scholarly journals Communication and Remote Care Delivery for an Aging Population With Kidney Disease

2021 ◽  
Vol 4 (12) ◽  
pp. e2138694
Author(s):  
Devika Nair
Keyword(s):  
Kidney Disease ◽  
Care Delivery ◽  
Aging Population ◽  
Remote Care

scholarly journals Physician requirements for adoption of telehealth following the SARS-CoV-2 pandemic

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Michael Hodgkins ◽  
Meg Barron ◽  
Shireesha Jevaji ◽  
Stacy Lloyd
Keyword(s):  
Care Delivery ◽  
Virtual Technology ◽  
Privacy Concerns ◽  
Face To Face ◽  
House Calls ◽  
Care Delivery Model ◽  
Virtual Visits ◽  
Similar Survey ◽  
Remote Care

AbstractIt took the advent of SARS-CoV-2, a “black swan event”, to widely introduce telehealth, remote care, and virtual house calls. Prior to the epidemic (2019), the American Medical Association (AMA) conducted a routine study to compare physicians’ adoption of emerging technologies to a similar survey in 2016. Most notable was a doubling in the adoption of telehealth/virtual technology to 28% and increases in the use of remote monitoring and management for improved care (13–22%). These results may now seem insignificant when compared to the unprecedented surge in telehealth visits because of SARS-CoV-2. Even as this surge levels off and begins to decline, many observers believe we will continue to see a persistent increase in the use of virtual visits compared to face-to-face care. The requirements for adoption communicated by physicians in both the 2016 and 2019 surveys are now more relevant than ever: Is remote care as effective as in-person care and how best to determine when to use these modalities? How do I safeguard my patients and my practice from liability and privacy concerns? How do I optimize using these technologies in my practice and, especially integration with my EHR and workflows to improve efficiency? And how will a mix of virtual and in-person visits affect practice revenue and sustainability? Consumers have also expressed concerns about payment for virtual visits as well as privacy and quality of care. If telehealth and remote care are here to stay, continuing to track their impact during the current public health emergency is critically important to address so that policymakers and insurers will take necessary steps to ensure that the “new normal” will reflect a health care delivery model that can provide comparable or improved results today and into the future.

scholarly journals Video-Based Telemedicine for Kidney Disease Care

2021 ◽  
Vol 16 (12) ◽  
pp. 1813-1823
Author(s):  
Ann Young ◽  
Ani Orchanian-Cheff ◽  
Christopher T. Chan ◽  
Ron Wald ◽  
Stephanie W. Ong
Keyword(s):  
Health Care ◽  
Kidney Disease ◽  
Systematic Reviews ◽  
Care Delivery ◽  
Case Series ◽  
Care Utilization ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Content Type ◽  
Patient Reported

Background and objectivesVideo-based telemedicine provides an alternative health care delivery model for patients with CKD. The objective was to provide an overview of the available evidence on the implementation and outcomes of adopting video-based telemedicine in nephrology.Design, setting, participants, & measurementsMEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL were searched in December 2019 and again in January 2021 for studies using video-based telemedicine for adults across the spectrum of kidney disease. Study types included peer-reviewed clinical trials, observational studies, and descriptive studies available in full text. Search results were independently screened by two authors, who then independently reviewed and extracted data from the eligible studies. Results were synthesized in tabular format, summarizing study characteristics by area within nephrology; the video-based interventions used; and clinical, health care utilization, and patient-reported outcomes.ResultsAfter reviewing 1870 unique citations, 24 studies were included (four randomized controlled trials, six cohort studies, five pre-post intervention studies, seven case series, and two qualitative studies). Video-based technology was used to facilitate care across all stages of CKD. Although earlier studies used a range of institution-specific technologies that linked main hospital sites to more remote health care locations, more recent studies used technology platforms that allowed patients to receive care in a location of their choice. Video-based care was well received, with the studies reporting high patient satisfaction and acceptable clinical outcomes.ConclusionsVideo-based telemedicine is being used for kidney care and has evolved to be less reliant on specialized telemedicine equipment. As its use continues to grow, further primary studies and systematic reviews of outcomes associated with the latest innovations to video-based care in nephrology can address knowledge gaps, such as approaches to sustainable integration and minimization of barriers to access.

Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: An International Cross-sectional Survey Study (Preprint)

2021 ◽  
Author(s):  
Edmond Li ◽  
Rosy Tsopra ◽  
Geronimo Jimenez ◽  
Alice Serafini ◽  
Gustavo Gusso ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Delivery ◽  
Lessons Learned ◽  
Survey Study ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Face To Face ◽  
Remote Care

BACKGROUND With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. OBJECTIVE We explored GPs’ perspectives on the main benefits and challenges of using digital remote care. METHODS GPs across 20 countries completed an online questionnaire between June – September 2020. GPs’ perceptions on main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. RESULTS A total of 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and accompanying legal frameworks. Main challenges included patient’s preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. CONCLUSIONS At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how during the pandemic. Lessons learned can be used to inform the adoption of improved virtual care solutions, and support the long-term development of platforms that are more technologically robust, secure. INTERNATIONAL REGISTERED REPORT RR2-10.2196/30099

Challenges Facing Health Service Delivery in Developing Countries and Solution Approaches

