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1.
BMJ Open Qual ; 10(1)2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33547156

RESUMEN

We report our experience in using virtual technology in our emergency department (ED) to meet communication needs of our patients who have limited English proficiency (LEP) during the COVID-19 pandemic. Our project aim was to improve communication between our ED staff and patients who have LEP. Specifically, our primary aim was to eliminate the use of healthcare staff as ad hoc interpreters by 50% in our ED by using virtual medical interpreters within 2 months. To achieve our goal, several strategies were employed. First, we assessed the need for interpreters in our ED by tracking the number of times our nursing staff is pulled away from their nursing role to help other staff as an ad hoc interpreter. Second, a patient survey was conducted to understand their thoughts and needs for interpretation in the ED. Third, we developed strategies in improving access to interpreters in our ED. During the COVID-19 pandemic, we conducted a trial of using 'Interpreter on Wheels' (IOW) in our ED. In a 2-month period, we had 477 virtual interpretation encounters totaling 4123 interpretation minutes of IOW usage. We found that it satisfied not only our communication needs but also reduced some of our potential infection control risks during the pandemic.


Asunto(s)
/enfermería , Comunicación , Telemedicina/métodos , Traducción , Adulto , Servicio de Urgencia en Hospital/normas , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Rol de la Enfermera/psicología , Aceptación de la Atención de Salud/psicología , Mejoramiento de la Calidad
2.
J Med Internet Res ; 23(2): e25518, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33529157

RESUMEN

BACKGROUND: COVID-19 has necessitated the implementation of innovative health care models in preparation for an influx of patients. A virtual ward model delivers clinical care remotely to patients in isolation. We report on an Australian cohort of patients with COVID-19 treated in a virtual ward. OBJECTIVE: The aim of this study was to describe and evaluate the safety and efficacy of a virtual ward model of care for an Australian cohort of patients with COVID-19. METHODS: Retrospective clinical assessment was performed for 223 patients with confirmed COVID-19 treated in a virtual ward in Brisbane, Australia, from March 25 to May 15, 2020. Statistical analysis was performed for variables associated with the length of stay and hospitalization. RESULTS: Of 223 patients, 205 (92%) recovered without the need for escalation to hospital care. The median length of stay in the virtual ward was 8 days (range 1-44 days). In total, 18 (8%) patients were referred to hospital, of which 6 (33.3%) were discharged after assessment at the emergency department. Furthermore, 12 (5.4%) patients were admitted to hospital, of which 4 (33.3%) required supplemental oxygen and 2 (16.7%) required mechanical ventilation. No deaths were recorded. Factors associated with escalation to hospital care were the following: hypertension (odds ratio [OR] 3.6, 95% CI 1.28-9.87; P=.01), sputum production (OR 5.2, 95% CI 1.74-15.49; P=.001), and arthralgia (OR 3.8, 95% CI 1.21-11.71; P=.02) at illness onset and a polymerase chain reaction cycle threshold of ≤20 on a diagnostic nasopharyngeal swab (OR 5.0, 95% CI 1.25-19.63; P=.02). CONCLUSIONS: Our results suggest that a virtual ward model of care to treat patients with COVID-19 is safe and efficacious, and only a small number of patients would potentially require escalation to hospital care. Further studies are required to validate this model of care.


Asunto(s)
Atención Ambulatoria/métodos , Hospitalización/estadística & datos numéricos , Aislamiento de Pacientes , Telemedicina/métodos , Adolescente , Adulto , Anciano , Australia , Estudios de Cohortes , Manejo de la Enfermedad , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Hospitales , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Evaluación en Enfermería , Alta del Paciente , Respiración Artificial/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Teléfono , Adulto Joven
3.
J Psychiatr Pract ; 27(1): 48-51, 2021 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-33438867

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic thrust health care professionals around the globe to the frontlines to care for those affected by this medical crisis. While many surgical and procedural medical subspecialties experienced drastic declines in patient visits during this time, the demand for psychiatric services was more stable. In response to statewide stay at home orders, third-year residents in the psychiatry outpatient clinic described in this article quickly transitioned to telepsychiatry to continue providing care to their patients. While providing care from home, these residents experienced a number of challenges that serve as important lessons for enhancing competence in telepsychiatry services.


