidemiología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Telemedicina/estadística & datos numéricos , Adulto , Betacoronavirus , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Estudios Transversales , Femenino , Humanos , India/epidemiología , Masculino , Tamizaje Masivo , Neurocirujanos/economía , Neurocirujanos/psicología , Pandemias , Equipo de Protección Personal/provisión & distribución , Admisión y Programación de Personal , Neumonía Viral/diagnóstico , Encuestas y Cuestionarios
6.
Farm Hosp ; 44(4): 135-140, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-32646343

RESUMEN

OBJECTIVE: To analyze the status of the implementation and development of  telepharmacy as applied to the pharmaceutical care of outpatients treated at  hospital pharmacy services in Spain during the COVID-19 pandemic. METHOD: Six weeks after the beginning of the confinement period, an online 10- question survey was sent to all members of the Spanish Society of Hospital  Pharmacists. A single response per hospital was requested. The survey included  questions on the provision of remote pharmaceutical care prior to the onset of  the health crisis, patient selection criteria, procedures for home delivery of  medications and the means used to deliver them, the number of patients who  benefited from telepharmacy, and the number of referrals made. Finally,  respondents were asked whether a teleconsultation was carried out before  sending patients their medication and whether these deliveries were recorded. RESULTS: A total of 39.3% (n = 185) of all the hospitals in the National Health  System (covering all of Spain's autonomous regions) responded to the survey.  Before the beginning of the crisis, 83.2% (n = 154) of hospital pharmacy  services did not carry out remote pharmaceutical care activities that included  telepharmacy with remote delivery of medication. During the study period,  119,972 patients were treated, with 134,142 deliveries of medication being  completed. Most hospitals did not use patient selection criteria. A total of 30.2%  of hospitals selected patients based on their personal circumstances. Home  delivery and informed delivery (87%; 116,129 deliveries) was the option used in most cases. The means used to deliver the medication mainly included the use  of external courier services (47.0%; 87 hospitals) or the hospital's own transport services (38.4%; 71 hospitals). As many as 87.6% of hospitals carried out  teleconsultations prior to sending out medications and 59.6% recorded their  telepharmacy activities in the hospital pharmacy appointments record. CONCLUSIONS: The rate of implementation of telepharmacy in outpatient care in  Spain during the study period in the pandemic was high. This made it possible to guarantee the continuity of care for a large number of patients.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Betacoronavirus , Infecciones por Coronavirus , Pandemias , Servicio de Farmacia en Hospital/estadística & datos numéricos , Neumonía Viral , Telemedicina/estadística & datos numéricos , Encuestas de Atención de la Salud , Servicios de Atención de Salud a Domicilio/organización & administración , Capacidad de Camas en Hospitales , Humanos , Sistemas de Medicación/organización & administración , Sistemas de Medicación/estadística & datos numéricos , Selección de Paciente , Servicio de Farmacia en Hospital/organización & administración , Derivación y Consulta/estadística & datos numéricos , España , Telemedicina/organización & administración , Carga de Trabajo
8.
Neurologia ; 35(6): 372-380, 2020.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32561333

