scholarly journals Patients’ Experiences of Remote Neurology Consultations during the COVID-19 Pandemic

2020 ◽  
pp. 1-4
Author(s):  
Mary Clare McKenna ◽  
Mahmood Al-Hinai ◽  
David Bradley ◽  
Elisabeth Doran ◽  
Isabelle Hunt ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Continuity Of Care ◽  
Chronic Illnesses ◽  
Telephone Consultation ◽  
General Neurology ◽  
Face To Face ◽  
Global Pandemic ◽  
Neurology Clinic ◽  
The Mean ◽  
Remote Consultations

Telemedicine has been widely implemented during the COVID-19 global pandemic to enable continuity of care of chronic illnesses. We modified our general neurology clinic to be conducted using remote audio-only telephone consultations. We included all patients over a 10-week period who agreed to both a telephone consultation and a questionnaire afterwards in order to ascertain the patient’s perspective of the experience. There were 212 participants consisting of men (43.8%) and women (56.2%). The mean ± standard deviation of age was 47.8 ± 17.0 (range 17–93) years. For the most part, patients found remote consultations either “just as good” (67.1%) or “better” (9.0%) than face-to-face consultations. Those who deemed it to be “not as good” were significantly older (52.3 ± 17.9 years vs. 46.6 ± 16.6 years, <i>p =</i>0.045) or were more likely to have a neurological disorder that required clinical examination, namely, a neuromuscular condition (66.7%, <i>p =</i> 0.002) or an undiagnosed condition (46.7%, <i>p =</i> 0.031). At the height of the COVID-19 global pandemic, most patients were satisfied with remote consultations. The positive feedback for remote consultations needs to be verified outside of this unique scenario because the results were likely influenced by the patients’ apprehension to attend the hospital amongst other factors.

scholarly journals A method for measuring continuity of care in day-to-day general practice: a quantitative analysis of appointment data

2019 ◽  
Vol 69 (682) ◽  
pp. e356-e362 ◽  
Author(s):  
Kate Sidaway-Lee ◽  
Denis Pereira Gray ◽  
Philip Evans
Keyword(s):  
Decision Making ◽  
General Practice ◽  
Standard Deviation ◽  
Performance Management ◽  
Continuity Of Care ◽  
Face To Face ◽  
Personal Doctor ◽  
Audit Data ◽  
Part Time ◽  
The Mean

BackgroundDespite patient preference and many known benefits, continuity of care is in decline in general practice. The most common method of measuring continuity is the Usual Provider of Care (UPC) index. This requires a number of appointments per patient and a relatively long timeframe for accuracy, reducing its applicability for day-to-day performance management.AimTo describe the St Leonard’s Index of Continuity of Care (SLICC) for measuring GP continuity regularly, and demonstrate how it has been used in service in general practice.Design and settingAnalysis of appointment audit data from 2016–2017 in a general practice with 8823–9409 patients and seven part-time partners, in Exeter, UK.MethodThe percentage of face-to-face appointments for patients on each doctor’s list, with the patient’s personal doctor (the SLICC), was calculated monthly. The SLICC for different demographic groupings of patients (for example, sex and frequency of attendance) was compared. The UPC index over the 2 years was also calculated, allowing comparisons between indices.ResultsIn the 2-year study period, there were 35 622 GP face-to-face appointments; 1.96 per patient per year. Overall, 51.7% (95% confidence interval = 51.2 to 52.2) of GP appointments were with the patients’ personal doctor. Patients aged ≥65 years had a higher level of continuity with 64.9% of appointments being with their personal doctor. The mean whole-practice UPC score was 0.61 (standard deviation 0.23), with ‘usual provider’ being the personal GP for 52.8% and a trainee or locum for 8.1% of patients.ConclusionThis method could provide working GPs with a simple way to track continuity of care and inform practice management and decision making.

scholarly journals Completing asthma action plans by screen-sharing in video-consultations: practical insights from a feasibility assessment

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Omer Hamour ◽  
Eve Smyth ◽  
Hilary Pinnock
Keyword(s):  
Action Plan ◽  
Action Plans ◽  
Face To Face ◽  
Feasibility Assessment ◽  
Global Pandemic ◽  
The Face ◽  
Vital Component ◽  
Asthma Action Plans ◽  
Screen Sharing ◽  
Remote Consultations