Asunto(s)
/psicología , Psiquiatría/métodos , Telemedicina/métodos , /epidemiología , Humanos , Internado y Residencia/métodos , Trastornos Mentales/terapia , Tennessee
4.
JMIR Public Health Surveill ; 7(1): e21327, 2021 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-33400680

RESUMEN

BACKGROUND: The COVID-19 pandemic, caused by SARS-CoV-2, has forced the health care delivery structure to change rapidly. The pandemic has further widened the disparities in health care and exposed vulnerable populations. Health care services caring for such populations must not only continue to operate but create innovative methods of care delivery without compromising safety. We present our experience of incorporating telemedicine in our university hospital-based outpatient clinic in one of the worst-hit areas in the world. OBJECTIVE: Our goal is to assess the adoption of a telemedicine service in the first month of its implementation in outpatient practice during the COVID-19 pandemic. We also want to assess the need for transitioning to telemedicine, the benefits and challenges in doing so, and ongoing solutions during the initial phase of the implementation of telemedicine services for our patients. METHODS: We conducted a prospective review of clinic operations data from the first month of a telemedicine rollout in the outpatient adult ambulatory clinic from April 1, 2020, to April 30, 2020. A telemedicine visit was defined as synchronous audio-video communication between the provider and patient for clinical care longer than 5 minutes or if the video visit converted to a telephone visit after 5 minutes due to technical problems. We recorded the number of telemedicine visits scheduled, visits completed, and the time for each visit. We also noted the most frequent billing codes used based on the time spent in the patient care and the number of clinical tasks (eg, activity suggested through diagnosis or procedural code) that were addressed remotely by the physicians. RESULTS: During the study period, we had 110 telemedicine visits scheduled, of which 94 (85.4%) visits were completed. The average duration of the video visit was 35 minutes, with the most prolonged visit lasting 120 minutes. Of 94 patients, 24 (25.54%) patients were recently discharged from the hospital, and 70 (74.46%) patients were seen for urgent care needs. There was a 50% increase from the baseline in the number of clinical tasks that were addressed by the physicians during the pandemic. CONCLUSIONS: There was a high acceptance of telemedicine services by the patients, which was evident by a high show rate during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, a shortage of providers, and increased outpatient needs, telemedicine was successfully implemented in our practice.


Asunto(s)
Pandemias/prevención & control , Telemedicina/métodos , Atención Ambulatoria/métodos , /transmisión , Humanos , Michigan , Pandemias/estadística & datos numéricos , Satisfacción del Paciente , Estudios Prospectivos , Estudios Retrospectivos , Telemedicina/tendencias , Centros de Atención Terciaria/organización & administración , Centros de Atención Terciaria/tendencias
6.
BMJ Open Respir Res ; 8(1)2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33414261

RESUMEN

INTRODUCTION: The COVID-19 pandemic has impacted specialty chronic obstructive pulmonary disease (COPD) care. We examined the degree to which care has moved to remote approaches, eliciting clinician and patient perspectives on what is appropriate for ongoing remote delivery. METHODS: Using an online research platform, we conducted a survey and consensus-building process involving clinicians and patients with COPD. RESULTS: Fifty-five clinicians and 19 patients responded. The majority of clinicians felt able to assess symptom severity (n=52, 95%), reinforce smoking cessation (n=46, 84%) and signpost to other healthcare resources (n=44, 80%). Patients reported that assessing COPD severity and starting new medications were being addressed through remote care. Forty-three and 31 respondents participated in the first and second consensus-building rounds, respectively. When asked to rate the appropriateness of using remote delivery for specific care activities, respondents reached consensus on 5 of 14 items: collecting information about COPD and overall health status (77%), providing COPD education and developing a self-management plan (74%), reinforcing smoking cessation (81%), deciding whether patients should seek in-person care (72%) and initiating a rescue pack (76%). CONCLUSION: Adoption of remote care delivery appears high, with many care activities partially or completely delivered remotely. Our work identifies strengths and limitations of remote care delivery.