RESUMEN

INTRODUCTION: The COVID-19 pandemic has had a great impact on healthcare systems. Spain, where headache is the main reason for outpatient neurology consultation, is one of the countries with the most reported cases of the disease. OBJECTIVE: This study aimed to analyse the impact of the COVID-19 pandemic on headache units in Spain and to evaluate how neurologists see the future of these units. METHODS: We conducted a cross-sectional online survey of headache units during the sixth week of the state of alarm declared in Spain in response to the pandemic. RESULTS: The response rate was 74%, with the participation of centres with different characteristics and from all Autonomous Communities of Spain. Limitations in face-to-face activity were reported by 95.8% of centres, with preferential face-to-face consultation being maintained in 60.4%, and urgent procedures in 45.8%. In 91.7% of centres, the cancelled face-to-face activity was replaced by telephone consultation. 95.8% of respondents stated that they would use personal protection equipment in the future, and 86% intended to increase the use of telemedicine. The majority foresaw an increase in waiting lists (93.8% for initial consultations, 89.6% for follow-up, and 89.4% for procedures) and a worse clinical situation for patients, but only 15% believed that their healthcare structures would be negatively affected in the future. CONCLUSIONS: As a consequence of the pandemic, headache care and research activity has reduced considerably. This demonstrates the need for an increase in the availability of telemedicine in our centres in the near future.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Cefalea/terapia , Pandemias , Neumonía Viral , Analgésicos/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/uso terapéutico , Estudios Transversales , Manejo de la Enfermedad , Servicios Médicos de Urgencia/organización & administración , Predicción , Cefalea/tratamiento farmacológico , Cefalea/epidemiología , Encuestas de Atención de la Salud , Humanos , Visita a Consultorio Médico/estadística & datos numéricos , Aceptación de la Atención de Salud , Equipo de Protección Personal , Derivación y Consulta , España/epidemiología , Telemedicina/estadística & datos numéricos , Tiempo de Tratamiento
9.
J Med Internet Res ; 22(7): e19322, 2020 07 06.
Artículo en Inglés | MEDLINE | ID: mdl-32568721

RESUMEN

BACKGROUND: The emergence of the coronavirus disease (COVID-19) pandemic in March 2020 created unprecedented challenges in the provision of scheduled ambulatory cancer care. As a result, there has been a renewed focus on video-based telehealth consultations as a means to continue ambulatory care. OBJECTIVE: The aim of this study is to analyze the change in video visit volume at the University of California, San Francisco (UCSF) Comprehensive Cancer Center in response to COVID-19 and compare patient demographics and appointment data from January 1, 2020, and in the 11 weeks after the transition to video visits. METHODS: Patient demographics and appointment data (dates, visit types, and departments) were extracted from the electronic health record reporting database. Video visits were performed using a HIPAA (Health Insurance Portability and Accountability Act)-compliant video conferencing platform with a pre-existing workflow. RESULTS: In 17 departments and divisions at the UCSF Cancer Center, 2284 video visits were performed in the 11 weeks before COVID-19 changes were implemented (mean 208, SD 75 per week) and 12,946 video visits were performed in the 11-week post-COVID-19 period (mean 1177, SD 120 per week). The proportion of video visits increased from 7%-18% to 54%-72%, between the pre- and post-COVID-19 periods without any disparity based on race/ethnicity, primary language, or payor. CONCLUSIONS: In a remarkably brief period of time, we rapidly scaled the utilization of telehealth in response to COVID-19 and maintained access to complex oncologic care at a time of social distancing.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Neoplasias/terapia , Neumonía Viral/epidemiología , Telemedicina/estadística & datos numéricos , Comunicación por Videocoferencia/estadística & datos numéricos , Anciano , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Citas y Horarios , Betacoronavirus , Estudios Transversales , Registros Electrónicos de Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Derivación y Consulta/estadística & datos numéricos , San Francisco
10.
J Plast Reconstr Aesthet Surg ; 73(7): 1348-1356, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32499187

RESUMEN

The Covid 19 epidemic has modified the way that plastic surgeons can treat their patients. At our hospital all elective surgery was canceled and only the more severe cases were admitted. The outpatient department activity has been reduced also. We present the number and diagnoses of patients, treated as in- and out-patients, during seven weeks from the onset of the epidemic, comparing our activity from the lockdown of elective surgery with the numbers and diagnoses observed during the same weeks of last year. Finally we underline the importance of using telemedicine and web-based tools to transmit images of lesions that need the surgeon's evaluation, and can be used by the patient to keep in touch with a doctor during the distressing time of delay of the expected procedure.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Accesibilidad a los Servicios de Salud/organización & administración , Control de Infecciones/métodos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Procedimientos Quirúrgicos Reconstructivos , Centros de Atención Terciaria/organización & administración , Adolescente , Adulto , Cuidados Posteriores/métodos , Cuidados Posteriores/organización & administración , Cuidados Posteriores/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Atención Ambulatoria/organización & administración , Atención Ambulatoria/estadística & datos numéricos , Niño , Preescolar , Infecciones por Coronavirus/epidemiología , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Urgencias Médicas , Femenino , Estudios de Seguimiento , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Lactante , Control de Infecciones/organización & administración , Italia/epidemiología , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Procedimientos Quirúrgicos Reconstructivos/estadística & datos numéricos , Telemedicina/métodos , Telemedicina/organización & administración , Telemedicina/estadística & datos numéricos , Centros de Atención Terciaria/estadística & datos numéricos , Adulto Joven
11.
Artículo en Inglés | MEDLINE | ID: mdl-32471295

