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1.
Multimedia | Recursos Multimídia | ID: multimedia-9512

RESUMO

Presentación hecha por Anton Zamora Ilarionov, MSc., consultor e investigador Informática en Salud y miembro de la Red Centroamericana de Informática en Salud, en el webinar "Uso de Telemedicina en la Región Centroamericana", el 25 de septiembre de 2019.


Assuntos
Telemedicina/normas , Estratégias de eSaúde , Informática Médica , Sistemas de Informação em Saúde
2.
Multimedia | Recursos Multimídia | ID: multimedia-9516

RESUMO

Presentación hecha por Alejandro Benavides, Sub-coordinador de la Red Centroamericana de Informática en Salud, durante el Webinar "Panorama Regional de Estándares de Informática en Salud" realizado el día 4 de diciembre de 2019.


Assuntos
Telemedicina/normas , Estratégias de eSaúde , Interoperabilidade da Informação em Saúde/normas , Sistemas de Informação em Saúde/organização & administração , Confidencialidade/legislação & jurisprudência , Segurança Computacional
3.
Multimedia | Recursos Multimídia | ID: multimedia-9517

RESUMO

Presentación realizada por Diego Kaminker, Affiliate Director y Education Advisory Commitee Member de HL7 International y Board Member de HL7 Argentina, durante el Webinar "Panorama Regional de Estándares de Informática en Salud", realizado el 4 de diciembre de 2019.


Assuntos
Telemedicina/normas , Sistemas de Informação em Saúde , Troca de Informação em Saúde , Informática Médica
4.
J Cyst Fibros ; 20 Suppl 3: 1-2, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34930534

RESUMO

The findings of this body of work are presented in the eight articles included in this supplement. The impact and perspectives of adult and pediatric care teams and patient/families are covered with special attention to mental health care, the financial and personnel impacts within care programs, the experiences of vulnerable and underrepresented patient populations, and implementation of remoting monitoring. Commentaries from colleagues provide a broader perspective, offering reflections on the findings and their implications regarding the future CF care model.


Assuntos
COVID-19 , Fibrose Cística , Prestação Integrada de Cuidados de Saúde/organização & administração , Atenção à Saúde/tendências , Telemedicina , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Continuidade da Assistência ao Paciente , Fibrose Cística/epidemiologia , Fibrose Cística/terapia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/tendências , Humanos , Inovação Organizacional , SARS-CoV-2 , Telemedicina/organização & administração , Telemedicina/normas , Estados Unidos/epidemiologia
5.
J Cyst Fibros ; 20 Suppl 3: 23-28, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34930537

RESUMO

BACKGROUND: The COVID-19 pandemic forced cystic fibrosis (CF) care programs to rapidly shift from in-person care delivery to telehealth. Our objective was to provide a qualitative exploration of facilitators and barriers to: 1) implementing high-quality telehealth and 2) navigating reimbursement for telehealth services. METHODS: We used data from the 2020 State of Care CF Program Survey (n=286 U.S. care programs) administered in August-September to identify two cohorts of programs, with variation in telehealth quality (n=12 programs) and reimbursement (n=8 programs). We conducted focus groups and semi-structured interviews with CF program directors and coordinators in December 2020, approximately 9 months from onset of the pandemic. We used the Consolidated Framework for Implementation Research to identify facilitators and barriers of implementation, and inductive thematic analysis to identify facilitators and barriers of reimbursement. RESULTS: Factors differentiating programs with greater and lower perceived telehealth quality included telehealth characteristics (perceived advantage over in-person care, cost, platform quality); external influences (needs and resources of those served by the CF program), characteristics of the CF program (compatibility with workflows, relative priority, available resources); characteristics of team members (individual stage of change), and processes for implementation (engaging patients and teams). Reimbursement barriers included documentation to optimize billing; reimbursement of multi-disciplinary team members, remote monitoring, and telephone-only telehealth; and lower volume of patients. CONCLUSIONS: A number of factors are associated with successful implementation and reimbursement of telehealth. Future efforts should provide guidance and incentives that support telehealth delivery and infrastructure, share best practices across CF programs, and remove barriers.


