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.

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

scholarly journals Online Medical Education for Doctors: Identifying Potential Gaps to the Traditional, Face-to-Face Modality

2019 ◽  
Vol 6 ◽  
pp. 238212051982791 ◽  
Author(s):  
Chris O Ifediora
Keyword(s):  
Medical Education ◽  
Online Education ◽  
Care Delivery ◽  
Continuing Professional Development ◽  
Easy Access ◽  
Face To Face ◽  
Education And Health ◽  
House Call ◽  
After Hours

Background: Online education options increasingly complement traditional face-to-face (F2F) approaches. Few studies have compared both formats on doctors, and little evidence exists to prove that the online approach is universally effective. This gap needs to be addressed to ensure that the quality of education and health care delivery is not compromised. Methods: A quantitative survey targeting 881 doctors that required online and F2F teaching sessions offers identical contents over a 12-month period. The surveyed doctors work in the Australian after-hours house-call (AHHC) industry, and the teachings were parts of their continuing professional development activities. Results: In all, 89 responses were received; 10 (11.2%) participated exclusively online, while 23 (25.8%) did so by F2F; 52 (58.4%) engaged through both modalities. No statistical differences existed based on sex, specialty, and post-graduate fellowship status, as well as on the perceptions with teaching structure, contents, and duration of the education programmes. However, F2F-only doctors were likely to be junior and younger than 40 years (odds ratio [OR]: 3.85; P = .01). They also admit easy access to effective teaching environment (OR: 4.07; P = .01) and receive better feedbacks (OR: 3.75; P = .01). Conversely, online-only participants were more likely to combine AHHC duties with regular-hours general practice (OR: 0.15; P = .02) and are generally more satisfied with the programme frequency (OR: 6.90; P = .01). Conclusions: On multiple areas, no differences exist in the medical education delivered by online and the F2F methods to doctors and both should be encouraged. However, younger and junior practitioners, who tend to need feedbacks on their jobs, should participate more in the F2F sessions.

Physicians’ Perceptions Toward Use of Telemedicine During COVID-19 Pandemic in Riyadh, Saudi Arabia (Preprint)

2021 ◽  
Author(s):  
sarah idriss ◽  
walaa alasaadi ◽  
abdullah Aldhuhayyan ◽  
Ahmed alenzi ◽  
Reem alharbi ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Well Being ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Face To Face

BACKGROUND The use of communication technologies to deliver health care remotely is known as telemedicine. The coronavirus disease 2019 (COVID-19) pandemic had a variety of consequences for health-care delivery in 2020. As a result, it was necessary to adapt and deliver high-quality care to patients while limiting possible viral exposure for both patients and health-care workers. During the pandemic, physicians employed video visits, phone visits, and electronic written visits (e-consultations), all of which have the ability to provide a comparable quality of care while removing social barriers. OBJECTIVE The study’s aim is to assess physicians’ perspectives and attitudes concerning the usage of telemedicine in Riyadh hospitals during the COVID-19 pandemic. The main domains of the assessment are physicians’ overall experience with telemedicine use before and during COVID-19, future adaptability to using telemedicine, perceptions about patients’ experience, and the influence of telemedicine on burnout. METHODS Methods: An anonymous 28-question cross-sectional survey was developed using SurveyMonkey and distributed to all physicians from all specialty disciplines across Riyadh city hospitals. RESULTS A total of 362 doctors were included in the study. Among them, 28.7% were consultants, 30.4% were specialists, and 40.9% were residents. Male doctors formed the majority (56.1%). When asked about the frequency of using telemedicine, 41.4% answered “frequently,” 26% responded “occasionally,” and 32.6% said “never.” Thirty one percent of doctors agreed and somewhat agreed that the “quality of care during telemedicine is comparable with face-to-face visits.” About 55% doctors believed that telemedicine consultation is a cost-effective way, compared to face-to-face visits. Most of the doctors were skilled (70%) at telemedicine, and they were also able to solve technology issues during telemedicine visits (54%). Overall, the physicians felt that their patients liked telemedicine: 68% said they felt comfortable using telemedicine and 76% said theyfound that it saved time. As per the burnout question, 4.1% of doctors felt burnout every day, 7.5% felt burnout a few times a week, and 27.3% felt burnout a few times per month. CONCLUSIONS Physicians had a generally favorable attitude toward telemedicine, believing that the quality of health-care delivery using it was comparable to that of in-person care. Future research is needed to investigate how physicians’ attitudes toward telemedicine have changed since the pandemic, as well as how this virtual technology might be used to improve their professional and personal well-being.

scholarly journals A study of prevalence of urogenital problem among menopausal women attending the OPD at tertiary care hospital in Bhopal

