Telemedicine in Germany During the COVID-19 Pandemic: Multi-Professional National Survey

Background In an effort to contain the effects of the coronavirus disease (COVID-19) pandemic, health care systems worldwide implemented telemedical solutions to overcome staffing, technical, and infrastructural limitations. In Germany, a multitude of telemedical systems are already being used, while new approaches are rapidly being developed in response to the crisis. However, the extent of the current implementation within different health care settings, the user’s acceptance and perception, as well as the hindering technical and regulatory obstacles remain unclear. Objective The aim of this paper is to assess the current status quo of the availability and routine use of telemedical solutions, user acceptance, and the subjectively perceived burdens on telemedical approaches. Furthermore, we seek to assess the perception of public information quality among professional groups and their preferred communication channels. Methods A national online survey was conducted on 14 consecutive days in March and April 2020, and distributed to doctors, nurses, and other medical professionals in the German language. Results A total of 2827 medical professionals participated in the study. Doctors accounted for 65.6% (n=1855) of the professionals, 29.5% (n=833) were nursing staff, and 4.9% (n=139) were identified as others such as therapeutic staff. A majority of participants rated the significance of telemedicine within the crisis as high (1065/2730, 39%) or neutral (n=720, 26.4%); however, there were significant differences between doctors and nurses (P=.01) as well as between the stationary sector compared to the ambulatory sector (P<.001). Telemedicine was already in routine use for 19.6% (532/2711) of German health care providers and in partial use for 40.2% (n=1090). Participants working in private practices (239/594, 40.2%) or private clinics (23/59, 39.0%) experienced less regulatory or technical obstacles compared to university hospitals (586/1190, 49.2%). A majority of doctors rated the public information quality on COVID-19 as good (942/1855, 50.8%) or very good (213/1855, 11.5%); nurses rated the quality of public information significantly lower (P<.001). Participant’s age negatively correlated with the perception of telemedicine’s significance (ρ=–0.23; P<.001). Conclusions Telemedicine has a broad acceptance among German medical professionals. However, to establish telemedical structures within routine care, technical and regulatory burdens must be overcome.

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Telemedicine in Germany During the COVID-19 Pandemic: Multi-Professional National Survey (Preprint)

10.2196/preprints.19745 ◽

2020 ◽

Author(s):

Arne Peine ◽

Pia Paffenholz ◽

Lukas Martin ◽

Sandra Dohmen ◽

Gernot Marx ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Online Survey ◽

Information Quality ◽

Health Care Systems ◽

Public Information ◽

Current Status ◽

Medical Professionals ◽

Care Providers ◽

University Hospitals

BACKGROUND In an effort to contain the effects of the coronavirus disease (COVID-19) pandemic, health care systems worldwide implemented telemedical solutions to overcome staffing, technical, and infrastructural limitations. In Germany, a multitude of telemedical systems are already being used, while new approaches are rapidly being developed in response to the crisis. However, the extent of the current implementation within different health care settings, the user’s acceptance and perception, as well as the hindering technical and regulatory obstacles remain unclear. OBJECTIVE The aim of this paper is to assess the current status quo of the availability and routine use of telemedical solutions, user acceptance, and the subjectively perceived burdens on telemedical approaches. Furthermore, we seek to assess the perception of public information quality among professional groups and their preferred communication channels. METHODS A national online survey was conducted on 14 consecutive days in March and April 2020, and distributed to doctors, nurses, and other medical professionals in the German language. RESULTS A total of 2827 medical professionals participated in the study. Doctors accounted for 65.6% (n=1855) of the professionals, 29.5% (n=833) were nursing staff, and 4.9% (n=139) were identified as others such as therapeutic staff. A majority of participants rated the significance of telemedicine within the crisis as high (1065/2730, 39%) or neutral (n=720, 26.4%); however, there were significant differences between doctors and nurses (P=.01) as well as between the stationary sector compared to the ambulatory sector (P<.001). Telemedicine was already in routine use for 19.6% (532/2711) of German health care providers and in partial use for 40.2% (n=1090). Participants working in private practices (239/594, 40.2%) or private clinics (23/59, 39.0%) experienced less regulatory or technical obstacles compared to university hospitals (586/1190, 49.2%). A majority of doctors rated the public information quality on COVID-19 as good (942/1855, 50.8%) or very good (213/1855, 11.5%); nurses rated the quality of public information significantly lower (P<.001). Participant’s age negatively correlated with the perception of telemedicine’s significance (ρ=–0.23; P<.001). CONCLUSIONS Telemedicine has a broad acceptance among German medical professionals. However, to establish telemedical structures within routine care, technical and regulatory burdens must be overcome.