Assuntos
COVID-19 , Barreiras de Comunicação , Fibrose Cística , Transmissão de Doença Infecciosa/prevenção & controle , Acesso aos Serviços de Saúde , Participação do Paciente , Telemedicina , Adulto , Atitude do Pessoal de Saúde , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Fibrose Cística/epidemiologia , Fibrose Cística/psicologia , Fibrose Cística/terapia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/tendências , Humanos , Determinação de Necessidades de Cuidados de Saúde , Participação do Paciente/métodos , Participação do Paciente/psicologia , Pesquisa Qualitativa , Melhoria de Qualidade , Mecanismo de Reembolso , SARS-CoV-2 , Telemedicina/economia , Telemedicina/métodos , Telemedicina/normas , Estados Unidos/epidemiologia
6.
J Cyst Fibros ; 20 Suppl 3: 3-8, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34930539

RESUMO

BACKGROUND: Novel therapies have dramatically changed cystic fibrosis (CF) and innovative care delivery systems are needed to meet future patient needs. Telehealth has been shown to be an efficient and desirable form of care delivery. The COVID-19 pandemic caused a rapid shift to telehealth, and this presented a unique opportunity to study facilitators, barriers, and satisfaction with this mode of care delivery. We aim to report survey methods, demographics and telehealth use among CF care programs, patients, and families during the pandemic. METHODS: CF programs completed two surveys between July 29 and September 18, 2020, and between April 19 and May 19, 2021. Patients and families completed a similar survey between August 31 and October 30, 2020. The surveys addressed topics assessing the pandemic's financial impact, telehealth modes and experiences, licensure and reimbursement issues, health screening, and remote monitoring. Quantitative data were analyzed with descriptive statistics and were compared to the CF Foundation Patient Registry. RESULTS: Most programs (278 at timepoint one and 274 at timepoint two) provided telehealth during the pandemic. The percent of visits containing either telephone or video components changed from 45% to 25% over the time periods. Additionally, 424 patients and families from various ages and backgrounds responded to the survey and 81% reported having a telehealth visit. CONCLUSIONS: The pandemic accelerated telehealth adoption and these datasets are a valuable source for exploring telehealth barriers and facilitators, the quality-of-care experience, financial and workforce implications, the impact on underrepresented populations, and implications for coverage and reimbursement.


Assuntos
COVID-19 , Fibrose Cística , Acesso aos Serviços de Saúde , Telemedicina , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Controle de Doenças Transmissíveis/métodos , Barreiras de Comunicação , Continuidade da Assistência ao Paciente , Custos e Análise de Custo , Fibrose Cística/epidemiologia , Fibrose Cística/psicologia , Fibrose Cística/terapia , Feminino , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/tendências , Humanos , Masculino , Inovação Organizacional , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde , SARS-CoV-2 , Telemedicina/organização & administração , Telemedicina/normas , Estados Unidos/epidemiologia
7.
J Cyst Fibros ; 20 Suppl 3: 41-46, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34930542

RESUMO

BACKGROUND: During the COVID-19 pandemic, CF centers shifted to a telehealth delivery model. Our study aimed to determine how people with CF (PwCF) and their families experienced telehealth and assessed its quality and acceptability for future CF care. METHODS: The CF Patient and Family State of Care Survey (PFSoC) was fielded from August 31-October 30, 2020. The PFSoC explored themes of overall telehealth quality, ease of use, desirability, and preference for a future mix of in-person and telehealth care. Demographic covariates considered included: gender, age, CFTR modulator status, and region of residence. RESULTS: 424 PwCF and parents of PwCF responded (47% parents). Most (81%) reported a telehealth visit which included a MD/APP and nurse team members. 91% found telehealth easy to use, and 66% reported similar/higher quality than in-person care. One-third (34%) reported the highest desire for future telehealth care, with 45% (n =212) desiring 50% or more of visits conducted via telehealth. Adults were more likely than parents to report highest desire for future telehealth (64% vs. 36%). Respondents who perceived telehealth as similar/higher quality were more likely to desire future telehealth compared to those who perceived telehealth as lower quality (96% vs. 50%). Mixed methods analysis revealed themes affecting perceptions of telehealth. CONCLUSIONS: PwCF desire for future telehealth was influenced by perception of quality and age. Several themes emerged that need to be explored as telehealth is adapted into the CF chronic care model, especially when thinking about integration into pediatric care.