Abstract Supported self-management is a vital component of routine asthma care. Completion of an agreed personalised asthma action plan is integral to implementation of this care, and traditionally this requires a face-to-face consultation. We aimed to assess the practical feasibility and potential utility of using screen-sharing technologies to complete asthma action plans remotely. Assisted by people with diverse technological ability and using a range of devices, we tested the technological feasibility of completing action plans in remote consultations using two leading video-conference systems. We used a semi-structured topic guide to check functionality and lead feedback discussions. Themes were interpreted using the Model for ASsessment of Telemedicine applications (MAST). Discussions with ten participants (age 20–74 years) revealed that screen-sharing was practical on most devices. Joint editing of an action plan (as was possible with Zoom) was considered to encourage participation and improve communication. Attend Anywhere had less functionality than Zoom, but the NHS badging was reassuring. Most participants appreciated the screen-sharing and considered it enabled a meaningful discussion about their action plan. Online shared completion of action plans is feasible with only a few (potentially remediable) practical problems. These findings suggest this may be a fruitful approach for further study—made more urgent by the imperative to develop remote consultations in the face of a global pandemic.

scholarly journals Survey of remote consultations in psychiatry during the SARS-CoV-2 outbreak

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S264-S265
Author(s):  
Nusra Khodabux ◽  
Satheesh Gangadharan ◽  
Samuel Tromans ◽  
Avinash Hiremath
Keyword(s):  
Mental Health ◽  
Qualitative Data ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Technical Quality ◽  
Face To Face ◽  
The Mean ◽  
Detrimental Impact ◽  
Remote Consultations

AimsTo compare the usage of remote consultations before and after the first wave of the SARS-CoV-2 outbreak and explore mental health workers’ views on the usage of telemedicine.MethodAn online questionnaire survey was developed, and disseminated to mental healthcare professionals via e-mail and social media. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using Braun and Clarke's six step procedure for thematic analysis.1ResultThere were 40 responses from mental healthcare professionals of varying grades from different sub-specialties, predominantly from the UK. Compared to before the SARS-CoV-2 outbreak, there was an increase in usage of telephone (9(22.5% to (29)72.5%) and video consultations (4(10%) to 17(42.5%)). Respondents reported an increase in virtual MDTs (35(87.5%) during the pandemic, 9(22.5%) pre-pandemic).Based on a 5-point Likert scale, the mean technical quality of telephone consultations was 3.56/5 (Range 2-5), with 75% rating telephone consultations as not being as good as face-to-face consultations. The mean technical quality of video consultations was 3.58/5 (Range 2-5), with 63% rating video consultations as not being as good as face-to-face consultations. 25 (62.5%) respondents felt comfortable using telephone consultations during the pandemic, 20(50%) felt comfortable using video consultations. Recurring themes identified from the qualitative data regarding reasons for the technical quality ratings were: connection issues, poor infrastructure and security concerns.Nine (23%) respondents felt that using video conferencing consultations had a detrimental impact on the mental health of patients while 14(35%) felt that telephone consultations had a detrimental impact on patients’ mental health. Recurring themes for health practitioners’ perceived effect of the use of telemedicine on patients’ mental heath were the loss of personal touch and reduced patient engagement.ConclusionThere was a substantial increase in usage of remote consultations during the first wave of the SARS-CoV-2 pandemic among mental healthcare professionals. The results reported in the present study suggest there are numerous barriers to the use of telemedicine in psychiatry, which require future exploration, ideally through interview or ethnographic studies.

scholarly journals 1599 Review of Telephone Consultations for Suspected Head and Neck Cancer Referrals During The COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Suresh ◽  
A Goel ◽  
N Khan ◽  
P Promod ◽  
R Pabla ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Patient Choice ◽  
Electronic Records ◽  
Continuing Care ◽  
Delivery Of Healthcare ◽  
Telephone Consultation ◽  
Face To Face ◽  
Remote Consultations

