Ushering in the Silver Age of Telehealth: Addressing Telehealth Disparities for Older Adults With Disabilities

One silver lining of COVID-19 has been the ushering in of ‘the golden age of telehealth’. However, this unplanned rapid conversion to telehealth left many providers and clinics unprepared to address systemic barriers that adversely affect older adults, particularly those with disabilities. Data from the VA Corporate Data Warehouse suggest that the rapid adoption of telehealth in mental health clinics during COVID-19 widened telehealth utilization disparities for older Veterans (65+) with disabilities. With 4.5 million Veterans 55+ who have at least one disability more attention to addressing this widening gap is needed. For those with hearing, vision, and complex mobility impairments, there are unique challenges to initiating telehealth services. Dr. Touchett will present preliminary findings while discussing ethical and contextual considerations when using telehealth with older Veterans who have disabilities, while discussing ways to facilitate robust clinical encounters for this population.

Rapid conversion of replicating and integrating Saccharomyces cerevisiae plasmid vectors via Cre recombinase

Plasmid shuttle vectors capable of replication in both Saccharomyces cerevisiae and Escherichia coli and optimized for controlled modification in vitro and in vivo are a key resource supporting yeast as a premier system for genetics research and synthetic biology. We have engineered a series of yeast shuttle vectors optimized for efficient insertion, removal and substitution of plasmid yeast replication loci, allowing generation of a complete set of integrating, low copy and high copy plasmids via predictable operations as an alternative to traditional subcloning. We demonstrate the utility of this system through modification of replication loci via Cre recombinase, both in vitro and in vivo, and restriction endonuclease treatments.

Medical Student Experience and Outcomes, as Well as Preceptor Experience, with Rapid Conversion of a Preclinical Medical School Course to a Remote-Based Learning Format in the Setting of the COVID-19 Pandemic

Objectives To assess student outcomes and experiences, as well as preceptor experiences, after emergently converting a preclinical medical school renal course to a remote setting during the COVID-19 pandemic. Methods First-year medical student examination scores and responses to Likert-scale questions on end-of-course evaluations from the 2018–2019 (traditional) and 2019–2020 (remote) academic years were compared. Free-text responses from students and preceptors were analyzed using a qualitative summative approach to extract major themes in perceptions of remote learning. Results Mean student scores on course examinations did not significantly differ between the traditional and remote settings (p = 0.23 and 0.84 respectively). Quantitative analysis of student evaluations revealed no significant difference across all items in mean Likert-scale responses. Student and preceptor free-text responses identified course leader engagement and responsiveness as essential to the success of remote-based learning. Optimal group size and online etiquette are areas that require attention. Conclusions Despite rapid conversion of a preclinical medical school renal course to a remote-based format in the setting of the COVID-19 pandemic, student scores and evaluations remain positive and largely unchanged.

Successes and Challenges of Implementing Telehealth for Diverse Patient Populations: Attending to Prenatal Care during COVID-19 (Preprint)

BACKGROUND While telehealth appears to have been accepted among some obstetric populations before the pandemic, patients’ receptivity and experience with the rapid conversion of this mode of healthcare delivery is unknown. In this study, we examine patients' prenatal care needs, preferences, and experiences during the COVID-19 pandemic. OBJECTIVE To examine patients' prenatal care needs, preferences, and experiences during the COVID-19 pandemic, with the aim of supporting the development of successful models to serve the needs of pregnant patients, obstetric providers, and healthcare systems during this time. METHODS This study involved qualitative methods to explore pregnant patients’ experiences with prenatal healthcare delivery at the onset of the COVID-19 pandemic. We conducted in-depth interviews with pregnant patients in the 1st and 2nd trimester of pregnancy who received prenatal care in Cleveland, Ohio from May to July 2020. An interview guide probed experiences with healthcare delivery as it rapidly evolved at the onset of the pandemic. RESULTS While advantages of telehealth were noted, there were several concerns noted with the broad implementation of telehealth for prenatal care during the pandemic. This included concerns about monitoring the pregnancy at home, the need for additional reassurance for the pregnancy given the uncertainties presented by the pandemic, and the ability to have effective patient-provider discussions via a telehealth visit. The need to tailor telehealth to prenatal healthcare delivery was noted. CONCLUSIONS Although previous studies have demonstrated telehealth is a flexible and convenient alternative for some prenatal appointments, our study suggests that there may be specific needs and concerns among the diverse patient groups using this modality during the pandemic. More research is needed to understand patients' experiences with telehealth during the pandemic and develop approaches that are responsive to the needs and preferences of patients.