Assuntos
COVID-19 , Barreiras de Comunicação , Comportamento do Consumidor/estatística & dados numéricos , Fibrose Cística , Transmissão de Doença Infecciosa/prevenção & controle , Telemedicina , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Fibrose Cística/epidemiologia , Fibrose Cística/psicologia , Fibrose Cística/terapia , Saúde da Família , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/tendências , Humanos , Modelos Organizacionais , Participação do Paciente/métodos , Participação do Paciente/psicologia , Pediatria/métodos , Pediatria/tendências , Melhoria de Qualidade , Qualidade da Assistência à Saúde/tendências , SARS-CoV-2 , Telemedicina/métodos , Telemedicina/organização & administração , Telemedicina/normas , Estados Unidos/epidemiologia
8.
J Cyst Fibros ; 20 Suppl 3: 49-54, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34930543

RESUMO

BACKGROUND: Due to the COVID-19 pandemic, there was an uptake of telehealth in cystic fibrosis care. Previous studies show disparities in telehealth use based on socioeconomic status (SES). We aimed to: (1) understand telehealth use and perceptions and (2) identify the facilitators and barriers to telehealth use among people with CF and their families (PwCF) from diverse racial/ethnic and socioeconomic backgrounds. METHODS: We conducted an analysis of the 2020 Cystic Fibrosis State of Care surveys completed by PwCF (PFSoC), CF Care Programs (SoC1) and the CF Foundation Patient Registry (CFFPR). RESULTS: A total of 424 PwCF and 286 programs responded to the PFSoC and SoC1. Among PwCF, 90% self-identified as White, 6% as Hispanic/Latino, and 2% as Black. Racial/ethnic minorities were less likely to have had a telehealth visit (p=.015). This difference was pronounced among the Hispanic/Latino population (p<.01). Telehealth use did not differ by health insurance and was similarly offered independent of financial status. Compared to PwCF who denied financial constraints, those who reported financial difficulties found telehealth more difficult to use (p=.018) and were less likely to think that their concerns (p=.010) or issues that mattered most to them (p=.020) were addressed during telehealth. Programs perceived lack of technology, language barriers, and home conditions as barriers to telehealth in vulnerable populations. CONCLUSION: PFSoC and SoC1 identified differences in telehealth use and care perceptions by ethnicity, race, and socioeconomic characteristics. Further studies are needed to understand how telehealth can change access to CF care in diverse subpopulations.


Assuntos
COVID-19 , Barreiras de Comunicação , Fibrose Cística , Saúde das Minorias , Telemedicina , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Fibrose Cística/economia , Fibrose Cística/etnologia , Fibrose Cística/psicologia , Fibrose Cística/terapia , Estresse Financeiro/etnologia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/tendências , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/normas , Humanos , Saúde das Minorias/etnologia , Saúde das Minorias/normas , Saúde das Minorias/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde , Inovação Organizacional , SARS-CoV-2 , Fatores Socioeconômicos , Telemedicina/organização & administração , Telemedicina/normas , Estados Unidos/epidemiologia , Populações Vulneráveis/estatística & dados numéricos
9.
J Cyst Fibros ; 20 Suppl 3: 57-63, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34930544

