Designing Virtual Medical Student Ambulatory Rotations in Light of the Coronavirus Pandemic: A Pilot Project

2020 ◽  
Author(s):  
Shreya Louis ◽  
J. Harry Isaacson ◽  
Monica Yepes-Rios ◽  
Neil Mehta
Keyword(s):  
Communication Technologies ◽  
Pilot Project ◽  
Rapid Expansion ◽  
Clinical Experiences ◽  
Department Of Health ◽  
Technology Platforms ◽  
Vulnerable Patients ◽  
Patient Consent ◽  
Virtual Visits ◽  
Set Up

Problem: Medical schools across the country have suspended in-person student clinical rotations in light of the ongoing COVID-19 pandemic to reduce transmission of infection, protect students, and preserve personal protective equipment (PPE) for health care workers on the front lines of care. The COVID-19 pandemic has led to a rapid expansion of outpatient virtual visits. While involving students into these visits will provide meaningful clinical experiences, and help offset the provider burden of increased virtual visits, students and preceptors alike may initially struggle initially in adapting to these new modalities due to the lack of a formal telemedicine curriculum.Approach/Method: The U.S. Department of Health & Human Services has relaxed HIPAA rules to allow for the use of audio and video communication technologies. This study aims to evaluate if ambulatory virtual visits can replicate key elements of the teaching model of in-person visits. Patient consent, preference for virtual visits (audio vs. video), and student involvement are documented in a virtual encounter note template created for this study. We evaluated several platforms to maximize patient access to visits including FaceTime, WhatsApp, Doximity, and Google Voice. Two virtual scenarios were evaluated: one in which students virtually interview patients alone first, and another in which students interview patients with their preceptors for the entire virtual visit. Outcome: Following our initial implementation of this virtual model, students and preceptors were able to replicate the general in-person clinic workflow with the exception physical exam maneuvers and procedures. Students saw patients virtually, completed notes, and participated in feedback sessions with preceptors for each visit. While this pilot study is ongoing, we wanted to share our workflow, note templates, and challenges in order to help other programs initiate implementation of their own student virtual visit encounters. Next Steps: The unique ability for students and preceptors to practice telemedicine with a variety of platforms in light of the COVID-19 pandemic has provided insight into the difficulties in implementing and obtaining access to telemedical visits. To ensure that our most vulnerable patients (those who rely on home health visits) will have access to virtual outpatient care, we aim to enlist medical students in outreach to patients to help them set up various technology platforms or better understand how virtual visits take place prior to their scheduled visit. Lastly, we plan to survey patient, student, and preceptor satisfaction with virtual encounters, to further develop our telemedicine curriculum and implementation for the future.

Online Patient Consultation

2020 ◽  
Vol 158 (04) ◽  
pp. 345-350
Author(s):  
Christian Juhra ◽  
Jörg Ansorg ◽  
David Alexander Back ◽  
Dominik John ◽  
Andrea Kuckuck-Winkelmann ◽  
...  
Keyword(s):  
New Technologies ◽  
Communication Technologies ◽  
Phone Call ◽  
Insurance Companies ◽  
Personal Contact ◽  
Software Products ◽  
Patient Consent ◽  
Health Insurance Companies ◽  
Patient Consultation ◽  
Certified Software

AbstractNew communication technologies allow patients to communicate with their physicians from anywhere using computer or smartphone. Adding video to the mere phone call optimizes the personal contact between patient and physicians regardless of distance. Legal and reimbursements requirements must be taken into account, especially only certified software products must be used. In addition, patient consent is needed and confidentiality must be assured. The video patient consultation can be reimbursed by the health insurance companies. As with all new technologies, the introduction of these video consultations faced some challenges. Although patients and physicians have expressed great interest in this technology, it has been rarely used so far. The current COVID crisis increased the need for video consultations resulting in an increasing use of video patient consultation. It can be expected that this demand will still exists after the COVID crisis.

Webside manner: maskless communication

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ankit Mehta ◽  
Benji K. Mathews
Keyword(s):  
Communication Skills ◽  
Rapid Expansion ◽  
Technical Aspects ◽  
The Core ◽  
Core Elements ◽  
Virtual Visits ◽  
Virtual Platform ◽  
Structured Approach

Abstract Telemedicine has seen a rapid expansion lately, with virtual visits ushering in telediagnosis. Given the shift in the interpersonal and technical aspects of communications in a virtual visit, it is prudent to understand its effect on the patient-provider relationships. A range of interpersonal and communication skills can be utilized during telemedicine consultations in establishing relationships, and reaching a diagnosis. We propose a construct of “webside manner,” a structured approach to ensure the core elements of bedside etiquette are translated into the virtual encounter. This approach entails the totality of any interpersonal exchange on a virtual platform, to ensure a clinician’s presence, empathy and compassion is translated through this medium.

scholarly journals Coworking, the Sharing Economy, and the City: Which Role for the ‘Coworking Entrepreneur’?