Asunto(s)
Actitud del Personal de Salud , Educación del Paciente como Asunto , Pautas de la Práctica en Medicina , Enfermedad Pulmonar Obstructiva Crónica/terapia , Automanejo , Cese del Hábito de Fumar , Telemedicina/métodos , Adulto , Anciano , Actitud Frente a la Salud , Prestación de Atención de Salud/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros , Aceptación de la Atención de Salud , Fisioterapeutas , Médicos , Pautas de la Práctica en Enfermería , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Reino Unido
7.
J Med Syst ; 45(1): 9, 2021 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-33404890

RESUMEN

The coronavirus disease 2019 (COVID-19), which is caused by a novel coronavirus (SARS-COV-2), has compromised health care systems and normal management of patients with cardiovascular diseases [1-3]. Patients with non-communicable diseases, including acute myocardial infarction (AMI) are vulnerable to this stress [4, 5]. Acute ST segment elevation myocardial infarction (STEMI), the most critical type of AMI, is associated with high mortality even with modern medicine [6-8]. Timely reperfusion therapy is critical for STEMI patients because a short ischemia time is associated with better clinical outcomes and lower acute and long -term mortality [9-12]. The COVID-19 pandemic placed the management of STEMI patients in a difficult situation due to the need to balance timely reperfusion therapy and maintaining strict infection control practices [13, 14]. Telemedicine, which is used to deliver health care services using information or communication technology, provides an opportunity to carry out the evaluation, diagnosis, and even monitor the patients after discharge when social distancing is needed [15]. In this article, we reported our preliminary experience with the usefulness of telemedicine in managing STEMI patients during the COVID-19 pandemic. We also provided a review of this topic.


Asunto(s)
/terapia , Infarto del Miocardio con Elevación del ST/terapia , Telemedicina/métodos , /complicaciones , Manejo de la Enfermedad , Femenino , Humanos , Masculino , Atención al Paciente/métodos , Medición de Riesgo , Infarto del Miocardio con Elevación del ST/diagnóstico
8.
J Med Internet Res ; 23(1): e25652, 2021 01 29.
Artículo en Inglés | MEDLINE | ID: mdl-33464206

RESUMEN

BACKGROUND: A reduction in the number of face-to-face medical examinations conducted for patients with noncommunicable diseases (NCDs) during the first wave of the COVID-19 pandemic has led to health care professionals quickly adopting different strategies to communicate with and monitor their patients. Such strategies include the increased use of digital health tools. However, patient preferences, privacy concerns, a lack of regulations, overregulation, and insufficient evidence on the efficacy of digital health tools may have hampered the potential positive benefits of using such tools to manage NCDs. OBJECTIVE: This viewpoint aims to discuss the views of an advisory board of patient and caregiver association members. Specifically, we aim to present this advisory board's view on the role of digital health tools in managing patients with NCDs during and after the COVID-19 pandemic, and to identify future directions based on patients' perspectives. METHODS: As an initiative under the NCD Partnership (PARTners in Ncds Engage foR building Strategies to improve Healthy ageing In Patients) model of Upjohn, a web-based advisory board of patient and caregiver advocates was held on July 28, 2020, to bring together key stakeholders from public and private sectors. RESULTS: The following key themes emerged: (1) technology developers should understand that the goals of patients may differ from those of health care professionals and other stakeholders; (2) patients, health care professionals, caregivers, and other end users need to be involved in the development of digital health tools at the earliest phase possible, to guarantee usability, efficacy, and adoption; (3) digital health tools must be better tailored to people with complex conditions, such as multimorbidity, older age, and cognitive or sensory impairment; and (4) some patients do not want or are unable to use digital health care tools, so adequate alternatives should always be available. CONCLUSIONS: There was consensus that public-private partnership models, such as the Upjohn NCD Partnership, can be effective models that foster innovation by integrating multiple perspectives (eg, patients' perspectives) into the design, development, and implementation of digital and nondigital health tools, with the main overall objective of improving the life of patients with NCDs.