Abstract Introduction Pandemic COVID-19 necessitated a transformation in the delivery of healthcare. Telephone consultations were introduced to protect and progressively manage patients with minimal delay. This is a review of the effectiveness of these remote consultations for suspected 2-week wait (2ww) head and neck cancer referrals to a north London NHS teaching hospital Oral and Maxillofacial unit during the first official UK government lockdown from March - July 2020. Method Prospective electronic records of 176 consecutive 2ww referrals between March – July 2020 was assessed. Data analysed included initial telephone consultations, subsequent face-to-face (F2F) appointments, if required, the interval from telephone to F2F appointments and histopathological diagnoses. Results 157 patients (n = 176) received an initial telephone call, of which 127 (80.9%) required a F2F consultation. The number of days between the initial telephone consultation and subsequent F2F assessment ranged from 0 to 141, with a mean of 11 and a median of 1. Notably, 31 patients (24.4%) were seen in person on the same day as their telephone consultation. Biopsies were indicated for 69 patients (54.3%) of which 9 (13.0%) were diagnosed as malignancies. Conclusions Whilst protecting patients from a pandemic is utmost, continuing care for non-pandemic conditions must be considered. It is even more important to manage 2ww referrals efficiently. These results indicate the majority of suspected cancer referrals warrant F2F assessment for a confident outcome. Despite reinstated, ongoing social restrictions, 2ww referrals are now being seen exclusively F2F, subject to patient choice. This information is useful for planning and strategizing services in a head and neck OMFS unit.

scholarly journals Telemedicine during COVID-19: a survey of Health Care Professionals’ perceptions

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Abdula Elawady ◽  
Ahmed Khalil ◽  
Omar Assaf ◽  
Samirah Toure ◽  
Christopher Cassidy
Keyword(s):  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Medical Condition ◽  
General Medical Council ◽  
Medical Council ◽  
Remote Consultation ◽  
Telephone Consultation ◽  
Implementation Challenges ◽  
Face To Face ◽  
Remote Consultations

The National Health Service (NHS) has rapidly adopted telemedicine solutions as an alternative to face-to-face consultations during the COVID-19 pandemic. The majority of HCPs (Healthcare Professionals) were unfamiliar with Telemedicine prior to the current pandemic. Remote consultation is expected to continue for the foreseeable future, thus we designed this survey. A survey designed to evaluate the use of telephone consultation by HCPs, assessing its implementation, challenges and drawbacks. A web link survey conducted through SurveyMonkey was sent to HCPs across six UK Trusts the period of May 2020. The survey received 114 responses (84%) being doctors. 95% of respondents had not received training prior to engaging in telemedicine consultations. 64% were unaware of the updated General Medical Council guidance concerning remote consultations. The most common barrier in remote consultation was the inability to access patient records raised by 37% of respondents. However, 73% of respondents felt that patients understood their medical condition and the instructions given to them over the phone, and 70% agreed that videoconference consultations would add to patients care. Telemedicine can be used for selected groups of patients in the post COVID-19 era, and the HCPs carrying that should have the sufficient experience and knowledge expected to operate these clinics.

scholarly journals Telephone versus face-to-face neuro-oncology consultations: comparing patient satisfaction, convenience, family support and clinician attitude during the COVID-19 pandemic

2021 ◽  
Vol 23 (Supplement_4) ◽  
pp. iv14-iv14
Author(s):  
Emma Toman ◽  
Claire Goddard ◽  
William Garratt ◽  
Frederick Berki ◽  
Zenab Sher ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Family Member ◽  
Telephone Consultation ◽  
Face To Face ◽  
Oncology Service ◽  
Level Of Satisfaction ◽  
Number Of Patients ◽  
Significant Difference ◽  
Remote Consultations