RESUMO

BACKGROUND: Cystic fibrosis (CF) programs and people with CF (PwCF) employed various monitoring methods for virtual care during the COVID-19 pandemic. This paper characterizes experiences with remote monitoring across the U.S. CF community. METHODS: The CF Foundation (CFF) sponsored distribution of home spirometers (April 2020 to May 2021), surveys to PwCF and CF programs (July to September 2020), and a second program survey (April to May 2021). We used mixed methods to explore access, use, and perspectives regarding the use of remote monitoring in future care. RESULTS: By October 2020, 13,345 spirometers had been distributed, and 19,271 spirometers by May 2021. Programs (n=286) estimated proportions of PwCF with home devices increased over seven months: spirometers (30% to 70%), scales (50% to 70%), oximeters (5% to 10%) with higher estimates in adult programs for spirometers and oximeters. PwCF (n=378) had access to scales (89%), followed by oximeters (48%) and spirometers (47%), often using scales and oximeters weekly, and spirometers monthly. Over both surveys, some programs had no method to collect respiratory specimens for cultures associated with telehealth visits (47%, n=132; 41%, n=118). Most programs (81%) had a process for phlebotomy associated with a telehealth visit, primarily through off-site labs. Both PwCF and programs felt future care should advance remote monitoring and recommended improvements for access, training, and data collection systems. CONCLUSIONS: PwCF and programs experienced unprecedented access to remote monitoring and raised its importance for future care. Improvements to current systems may leverage these shared experiences to augment future care models.


Assuntos
COVID-19 , Fibrose Cística , Equipamentos e Provisões/provisão & distribuição , Serviços de Assistência Domiciliar , Monitorização Fisiológica/métodos , Espirometria , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Fibrose Cística/diagnóstico , Fibrose Cística/epidemiologia , Fibrose Cística/terapia , Atenção à Saúde/organização & administração , Atenção à Saúde/tendências , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Serviços de Assistência Domiciliar/organização & administração , Serviços de Assistência Domiciliar/normas , Humanos , Modelos Organizacionais , Determinação de Necessidades de Cuidados de Saúde , Oximetria/instrumentação , Oximetria/métodos , Melhoria de Qualidade , SARS-CoV-2 , Espirometria/instrumentação , Espirometria/métodos , Telemedicina/métodos , Telemedicina/normas , Estados Unidos/epidemiologia
10.
J Cyst Fibros ; 20 Suppl 3: 9-13, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34930545

RESUMO

BACKGROUND: Cystic fibrosis (CF) care programs in the United States rapidly adopted telehealth during the COVID-19 pandemic. Understanding factors that promote or impede telehealth will inform planning for future telehealth-enabled care models. METHODS: Adult, pediatric, and affiliate CF care programs in the United States (n = 287) were surveyed twice eight months apart in 2020-2021 about telehealth use. Programs were asked to describe barriers to and promoters of telehealth. RESULTS: Ninety-seven percent of programs provided telehealth services. In the first CF Care Program State of Care Survey (SoC1), programs estimated that 57% of patients exclusively received in-person care, 36% of patients received telehealth by phone/computer with video, and 8% of patients received telephone-only care. In the second CF Care Program State of Care Survey (SoC2), programs estimated that 80% of visits were in-person and 15% were via audio and video telehealth. Pediatric programs (21%) were less likely than adult (37%) or affiliate (41%) programs to recommend telehealth (p = 0.007). All programs ranked lack of internet access as the highest barrier to patient engagement with telehealth. Promoters of telehealth were increased accessibility and avoidance of infection transmission. Top ranked changes to improve telehealth were expanded provision of remote monitoring devices and technology access. Similar proportions of program types anticipated institutional telehealth expansion. CONCLUSION: During the COVID-19 pandemic, CF programs in the United States identified factors to improve future care delivery via telehealth. Targeting specific barriers and promoters will improve the use and quality of telehealth throughout the care center network.