Asunto(s)
/epidemiología , Cuidadores/psicología , Prestación de Atención de Salud/métodos , Manejo de la Enfermedad , Enfermedades no Transmisibles/terapia , Satisfacción del Paciente/estadística & datos numéricos , Telemedicina/métodos , Factores de Edad , Anciano , Humanos , Persona de Mediana Edad , Pandemias , Privacidad
9.
Asia Pac J Ophthalmol (Phila) ; 10(1): 39-48, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33512827

RESUMEN

PURPOSE: The COVID-19 pandemic has put strain on healthcare systems and the availability and allocation of healthcare manpower, resources and infrastructure. With immediate priorities to protect the health and safety of both patients and healthcare service providers, ophthalmologists globally were advised to defer nonurgent cases, while at the same time managing sight-threatening conditions such as neovascular Age-related Macular Degeneration (AMD). The management of AMD patients both from a monitoring and treatment perspective presents a particular challenge for ophthalmologists. This review looks at how these pressures have encouraged the acceptance and speed of adoption of digitalization. DESIGN AND METHODS: A literature review was conducted on the use of digital technology during COVID-19 pandemic, and on the transformation of medicine, ophthalmology and AMD screening through digitalization. RESULTS: In the management of AMD, the implementation of artificial intelligence and "virtual clinics" have provided assistance in screening, diagnosis, monitoring of the progression and the treatment of AMD. In addition, hardware and software developments in home monitoring devices has assisted in self-monitoring approaches. CONCLUSIONS: Digitalization strategies and developments are currently ongoing and underway to ensure early detection, stability and visual improvement in patients suffering from AMD in this COVID-19 era. This may set a precedence for the post COVID-19 new normal where digital platforms may be routine, standard and expected in healthcare delivery.


Asunto(s)
/epidemiología , Prestación de Atención de Salud/métodos , Técnicas de Diagnóstico Oftalmológico , Degeneración Macular/diagnóstico , Telemedicina/métodos , Humanos , Degeneración Macular/terapia
10.
N Z Med J ; 134(1528): 26-34, 2021 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-33444304

RESUMEN

AIMS: Poisoning is a common type of injury in New Zealand. The New Zealand National Poisons Centre (NZNPC) offers a free 24/7 specialist assessment service for enquiries about substance exposures for all New Zealanders. This study aimed to characterise calls to the NZNPC relating to Pasifika patients to explore the potential for unmet need or health disparity in this area. METHODS: A retrospective analysis of 2018-2019 human exposure call data was performed. Patients were stratified into three groups: those with at least one Pacific ethnicity listed (Pasifika); those with known ethnicities but no Pacific ethnicity listed (non-Pasifika); those of unknown ethnicity (unknown). Demographic variables and substance groups were described. RESULTS: Of the 40,185 human exposure patients, 1,367 (3.4%) were Pasifika, 24,892 (61.9%) were non-Pasifika and 13,926 (34.7%) were of unknown ethnicity. The median age of Pasifika patients was 2.0 years, with 78.0% aged 0-5, and the exposure most commonly involved a liquid product (46.6%) and a simple analgesic (8.3%). CONCLUSIONS: The NZNPC receives a relatively small number of calls about exposures to Pasifika patients, especially given the youthful population demographic. It is unclear whether there is unmet need for this service, and this study suggests the need for further research.


Asunto(s)
Grupos Étnicos , Centros de Control de Intoxicaciones/estadística & datos numéricos , Envenenamiento/etnología , Telemedicina/métodos , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Estudios Retrospectivos , Adulto Joven
11.
J Med Internet Res ; 23(1): e23775, 2021 01 26.
Artículo en Inglés | MEDLINE | ID: mdl-33434141

RESUMEN

BACKGROUND: COVID-19 has thrust video consulting into the limelight, as health care practitioners worldwide shift to delivering care remotely. Evidence suggests that video consulting is acceptable, safe, and effective in selected conditions and settings. However, research to date has mostly focused on initial adoption, with limited consideration of how video consulting can be mainstreamed and sustained. OBJECTIVE: This study sought to do the following: (1) review and synthesize reported opportunities, challenges, and lessons learned in the scale-up, spread, and sustainability of video consultations, and (2) identify transferable insights that can inform policy and practice. METHODS: We identified papers through systematic searches in PubMed, CINAHL, and Web of Science. Included articles reported on synchronous, video-based consultations that had spread to more than one setting beyond an initial pilot or feasibility stage, and were published since 2010. We used the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability (NASSS) framework to synthesize findings relating to 7 domains: an understanding of the health condition(s) for which video consultations were being used, the material properties of the technological platform and relevant peripherals, the value proposition for patients and developers, the role of the adopter system, organizational factors, wider macro-level considerations, and emergence over time. RESULTS: We identified 13 papers describing 10 different video consultation services in 6 regions, covering the following: (1) video-to-home services, connecting providers directly to the patient; (2) hub-and-spoke models, connecting a provider at a central hub to a patient at a rural center; and (3) large-scale top-down evaluations scaled up or spread across a national health administration. Services covered rehabilitation, geriatrics, cancer surgery, diabetes, and mental health, as well as general specialist care and primary care. Potential enablers of spread and scale-up included embedded leadership and the presence of a telehealth champion, appropriate reimbursement mechanisms, user-friendly technology, pre-existing staff relationships, and adaptation (of technology and services) over time. Challenges tended to be related to service development, such as the absence of a long-term strategic plan, resistance to change, cost and reimbursement issues, and the technical experience of staff. There was limited articulation of the challenges to scale-up and spread of video consultations. This was combined with a lack of theorization, with papers tending to view spread and scale-up as the sum of multiple technical implementations, rather than theorizing the distinct processes required to achieve widespread adoption. CONCLUSIONS: There remains a significant lack of evidence that can support the spread and scale-up of video consulting. Given the recent pace of change due to COVID-19, a more definitive evidence base is urgently needed to support global efforts and match enthusiasm for extending use.


