scholarly journals VA Video Telehealth and Training Programs During the COVID-19 Response

2021 ◽  
Author(s):  
Rhonda Johnston ◽  
Rita F. Kobb ◽  
Claire Marty ◽  
Padraic McVeigh
Keyword(s):  
Online Survey ◽  
Surgical Care ◽  
Office Visits ◽  
Face To Face ◽  
Patient Interaction ◽  
Telemedicine Consultation ◽  
Physician Patient ◽  
And Training

Study Design: An online survey modeled after the TeleENT Satisfaction Questionnaire and the Medical Communication Competence Scale (MCCS) were administered to gauge patient experience with electronic medical record-based telemedicine visits. Results: Participants noted several advantages of telemedicine visits over traditional in-office visits: shorter visits, saving money, and avoiding potential exposure during the pandemic. Thirty-six percent of the patients agreed that the quality of care was hindered by the lack of a physical exam, and 61.7% of the patients agreed that they prefer a face-to-face visit rather than telemedicine consultation. Most patients were satisfied with the care they received via telemedicine (Likert 6.19/7), and 95.8% of the patients would use telemedicine again. Participants self-reported an average saving of $108.70 when using telemedicine. When comparing the telemedicine cohort to the in-office control, the telemedicine patients noted an improved ability to communicate with their physician in 5 out of 8 domains of the MCCS. Conclusion: Surgical preoperative consultation, postoperative follow-up, and routine visits were conducted via telemedicine during the COVID-19 pandemic, representing a new direction for surgical appointments and consultations. This study shows that telehealth provides satisfactory care and increases access to surgical care for patients when external factors prevent the traditional physician–patient interaction. With better-perceived communication via telemedicine appointments, patients may subjectively feel that they can express their symptoms and gather information from the doctor regarding their diagnosis more efficiently.

scholarly journals Surgical Patient Experience with a Novel Telemedicine Program in the COVID-19 Era

2021 ◽  
Author(s):  
Rachel M. Segal ◽  
Jared Matson ◽  
Omid Moshtaghi ◽  
Elina Vaidya ◽  
Elina Kari ◽  
...  
Keyword(s):  
Online Survey ◽  
Rectal Surgery ◽  
Surgical Care ◽  
Surgical Patient ◽  
Colon And Rectal Surgery ◽  
Office Visits ◽  
Face To Face ◽  
Viral Spread ◽  
Telemedicine Consultation ◽  
Patient’S Experience

Background: During the COVID-19 pandemic, measures were taken to decrease viral spread by transitioning health care appointments to virtual mediums. This study evaluates the use of telemedicine within the Divisions of Colon and Rectal Surgery and Otolaryngology-Neurotology at a single academic institution during the COVID-19 pandemic. Study Design: An online survey modeled after the TeleENT Satisfaction Questionnaire and the Medical Communication Competence Scale (MCCS) was administered to gauge patient’s experience with Electronic Medical Record-based telemedicine visits. Results: Participants noticed several advantages of telemedicine visits over traditional in-office visits: shorter visits, saving money, and avoiding potential exposure during the pandemic. A total of 36% at least somewhat agreed that the quality of care was hindered by the lack of a physical examination;61.7% participants at least somewhat agreed that they prefer a face-to-face visit rather than telemedicine consultation. Most patients were satisfied with the care they received via telemedicine (Likert 6.19/7) and 95.8% would use telemedicine again. Participants self-reported an average saving of $108.70 when using telemedicine. When comparing the telemedicine cohort with the in-office control, the telemedicine patients noticed an improved ability to communicate with their physician in five out of eight domains of the MCCS. Conclusion: Surgical preoperative consultation, postoperative follow-up, and routine visits were conducted via telemedicine during the COVID-19 pandemic, representing a new direction for surgical appointments and consultations. This study shows that telehealth can provide satisfactory care and increases access to surgical care for patients when external factors prevent the traditional physician–patient interaction. With better-perceived communication via telemedicine appointments, patients may subjectively feel that they can express their symptoms and gather information from the doctor regarding their diagnosis more efficiently.

scholarly journals A88 PATIENT AND PHYSICIAN PERSPECTIVE OF TELE-HEALTH IN GASTROENTEROLOGY

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 59-60
Author(s):  
M Tomaszewski ◽  
B Zhao ◽  
H Kim ◽  
R A Enns ◽  
B Bressler ◽  
...  
Keyword(s):  
British Columbia ◽  
Online Survey ◽  
Tertiary Care ◽  
Outpatient Setting ◽  
Physician Satisfaction ◽  
Physical Exam ◽  
Office Visits ◽  
Physician Perspective