Assuntos
COVID-19 , Barreiras de Comunicação , Fibrose Cística , Transmissão de Doença Infecciosa/prevenção & controle , Acesso aos Serviços de Saúde , Participação do Paciente , Telemedicina , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Fibrose Cística/epidemiologia , Fibrose Cística/psicologia , Fibrose Cística/terapia , Feminino , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/tendências , Humanos , Acesso à Internet , Masculino , Determinação de Necessidades de Cuidados de Saúde , Participação do Paciente/métodos , Participação do Paciente/psicologia , Satisfação do Paciente/estatística & dados numéricos , Melhoria de Qualidade , SARS-CoV-2 , Telemedicina/métodos , Telemedicina/organização & administração , Telemedicina/normas , Estados Unidos/epidemiologia
12.
J Huntingtons Dis ; 10(4): 479-484, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34719505

RESUMO

BACKGROUND: The COVID-19 pandemic has increased the need for remote healthcare options among patients with Huntington's disease (HD). However, since not every HD patient is suitable for telehealth, it is important to differentiate who can be seen virtually from who should remain as in-person. Unfortunately, there are no clinical guidelines on how to evaluate HD patients for telehealth eligibility. OBJECTIVE: To standardize the teleneurology selection process in HD by implementing a screening tool that accounts for patient-specific factors. METHODS: We organized various indications and contraindications to teleneurology into a flowchart. If any indications or contraindications were met, patients were assigned to telehealth or maintained as in-person, respectively. If no indications or contraindications were met, patients were given the option of telehealth or in-person for their upcoming appointments. In two implementation cycles, we tested this screening tool among all HD patients scheduled for clinic visits, aided by chart review and phone interview. RESULTS: In a cohort of 81 patients, telehealth acceptance among eligible patients increased from 45.0%to 83.3%. Frequency of telehealth visits increased from a pre-intervention baseline of 12.8%to 28.2%. CONCLUSION: Teleneurology utilization among HD patients more than doubled across our study. Our intervention promotes consistency and patient-centeredness in HD clinical care and streamlines the overall telehealth selection process. Future studies can seek to reduce telehealth no-shows and also evaluate the utility of the motor and psychiatric criteria included in our screening tool.


Assuntos
COVID-19 , Doença de Huntington/terapia , Neurologia/normas , Aceitação pelo Paciente de Cuidados de Saúde , Preferência do Paciente , Telemedicina/normas , Adulto , Assistência Ambulatorial , COVID-19/prevenção & controle , Estudos de Coortes , Utilização de Instalações e Serviços , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurologia/organização & administração , Design de Software , Telemedicina/organização & administração , Centros de Atenção Terciária
13.
BMC Cancer ; 21(1): 1094, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635061

RESUMO

BACKGROUND: To ensure safe delivery of oncologic care during the COVID-19 pandemic, telemedicine has been rapidly adopted. However, little data exist on the impact of telemedicine on quality and accessibility of oncologic care. This study assessed whether conducting an office visit for thoracic oncology patients via telemedicine affected time to treatment initiation and accessibility. METHODS: This was a retrospective cohort study of patients with thoracic malignancies seen by a multidisciplinary team during the first surge of COVID-19 cases in Philadelphia (March 1 to June 30, 2020). Patients with an index visit for a new phase of care, defined as a new diagnosis, local recurrence, or newly discovered metastatic disease, were included. RESULTS: 240 distinct patients with thoracic malignancies were seen: 132 patients (55.0%) were seen initially in-person vs 108 (45.0%) via telemedicine. The majority of visits were for a diagnosis of a new thoracic cancer (87.5%). Among newly diagnosed patients referred to the thoracic oncology team, the median time from referral to initial visit was significantly shorter amongst the patients seen via telemedicine vs. in-person (median 5.0 vs. 6.5 days, p < 0.001). Patients received surgery (32.5%), radiation (24.2%), or systemic therapy (30.4%). Time from initial visit to treatment initiation by modality did not differ by telemedicine vs in-person: surgery (22 vs 16 days, p = 0.47), radiation (27.5 vs 27.5 days, p = 0.86, systemic therapy (15 vs 13 days, p = 0.45). CONCLUSIONS: Rapid adoption of telemedicine allowed timely delivery of oncologic care during the initial surge of the COVID19 pandemic by a thoracic oncology multi-disciplinary clinic.


