Telemedicine in Orthopedic Oncology During COVID-19: Patient Satisfaction, Reimbursement, and Physical Examination Competency

Orthopedics ◽  
2021 ◽  
Vol 44 (5) ◽  
pp. 274-279
Author(s):  
Joshua M. Lawrenz ◽  
Jeffrey C. Krout ◽  
Cullen P. Moran ◽  
Ashley K. Ready ◽  
Eden A. Schafer ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Physical Examination ◽  
Orthopedic Oncology

scholarly journals P071 Survey of rheumatology patient satisfaction with telephone consultations during the COVID-19 pandemic

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mia Rodziewicz ◽  
Terence O'Neill ◽  
Audrey Low
Keyword(s):  
Patient Satisfaction ◽  
Physical Examination ◽  
Management Plan ◽  
Service Development ◽  
Telephone Consultation ◽  
Face To Face ◽  
Communication Difficulties ◽  
Strongly Agree ◽  
The Uk

Abstract Background/Aims  Rheumatology departments were required to switch rapidly from face-to-face (F2F) to remote consultations during the COVID-19 pandemic in the UK. We conducted a patient satisfaction survey on the switch to inform future service development. Methods  All patients [new (NP), follow-up (FU)] were identified between 1st to 5th June 2020. Patients who attended or did not attend (DNA) a pre-booked F2F consultation or cancelled were excluded. Of the remainder, half the patients was surveyed by phone using a standardised questionnaire and the other half was posted the same questionnaire. Both groups were offered the opportunity to complete the survey online. Patients were surveyed on the organisation and content of the consultation, whether they were offered a subsequent F2F appointment and future consultation preference. Results  233 consultations were scheduled during the study period. After 53 exclusions (34 pre-booked F2F, 16 DNA, 3 cancellations), 180 eligible consultations were surveyed (85 via mailshot, 95 by telephone). 75/180 patients (42%) responded within 1 month of the telephone consultation (20 NP, 47 FU, 8 missing). The organisation of the switch was positively perceived (Table). Patients were highly satisfied with 4 of the 5 consultation domains but were undecided whether a physical assessment would have changed the outcome of the consultation (Table). After the initial phone consultation, 7 of 20 NP and 19 of 47 FU were not offered subsequent F2F appointments at the clinicians’ discretion. Of those not offered subsequent F2F appointments, proportionally more NP (3/7, 43%) would have liked one, compared to FU (5/19, 26%). Reasons included communication difficulties and a desire for a definitive diagnosis. 48/75 (64%) would be happy for future routine FU to be conducted by phone “most of the time" or "always”; citing patient convenience and disease stability. Caveats were if physical examination was required or if more serious issues (as perceived by the patient) needed F2F discussion. Conclusion  Patients were generally satisfied with telephone consultations and most were happy to be reviewed again this way. NPs should be offered F2F appointments for first visits to maximise patient satisfaction and time efficiency. P071 Table 1:Median age, yearsFemale; n (%)Follow-up; n (%)All eligible for survey; n = 18056122 (68)133 (74)Sent mailshot; n = 855459 (69)65 (76)Surveyed by phone; n = 955663 (66)68 (72)Responder by mail; n = 166911 (69)13 (82)Responder by phone; n = 525437 (71)34 (65)Responder by e-survey; n = 7495 (71)UnknownOrganisation of the telephone consultation, N = 75Yes, n (%)No, n (%)Missing, n (%)Were you informed beforehand about the phone consultation?63 (84)11 (15)1 (1)Were you called within 1-2 hours of the appointed date and time?66 (88)6 (8)3 (4)Domains of the consultation, N = 75Strongly disagree, n (%)Disagree, n (%)Neutral, n (%)Agree, n (%)Strongly agree, n (%)Missing, n (%)During the call, I felt the clinician understood my problem3 (4)1 (1)1 (1)20 (27)49 (65)1 (1)During the call, I had the opportunity to ask questions regarding my clinical care1 (1)02 (3)16 (21)55 (73)1 (1)A physical examination would have changed the outcome of the consultation16 (21)18 (24)20 (27)11 (15)10 (13)0The clinician answered my questions to my satisfaction2 (3)06 (8)18 (24)49 (65)0At the end of the consultation, the clinician agreed a management plan with me3 (4)2 (3)6 (8)24 (32)39 (52)1 (1)Future consultations, N = 75Never, n (%)Sometimes, n (%)Most of the time, n (%)Always, n (%)Missing, n, (%)In the future, would you be happy for routine FU to be conducted by phone?5 (7)20 (27)16 (21)32 (43)2 (3) Disclosure  M. Rodziewicz: None. T. O'Neill: None. A. Low: None.