RESUMEN

Reducing personal contacts is a central measure against the spreading of the novel coronavirus disease (COVID-19). This troubles mental health, but also mental health care as treatments usually take place in personal contact and switching to remote treatments might be necessary in times of COVID-19. The present study investigated the question how the provision of psychotherapy changed in the early weeks of the COVID-19 lockdown in Austria and whether there were differences between the four therapeutic orientations eligible in Austria (psychodynamic, humanistic, systemic, behavioral). Psychotherapists (N = 1547) completed an online survey. They entered their number of patients treated on average per week (in personal contact, via telephone, via Internet) in the early weeks of the COVID-19 lockdown in Austria as well as (retrospectively) in the months before. The number of patients treated on average per week in personal contact decreased (on average 81%; p < 0.001), whereas the number of patients treated on average per week via telephone and via Internet increased (on average 979% and 1561%; both p < 0.001). Yet, the decrease of psychotherapies through personal contact was not compensated for by increases of remote psychotherapies (p < 0.001). No differences between the four therapeutic orientations emerged. Results imply an undersupply of psychotherapy in the COVID-19 lockdown and that further changes are necessary to cover the increased need for timely psychotherapy in times of COVID-19.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Psicoterapia/métodos , Psicoterapia/estadística & datos numéricos , Telemedicina/estadística & datos numéricos , Austria/epidemiología , Betacoronavirus , Humanos , Pandemias , Estudios Retrospectivos
15.
J Am Acad Orthop Surg ; 28(11): e487-e492, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32459409

RESUMEN

INTRODUCTION: The purpose of this investigation is to assess the current utilization of telehealth capabilities at academic orthopaedic departments in the United States and to determine how practice patterns have been directly influenced by the coronavirus disease 19 (COVID-19) pandemic. METHODS: Orthopaedic surgery programs participating in the Electronic Residency Application Service were identified. One hundred seventy-five (175) programs were presented with a seven-item questionnaire addressing whether each program is using telehealth services in response to the COVID-19 pandemic. RESULTS: Of the 175 Electronic Residency Application Service participant orthopaedic programs, 168 responded for a total response rate of 96%. Of the 106 institutions using telehealth services, 88 (83%) cited the COVID-19 pandemic as the impetus for implementation of telehealth services. Institutions located in the Northeast and South regions were markedly more likely to offer telehealth services. Heat map analysis demonstrates an associative overlap of regional "hot spots" with direct comparison of COVID-19 cases in the United States and orthopaedic departments providing telehealth services. DISCUSSION: This study demonstrates the impressive measures academic orthopaedic institutions are taking to meet the needs of our patients by identifying a notable increase in new telehealth offerings throughout the United States with a positive correlation with COVID-19 disease burden.