Abstract Background Given the social distancing measures employed to reduce the transmission of SARS-CoV-2, tele-health has rapidly expanded and is now routinely used in new patient encounters and in follow up appointments across Canada. Aims To determine the patient and physician perspective towards tele-health in a gastroenterology outpatient setting. Methods An anonymous voluntary online survey was distributed to patients who had previously undergone at least one tele-health visit in a tertiary care gastroenterology outpatient setting. A separate online survey was distributed to gastroenterologists practising across Canada. Results A total of 181 patients from British Columbia (59.8% female) completed the survey. The tele-health appointment was the first visit for 21.8% of patients. Appointments occurred by phone call alone (61.4%) or by video and audio software (38.6%) and started within 5 minutes of the scheduled time in 75% of visits. Patient satisfaction with the tele-health visit was high (8.54 on a scale of 0–10; 0 completely dissatisfied, 10 extremely satisfied; IQR 8–10). Most patients did not perceive a difference in likelihood of compliance compared to a non-tele-health visit (90.6%), were not concerned about the lack of physical exam during a tele-health visit (82.4%) and did not with-hold information they would have revealed in person (88.7%). After the COVID-19 pandemic, some patients would prefer tele-heath visits (39.2%), whereas others would prefer in office visits (28.5%) and the remainder were indifferent (32.3%). Post-pandemic, most patients would prefer tele-health for follow up visits (68.4%), over tele-health for all possible visits (27.9%) or no tele-health visits (3.8%). A total of 25 Canadian gastroenterologists (28.0% female; 60% academic practice, 40% community practice) completed a separate survey. Regarding the lack of physical exam in tele-health, 44% of physicians believed this did not affect the quality of their assessment, whereas some physicians believed it had either minimally (48%) or greatly (8%) impaired the quality of their assessment. Almost all physicians (96%) perceived that patients either appreciate tele-health as much as or more than in office visits. Post-pandemic, most physicians (96%) supported a hybrid model of both tele-health and in office visits. Appointments for follow up of benign endoscopic pathology results (96%), follow up visits (92%), consultations prior to endoscopy (76%) were deemed to be most appropriate for tele-health. Follow up of malignant pathology results (24%) and consultations for new patients (32%) were thought to be less appropriate for tele-health visits. Conclusions Patient and physician satisfaction with tele-health in a Canadian outpatient gastroenterology setting is high. Most patients and physicians wish for tele-health to remain available in the post-pandemic setting. Funding Agencies Gastrointestinal Research Institute, Vancouver, British Columbia

scholarly journals 829 Is There an Ongoing Role For 'Telephone Triage Clinics' Post COVID-19?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
B Holmes ◽  
U Mirza ◽  
C Manning ◽  
R Cooke ◽  
R Jugdey
Keyword(s):  
Common Theme ◽  
Telephone Triage ◽  
Telephone Consultation ◽  
Face To Face ◽  
Clinician Satisfaction ◽  
Set Up ◽  
Local Protocol ◽  
Telephone Questionnaire

Abstract Introduction COVID-19 has placed unprecedented demand on services at ELHT and it has become necessary to have telephone clinics to reduce the number of face-to-face clinics. A ‘telephone triage clinic’ was set up for referrals from A&E. Our project evaluated patient and clinician satisfaction on this. Method We carried out a retrospective telephone questionnaire with patients over a one-week period during the pandemic. We focussed on overall satisfaction of the consultation and quality of communication. Consultants were also surveyed for their opinion on the clinics. Results From 30 patients, 77% said they were ‘very satisfied’ with the overall experience. 80% of patients were ‘very satisfied’ with the overall length of the telephone consultation. 50% of patients felt the clinician was only ‘adequately’ able to assess them over the telephone. The consultants were less satisfied with the overall experience of telephone consultation. A common theme was that they felt ED documentation could be improved to help inform ongoing management. Conclusions Overall, patients were satisfied with the consultations. It has been successful in minimising face to face consultations however some presentations necessitate further evaluation. We need to identify those injuries appropriate for virtual follow up and design a local protocol for these.

scholarly journals Are telephone consultations here to stay in rheumatology?

2020 ◽  
Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham
Keyword(s):  
Older Patients ◽  
Online Survey ◽  
Vulnerable Groups ◽  
Age Group ◽  
Telephone Consultation ◽  
Survey Tool ◽  
Face To Face ◽  
Vulnerable Patients ◽  
Number Of Patients

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.

scholarly journals Teledermatology in Times of COVID-19 Confinement: Comparing Patients’ and Physicians’ Satisfaction by the Standardized Brest Teledermatology Questionnaire

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Joachim W. Fluhr ◽  
Annie Gueguen ◽  
Delphine Legoupil ◽  
Emilie Brenaut ◽  
Claire Abasq ◽  
...  
Keyword(s):  
Main Question ◽  
Chronic Patients ◽  
Dermatology Department ◽  
Global Satisfaction ◽  
Technical Parameters ◽  
Face To Face ◽  
Almost All ◽  
Outpatient Settings