What is the patient's and multidisciplinary team's perspective on telephone clinics?

2021 ◽  
Vol 27 (1) ◽  
pp. 26-31
Author(s):  
Sonia Bouri ◽  
Jean-Frédéric LeBlanc ◽  
Ravi Misra ◽  
Nikolaos Kamperidis ◽  
Gabriela Poufou ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Patient Satisfaction ◽  
Physical Examination ◽  
Bowel Disease ◽  
High Patient Satisfaction ◽  
Face To Face ◽  
Inflammatory Bowel ◽  
Remote Services ◽  
Remote Care

Background/Aims During the COVID-19 pandemic, inflammatory bowel disease clinics were converted to telephone clinics at St. Mark's Hospital in Harrow. This study assessed the response of patients and clinicians to remote telemedicine services, with the view of establishing whether there was scope for increasing the role of remote services in the inflammatory bowel disease clinics. Methods Clinicians administered a questionnaire to patients at the end of their appointments regarding their opinions on the telephone clinic format. Eleven questions used a 5-point Likert scale while a further three questions asked the patient for their comments on future clinics. Clinicians provided information about the patients' condition and management, as well as their own comments. Results Overall satisfaction with telephone clinics was found to be high among patients and clinicans, with many feeling that telephone clinics were more convenient. In total, 94.3% of patients said they would prefer either all telephone or a mix of phone and face-to-face clinics in the future. However, some patients felt that it was more complicated to have blood or stool tests done and roughly a quarter of patients were concerned that something could be missed without a physical examination. Conclusions High patient satisfaction can be achieved by delivering a mix of telephone, video and face-to-face clinics. In certain clinical situations, face-to-face clinics would be appropriate, such as patients with active diseases and first appointments. The pandemic is an opportunity respond to patients' preferences by increasing the range of remote care options.

What are the medicolegal implications of virtual clinics?

2021 ◽  
pp. 1-6
Author(s):  
JA Street ◽  
MR Ricks
Keyword(s):  
Patient Satisfaction ◽  
Physical Examination ◽  
Clinical Assessment ◽  
Literature Search ◽  
Clinical Care ◽  
Patient Interaction ◽  
Change In Practice ◽  
Areas Of Concern

Recently there has been increased interest in the use and development of virtual clinics, particularly in the wake of the COVID-19 pandemic. The need to provide clinical care, while minimising patient interaction, has led to wider adoption of both telephone and online consultations, with the potential complications and pitfalls that accompany such a change in practice. A literature search was performed using the Pubmed, MEDLINE and Embase databases, from database inception up to 25 January 2021. A total of 21 papers were identified as discussing virtual clinical assessment and the medicolegal implications. The main areas of concern included consent, misdiagnosis, lack of physical examination, privacy and patient satisfaction. This article assesses these areas and suggests techniques to address them.

The neurological examination in neuropsychiatry

2020 ◽  
pp. 23-34
Author(s):  
Jan A. Coebergh ◽  
Biba R. Stanton
Keyword(s):  
Nervous System ◽  
Patient Satisfaction ◽  
Physical Examination ◽  
Neurological Examination ◽  
Mental State ◽  
Interobserver Reliability ◽  
Neurological Signs ◽  
Sensitivity Specificity ◽  
State Examination ◽  
Limited Sensitivity

The neurological examination in neuropsychiatry is as essential as the mental state examination in neurology. The neurological examination includes the whole nervous system and is part of the wider physical examination. Many neurological signs have limited sensitivity, specificity, and intra- and interobserver reliability, so they need to be interpreted in the context of the assessment as a whole. Misinterpretation of the neurological examination can lead to unnecessary investigations and treatment or delay diagnosis and management. A focused neurological examination in neuropsychiatry, however, is essential for patient satisfaction and diagnosis and can be part of treatment. This chapter discusses how to approach the neurological examination in neuropsychiatry.

scholarly journals Physical Examination of the Spine Using Telemedicine: A Systematic Review

2020 ◽  
pp. 219256822096042
Author(s):  
Joshua Piche ◽  
Bilal B. Butt ◽  
Arya Ahmady ◽  
Rakesh Patel ◽  
Ilyas Aleem
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Patient Satisfaction ◽  
Physical Examination ◽  
Primary Outcome ◽  
Low Back ◽  
Inclusion Criteria ◽  
Physical Examinations ◽  
Secondary Outcomes ◽  
Acceptable Reliability