Asunto(s)
/epidemiología , Prestación de Atención de Salud/normas , Telemedicina/métodos , Comunicación por Videocoferencia/normas , Humanos , Pandemias , Atención Primaria de Salud/organización & administración , /aislamiento & purificación
12.
PLoS One ; 16(1): e0244962, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33465108

RESUMEN

The coronavirus disease pandemic has brought a new urgency for the development and deployment of web-based applications which complement, and offer alternatives to, traditional one-on-one consultations and pencil-and-paper (PaP) based assessments that currently dominate clinical research. We have recently developed a web-based application that can be used for the self-administered collection of patient demographics, self-rated health, depression and anxiety, and cognition as part of a single platform. In this study we report the findings from a study with 155 cognitively healthy older adults who received established PaP versions, as well as our novel computerized measures of self-rated health, depression and anxiety, and cognition. Moderate to high correlations were observed between PaP and web- based measures of self-rated health (r = 0.77), depression and anxiety (r = 0.72), and preclinical Alzheimer's disease cognitive composite (PACC) (r = .61). Test-retest correlations were variable with high correlations for a measure of processing speed and a measure of delayed episodic memory. Taken together, these data support the feasibility and validity of utilization of this novel web-based platform as a new alternative for collecting patient demographics and the assessment of self-rated health, depression and anxiety, and cognition in the elderly.


Asunto(s)
Ansiedad/diagnóstico , Disfunción Cognitiva/diagnóstico , Depresión/diagnóstico , Autoevaluación Diagnóstica , Evaluación Geriátrica/métodos , Internet , Telemedicina/métodos , Anciano , Anciano de 80 o más Años , Ansiedad/epidemiología , Disfunción Cognitiva/epidemiología , Demografía/estadística & datos numéricos , Depresión/epidemiología , Femenino , Humanos , Vida Independiente , Masculino , Persona de Mediana Edad
13.
J Med Internet Res ; 23(1): e21825, 2021 01 20.
Artículo en Inglés | MEDLINE | ID: mdl-33417586

RESUMEN

BACKGROUND: Internet hospitals in China are being rapidly developed as an innovative approach to providing health services. The ongoing COVID-19 pandemic has triggered the development of internet hospitals that promote outpatient service delivery to the public via internet technologies. To date, no studies have assessed China's internet hospitals during the COVID-19 pandemic. OBJECTIVE: This study aimed to elucidate the characteristics of China's internet hospitals and assess the health service capacity of these hospitals. METHODS: Data on 711 internet hospitals were collected from official websites, the WeChat (Tencent Inc) platform, smartphone apps, and the Baidu search engine until July 16, 2020. RESULTS: As of July 16, 2020, 711 internet hospitals were developed in mainland China. More than half of these internet hospitals (421/711, 59.2%) were established during 2019 (206/711, 29%) and 2020 (215/711, 30.2%). Furthermore, about one-third (215/711, 30.2%) of internet hospitals were established at the beginning of 2020 as an emergency response to the COVID-19 epidemic. The 711 internet hospitals consisted of the following 3 types of hospitals: government-oriented (42/711, 5.91%), hospital-oriented (143/711, 20.11%), and enterprise-oriented internet hospitals (526/711, 73.98%). The vast majority of internet hospitals were traditional hospitals (526/711, 74%). Nearly 46.1% (221/711) of internet hospitals requested doctors to provide health services at a specific web clinic. Most patients (224/639, 35.1%) accessed outpatient services via WeChat. Internet hospitals' consulting methods included SMS text messaging consultations involving the use of graphics (552/570, 96.8%), video consultations (248/570, 43.5%), and telephone consultations (238/570, 41.8%). The median number of available web-based doctors was 43, and the median consultation fees of fever clinics and other outpatient clinics were ¥0 (US $0) per consultation and ¥6 (US $0.93) per consultation, respectively. Internet hospitals have provided various services during the COVID-19 pandemic, including medical prescription, drug delivery, and medical insurance services. CONCLUSIONS: The dramatic increase of internet hospitals in China has played an important role in the prevention and control of COVID-19. Internet hospitals provide different and convenient medical services for people in need.