Asunto(s)
Centros Médicos Académicos/organización & administración , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Utilización de Instalaciones y Servicios , Ortopedia/organización & administración , Pandemias , Neumonía Viral/epidemiología , Telemedicina/estadística & datos numéricos , Departamentos de Hospitales/organización & administración , Humanos , Pautas de la Práctica en Medicina , Estados Unidos/epidemiología
16.
J Med Internet Res ; 22(6): e19264, 2020 06 09.
Artículo en Inglés | MEDLINE | ID: mdl-32463377

RESUMEN

BACKGROUND: On March 12, 2020, the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic. On that date, there were 134,576 reported cases and 4981 deaths worldwide. By March 26, 2020, just 2 weeks later, reported cases had increased four-fold to 531,865, and deaths increased five-fold to 24,073. Older people are both major users of telehealth services and are more likely to die as a result of COVID-19. OBJECTIVE: This paper examines the extent that Australia, the United Kingdom, and the United States, during the 2 weeks following the pandemic announcement, sought to promote telehealth as a tool that could help identify COVID-19 among older people who may live alone, be frail, or be self-isolating, and give support to or facilitate the treatment of people who are or may be infected. METHODS: This paper reports, for the 2-week period previously mentioned and immediately prior, on activities and initiatives in the three countries taken by governments or their agencies (at national or state levels) together with publications or guidance issued by professional, trade, and charitable bodies. Different sources of information are drawn upon that point to the perceived likely benefits of telehealth in fighting the pandemic. It is not the purpose of this paper to draw together or analyze information that reflects growing knowledge about COVID-19, except where telehealth is seen as a component. RESULTS: The picture that emerges for the three countries, based on the sources identified, shows a number of differences. These differences center on the nature of their health services, the extent of attention given to older people (and the circumstances that can relate to them), the different geographies (notably concerned with rurality), and the changes to funding frameworks that could impact these. Common to all three countries is the value attributed to maintaining quality safeguards in the wider context of their health services but where such services are noted as sometimes having precluded significant telehealth use. CONCLUSIONS: The COVID-19 pandemic is forcing changes and may help to establish telehealth more firmly in its aftermath. Some of the changes may not be long-lasting. However, the momentum is such that telehealth will almost certainly find a stronger place within health service frameworks for each of the three countries and is likely to have increased acceptance among both patients and health care providers.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Telemedicina/estadística & datos numéricos , Anciano , Australia/epidemiología , Brotes de Enfermedades , Humanos , Pandemias , Reino Unido/epidemiología , Estados Unidos/epidemiología
17.
J Med Internet Res ; 22(5): e19577, 2020 05 08.
Artículo en Inglés | MEDLINE | ID: mdl-32349962

RESUMEN

Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.


Asunto(s)
Infecciones por Coronavirus , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/estadística & datos numéricos , Pandemias , Neumonía Viral , Telemedicina/organización & administración , Telemedicina/estadística & datos numéricos , Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , China/epidemiología , Enfermedad Crónica/terapia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Prestación de Atención de Salud/métodos , Brotes de Enfermedades , Prescripciones de Medicamentos , Educación a Distancia , Educación en Salud , Personal de Salud/educación , Humanos , Internet , Aplicaciones Móviles , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/terapia , Servicios Postales , Teléfono Inteligente , Telemedicina/economía , Telemedicina/instrumentación , Teléfono
19.
JMIR Public Health Surveill ; 6(2): e18668, 2020 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-32250958