Study Design: This is a systematic review. Objective: To systematically review (1) the reliability of the physical examination of the spine using telehealth as it pertains to spinal pathology and (2) patient satisfaction with the virtual spine physical examination. Methods: We searched EMBASE, PubMed, Medline Ovid, and SCOPUS databases from inception until April 2020. Eligible studies included those that reported on performing a virtual spine physical examination. Two reviewers independently assessed all potential studies for eligibility and extracted data. The primary outcome of interest was the reliability of the virtual spine physical exam. Secondary outcomes of interest were patient satisfaction with the virtual encounter. Results: A total of 2321 studies were initially screened. After inclusion criteria were applied, 3 studies (88 patients) were included that compared virtual with in-person spine physical examinations. These studies showed acceptable reliability for portions of the low back virtual exam. Patient satisfaction surveys were conducted in 2 of the studies and showed general satisfaction (>80% would recommend). Conclusions: These results suggest that the virtual spine examination may be comparable to the in-person physical examination for low back pain, though there is a significant void in the literature regarding the reliability of the physical examination as it pertains to specific surgical pathology of the spine. Because patients are overall satisfied with virtual spine assessments, validating a virtual physical examination of the spine is an important area that requires further research.

scholarly journals 1219 Patient Satisfaction with Virtual Orthopaedic Clinics During the COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Y Shah ◽  
K Shah
Keyword(s):  
Patient Satisfaction ◽  
Physical Examination ◽  
Satisfaction Level ◽  
Orthopaedic Surgeons ◽  
Social Distancing ◽  
Face To Face ◽  
Current Climate ◽  
The Future ◽  
Question Survey

Abstract Background The COVID-19 pandemic has elicited the need to deliver consultation appointments remotely due to social-distancing measures, as well as some individuals having to shield. Virtual clinics are not a familiar setting for orthopaedic surgeons or their patients, but it is a necessity in the current climate and potentially also in the future. Aim This study aims to determine patient satisfaction of virtual orthopaedic consultations, during the COVID-19 pandemic and for the future. Method A 10-question survey assessed the satisfaction level of both new and follow-up patients towards virtual clinics for consultations with orthopaedic surgeons. Results Based on 100 patients who completed the surveys in a 6-month study during the pandemic, it was found that a majority (90%) of patients reported being satisfied (either very satisfied or satisfied) with the telephone clinics and would be content on having virtual clinics in the future. Conclusions Many patients view virtual clinics as an acceptable substitute for face-to-face appointments, specifically during the pandemic. However, it was also reported that a majority of patients would still prefer a physical examination as well. If virtual consultations are to persist beyond the COVID-19 pandemic, further exploration would need to be carried out to determine the efficacy.

Improving Communication Skills in Health Care

2013 ◽  
Vol 20 (3) ◽  
pp. 109-117
Author(s):  
Lynda Katz Wilner ◽  
Marjorie Feinstein-Whittaker
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Communication Skills ◽  
Health Care Professionals ◽  
Skills Training ◽  
International Medical Graduate ◽  
Medical Graduate ◽  
Health Care Environment ◽  
Medical Interpreters ◽  
Accent Modification

Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s health care environment, interactions are challenged by diversity — Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.

Teletinnitus Program at the VA Gulf Coast Veterans Health Care System

2014 ◽  
Vol 4 (1) ◽  
pp. 23-29
Author(s):  
Constance Hilory Tomberlin
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Patient Care ◽  
Health Care System ◽  
Gulf Coast ◽  
New Technology ◽  
Cost Effective ◽  
Veterans Health ◽  
Potential Benefits ◽  
Care System

There are a multitude of reasons that a teletinnitus program can be beneficial, not only to the patients, but also within the hospital and audiology department. The ability to use technology for the purpose of tinnitus management allows for improved appointment access for all patients, especially those who live at a distance, has been shown to be more cost effective when the patients travel is otherwise monetarily compensated, and allows for multiple patient's to be seen in the same time slots, allowing for greater access to the clinic for the patients wishing to be seen in-house. There is also the patient's excitement in being part of a new technology-based program. The Gulf Coast Veterans Health Care System (GCVHCS) saw the potential benefits of incorporating a teletinnitus program and began implementation in 2013. There were a few hurdles to work through during the beginning organizational process and the initial execution of the program. Since the establishment of the Teletinnitus program, the GCVHCS has seen an enhancement in patient care, reduction in travel compensation, improvement in clinic utilization, clinic availability, the genuine excitement of the use of a new healthcare media amongst staff and patients, and overall patient satisfaction.

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