Asunto(s)
/epidemiología , Telemedicina/métodos , /terapia , China/epidemiología , Estudios Transversales , Análisis de Datos , Femenino , Hospitales , Humanos , Internet , Masculino , Pandemias
14.
Wound Manag Prev ; 67(1): 12-17, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33448938

RESUMEN

BACKGROUND: Italy instituted a lockdown from March 10 to May 3, 2020, due to the coronavirus disease-19 pandemic. All nonessential businesses were closed during this time, and health care services were reorganized. On March 11, the Stoma Care Center started providing telehealth services for patients with a stoma. PURPOSE: This retrospective observational study describes the experience of the Stoma Care Center of the University Hospital Federico II, Naples, Italy, before and during the lockdown. METHODS: Consultation records from January 1 through April 29 were retrieved, patient demographics and reasons for consultation abstracted, and pre-lockdown (January 1 to February 29) and lockdown (March 1 to April 29) information was compared. Patients who used telehealth services were also asked to rate their satisfaction with these services on a scale of 0 (extremely dissatisfied) to 4 (extremely satisfied). The authors analyzed all consultations provided from January to April 2020 and evaluated the use of telemedicine services for patients with an ostomy. Consultations were divided into 2 groups. Group A included consultations provided from January 1 to February 29. Group B included consultations provided from March 1 to April 29, which included the lockdown period. Group B included both in-person and telemedicine consultations. RESULTS: During the pre-lockdown period, 240 in-person consultations were provided. During the lockdown period, 181 in-person and 99 telemedicine consultations were provided. The number of in-person consultations for mechanical bowel preparation and transanal irrigation system training was lower (12.5% vs 6.6% [P = .046] and 3.3% vs 0% [P = .03]), whereas the number of consults for stoma care follow-up and stoma complications was higher (202 [84.1%] vs 266 [95%]). Of the 65 patients who completed the questionnaire, 82% indicated being extremely satisfied. CONCLUSIONS: The reorganization of stoma care services, including the availability of telemedicine, did not result in a decrease in the number of consultations provided. The results suggest that stoma care services using telemedicine may provide valid support for patients with an ostomy in the future.


Asunto(s)
/complicaciones , Estomía/enfermería , Cuarentena/tendencias , Adulto , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Satisfacción del Paciente , Estudios Retrospectivos , Telemedicina/métodos
15.
Neurol Sci ; 42(3): 805-809, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33433756

RESUMEN

INTRODUCTION: The pandemic has implemented the need for new digital technologies as useful tools during the emergency and the long recovery phase that will follow. SARS-CoV-2 has strongly impacted stroke care with significant contraction in a number of patients treated. METHODS: This mini-review is an initiative of the "Digital Technologies, Web and Social Media Study Group" of the Italian Society of Neurology and briefly discusses digital tools for managing the acute phase and the rehabilitation after stroke, even considering the new apps that will improve the process of remote monitoring of patients after discharge at home. RESULTS: Telemedicine and digital technologies could play a role in each of the three stroke-belt stages: hyperacute treatment and reperfusion, acute care, etiological classification and secondary prevention and rehabilitation. CONCLUSION: The global emergency represented by the COVID-19 pandemic can be the stimulus to accelerate the digitalization process in the field of stroke for the use of new methods on a large scale.


