Tailored Online Neurosurgical Evaluation in the Outpatient Setting during COVID-19 Pandemic—The Maldives Experience

2021 ◽  
Vol 1 (4) ◽  
pp. e279
Author(s):  
Ali Niyaf ◽  
Kiran Niraula ◽  
Mohamed Sajuan Mushrif ◽  
Tej D. Azad ◽  
Megha Ghimire ◽  
...  
Keyword(s):  
Neurological Examination ◽  
Health Care Systems ◽  
Outpatient Setting ◽  
Efficient Manner ◽  
Online Consultation ◽  
Video Consultation ◽  
Online Examination ◽  
Care Systems ◽  
Examination Methods ◽  
Consistent Method

Introduction: The recent COVID-19 pandemic has revealed important obstacles in our health care systems, including online specialist consultations. Amidst mass lockdowns and social distancing, we observed the importance of developing a consistent method of performing effective neurological examinations that yield accurate results in a time efficient manner. Objectives: To describe our experience in the Maldives of performing effective online neurological examination. Methodology: We designed and implemented a platform for patients to register for online consultation, collected a comprehensive neurological history, including pictures/scroll-videos of past radiological reports, and guided the patient and their aide through neurological examination methods- both verbally through online video consultation and informative pictorials that depict exactly how-to perform said examinations. Conclusions: Neurological examinations are time consuming, detailed and require skill and expertise to be performed appropriately. Yet, can be customized and adapted to be performed remotely. Proper guidance by examiner and assistance by family or friend with use of pictorials can conclude a thorough online examination.

scholarly journals Outpatient Stereotactic Brain Biopsies

2021 ◽  
Author(s):  
Bertrand MATHON ◽  
Pauline MARIJON ◽  
Maximilien RICHE ◽  
Vincent DEGOS ◽  
Alexandre CARPENTIER
Keyword(s):  
Health Care ◽  
Medical Center ◽  
Health Care Systems ◽  
Cost Savings ◽  
Brain Biopsy ◽  
Outpatient Setting ◽  
Stereotactic Brain Biopsy ◽  
Same Day Discharge ◽  
Care Systems ◽  
Few Data

Abstract BackgroundOutpatient neurosurgery is rising popularity leading to patients’ satisfaction and cost-savings. Although several North-American teams have shown the safety of outpatient stereotactic brain biopsies, few data from other countries with different health care systems are available. ObjectiveWe therefore conducted a feasibility and safety study on the outpatient stereotactic brain biopsies. MethodsWe prospectively examined all the consecutive stereotactic brain biopsies performed in an outpatient setting at our tertiary medical center, between June 2018 and September 2020.ResultsAmong the 437 patients who underwent stereotactic brain biopsy during the study period, 40 (9.2%) patients were enrolled for an outpatient management. The sex ratio was 1 and the median age on biopsy day was 55 [41-66] years. The median distance from patients’ home to hospital was 17 kms [3-47]. 95% of patients had prebiopsy ASA score of 1 or 2 and mRs equal to 2 or less. The rate of same-day discharge was 100%. No patient experienced post-biopsy symptomatic complication necessitating readmission within the month following the biopsy. One patient (2.5%) resorted to an unplanned consultation. Histological findings obtained from brain biopsy led to a diagnosis in all patients; the most frequently found were neoplastic lesions (77.5%)ConclusionStereotactic brain biopsies can therefore be safely achieved on an outpatient setting in carefully selected patients. This process could be more widely adopted in other neurosurgical centers, without affecting the quality of patient’s health care and safety. In this article, we propose management guidelines and pre-biopsy checklist for performing ambulatory stereotactic brain biopsies.

scholarly journals Self-Collected Gargle Lavage Allows Reliable Detection of SARS-CoV-2 in an Outpatient Setting

2021 ◽  
Author(s):  
Johannes Zander ◽  
Stephan Scholtes ◽  
Maximilian Ottinger ◽  
Marcel Kremer ◽  
Azadeh Kharazi ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Health Care ◽  
Health Care Systems ◽  
Outpatient Setting ◽  
Health Care Personnel ◽  
Reliable Detection ◽  
Care Systems ◽  
Outpatient Settings

The SARS-CoV-2 pandemic still strains health care systems worldwide. While COVID-19 testing is considered an essential pillar in combating this infectious disease, shortages in supplies and trained health care personnel often limit the procurement of patient samples, in particular in outpatient settings.

scholarly journals COVID-19 financing strategies for refugees and migrants in the Eastern Mediterranean Region

2021 ◽  
Vol 27 (12) ◽  
pp. 1229-1238
Author(s):  
Elena Habersky ◽  
Aya Damir
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Health Care Systems ◽  
Eastern Mediterranean Region ◽  
Health Financing ◽  
Efficient Manner ◽  
Internally Displaced ◽  
Care Systems