2021 ◽  
Vol 10 (3) ◽  
pp. 1062
Author(s):  
Malini Bhardwaj ◽  
Tarani Shinde
Keyword(s):  
Care Delivery ◽  
Human Life ◽  
Tertiary Care ◽  
Care Hospital ◽  
Face To Face ◽  
Medical College ◽  
Menopausal Women ◽  
First Time ◽  
Human Life Span

Background: The interest in menopausal problems has increased in recent years, due to the expansion of human life span. Women are spending more than one-third of their lives in menopausal period. Due to this fact, estrogen deprivation can cause vaginal atrophy symptoms and vasomotor symptoms, which critically diminish quality of life (QOL) in postmenopausal women.Methods: This study is a retrospective observational/analytical study conducted in the menopausal specialty clinic in J. K. Hospital, L. N. Medical College, Bhopal over a period of 1 year. All the women who attained menopause either naturally or surgically who presented first time to the clinic for any complaints were evaluated for the UG symptoms with the help of face to face interview.Results: Out of the 300 women with menopausal symptoms, 182 i.e. 60.6% were married and 52% (156) were illiterate. The most prevalent menopausal symptom in present study was vaginal dryness 240 (80%).Conclusions: There is association with lower educational levels. Hence efforts should be made educate women about the symptoms and provide care at all the levels of health care delivery. 

Using Twitter comments to understand people’s experiences of UK healthcare during the Covid-19 pandemic. (Preprint)

2021 ◽  
Author(s):  
Esther Ainley ◽  
Cara Witwicki ◽  
Amy Tallett ◽  
Chris Graham
Keyword(s):  
Public Discourse ◽  
Care Delivery ◽  
Public Attitudes ◽  
Research Question ◽  
Healthcare Delivery ◽  
Use Of Technology ◽  
Utilization Patterns ◽  
Remote Care ◽  
The Uk

BACKGROUND The Covid-19 pandemic has led to changes in health service utilization patterns and a rapid rise in care being delivered remotely. There has been little published research examining patients’ experiences of accessing remote consultations since Covid-19. Such research is important as remote methods for delivering some care may be maintained in the future. OBJECTIVE To use content from Twitter to understand public discourse around health and care delivery in the UK as a result of Covid-19, in particular views on and attitudes to care being delivered remotely. METHODS Tweets posted from the UK between January 2018 and October 2020 were extracted using the Twitter API. 1,408 tweets across three search terms were extracted into Excel. 161 tweets were removed following de-duplication, and 610 were identified as irrelevant to the research question. Relevant tweets (n=637) were coded into categories using NVivo software, and assigned a positive, neutral, or negative sentiment. To examine views of remote care over time, the coded data was imported back into Excel so that each tweet was associated with both a theme(s) and sentiment. RESULTS The volume of tweets on remote care delivery increased markedly following the Covid-19 outbreak. Five main themes were identified in the tweets: access to remote care (n=267), quality of remote care (n=130), anticipation of remote care (n=39), online booking and asynchronous communication (n=85) and publicising changes to services or care delivery (n=160). Mixed public attitudes and experiences to the changes in service delivery were found. The proportion of positive tweets regarding access to, and quality of, remote care was higher in the immediate period following the Covid-19 outbreak (March-May 2020) when compared to the time before the Covid-19 onset, and the time when restrictions from the first lockdown eased (June-October 2020). CONCLUSIONS Using Twitter data to address our research questions proved beneficial for providing rapid access to a breadth of attitudes to remote care delivery at a time when it would have been difficult to conduct primary research due to Covid-19. It allowed us to examine public discourse on remote care over a relatively long period and explore shifting public attitudes at a time of rapid changes in care delivery. The mixed attitudes towards remote care highlights the importance that patients have a choice over the type of consultation that best suits their needs, and that the increased use of technology for delivering care does not become a barrier for some. The finding that overall sentiment about remote care was more positive in the early stages of the pandemic but since declined emphasises the need for a continued examination of people’s preference, particularly if remote appointments are likely to remain central to healthcare delivery.

scholarly journals National randomized controlled trial of virtual house calls for Parkinson disease

Neurology ◽  
2017 ◽  
Vol 89 (11) ◽  
pp. 1152-1161 ◽  
Author(s):  
Christopher A. Beck ◽  
Denise B. Beran ◽  
Kevin M. Biglan ◽  
Cynthia M. Boyd ◽  
E. Ray Dorsey ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Quality Of Care ◽  
Caregiver Burden ◽  
Controlled Trial ◽  
Class Iii ◽  
House Calls ◽  
Randomized Controlled ◽  
Virtual Visits