Urban Science ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 83 ◽  
Author(s):  
Giacomo Durante ◽  
Margherita Turvani
Keyword(s):  
Information And Communication Technologies ◽  
Organizational Factors ◽  
Communication Technologies ◽  
Sharing Economy ◽  
Internal Factors ◽  
Information And Communication ◽  
Entrepreneurial Action ◽  
Coworking Spaces ◽  
Set Up ◽  
The City

Sharing economy platforms enabled by information and communication technologies (ICTs) are facilitating the diffusion of collaborative workplaces. Coworking spaces are emerging as a distinctive phenomenon in this context, not only fostering knowledge transfer and facilitating innovation, but also affecting the urban and socio-economic fabric contributing to urban regeneration processes at both the local scale and the city scale. Although the positive impacts of coworking on the urban environment are documented, there is still little or no evidence of the economic viability of coworking businesses, and a “coworking bubble” has been evoked. Given the lack of data, a national survey was set up of Italian coworking businesses, aimed at assessing the relevance of internal organizational factors (size, occupancy, profitability, services provided) for the sustainability of coworking businesses. By presenting the results of the survey, we argue that the sustainability and viability of the coworking model is highly dependent on internal factors, strictly related to the entrepreneurial action of coworking managers.

scholarly journals HL7 Terminology Management for Disease Surveillance

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Emily Roberts ◽  
Theron Jeppson ◽  
Rachelle Boulton ◽  
Josh Ridderhoff
Keyword(s):  
Disease Surveillance ◽  
Communicable Disease ◽  
Laboratory Data ◽  
Data Entry ◽  
High Volume ◽  
Electronic Data ◽  
Disease Surveillance System ◽  
Department Of Health ◽  
Message Structure ◽  
Set Up

Objective: The objective of this abstract is to illustrate how the Utah Department of Health processes a high volume of electronic data. We do this by translating what reporters send within an HL7 message into "epidemiologist" language for consumption into our disease surveillance system.Introduction: In 2013, the Utah Department of Health (UDOH) began working with hospital and reference laboratories to implement electronic laboratory reporting (ELR) of reportable communicable disease data. Laboratories utilize HL7 message structure and standard terminologies such as LOINC and SNOMED to send data to UDOH. These messages must be evaluated for validity, translated, and entered into Utah’s communicable disease surveillance system (UT-NEDSS), where they can be accessed by local and state investigators and epidemiologists. Despite the development and use of standardized terminologies, reporters may use different, outdated versions of these terminologies, may not use the appropriate codes, or may send local, home-grown terminologies. These variations cause problems when trying to interpret test results and automate data processing. UDOH has developed a two-step translation process that allows us to first standardize and clean incoming messages, and then translate them for consumption by UT-NEDSS. These processes allow us to efficiently manage several different terminologies and helps to standardize incoming data, maintain data quality, and streamline the data entry process.Methods: UDOH uses the Electronic Message Staging Area (EMSA) to receive ELR messages, manage terminologies such as LOINC and SNOMED, translate messages, and automatically enter laboratory data into UT-NEDSS. LOINCs and other terms, such as facility name, sent by reporting facilities in an HL7 message are considered child terms. All child terms are mapped to a master LOINC or term and each master LOINC or term is mapped to a specific value within UT-NEDSS. In EMSA, the rules engine used for automated processing of electronic data is set to run at the master level and these rules will determine how the message is processed. No rules are set up or run on child terms.Results: As of 09/20/2017, EMSA contains 2,613 unique child LOINCs that are mapped to 906 master LOINCs. Those 906 master LOINCs are mapped to 179 UT-NEDSS test types and 2003 child facility names are mapped to 1043 master facility namesConclusions: Mapping child terminologies from an HL7 message to a master vocabulary helps us to standardize incoming data, allows us to accept non-standard terminologies and correct reporting errors. Translating this data into a format that is understandable to epidemiologists and investigators enables UT-NEDSS to work effectively in identifying outbreaks and improving health outcomes. This framework is working for ELR and will continue to grow and accept more data and the different terminologies that come with that.

The supra-regional assay service

1974 ◽  
Vol 12 (23) ◽  
pp. 89-90
Keyword(s):  
Financial Aid ◽  
England And Wales ◽  
Department Of Health ◽  
Laboratory Services ◽  
Set Up

Advances in biochemistry have made possible new clinically useful assays of hormones, proteins, drugs and vitamins. However, many of these are often outside the scope of routine hospital laboratories because they are infrequently used, technically complex or expensive. In 1971 the Department of Health (DHSS) set up working parties to advise how these analyses could best be provided and as a result of their recommendations a number of Supra-Regional Assay Centres has been established in England and Wales. These are based on existing laboratories with expertise in the appropriate techniques and they receive financial aid from the DHSS to help them provide the expanded service. They are a ‘third tier’ in the laboratory services, complementing the assay services already available at local and regional laboratories.