Assuntos
COVID-19/epidemiologia , Acesso aos Serviços de Saúde , Pandemias , Telemedicina/organização & administração , Neoplasias Torácicas/terapia , Tempo para o Tratamento , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Equipe de Assistência ao Paciente , Philadelphia/epidemiologia , Qualidade da Assistência à Saúde , Encaminhamento e Consulta , Estudos Retrospectivos , Telemedicina/normas , Telemedicina/estatística & dados numéricos , Neoplasias Torácicas/epidemiologia , Neoplasias Torácicas/patologia , Fatores de Tempo
15.
Ann Med ; 53(1): 1924-1934, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34714186

RESUMO

INTRODUCTION: The SARS-CoV-2 pandemic has forced healthcare providers to reorganize their activities to protect the population from infection, postponing or suspending many medical procedures. Patients affected by chronic conditions were among the most affected. In the case of catastrophes, women have a higher lifetime prevalence of post-traumatic stress disorder (PTSD), and those with endometriosis have higher anxiety levels, making them fragile in such circumstances. MATERIALS AND METHODS: In this cross-sectional study, conducted in May 2020, we considered all women aged ≥18 years, followed up at our referral centre for endometriosis. Patients were sent an anonymous 6-section questionnaire via email, containing different validated tools for the evaluation of anxiety levels and the risk of PTSD. A multivariable linear regression was performed to assess the impact of patients' characteristics on the distress caused by the SARS-COV-2 pandemic. RESULTS: Among the 468 women recruited, 68.8% were quite-to-extremely worried about not being able to access gynaecologic care, with almost one-third of them scoring ≥33 on the IES-R. Older age and increased levels of anxiety were associated with higher risks of PTSD (age: b = 0.28, 95% CI = 0.12 - 0.44; GAD-7: b = 1.71, 95% CI = 1.38 - 2.05), with up to 71.8% of patients with severe anxiety (GAD-7 > 15) having an IES-R score ≥33 suggestive for PTSD. Women who could leave home to work showed lower levels of PTSD (b = -4.79, 95% CI = -8.44 to - 1.15, ref. unemployed women). The implementation of telemedicine in routine clinical practice was favourably viewed by 75.6% of women. DISCUSSION: Women with endometriosis are particularly exposed to the risk of PTSD during the SARS-CoV-2 pandemic, especially if they are older or have higher levels of anxiety. Gynaecologists should resort to additional strategies, and telemedicine could represent a feasible tool to help patients cope with this situation.KEY MESSAGESThe COVID-19 pandemic significantly impacted the lives of women with endometriosis, who appeared to have a considerable risk of PTSD.Older age, higher anxiety levels and unemployment were independently associated with the risk of developing PTSD.Clinicians should develop successful alternative strategies to help patients cope with this situation, and telemedicine might represent an applicable and acceptable solution.


Assuntos
Ansiedade/epidemiologia , COVID-19/prevenção & controle , Endometriose/terapia , Acesso aos Serviços de Saúde/normas , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Fatores Etários , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/psicologia , COVID-19/epidemiologia , COVID-19/transmissão , Controle de Doenças Transmissíveis/normas , Estudos Transversais , Endometriose/psicologia , Feminino , Acesso aos Serviços de Saúde/organização & administração , Humanos , Internet/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Prevalência , Gestão de Riscos , SARS-CoV-2/patogenicidade , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários/estatística & dados numéricos , Telemedicina/organização & administração , Telemedicina/normas , Adulto Jovem
16.
Aust J Gen Pract ; 50(10): 778-781, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34590087

RESUMO

BACKGROUND: Telehealth has seen rapid but unregulated growth in Australia during the COVID-19 pandemic, facilitated by the interim establishment of a universal Medicare Benefits Schedule item for telehealth consultations. Consumers and healthcare providers, including many general practitioners, have turned to telehealth with enthusiasm. OBJECTIVE: The aim of this article is to present evidence and analysis supporting the adoption of national telehealth standards in Australia. DISCUSSION: Despite efforts by professional organisations to develop telehealth standards, Australia lacks a national telehealth strategy and a unified set of shared standards for clinical governance and quality assurance that can be applied across the health system. To ensure consumer safety and support healthcare providers in telehealth, a national regulatory framework and telehealth standards should be established on the basis of the latest evidence on safety and quality in all forms of telehealth.