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The Short-Term Impact of COVID-19 Pandemic on Spine Surgeons: A cross sectional global study

10.21203/rs.3.rs-28700/v1 ◽

2020 ◽

Author(s):

Mohamed Fawzy Khattab ◽

Tareq M.A. Kannan ◽

Ahmed Morsi ◽

Qussay Al-Sabbagh ◽

Fadi Hadidi ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Systems ◽

Cross Sectional Study ◽

Care Providers ◽

University Hospitals ◽

Short Term ◽

Cross Sectional ◽

Validated Questionnaire ◽

The Impact

Abstract Purpose: The outbreak of COVID-19 erupted in December 2019 in Wuhan-China. In a few weeks it progressed rapidly into a global pandemic which resulted in an overwhelming burden on health care systems, medical resources and staff.Spine surgeons as health care providers are no exception. In this study we try to highlight the impact of the crisis on spine surgeons in terms of knowledge, attitude, practice and socioeconomic BurdenMethods: This was global, multi-centric cross-sectional study on 781 spine surgeons that utilized an internet-based validated questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perceptions, effect of this crisis on practice and psychological distress. Univariate and multivariate ordinal logistic regression analyses were used to evaluate the predictors for the degree of COVID-19 effect on practice. Results: Overall, 20.2%, 52%, and 27.8% of the participants were affected minimally, intermediately, and hugely by COVID-19, respectively. Older ages (β= 0.33, 95% CI 0.11 to 0.56), orthopedic spine surgeons (β=0.30, 95% CI 0.01 to 0.61) and those who work in the private sector (β=0.05, 95% CI 0.19 to 0.61) were the most affected by COVID-19. Those who work in university hospitals (β=-0.36, 95% CI 0.00 to -0.71) were affected the least. The availability of N95 masks (47%) and disposable eye protectors or face shields (39.4%) was significantly associated with lower psychological stress (p=0.01). Only (6.9%), (3.7%), and (5%) had mild, moderate and severe mental distress, respectively.Conclusion: While it is important to recognize the short-term impact of COVID-19 pandemic on the practice of spine surgery, predicting where we will be standing in 6-12 months remains difficult and unknown. The COVID-19 crisis will probably have an unexpected long-term impact on lives and economies.

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Reopening Oral Health Services during the COVID-19 Pandemic through a Knowledge Exchange Coalition

JDR Clinical & Translational Research ◽

10.1177/23800844211011985 ◽

2021 ◽

pp. 238008442110119

Author(s):

M. McNally ◽

L. Rock ◽

M. Gillis ◽

S. Bryan ◽

C. Boyd ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Services ◽

Return To Work ◽

Health Care Providers ◽

Online Survey ◽

Knowledge Exchange ◽

Oral Health Care ◽

Care Providers ◽

Oral Health Services

Background: The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work. Methods: Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic. Results: Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic. Conclusions: A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings. Knowledge Transfer Statement: The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.

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Burnout Impact of COVID-19 Pandemic on Health-Care Professionals at Assiut University Hospitals, 2020

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105368 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5368

Author(s):

Shimaa A. Elghazally ◽

Atef F. Alkarn ◽

Hussein Elkhayat ◽

Ahmed K. Ibrahim ◽

Mariam Roshdy Elkhayat

Keyword(s):

Health Care ◽

Health Care Providers ◽

Emotional Exhaustion ◽

Health Care Professionals ◽

Maslach Burnout Inventory ◽

Adverse Outcomes ◽

Personal Accomplishment ◽

Burnout Syndrome ◽

Care Providers ◽

University Hospitals

Background: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers’ health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. Objectives: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. Methods: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. Conclusion: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.