Objective:To determine whether providing remote neurologic care into the homes of people with Parkinson disease (PD) is feasible, beneficial, and valuable.Methods:In a 1-year randomized controlled trial, we compared usual care to usual care supplemented by 4 virtual visits via video conferencing from a remote specialist into patients' homes. Primary outcome measures were feasibility, as measured by the proportion who completed at least one virtual visit and the proportion of virtual visits completed on time; and efficacy, as measured by the change in the Parkinson's Disease Questionnaire–39, a quality of life scale. Secondary outcomes included quality of care, caregiver burden, and time and travel savings.Results:A total of 927 individuals indicated interest, 210 were enrolled, and 195 were randomized. Participants had recently seen a specialist (73%) and were largely college-educated (73%) and white (96%). Ninety-five (98% of the intervention group) completed at least one virtual visit, and 91% of 388 virtual visits were completed. Quality of life did not improve in those receiving virtual house calls (0.3 points worse on a 100-point scale; 95% confidence interval [CI] −2.0 to 2.7 points; p = 0.78) nor did quality of care or caregiver burden. Each virtual house call saved patients a median of 88 minutes (95% CI 70–120; p < 0.0001) and 38 miles per visit (95% CI 36–56; p < 0.0001).Conclusions:Providing remote neurologic care directly into the homes of people with PD was feasible and was neither more nor less efficacious than usual in-person care. Virtual house calls generated great interest and provided substantial convenience.ClinicalTrials.gov identifier:NCT02038959.Classification of evidence:This study provides Class III evidence that for patients with PD, virtual house calls from a neurologist are feasible and do not significantly change quality of life compared to in-person visits. The study is rated Class III because it was not possible to mask patients to visit type.

Reactive to Proactive: The telemedicine we need (Preprint)

2020 ◽  
Author(s):  
Sarah Hallberg ◽  
David Harrison
Keyword(s):  
Health Outcomes ◽  
Care Delivery ◽  
Care Team ◽  
Patient Needs ◽  
Healthcare Organizations ◽  
Delivery Of Care ◽  
Delivery Model ◽  
Care Delivery Model ◽  
Remote Care

UNSTRUCTURED The COVID-19 pandemic has brought attention to telemedicine like never before. Physicians and healthcare organizations have worked quickly to give patients the care they need remotely. The fastest way to transition to telemedicine was to replicate the current episodic delivery of care. However, a continuous remote care delivery model involving a care team that is proactive to patient needs can help us get the most out of the addition of technology allowing both increased access and improved health outcomes.

scholarly journals The impact of medical teleconsultations on general practitioner-patient communication during COVID- 19: A case study from Poland

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254960
Author(s):  
Magdalena Kludacz-Alessandri ◽  
Liliana Hawrysz ◽  
Piotr Korneta ◽  
Grażyna Gierszewska ◽  
Wioletta Pomaranik ◽  
...  
Keyword(s):  
Positive Impact ◽  
Patient Communication ◽  
Face To Face ◽  
Results Of Treatment ◽  
Level Of Satisfaction ◽  
Physical Examinations ◽  
Remote Care ◽  
High Level ◽  
The Impact

According to the outbreak of the Covid-19 pandemic, medical teleconsultations using various technologies have become an important tool to mediate communication between general practitioners (GP) and the patients in primary health care in many countries. The quality of the GP-patient communication is an essential factor, which improves the results of treatment and patient satisfaction. The objective of this paper is to study patients’ satisfaction from teleconsultation in primary care and the impact of teleconsultations on GP-patient communication through the Covid-19 pandemic in Poland. We analyse whether the teleconsultations performed without physical examinations have a positive impact on GP-patient communication. The quality of teleconsultation and GP-patient communication have been measured using a questionnaire regarding the quality of medical care in a remote care conditions. Among 36 items, nine questions have been related to the dimension of GP-patient communication and ten to system experience. Our results suggest that the quality of teleconsultations is not inferior to the quality of consultation during a face-to-face visit. The patients indicated a high level of satisfaction regarding communication with their GP during teleconsultation. We have also identified that the technical quality and the sense of comfort during teleconsultation positively impact the communication quality.

scholarly journals Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: From Key Lessons to a Framework for Implementation

2021 ◽  
Author(s):  
Edmond C Li ◽  
Rosy Tsopra ◽  
Geronimo Larrain Gimenez ◽  
Alice Serafini ◽  
Gustavo Gusso ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Lessons Learned ◽  
Free Text ◽  
Online Questionnaire ◽  
Face To Face ◽  
Need To Evaluate ◽  
Barriers And Challenges ◽  
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: 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 the 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. Conclusion: At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how. Lessons learned during the emergency phase can be used to inform the stable adoption of virtual care solutions, and co-design processes and platforms that are technologically robust, secure, and supported by a strategic long-term plan.

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