Assuntos
Telemedicina/normas , Austrália , COVID-19/epidemiologia , Humanos , Programas Nacionais de Saúde , Pandemias
17.
Sch Psychol ; 36(5): 377-387, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34591588

RESUMO

School psychologists play a critical role in school-based Autism (AU) evaluations. Evidence-based AU evaluations should be multimodal, include multiple informants, and assess functioning across several domains. In the current era of COVID-19, school-based AU evaluations have become increasingly complex with school psychologists having to significantly adapt face-to-face evaluation procedures and/or conduct evaluations via teleassessment approaches. This poses profound challenges for some families, many of whom are from vulnerable groups. In the current article, we outline school psychologists' traditional role in school-based AU evaluations and review best practice guidelines. We then discuss the impact of COVID-19 on these processes and provide a framework for school psychologists to use when conducting school-based AU evaluations during this unprecedented time. We also provide resources school psychologists may find useful as they conduct school-based AU evaluations during the COVID-19 pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtorno do Espectro Autista/diagnóstico , COVID-19 , Psicologia , Serviços de Saúde Mental Escolar , Instituições Acadêmicas , Telemedicina , Escala de Avaliação Comportamental , Criança , Educação Especial , Humanos , Escalas de Graduação Psiquiátrica , Psicologia/instrumentação , Psicologia/métodos , Psicologia/normas , Serviços de Saúde Mental Escolar/normas , Telemedicina/métodos , Telemedicina/normas
18.
J Am Coll Surg ; 233(5): 593-605.e4, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34509613

RESUMO

BACKGROUND: Virtual visits (VVs) are being used increasingly to provide patient-centered care and have undergone rapid uptake during the COVID-19 pandemic. Our aim was to compare satisfaction and convenience of virtual post-discharge follow-up for surgical patients and qualitatively analyze free-text survey responses in a randomized controlled noninferiority trial. Patient satisfaction with VVs has not been evaluated previously in a randomized controlled trial and few mixed-methods analyses have been done to understand barriers and facilitators to post-discharge visits. STUDY DESIGN: Patients undergoing laparoscopic appendectomy or cholecystectomy were randomized to VV or in-person visit (2:1). Surveys with 11 multiple-choice and 2 open-ended questions evaluated patient satisfaction and convenience. Univariate analysis compared responses to the multiple-choice questions and qualitative content analysis evaluated open-ended responses. RESULTS: Of 442 enrolled patients, 289 completed their postoperative visit and were sent surveys (55% response rate). Patients were categorized as VV (n = 135), crossover (randomized to virtual but completed in-person; n = 53), and in-person visits (n = 101). Patient-reported satisfaction was similar, but convenience was higher for VV patients. Open-ended responses (72 VVs, 14 crossovers, and 41 in-person visits) were qualitatively analyzed. In all groups, patient experience was influenced by quality of care, efficiency, and convenience. Barriers were different for virtual and in-person appointments. CONCLUSIONS: We found that quality of, and access to, care-whether in person or virtual-remained critical components of patient satisfaction. VVs address many barriers associated with in-person visits and were more convenient, but can present additional technological barriers.