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Plain Talk About Health: Linguistic Aspects of Mediation between Amish and Mennonites and Health Care Professionals

The Journal of Plain Anabaptist Communities ◽

10.18061/jpac.v1i1.7803 ◽

2020 ◽

Vol 1 (1) ◽

pp. 1

Author(s):

Mark L. Louden

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Language Use ◽

Medical Professionals ◽

Care Providers ◽

Public Spheres ◽

Pennsylvania Dutch ◽

Old Order ◽

Cultural Mediator

As the population of Amish and Old Order Mennonites grows exponentially, so are the contacts between Plain people and medical professionals increasing. All Plain adults are bilingual; however, the fact that the primary everyday language for most is Pennsylvania Dutch is important for understanding how they navigate the health care system. In this article I give an overview of language-related questions involved in communication between Plain people and health care providers with a focus on three areas: translation, interpretation, and patterns of language use. Much of the information I present in this article is drawn from my experience as an interpreter and cultural mediator for Plain people in a number of different public spheres, mainly health care.

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An Evaluation of the Self-Reported Knowledge Base of Disaster Management Core Competencies of Australian Paramedics

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19002814 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s129-s130

Author(s):

Peter Horrocks ◽

Vivienne Tippett ◽

Peter Aitken

Keyword(s):

Health Care ◽

Disaster Management ◽

Health Care Providers ◽

Health Care Professionals ◽

Disaster Response ◽

Online Survey ◽

Core Competencies ◽

Ambulance Service ◽

Care Providers ◽

Extensive Experience

Introduction:Evidence-based training and curriculum are seen as vital in order to be successful in preparing paramedics for an effective disaster response. The creation of broadly recognized standard core competencies to support the development of disaster response education and training courses for general health care providers and specific health care professionals will help to ensure that medical personnel are truly prepared to care for victims of mass casualty events.Aim:To identify current Australian operational paramedic’s specific disaster management education and knowledge as it relates to disaster management core competencies identified throughout the literature and the frequency of measures/techniques which these paramedics use to maintain competency and currency.Methods:Paramedics from all states of Australia were invited to complete an anonymous online survey. Two professional bodies distributed the survey via social media and a major ambulance service was surveyed via email.Results:The study population includes 130 respondents who self-identified as a currently practicing Australian paramedic. Paramedics from all states except South Australia responded, with the majority coming from Queensland Ambulance Service (N= 81%). In terms of experience, 81.54% of respondents report being qualified for greater than 5 years. Initial analysis shows that despite the extensive experience of the practitioners surveyed when asked to rate from high to low their level of knowledge of specific disaster management core competencies a number of gaps exist.Discussion:Core competencies are a defined level of expertise that is essential or fundamental to a particular job, and serve to form the foundation of education, training, and practice for operational service delivery. While more research is needed, these results may help inform industry, government, and education providers to better understand and to more efficiently provide education and ongoing training to paramedics who are responsible for the management of disaster within the Australian community.

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Improving Patient Safety with Information Technology

Handbook of Research on Advances in Health Informatics and Electronic Healthcare Applications ◽

10.4018/978-1-60566-030-1.ch009 ◽

2010 ◽

pp. 144-152 ◽

Cited By ~ 1

Author(s):

James G. Anderson

Keyword(s):

Health Care ◽

Information Technology ◽

Medication Errors ◽

Health Care Providers ◽

Adverse Drug Events ◽

Health Care Systems ◽

Simulation Models ◽

Care Providers ◽

Care Systems ◽

Computer Simulation Models

Over three-quarters of a million people are injured or die in hospitals annually from adverse drug events. The majority of medication errors result from poorly designed health care systems rather than from negligence on the part of health care providers. Health care systems, in general, rely on voluntary reporting which seriously underestimates the number of medication errors and adverse drug events (ADEs) by as much as 90%. This chapter reviews the literature on (1) the incidence and costs of medication errors and ADEs; (2) detecting and reporting medication errors and related ADEs; (3) and the use of information technology to reduce the number of medication errors and ADEs in health care settings. Results from an analysis of data on medication errors from a regional data sharing consortium and from computer simulation models designed to analyze the effectiveness of information technology (IT) in preventing medication errors are summarized.