Asunto(s)
Neurología/métodos , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular , Telemedicina/métodos , Humanos , Italia , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/terapia
16.
J Am Osteopath Assoc ; 121(1): 43-47, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33512395

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic had an overwhelming impact on both clinical practices and learning environments. On March 17th, 2020, the American Association of Colleges of Osteopathic Medicine and Commission on Osteopathic College Accreditation issued a statement recommending a "pause" in medical student participation in-person at clinical sites. In response, the Family Medicine Department at the Rowan University School of Osteopathic Medicine recognized the need to evolve the traditional curriculum and quickly transitioned to an online format, incorporating telemedicine into the clerkship. This new model enabled 44 third-year medical students to obtain high-quality, offsite, virtual education and learn new skills.


Asunto(s)
/epidemiología , Prácticas Clínicas/métodos , Curriculum/normas , Medicina Osteopática/educación , Facultades de Medicina/normas , Estudiantes de Medicina , Telemedicina/métodos , Competencia Clínica , Humanos , Aprendizaje , Pandemias
17.
J Med Internet Res ; 23(2): e24785, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33477104

RESUMEN

The telehealth revolution in response to COVID-19 has increased essential health care access during an unprecedented public health crisis. However, virtual patient care can also limit the patient-provider relationship, quality of examination, efficiency of health care delivery, and overall quality of care. As we witness the most rapidly adopted medical trend in modern history, clinicians are beginning to comprehend the many possibilities of telehealth, but its limitations also need to be understood. As outcomes are studied and federal regulations reconsidered, it is important to be precise in the virtual patient encounter approach. Herein, we offer some simple guidelines that could assist health care providers and clinic schedulers in determining the appropriateness of a telehealth visit by considering visit types, patient characteristics, and chief complaint or disease states.


Asunto(s)
/prevención & control , Accesibilidad a los Servicios de Salud , Selección de Paciente , Telemedicina/métodos , Personal de Salud , Humanos , Guías de Práctica Clínica como Asunto , Medición de Riesgo , Telemedicina/normas
18.
Res Dev Disabil ; 109: 103852, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33465590

RESUMEN

BACKGROUND: Screening and diagnostic assessments tools for autism spectrum disorder (ASD) are important to administer during childhood to facilitate timely entry into intervention services that can promote developmental outcomes across the lifespan. However, assessment services are not always readily available to families, as they require significant time and resources. Currently, in-person screening and diagnostic assessments for ASD are limited due to the COVID-19 pandemic and will continue to be a concern for situations that limit in-person contact. Thus, it is important to expand the modalities in which child assessments are provided, including the use of technology. AIMS: This systematic review aims to identify technologies that screen or assess for ASD in 0-12 year-old children, summarizing the current state of the field and suggesting future directions. METHODS: An electronic database search was conducted to gather relevant articles to synthesize for this review. OUTCOMES AND RESULTS: 16 studies reported use of novel technology to assess children suspected of ASD. CONCLUSIONS AND IMPLICATIONS: Results strongly supported live-video evaluations, video observations, and online or phone methods, but there is a need for research targeting the feasibility of these methods as it applies to the stay-at-home orders required by the pandemic, and other situations that limit clients from seeing providers in-person.


Asunto(s)
Trastorno del Espectro Autista/diagnóstico , Control de Enfermedades Transmisibles/métodos , Tamizaje Masivo , Telemedicina/métodos , /epidemiología , Niño , Humanos , Invenciones , Tamizaje Masivo/métodos , Tamizaje Masivo/tendencias
20.
Medicina (Kaunas) ; 57(2)2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33499251

RESUMEN

Throughout 2020, the COVID-19 pandemic has had a major impact on the care of non-communicable diseases across the world and diabetes is no exception. Whereas many branches of medicine have adapted to telemedicine, this is difficult and challenging for the diabetic foot which often requires "hands on" treatment. This review covers the challenges that have faced clinicians across the world in the management of complex diabetic foot problems and also includes some illustrative case vignettes which show how it is possible to manage foot ulcers without the usual access to laboratory and radiological testing. There is no doubt that the COVID-19 experience when handling diabetic foot problems will likely transform our approach to the management of diabetic foot disease especially in the areas of digital health and smart technology.


Asunto(s)
Pie Diabético/terapia , Salud Global/tendencias , Pautas de la Práctica en Medicina/tendencias , Telemedicina/métodos , Humanos
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