The French government imposed the first COVID-19 pandemic lockdown from March 17 until May 11, 2020. Only emergency cases and teledermatology (TD) were allowed in outpatient settings. A standardized questionnaire was developed to compare the satisfaction level of patients and their treating physicians. Our main question was whether the patients would perceive TD as a valid alternative for direct physical face-to-face consultation. Eighty-two patients and their 4 treating dermatologists from one dermatology department participated in the study (43 females, 39 males) with a mean age of 46.6 years (SD ±23.9). The reason for TD was a chronic disease in the majority (87.8%), and mainly as a follow-up (96.3%). Regarding satisfaction, almost all categories rated around 9 on a 0–10 verbal analogue scale. The same level of global satisfaction could be seen between the patients and the physicians as well as for the quality of the patient-physician relation and whether all questions could be addressed during the TC. Physicians showed significantly higher scores than patients only for the category of “length” of the consultation. Gender, age, as well as distance between the clinic and home of the patient were not influencing factors for satisfaction. Regarding the technical parameters, the evaluation was mostly comparable for patients and physicians, but overall lower than the relational satisfaction parameters, especially for image quality. Patients were significantly more motivated to continue the TD after the lockdown than their treating dermatologists. We see an interest for implementing TD in specialized centers with chronic patients coming from remote places for regular follow-ups. TD cannot replace in-person patient-physician interaction, but was helpful during the lockdown. As a result, TD might become part of dermatology training to prepare for future lockdown situations.

scholarly journals Education in Neurology Resident Documentation Using Payroll Simulation

2017 ◽  
Vol 9 (2) ◽  
pp. 231-236 ◽  
Author(s):  
John W. Liang ◽  
Vicki L. Shanker
Keyword(s):  
Medical Decision ◽  
Financial Loss ◽  
Income Loss ◽  
Face To Face ◽  
Number Of Patients ◽  
Specific Feedback ◽  
Didactic Lecture ◽  
E Mail

ABSTRACT Background Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. Objective To improve the quality of neurology resident documentation through payroll simulation. Methods A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback “paystubs” every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Results Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits (P < .001), with a reduction in the financial loss to 6% ($1,880). Conclusions Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided.

Management of Somatic Symptoms

2014 ◽  
Author(s):  
Andreas Schröder ◽  
Joel E Dimsdale
Keyword(s):  
Clinical Presentation ◽  
Health Anxiety ◽  
Management Strategies ◽  
Somatic Symptoms ◽  
Conversion Disorder ◽  
Effective Management ◽  
Patient Interaction ◽  
Step Care ◽  
Physician Patient

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains  5 highly rendered figures, 10 tables, and 235 references.

Management of Somatic Symptoms

2018 ◽  
Author(s):  
Andreas Schröder ◽  
Joel E Dimsdale
Keyword(s):  
Clinical Presentation ◽  
Health Anxiety ◽  
Management Strategies ◽  
Somatic Symptoms ◽  
Conversion Disorder ◽  
Effective Management ◽  
Patient Interaction ◽  
Step Care ◽  
Physician Patient

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains  5 highly rendered figures, 10 tables, and 235 references.

Effects of Physician-Patient Electronic Communications on the Quality of Care

2013 ◽  
Vol 2 (2) ◽  
pp. 54-62 ◽  
Author(s):  
Shima Tabatabai
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Electronic Communication ◽  
Process Efficiency ◽  
Electronic Communications ◽  
Face To Face ◽  
Potential Benefits ◽  
Healthcare Process ◽  
Physician Patient

The article summarizes evidence about the effectiveness of patient–physician electronic communication. The emphasis was on the importance of understanding the potential impact of e-communication on patient satisfaction, and on the quality of health care. A review of literature was performed in the area of patient–physician electronic communication, and references were appraised, and synthesized for an overview of benefits and challenges of this model of communication. Electronic communication is becoming popular, has the potential to transform the health care system, and support the patient–physician interaction. Patients are enthusiastic about this convenience model of communication, and feel strongly embraced in communicating via email & web messaging. Although, there is evidence that electronic communication could increase quality of care due to increased interaction and would extend health care efficiency, a variety of potential benefits and challenges is reported. Overall, electronic communication introduces a new model of patient-physician interaction that could supplement and reasonably replace a portion of traditional face-to-face encounters. However, further investigation is required to assess its impact on healthcare process efficiency.

scholarly journals An Effectiveness Study of a Digital Mindfulness-Based Program for Upper Secondary Education Students

Mindfulness ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 2494-2505
Author(s):  
Oskari Lahtinen ◽  
Christina Salmivalli
Keyword(s):  
Controlled Trial ◽  
Attrition Rate ◽  
Education Students ◽  
Online Questionnaire ◽  
Face To Face ◽  
Upper Secondary Education ◽  
Randomized Controlled ◽  
Upper Secondary

Abstract Objectives Mindfulness-based programs/interventions (MBPs) are emerging as treatments for anxiety and stress for adults and adolescents. MBPs can also be helpful as universal interventions for healthy subjects. Few studies have looked at how beneficial MBP effects transfer to digital MBPs. Methods The study was a randomized controlled trial with 1349 participants aged mostly 16–19. We compared a digital MBP vs. a waitlist condition. Online questionnaire data were collected pre-program, post-program, and at 3-month follow-up. Results Completing the MBP resulted in a small-to-moderate reduction in anxiety (F1,681 = 13.71, p < .01, d = .26), a small reduction in depression (F1,686 = 8.54, p < .01, d = .15), and a small increase in psychological quality of life (F1,708 = 3.94, p = .05, d = .16). Attrition rate for the MBP was 41.5%. Conclusions The results suggest that digital MBPs can be successful in delivering at least some of the benefits characteristic of face-to-face MBPs.

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