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How telemedicine integrated into China's anti-COVID-19 strategies: case from a National Referral Center.

ABSTRACT: INTRODUCTION:We present the integration of telemedicine into the healthcare system of West China Hospital of Sichuan University (WCH), one of the largest hospitals in the world with 4300 inpatient beds, as a means for maximising the efficiency of healthcare delivery during the COVID-19 pandemic. METHODS:Implemented on 22 January 2020, the telemedicine technology allowed WCH providers to conduct teleconsultations, telerounds, teleradiology and tele-intensive care unit, which in culmination provided screening, triage and treatment for COVID-19 and other illnesses. To encourage its adoption, the government and the hospital publicised the platform on social media and waived fees. DISCUSSION:From 1 February to 1 April 2020, 10557 online COVID-19 consultations were conducted for 6662 individuals; meanwhile, 32676 patients without COVID completed virtual follow-ups. We discuss that high-quality, secure, affordable and user-friendly telemedical platforms should be integrated into global healthcare systems to help decrease the transmission of the virus and protect healthcare providers from infection.

SUBMITTER: Li P

PROVIDER: S-EPMC7445101 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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How telemedicine integrated into China's anti-COVID-19 strategies: case from a National Referral Center.

Li Peiyi P Liu Xiaoyu X Mason Elizabeth E Hu Guangyu G Zhou Yongzhao Y Li Weimin W Jalali Mohammad S MS

BMJ health & care informatics 20200801 3

<h4>Introduction</h4>We present the integration of telemedicine into the healthcare system of West China Hospital of Sichuan University (WCH), one of the largest hospitals in the world with 4300 inpatient beds, as a means for maximising the efficiency of healthcare delivery during the COVID-19 pandemic.<h4>Methods</h4>Implemented on 22 January 2020, the telemedicine technology allowed WCH providers to conduct teleconsultations, telerounds, teleradiology and tele-intensive care unit, which in cul ...[more]

PMID: 32830110

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Project description:BackgroundIn an effort to contain the effects of the coronavirus disease (COVID-19) pandemic, health care systems worldwide implemented telemedical solutions to overcome staffing, technical, and infrastructural limitations. In Germany, a multitude of telemedical systems are already being used, while new approaches are rapidly being developed in response to the crisis. However, the extent of the current implementation within different health care settings, the user's acceptance and perception, as well as the hindering technical and regulatory obstacles remain unclear.ObjectiveThe aim of this paper is to assess the current status quo of the availability and routine use of telemedical solutions, user acceptance, and the subjectively perceived burdens on telemedical approaches. Furthermore, we seek to assess the perception of public information quality among professional groups and their preferred communication channels.MethodsA national online survey was conducted on 14 consecutive days in March and April 2020, and distributed to doctors, nurses, and other medical professionals in the German language.ResultsA total of 2827 medical professionals participated in the study. Doctors accounted for 65.6% (n=1855) of the professionals, 29.5% (n=833) were nursing staff, and 4.9% (n=139) were identified as others such as therapeutic staff. A majority of participants rated the significance of telemedicine within the crisis as high (1065/2730, 39%) or neutral (n=720, 26.4%); however, there were significant differences between doctors and nurses (P=.01) as well as between the stationary sector compared to the ambulatory sector (P<.001). Telemedicine was already in routine use for 19.6% (532/2711) of German health care providers and in partial use for 40.2% (n=1090). Participants working in private practices (239/594, 40.2%) or private clinics (23/59, 39.0%) experienced less regulatory or technical obstacles compared to university hospitals (586/1190, 49.2%). A majority of doctors rated the public information quality on COVID-19 as good (942/1855, 50.8%) or very good (213/1855, 11.5%); nurses rated the quality of public information significantly lower (P<.001). Participant's age negatively correlated with the perception of telemedicine's significance (ρ=-0.23; P<.001).ConclusionsTelemedicine has a broad acceptance among German medical professionals. However, to establish telemedical structures within routine care, technical and regulatory burdens must be overcome.

Project description:PurposeThe diagnosis of pulmonary blastomycosis is usually delayed because of its non-specific presentation. We aimed to assess the extent of diagnostic delay in hospitalized patients and detect the step in the diagnostic process that requires the most improvement.MethodsAdult patients diagnosed with pulmonary blastomycosis during a hospital admission between January 2010 through November 2021 were eligible for inclusion. Patients who did not have pulmonary involvement and who were diagnosed before admission were excluded. Demographics and comorbid conditions, specifics of disease presentation, and interventions were evaluated. The timing of the diagnosis, antifungal treatment, and patient outcomes were noted. Descriptive analytical tests were performed.ResultsA total of 43 patients were diagnosed with pulmonary blastomycosis during their admissions. The median age was 47 years, with 13 (30%) females. Of all patients, 29 (67%) had isolated pulmonary infection, while 14 (33%) had disseminated disease, affecting mostly skin and musculoskeletal system. The median duration between the initial symptoms and health care encounters was 4 days, and the time to hospital admission was 9 days. The median duration from the initial symptoms to the diagnosis was 20 days. Forty patients (93%) were treated with empirical antibacterials before a definitive diagnosis was made. In addition, corticosteroid treatment was empirically administered to 15 patients (35%) before the diagnosis, with indications such as suspicion of inflammatory processes or symptom relief. In 38 patients (88%), the first performed fungal diagnostic test was positive. Nineteen patients (44%) required admission to the intensive care unit, and 11 patients (26%) died during their hospital stay.ConclusionThere was a delay in diagnosis of patients with pulmonary blastomycosis, largely attributable to the lack of consideration of the etiological agent. Novel approaches to assist providers in recognizing the illness earlier and trigger evaluation are needed.

Dataset Information

How telemedicine integrated into China's anti-COVID-19 strategies: case from a National Referral Center.

Publications

How telemedicine integrated into China's anti-COVID-19 strategies: case from a National Referral Center.

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