An Expanded COVID-19 Telemedicine Intermediate Care Model Using Repurposed Hotel Rooms.
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ABSTRACT:
SUBMITTER: Fenton ME
PROVIDER: S-EPMC7560803 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC7427391 | biostudies-literature
Project description:The national importance of telemedicine for safe and effective patient care has been highlighted by the current COVID-19 pandemic. Prior to the 2020 pandemic the Division of Genetics and Metabolism piloted a telemedicine program focused on initial and follow-up visits in the patients' home. The goals were to increase access to care, decrease missed work, improve scheduling, and avoid the transport and exposure of medically fragile patients. Visits were conducted by physician medical geneticists, genetic counselors, and biochemical dietitians, together and separately. This allowed the program to develop detailed standard operating procedures. At the onset of the COVID-19 pandemic, this pilot-program was deployed by the full team of 22 providers in one business day. Two physicians remained on-site for patients requiring in-person evaluations. This model optimized patient safety and workforce preservation while providing full access to patients during a pandemic. We provide initial data on visit numbers, types of diagnoses, and no-show rates. Experience in this implementation before and during the pandemic has confirmed the effectiveness and value of telemedicine for a highly complex medical population. This program is a model that can and will be continued well-beyond the current crisis.
| S-EPMC7675281 | biostudies-literature
Project description:IntroductionThe novel coronavirus disease 2019 (COVID-19) created challenges with access to care including increased burden on healthcare systems and potential exposure risks for vulnerable patients. To address these needs, Rush University Medical Center created a virtual, urgent care program specifically designed to address these challenges during the COVID-19 pandemic.MethodsThis was a retrospective study analyzing adult patients with COVID-19-related telemedicine visits performed between March 1-June 30, 2020. COVID-19-related telemedicine visits refer to those who used the "Concern for Coronavirus" module. We assessed the total number of telemedicine visits using this module, percentage with a subsequent emergency department (ED) visit within seven days, and outcomes (ie, hospitalization status, intubation, and death) of patients who presented to the ED for evaluation. Data are presented using descriptive statistics.ResultsA total of 2,974 adult patients accessed the program via the COVID-19 module over the four-month period. Of those, 142 patients (4.8%) had an ED visit within seven days. Only 14 patients (0.5%) required admission. One patient was intubated, and there were no deaths among the telemedicine population.ConclusionThe data suggests that telemedicine may be a safe and effective way to screen and treat patients with possible COVID-19, while reducing potential burdens on EDs.
| S-EPMC8463054 | biostudies-literature
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| S-EPMC10231567 | biostudies-literature
Project description:ObjectiveTo assess feasibility, patient satisfaction, and financial advantages of telemedicine for epilepsy ambulatory care during the current COVID-19 pandemic.MethodsThe demographic and clinical characteristics of all consecutive patients evaluated via telemedicine at a level 4 epilepsy center between March 20 and April 20, 2020 were obtained retrospectively from electronic medical records. A telephone survey to assess patient satisfaction and preferences was conducted within one month following the initial visit.ResultsAmong 223 telehealth patients, 85.7% used both synchronous audio and video technology. During the visits, 39% of patients had their anticonvulsants adjusted while 18.8% and 11.2% were referred to laboratory/diagnostic testing and specialty consults, respectively. In a post-visit survey, the highest degree of satisfaction with care was expressed by 76.9% of patients. The degree of satisfaction tended to increase the further a patient lived from the clinic (p = 0.05). Beyond the pandemic, 89% of patients reported a preference for continuing telemedicine if their epilepsy symptoms remained stable, while only 44.4% chose telemedicine should their symptoms worsen. Inclement weather and lack of transportation were factors favoring continued use of telemedicine. An estimated cost saving to patient attributed to telemedicine was $30.20 ± 3.8 per visit.SignificanceOur findings suggest that epilepsy care via telemedicine provided high satisfaction and economic benefit, without compromising patients' quality of care, thereby supporting the use of virtual care during current and future epidemiological fallouts. Beyond the current pandemic, patients with stable seizure symptoms may prefer to use telemedicine for their epilepsy care.