RESUMEN

BACKGROUND: As part of the response plans for the current outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), authorities are drafting and implementing containment measures across jurisdictions worldwide in the effort to slow down transmission and reduce the infection rate. A solid communication strategy is needed to increase the reach of valid information to health professionals, reduce misinformation, and efficiently implement recommended measures. OBJECTIVE: The aim of this paper is to describe the utilization of a dedicated mobile health (mHealth) platform to disseminate up-to-date and validated information about SARS-CoV-2 to all medical staff of the Children's Hospital at the University Hospitals of Geneva. METHODS: Three documents containing institutional information concerning screening, local containment procedures, and frequently asked questions and answers for parents were made available to the staff through a mobile app developed in the University of Geneva, Switzerland. Using a third-party statistics tool, we anonymously monitored user activity as well as content utilization patterns since the diagnosis of the first case of SARS-CoV-2 in Switzerland on February 25, 2020. RESULTS: From February 25, 2020, to March 13, 2020 (18 days), information documents on SARS-CoV-2 were viewed 859 times, which accounted for 35.6% of the total content views (total views=332). User activity increased significantly with 50.8 (SD 14.4) users per day in this period as compared to the previous weeks (mean 26.4, SD 9.8; P<.001). In addition, session numbers per day more than doubled during the aforementioned period (P<.001). In a survey, medical staff found the information easy to find within the app. On a 10-point Likert scale, the ability of the app to reassure staff in clinical practice was rated as 7.6 (SD 2.1), time-saving ability was rated as 8.5 (SD 2.1), and the need to look for information from other sources was rated as 5.9 (SD 3.3). CONCLUSIONS: The use of an mHealth solution to disseminate novel coronavirus-related information seemed to be an effective and time-saving communication channel within our institution during the SARS-CoV-2 outbreak. Medical staff felt reassured and informed in daily practice. More research should be done on the clinical impact and outcomes of the integration of mHealth solutions as a communication channel of validated information within health institutions.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Coronavirus , Brotes de Enfermedades , Difusión de la Información , Pandemias/prevención & control , Neumonía Viral/epidemiología , Síndrome Respiratorio Agudo Grave/epidemiología , Teléfono Inteligente , Telemedicina/estadística & datos numéricos , Betacoronavirus , China/epidemiología , Difusión de Innovaciones , Instituciones de Salud , Política de Salud , Hospitales Pediátricos , Humanos
20.
JMIR Public Health Surveill ; 6(2): e18961, 2020 04 07.
Artículo en Inglés | MEDLINE | ID: mdl-32250963

RESUMEN

BACKGROUND: As the novel coronavirus disease (COVID-19) is widely spreading across the United States, there is a concern about the overloading of the nation's health care capacity. The expansion of telehealth services is expected to deliver timely care for the initial screening of symptomatic patients while minimizing exposure in health care facilities, to protect health care providers and other patients. However, it is currently unknown whether US hospitals have the telehealth capacity to meet the increasing demand and needs of patients during this pandemic. OBJECTIVE: We investigated the population-level internet search volume for telehealth (as a proxy of population interest and demand) with the number of new COVID-19 cases and the proportion of hospitals that adopted a telehealth system in all US states. METHODS: We used internet search volume data from Google Trends to measure population-level interest in telehealth and telemedicine between January 21, 2020 (when the first COVID-19 case was reported), and March 18, 2020. Data on COVID-19 cases in the United States were obtained from the Johns Hopkins Coronavirus Resources Center. We also used data from the 2018 American Hospital Association Annual Survey to estimate the proportion of hospitals that adopted telehealth (including telemedicine and electronic visits) and those with the capability of telemedicine intensive care unit (tele-ICU). Pearson correlation was used to examine the relations of population search volume for telehealth and telemedicine (composite score) with the cumulative numbers of COVID-19 cases in the United States during the study period and the proportion of hospitals with telehealth and tele-ICU capabilities. RESULTS: We found that US population-level interest in telehealth increased as the number of COVID-19 cases increased, with a strong correlation (r=0.948, P<.001). We observed a higher population-level interest in telehealth in the Northeast and West census region, whereas the proportion of hospitals that adopted telehealth was higher in the Midwest region. There was no significant association between population interest and the proportion of hospitals that adopted telehealth (r=0.055, P=.70) nor hospitals having tele-ICU capability (r=-0.073, P=.61). CONCLUSIONS: As the number of COVID-19 cases increases, so does the US population's interest in telehealth. However, the level of population interest did not correlate with the proportion of hospitals providing telehealth services in the United States, suggesting that increased population demand may not be met with the current telehealth capacity. Telecommunication infrastructures in US hospitals may lack the capability to address the ongoing health care needs of patients with other health conditions. More practical investment is needed to deploy the telehealth system rapidly against the impending patient surge.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , Telemedicina/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Estudios Transversales , Hospitales/provisión & distribución , Humanos , Unidades de Cuidados Intensivos/provisión & distribución , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Encuestas y Cuestionarios , Estados Unidos/epidemiología
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