Abstract Aims During the first wave of the COVID-19 pandemic, to limit the number of patients attending hospital, the neuro-oncology department selected a large number of appointments to be conducted via the telephone. This project aimed to determine how patients and clinicians perceived telephone consultations in the neuro-oncology service compared to traditional face to face appointments. Method A 20-question patient satisfaction survey combined quantitative and qualitative questions and was distributed between June and August 2020. These were distributed by email to 88 patients who attended neuro-oncology clinic in person ("face-to-face"), or by telephone. Concurrently, a 15-question survey was distributed to all clinicians conducting telephone and face-to-face consultations for the neuro-oncology service. Questions included in the clinician survey were designed to mirror the patient satisfaction questionnaire where possible. Fisher's exact test was used to determine significance, which was set at p&lt; 0.05. Results 51.1% (n=45) of patients returned the questionnaire. Of those who received telephone appointments, 89.5% (n=17) felt the consultation was convenient, 94.7% (n=18) were satisfied and 80.0% (n=16) were able to have a family member/friend present. Of those who attended face-to-face appointments, 96.0% (n=24) felt their consultation was convenient, 100% (n=25) were satisfied and 87.5% (n=21) were able to have a family member/friend present. There was no significant difference in patient convenience, satisfaction or family/friend presence (p=0.395, p=0.432 and p=0.498 respectively) between face-to-face and telephone clinics. Overall, the clinicians reported undertaking a mean of 9.5 telephone consultations per week. Only 42.8% (n=3) use telephone appointments for first-time neuro-oncology consultations, whereas 100.0% (n=7) use them for results and follow-up appointments. Only 51.7% (n=4) felt that undertaking telephone consultations is convenient and 42.8% (n=3) have experienced difficult situations with patients during telephone consultation. Conclusion This project suggests that neuro-oncology telephone consultations provide patients with the same level of satisfaction and convenience as face-to-face appointments. We have also demonstrated that using the telephone does not provide a significant barrier to having family or friends present to support the patient. We have shown that clinicians are universally utilising neuro-oncology telephone appointments for follow-up and results whereas much fewer use the telephone for performing initial consultations. Given the high-level of satisfaction demonstrated in the patient questionnaires this reflects effective patient-selection for remote consultations. The COVID-19 pandemic has forced oncology services to evolve and results of this project suggest that telephone neuro-oncology consultations are widely accepted by patients and clinicians. We therefore propose that remote consultations should continue beyond the pandemic in select cases.

Response Rates in Online Surveys With Affective Disorder Participants

2020 ◽  
Vol 228 (1) ◽  
pp. 14-24 ◽  
Author(s):  
Tanja Burgard ◽  
Michael Bošnjak ◽  
Nadine Wedderhoff
Keyword(s):  
Meta Analysis ◽  
Response Rates ◽  
Contact Mode ◽  
General Anxiety Disorder ◽  
General Anxiety ◽  
Face To Face ◽  
Survey Participation ◽  
The Mean ◽  
Design Characteristics ◽  
E Mail

Abstract. A meta-analysis was performed to determine whether response rates to online psychology surveys have decreased over time and the effect of specific design characteristics (contact mode, burden of participation, and incentives) on response rates. The meta-analysis is restricted to samples of adults with depression or general anxiety disorder. Time and study design effects are tested using mixed-effects meta-regressions as implemented in the metafor package in R. The mean response rate of the 20 studies fulfilling our meta-analytic inclusion criteria is approximately 43%. Response rates are lower in more recently conducted surveys and in surveys employing longer questionnaires. Furthermore, we found that personal invitations, for example, via telephone or face-to-face contacts, yielded higher response rates compared to e-mail invitations. As predicted by sensitivity reinforcement theory, no effect of incentives on survey participation in this specific group (scoring high on neuroticism) could be observed.

At Least One Standard Deviation Above the Mean

1969 ◽  
Vol 14 (9) ◽  
pp. 470-471
Author(s):  
M. DAVID MERRILL
Keyword(s):  
Standard Deviation ◽  
The Mean

The Estimation of Blood Platelet Survival

1972 ◽  
Vol 28 (03) ◽  
pp. 447-456 ◽  
Author(s):  
E. A Murphy ◽  
M. E Francis ◽  
J. F Mustard
Keyword(s):  
Standard Deviation ◽  
Least Squares ◽  
Experimental Error ◽  
Blood Platelet ◽  
Least Squares Estimation ◽  
Systematic Relationship ◽  
Platelet Survival ◽  
The Mean ◽  
Normally Distributed

SummaryThe characteristics of experimental error in measurement of platelet radioactivity have been explored by blind replicate determinations on specimens taken on several days on each of three Walker hounds.Analysis suggests that it is not unreasonable to suppose that error for each sample is normally distributed ; and while there is evidence that the variance is heterogeneous, no systematic relationship has been discovered between the mean and the standard deviation of the determinations on individual samples. Thus, since it would be impracticable for investigators to do replicate determinations as a routine, no improvement over simple unweighted least squares estimation on untransformed data suggests itself.

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