Background: The COVID-19 pandemic has had devastating consequences on health care systems worldwide. While the world was slowly moving towards achieving health for all, the pandemic destroyed progress made over the past 25 years and exposed the vulnerability of health care systems and health insurance schemes as well as their lack of resilience. Heath care systems failed to respond in a timely and efficient manner, lives have been, and continue to be, lost and vulnerable populations, especially refugees and migrants, are more at risk than ever as many are left out of country vaccination programmes. Aims: The Eastern Mediterranean region hosts 13 million internally displaced persons and 12 million refugees as of 2018. Thus, adopting inclusive health financing mechanisms is crucial to addressing the crisis and protecting indigenous and displaced populations. Methods: By looking at regional best practices and the response of the United Nations, we outline possible financing tools for including refugees and migrants in health insurance schemes for COVID 19 and introduce novel solutions for addressing gaps in funding. Results: Among the suggested solutions are the inclusion of refugees and migrants in national health care systems, setting up community-based health insurance for migrant and refugee populations, as well as introducing a catastrophe bond financing scheme. Conclusions: While COVID-19 is far from over, many countries in the EMR have included migrants in their COVID-19 vaccine rollout plans. While this is not the first instance of inclusion in some countries, many others are unable or do not prioritize migrants in their health systems, to the detriment of the entire country. This paper, therefore, tackles the possible health financing measures which curb or prevent migrants from accessing such systems and presents possible solutions to change the status quo.

scholarly journals Telemedicine and Computer-Based Technologies during Coronavirus Disease 2019 Infection; A Chance to Educate and Diagnose

2020 ◽  
Vol 23 (8) ◽  
pp. 561-563
Author(s):  
Reza Jafarzadeh-Esfehani ◽  
Mohsen Mirzaei Fard ◽  
Farzaneh Habibi Hatam-Ghale ◽  
Alireza Rezaei Kalat ◽  
Amir Fathi ◽  
...  
Keyword(s):  
Close Contact ◽  
Health Care Systems ◽  
Clinical Severity ◽  
Medical Decision ◽  
Web Based ◽  
Online Consultation ◽  
Pulmonary Manifestations ◽  
Care Systems ◽  
Rapid Dissemination ◽  
Computer Based

Coronavirus disease 2019 (COVID-19) is now of global concern due to its rapid dissemination across the globe. The rapid spread of this viral infection, along with many of its unknown aspects, has posed new challenges to the health care systems. The main challenging effects of COVID-19 are rapid dissemination through close contact and varying clinical severity among different individuals. Furthermore, the medical staff in endemic areas are becoming exhausted and deal with a considerable level of job burnout, which can negatively affect their medical decision making. Also, due to the variable pulmonary manifestations of COVID-19, some physicians may misdiagnose patients. To overcome these issues, we proposed a web-based software to aid physicians in detecting possible COVID-19 cases through online consultation with different specialists and educate the not-well experienced physicians. Our results demonstrated that this software could improve the diagnostic rate for not-well experienced physicians.

scholarly journals COVID-19 financing strategies for refugees and migrants in the Eastern Mediterranean Region

2021 ◽  
Author(s):  
Elena Habersky ◽  
Aya Damir
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Health Care Systems ◽  
Eastern Mediterranean Region ◽  
Health Financing ◽  
Efficient Manner ◽  
Internally Displaced ◽  
Care Systems

Background: The COVID-19 pandemic has had devastating consequences on health care systems worldwide. While the world was slowly moving towards achieving health for all, the pandemic destroyed progress made over the past 25 years and exposed the vulnerability of health care systems and health insurance schemes as well as their lack of resilience. Heath care systems failed to respond in a timely and efficient manner, lives have been, and continue to be, lost and vulnerable populations, especially refugees and migrants, are more at risk than ever as many are left out of country vaccination programmes. Aim: The Eastern Mediterranean region hosts 13 million internally displaced persons and 12 million refugees as of 2018. Thus, adopting inclusive health financing mechanisms is crucial to addressing the crisis and protecting indigenous and displaced populations. Methods: By looking at regional best practices and the response of the United Nations, we outline possible financing tools for including refugees and migrants in health insurance schemes for Covid 19 and introduce novel solutions for addressing gaps in funding. Results/conclusions: Among the suggested solutions are the inclusion of refugees and migrants in national health care systems, setting up community-based health insurance for migrant and refugee populations, as well as introducing a catastrophe bond financing scheme.

160: Cost-Effectiveness of Medical Management Strategies of Nephrolithiasis in Different Health Care Systems

2004 ◽  
Vol 171 (4S) ◽  
pp. 42-43 ◽  
Author(s):  
Yair Latan ◽  
David M. Wilhelm ◽  
David A. Duchene ◽  
Margaret S. Pearle
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Medical Management ◽  
Health Care Systems ◽  
Management Strategies ◽  
Care Systems

J 5 — A Data Processing System for Medical Information

1967 ◽  
Vol 06 (01) ◽  
pp. 1-6
Author(s):  
P. Hall ◽  
Ch. Mellner ◽  
T. Danielsson
Keyword(s):  
Medical Records ◽  
Medical Information ◽  
Health Care Systems ◽  
Processing System ◽  
Linear Pattern ◽  
Flexible Form ◽  
Care Systems ◽  
Pattern Recognition Analysis ◽  
Numeric Information

A system for medical information has been developed. The system is a general and flexible one which without reprogramming or new programs can accept any alphabetic and/or numeric information. Coded concepts and natural language can be read, stored, decoded and written out. Medical records or parts of records (diagnosis, operations, therapy, laboratory tests, symptoms etc.) can be retrieved and selected. The system can process simple statistics but even make linear pattern recognition analysis.The system described has been used for in-patients, outpatients and individuals in health examinations.The use of computers in hospitals, health examinations or health care systems is a problem of storing information in a general and flexible form. This problem has been solved, and now it is possible to add new routines like booking and follow-up-systems.

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