From Rural Outsourcing to Rural Opportunities

2013 ◽  
pp. 158-173
Author(s):  
Aarti Kawlra
Keyword(s):  
Information And Communication Technologies ◽  
Business Strategy ◽  
Communication Technologies ◽  
Development Project ◽  
Production Model ◽  
Overall Design ◽  
Key Innovation ◽  
Information And Communication ◽  
Set Up ◽  
Production Company

Inspired by the potential of Information and Communication Technologies, henceforth ICTs, for socio-economic development, and supported by a university based technology and business incubator, Rural Production Company, henceforth RPC, was set up in 2007 employing an ICT-mediated distributed production model. This paper reveals how RPC, initially an exploratory project whose key innovation was its Internet kiosk-facilitated model of crafts production and local empowerment, morphed into a social enterprise catering to global demands. The context of innovation provided by the Incubator led to a transformation of an ICT4D (ICT for Development) project into a business venture through the practice of formal and informal questioning at every stage of its implementation. This paper focuses on the iterative method adopted while highlighting the role of the incubator in the overall design and development process of the enterprise. This paper is a reflexive mapping of the organization’s evolution from the original research agenda of outsourcing production cum rural employment, to one that privileges local networks both as a conscious business strategy and as an arena for collaborative change for human development.

scholarly journals THU0645 VIRTUAL VISITS IS THE FUTURE COMING? TELEREUMATOLOGY. PILOT PROJECT: REVIR PROGRAM, RHEUMATOLOGY SERVICE. BARCELONA, SPAIN

2019 ◽  
Author(s):  
Fabiola Ojeda ◽  
Manel Ciria ◽  
Carolina Perez-Garcia ◽  
Eric Sitjas ◽  
Elena Martinez ◽  
...  
Keyword(s):  
Pilot Project ◽  
The Future ◽  
Virtual Visits

Training for E-Commerce Success in SMEs

2011 ◽  
pp. 334-348
Author(s):  
Yanqing Duan ◽  
Roisin Mullins ◽  
David Hamblin
Keyword(s):  
Information And Communication Technologies ◽  
Business Performance ◽  
Current Knowledge ◽  
Small And Medium Enterprises ◽  
Communication Technologies ◽  
Goods And Services ◽  
Skills Shortage ◽  
Information And Communication ◽  
Set Up ◽  
Medium Enterprises

Rapid developments in Information and Communication Technologies (ICTs), such as electronic commerce (e-commerce), have revolutionized the way that business is conducted. E-commerce refers to the process of buying and selling goods and services electronically involving transactions using Internet, network, and other digital technology. It offers companies tremendous opportunities to improve their business performance in new and innovative ways. However, its huge potential benefit would only be realized by capable managers who can deal with these emerging technologies and implement them wisely. A skills shortage has been categorized as one of the challenges facing global e-commerce by Bingi and Khamalah (2000). The demand for highly knowledgeable and skilled managers and workloads places enormous pressure upon companies to improve or update their current knowledge and skills. This is particularly important in Small and Medium Enterprises (SMEs) as compared with their larger counterparts, as they are often described as “lacking the expertise needed to set up the technologies necessary, despite having a great deal to gain from doing so” (Anonymous, 1998).

Multi-disciplinary assessment of attention-deficit hyperactivity disorder: a tertiary assessment package

1999 ◽  
Vol 23 (7) ◽  
pp. 421-424 ◽  
Author(s):  
H. Kat ◽  
Clay Frake ◽  
Rebecca Sawtell
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Clinical Practice ◽  
Attention Deficit ◽  
Pilot Project ◽  
Clinical Implications ◽  
Assessment Protocol ◽  
Hyperactivity Disorder ◽  
Set Up

Aims and methodA tertiary assessment package was set up for the more equivocal cases of attention-deficit hyperactivity disorder (ADHD) who present with problems of inattention, impulsivity and overactivity. The structure of the three-day package was discussed, with an analysis of our experience in assessing 12 children using the pilot project. The package and Its use in clinical practice are presented.ResultsThe pilot project described can be modified into a two-day package.Clinical implicationsAssessment of ADHD conducted in multiple settings inherently has many advantages over single clinic assessment. We suggest that such an assessment protocol can be conducted cost effectively.

Mega-Doses of Behaviour Therapy for Treatment-Resistant Agoraphobics*

1983 ◽  
Vol 28 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Morton S. Rapp ◽  
Martyn R. Thomas ◽  
Eleanor C. Reyes
Keyword(s):  
Effective Treatment ◽  
Cost Effective ◽  
Pilot Project ◽  
Treatment Resistant ◽  
Behaviour Therapy ◽  
The Past ◽  
Cost Effective Treatment ◽  
Intensive Program ◽  
Set Up

This was a pilot project set up to test the feasibility of effectively and inexpensively treating agoraphobic patients who had not responded to adequate trials of behaviour therapy (and other therapy) in the past. We employed a quantitatively intensive program of exposure therapy, calisthenics and muscular relaxation, and have explained the rationales for the choice of each treatment. The results were gratifying in four of the five patients, with follow-up to three years. This pilot project enabled us to set up a cost-effective treatment for all forms of agoraphobia which is as efficient as other programs described. It has also highlighted the fact that some patients exist who may do poorly on schedules of behaviour therapy which are adequate for some patients, and yet may do well if the amount of treatment is drastically increased.

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