Assuntos
Assistência ao Convalescente/métodos , COVID-19/prevenção & controle , Satisfação do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/diagnóstico , Telemedicina/normas , Adulto , Assistência ao Convalescente/psicologia , Assistência ao Convalescente/normas , Assistência ao Convalescente/estatística & dados numéricos , Apendicectomia/efeitos adversos , Agendamento de Consultas , COVID-19/epidemiologia , COVID-19/transmissão , Colecistectomia Laparoscópica/efeitos adversos , Controle de Doenças Transmissíveis/normas , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Alta do Paciente , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Inquéritos e Questionários/estatística & dados numéricos
19.
J Urol ; 206(6): 1469-1479, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34470508

RESUMO

PURPOSE: We examined changes in urological care delivery due to COVID-19 in the U.S. based on patient, practice, and local/regional demographic and pandemic response features. MATERIALS AND METHODS: We analyzed real-world data from the American Urological Association Quality (AQUA) Registry collected from electronic health record systems. Data represented 157 outpatient urological practices and 3,165 providers across 48 U.S. states and territories, including 3,297,721 unique patients, 12,488,831 total outpatient visits and 2,194,456 procedures. The primary outcome measure was the number of outpatient visits and procedures performed (inpatient or outpatient) per practice per week, measured from January 2019 to February 2021. RESULTS: We found large (>50%) declines in outpatient visits from March 2020 to April 2020 across patient demographic groups and states, regardless of timing of state stay-at-home orders. Nonurgent outpatient visits decreased more across various nonurgent procedures (49%-59%) than for procedures performed for potentially urgent diagnoses (38%-52%); surgical procedures for nonurgent conditions also decreased more (43%-79%) than those for potentially urgent conditions (43%-53%). African American patients had similar decreases in outpatient visits compared with Asians and Caucasians, but also slower recoveries back to baseline. Medicare-insured patients had the steepest declines (55%), while those on Medicaid and government insurance had the lowest percentage of recovery to baseline (73% and 69%, respectively). CONCLUSIONS: This study provides real-world evidence on the decline in urological care across demographic groups and practice settings, and demonstrates a differential impact on the utilization of urological health services by demographics and procedure type.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/normas , Pandemias/prevenção & controle , Doenças Urológicas/terapia , Urologia/estatística & dados numéricos , Adolescente , Adulto , Idoso , Assistência Ambulatorial/normas , Assistência Ambulatorial/estatística & dados numéricos , Assistência Ambulatorial/tendências , COVID-19/epidemiologia , COVID-19/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Padrões de Prática Médica/tendências , Telemedicina/normas , Telemedicina/estatística & dados numéricos , Telemedicina/tendências , Estados Unidos/epidemiologia , Procedimentos Cirúrgicos Urológicos/normas , Procedimentos Cirúrgicos Urológicos/estatística & dados numéricos , Procedimentos Cirúrgicos Urológicos/tendências , Urologia/normas , Urologia/tendências , Adulto Jovem
20.
Prof Case Manag ; 26(5): 250-254, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34397654

RESUMO

PURPOSE: To review current literature on texting as a sustainable intervention of case management in the outpatient setting. FINDINGS: Texting, as a case management intervention, provides the medically complex client with a pathway to achieve care plan goals. Texting increases adherence, communication, and self-management. It can increase client enrollment in disease management programs, while providing support, flexibility, convenience, cost savings, and increased participation. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: In current practice, such as management of the coronavirus (COVID-19), other pandemics, or natural/environmental disasters, texting is a solution-focused intervention that can deliver and retrieve real-time information to a medically complex population. It can link patients to resources and increase outreach, efficiency, quality, and coordination of care. Texting can promote adherence to appointments, increase medication compliance and disease management interventions, and provide motivational change messages. However, there are legal and regulatory concerns that carry potential consequences and implications that should be approached judiciously (Mellette, 2015). Texting is not one size fits all; it can cause HIPAA breeches, hinder communication with certain populations, confuse health messaging, and replace human communication, thereby reducing staffing in practice.


Assuntos
Assistência Ambulatorial/normas , Administração de Caso/normas , Comunicação , Guias como Assunto , Health Insurance Portability and Accountability Act/normas , Telemedicina/normas , Envio de Mensagens de Texto/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
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