| S-EPMC8803629 | biostudies-literature
Project description:BackgroundPrior to the COVID-19 pandemic there were many barriers to telemedicine primary care for adults ≥65 years including insurance coverage restrictions and having lower digital access and literacy. With the pandemic, insurance coverage broadened and many older adults utilized telemedicine creating an opportunity to learn from their experiences to inform future policy.MethodsBetween April 2020 and June 2021, we conducted a cross-sectional multimethod study of English-speaking, cognitively-intact, adults ≥65, who had a phone-only and/or video telemedicine visit with their primary care physician within one large Massachusetts health system (10 different practices) since March 2020. The study questionnaire asked participants their overall satisfaction with telemedicine (7-point scale) and to compare telemedicine with in-person care. We used linear regression to examine the association between participants' demographics, Charlson comorbidity score, and survey completion date with their satisfaction score. The questionnaire also included open-ended questions on perceptions of telemedicine; which were analyzed using qualitative methods.ResultsOf 278 eligible patients reached, 208 completed the questionnaire; mean age was 74.4 years (±4.4), 61.5% were female, 91.4% were non-Hispanic White, 64.4% had ≥1 comorbidity, and 47.2% had a phone-only visit. Regardless of their age, participants reported being satisfied with telemedicine; median score was 6.0 on the 7-point scale (25th percentile = 5.0 and 75th percentile = 7.0). Non-Whites satisfaction scores were on average 1 point lower than those of non-Hispanic Whites (p = 0.02). Those with comorbidity reported scores that on average were 0.5 points lower than those without comorbidity (p = 0.07). Overall, 39.5% felt their telemedicine visit was worse than in-person care; 4.9% thought it was better. Participants appreciated telemedicine's convenience but described frustrating technical challenges. While participants preferred in-person care, most wanted telemedicine to remain available.ConclusionsAdults ≥65 reported being satisfied with primary care telemedicine during the pandemic's first 14 months and wanted telemedicine to remain available.
| S-EPMC9538237 | biostudies-literature
Project description:Background For monitoring, providing, and managing COVID-19 pandemic healthcare services, telemedicine holds incredible potential. During this period, there has been a change in the remote services offered to cancer patients. As a result, the purpose of this study was to conduct a mapping review to identify and classify telemedicine applications for providing cancer care to patients during the COVID-19 pandemic. Methods Articles published in scientific databases such as Web of Science, Scopus, PubMed, and ProQuest up to 2022 were searched for in this systematic mapping study. Identifying keywords, creating a search strategy, and selecting data sources were all part of our search for relevant articles. The articles were chosen in phases based on inclusion and exclusion criteria. Results A total of 1331 articles were found, with the majority of them (46% of them) taking place in the United States. Telemedicine systems were most commonly developed for breast cancer (11.4%), lung cancer (7.9%), head and neck cancer (6.4%), brain cancer (5.4%), gynecologic cancer (6.0%), urological cancer (5.7%), prostate cancer (5.0%), colorectal cancer (5.0%), biliary tract cancer (5.0%), and skin cancer (5.0%). Teleconsultation was the most common type of telemedicine application, with 60% of it taking place in real time. Conclusion Because of its emphasis on providing high-quality health care while reducing costs, telemedicine has gained popularity in the majority of countries, with positive economic and social consequences. While telemedicine systems provide a variety of healthcare services, during the COVID-19 era, they do not currently provide many services to all cancer patients worldwide. Supplementary Information The online version contains supplementary material available at 10.1007/s12553-023-00762-2.
| S-EPMC10256577 | biostudies-literature
Project description:We investigated the effect of government support of hotels on hotels' employee support (namely, health support, staff retention, and staff training) and consequently on employee job satisfaction and organizational commitment, through the moderating role of perceived overall organizational justice and ethical climate, during the COVID-19 pandemic. Using a quantitative approach and a framework that drew on the stakeholder and organizational support theories, we collected data from 669 employees in Egyptian hotels through a web-based survey. The results support the proposed framework and show a positive effect of government support through the strengthened perception of perceived overall organizational justice. Surprisingly, findings indicated that the association between job satisfaction and organizational commitment is significantly and negatively influenced by hotel ethical climate. Furthermore, job satisfaction partially mediates the association between hotels' support of employees and organizational commitment. The study holds important implications for both theory and practice.
| S-EPMC9757666 | biostudies-literature
Project description:IntroductionThe COVID-19 pandemic has forced telehealth to be the primary means through which patients interact with their providers. There is a concern that the pandemic will exacerbate the existing disparities in overall healthcare utilization and telehealth utilization. Few national studies have examined the changes in telehealth use during the COVID-19 pandemic.MethodsData on 6.8 and 6.4 million employer-based health plan beneficiaries in 2020 and 2019, respectively, were collected in 2020. Unadjusted rates were compared both before and after the week of the declaration of the COVID-19 pandemic as a national emergency. Trends in weekly utilization were also examined using a difference-in-differences regression framework to quantify the changes in telemedicine and office-based care utilization while controlling for the patient's demographic and county-level sociodemographic measures. All analyses were conducted in 2020.ResultsMore than a 20-fold increase in the incidence of telemedicine utilization after March 13, 2020 was observed. Conversely, the incidence of office-based encounters declined by almost 50% and was not fully offset by the increase in telemedicine. The increase in telemedicine was greatest among patients in counties with low poverty levels (β=31.70, 95% CI=15.17, 48.23), among patients in metropolitan areas (β=40.60, 95% CI=30.86, 50.34), and among adults than among children aged 0-12 years (β=57.91, 95% CI=50.32, 65.49).ConclusionsThe COVID-19 pandemic has affected telehealth utilization disproportionately on the basis of patient age and both the county-level poverty rate and urbanicity.
| S-EPMC7936544 | biostudies-literature