2018 ◽  
pp. 515-559
Author(s):  
Thierry O. C. Edoh ◽  
Pravin Amrut Pawar ◽  
Laura Y. Loko
Keyword(s):  
Delivery System ◽  
Rural Areas ◽  
Care Delivery ◽  
Health Service Delivery ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Linguistic Barriers ◽  
Traditional Practitioners ◽  
Remote Care ◽  
Site Test

This chapter describes a case study of the poor access to healthcare in the developing the countries with more focus on the rural areas and presents an adapted remote care delivery system approach for improving and increasing the access to healthcare services by overcoming certain cultural, social, financial, and linguistic barriers. The remote care delivery system integrates traditional practitioners because most people are more confident with the traditional medicine. The chapter presents the results of a practical on-site test of the proposed system. The test has shown the potentiality of the proposed system to improve the quality and effectiveness of healthcare and increase the accessibility of healthcare systems. The chapter also discusses the obstacles for applying standard telemedicine systems and e-health solutions in the developing world.

Challenges Facing Health Service Delivery in Developing Countries and Solution Approaches

2021 ◽  
pp. 1533-1577
Author(s):  
Thierry O. C. Edoh ◽  
Pravin Amrut Pawar ◽  
Laura Y. Loko
Keyword(s):  
Delivery System ◽  
Rural Areas ◽  
Care Delivery ◽  
Health Service Delivery ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Linguistic Barriers ◽  
Traditional Practitioners ◽  
Remote Care ◽  
Site Test

This chapter describes a case study of the poor access to healthcare in the developing the countries with more focus on the rural areas and presents an adapted remote care delivery system approach for improving and increasing the access to healthcare services by overcoming certain cultural, social, financial, and linguistic barriers. The remote care delivery system integrates traditional practitioners because most people are more confident with the traditional medicine. The chapter presents the results of a practical on-site test of the proposed system. The test has shown the potentiality of the proposed system to improve the quality and effectiveness of healthcare and increase the accessibility of healthcare systems. The chapter also discusses the obstacles for applying standard telemedicine systems and e-health solutions in the developing world.

Preparing for an Epidemic: Cancer Care in an Aging Population

2014 ◽  
pp. 133-137 ◽  
Author(s):  
Ya-Chen Tina Shih ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Care Delivery ◽  
Quality Care ◽  
Aging Population ◽  
Population Based ◽  
Cancer Drug ◽  
Evidence Based ◽  
Evidence Based Care

The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer.

scholarly journals Management of Canadian Pediatric Patients With Glomerular Diseases During the COVID-19 Pandemic: Recommendations From the Canadian Association of Pediatric Nephrologists COVID-19 Rapid Response Team

2020 ◽  
Vol 7 ◽  
pp. 205435812097071
Author(s):  
Cal Robinson ◽  
Michelle Ruhl ◽  
Amrit Kirpalani ◽  
Abdullah Alabbas ◽  
Damien Noone ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Peer Review ◽  
Care Delivery ◽  
Rapid Response Team ◽  
Glomerular Disease ◽  
Rapid Response ◽  
Optimal Care ◽  
Glomerular Diseases ◽  
Canadian Association ◽  
Response Team

Purpose: The goal of these recommendations is to provide guidance on the optimal care of children with glomerular diseases during the COVID-19 pandemic. Patients with glomerular diseases are known to be more susceptible to infection. Risk factors include decreased vaccine uptake, urinary loss of immunoglobulins, and treatment with immunosuppressive medications. The Canadian Society of Nephrology (CSN) recently published guidelines on the care of adult glomerulonephritis patients. This guideline aims to expand and adapt those recommendations for programs caring for children with glomerular diseases. Sources of information: We used the CSN COVID-19 Rapid Response Team adult glomerulonephritis recommendations, published in the Canadian Journal of Kidney Health and Disease, as the foundation for our guidelines. We reviewed documents published by nephrology and non-nephrology societies and health care agencies focused on kidney disease and immunocompromised populations. Finally, we conducted a formal literature review of publications relevant to pediatric and adult glomerular disease, chronic kidney disease, hypertension, and immunosuppression in the context of the COVID-19 pandemic. Methods: The leadership of the Canadian Association of Pediatric Nephrologists (CAPN), which is affiliated with the CSN, identified a team of clinicians and researchers with expertise in pediatric glomerular diseases. The aim was to adapt Canadian adult glomerulonephritis guidelines to make them applicable to children and discuss pediatric-specific considerations. The updated guidelines were peer-reviewed by senior clinicians with expertise in the care of childhood glomerular diseases. Key findings: We identified a number of key areas of glomerular disease care likely to be affected by the COVID-19 pandemic, including (1) clinic visit scheduling, (2) visit types, (3) provision of multidisciplinary care, (4) blood work and imaging, (5) home monitoring, (6) immunosuppression, (7) other medications, (8) immunizations, (9) management of children with suspected COVID-19, (10) renal biopsy, (11) patient education and support, and (12) school and child care. Limitations: There are minimal data regarding the characteristics and outcomes of COVID-19 in adult or pediatric glomerular disease patients, as well as the efficacy of strategies to prevent infection transmission within these populations. Therefore, the majority of these recommendations are based on expert opinion and consensus guidance. To expedite the publication of these guidelines, an internal peer-review process was conducted, which may not have been as rigorous as formal journal peer-review. Implications: These guidelines are intended to promote optimal care delivery for children with existing or newly diagnosed glomerular diseases during the COVID-19 pandemic. The implications of modified care delivery, altered immunosuppression strategies, and limited access to existing resources remain uncertain.

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