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Patient Choice and Patient Empowerment in Northern European Health Systems: A Conceptual Framework

International Journal of Health Services ◽

10.2190/8wmp-rr2k-abm7-nvnh ◽

1994 ◽

Vol 24 (2) ◽

pp. 201-229 ◽

Cited By ~ 48

Author(s):

Richard B. Saltman

Keyword(s):

Health Care ◽

Health Systems ◽

Health Care Providers ◽

Health Care Systems ◽

Patient Empowerment ◽

Patient Choice ◽

Care Providers ◽

Care Systems ◽

European Health ◽

The Impact

The issue of patient choice presents a complicated challenge to publicly operated health systems. Increased patient choice can strengthen the citizen's commitment to traditional welfare state objectives, or alternatively, it can severely damage that commitment, depending upon the design of the choice mechanism and the structural context within which patient choice occurs. For patient choice to be linked to true empowerment, choice must reinforce rather than undercut the accountability of health care providers to the population they serve. This article explores the basic issues involved in empowering patients within publicly operated health systems. The author first reviews the conceptual components that could or should be incorporated within the notion of empowered patients, then examines what would be required to actually empower patients within health systems, defined in terms of expanding not only logistical choice but also clinical influence and decision-making participation. The article concludes with a wide-ranging analysis of the impact of potential policies and mechanisms on the long-term objectives of achieving democratically accountable health care systems.

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A Consensus-Based Set of Measures for Oral Health Care

Journal of Dental Research ◽

10.1177/0022034517702331 ◽

2017 ◽

Vol 96 (8) ◽

pp. 881-887 ◽

Cited By ~ 10

Author(s):

F. Baâdoudi ◽

A. Trescher ◽

D. Duijster ◽

N. Maskrey ◽

F. Gabel ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Care Providers ◽

Health Care Systems ◽

Routine Data ◽

Oral Health Care ◽

Care Providers ◽

Patient Centered ◽

Dental Practitioners ◽

Care Systems

Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more patient-centered and prevention-oriented oral health care. To accomplish this, an intermediate objective was to develop a comprehensive list of topics that a range of stakeholders would perceive as valid, important, and relevant for describing oral health and oral health care. A 4-stage approach was used to develop the list of topics: 1) scoping of literature and its appraisal, 2) a meeting of experts, 3) a 2-stage Delphi process (online), and 4) a World Café discussion. The aim was to create consensus through structured conversations via a range of stakeholders (general dental practitioners, patients, insurers, and policy makers) from the Netherlands, Germany, the United Kingdom, Ireland, Hungary, and Denmark. The study was part of the ADVOCATE project, and it resulted in a list of 48 topics grouped into 6 clusters: 1) access to dental care, 2) symptoms and diagnosis, 3) health behaviors, 4) oral treatments, 5) oral prevention, and 6) patient perception. All topics can be measured, as they all have a data source with defined numerators and denominators. This study is the first to establish a comprehensive and multiple-stakeholder consented topic list designed for guiding the implementation of transparent and explicit measurement of routine data of oral health and oral health care. Successful measurement within oral health care systems is essential to facilitate learning from variation in practice and outcomes within and among systems, and it potentiates improvement toward more patient-centered and prevention-oriented oral health care.

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ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic

Endoscopy ◽

10.1055/a-1155-6229 ◽

2020 ◽

Vol 52 (06) ◽

pp. 483-490 ◽

Cited By ~ 93

Author(s):

Ian M. Gralnek ◽

Cesare Hassan ◽

Ulrike Beilenhoff ◽

Giulio Antonelli ◽

Alanna Ebigbo ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

European Society ◽

Health Care Professionals ◽

Gastrointestinal Endoscopy ◽

Clinical Manifestations ◽

Current Status ◽

Infection Prevention And Control ◽

Care Providers ◽

Increased Risk

AbstractWe are currently living in the throes of the COVID-19 pandemic that imposes a significant stress on health care providers and facilities. Europe is severely affected with an exponential increase in incident infections and deaths. The clinical manifestations of COVID-19 can be subtle, encompassing a broad spectrum from asymptomatic mild disease to severe respiratory illness. Health care professionals in endoscopy units are at increased risk of infection from COVID-19. Infection prevention and control has been shown to be dramatically effective in assuring the safety of both health care professionals and patients. The European Society of Gastrointestinal Endoscopy (www.esge.com) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (www.esgena.org) are joining forces to provide guidance during this pandemic to help assure the highest level of endoscopy care and protection against COVID-19 for both patients and endoscopy unit personnel. This guidance is based upon the best available evidence regarding assessment of risk during the current status of the pandemic and a consensus on which procedures to perform and the priorities on resumption. We appreciate the gaps in knowledge and evidence, especially on the proper strategy(ies) for the resumption of normal endoscopy practice during the upcoming phases and end of the pandemic and therefore a list of potential research questions is presented. New evidence may result in an updated statement.

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